This is to report a case of immediate reconstruction after hemimandibulectomy by using of bicorticocancellous block bone harvested from the iliac crest in the case of an ameloblastomaon the mandible. Because the lesion involved condylar area, it was reconstructed with titanium artificial condyle attached to A/O metal plate. Three weeks after the operation, infection developed with suppuration and was well treated with adequate antibiotic therapy and drainage. The patient has been followed up over a four-year period and taken an orthopantomogram every three or six month for the examination of mandibular movement, the potentiality of recurrence and the remodeling of the grafted bone. At present, the patient is satisfied with her appearence and has a normal occlusion with proper masticatory function, and there is no sign of recurrence.
Ameloblastoma* ; Drainage ; Humans ; Mandible ; Mandibular Osteotomy ; Recurrence ; Suppuration ; Titanium ; Transplants*

Background: Although an ambulatory surgical practice continues to increase, there is a few data exist about patient discharge criteria. This study was undertaken to evaluate the usefulness and safety of Aldrete PAR (postanesthetic recovery) score and modified PADSS (modified postaneathesia discharge scoring system) on ambulatory surgery patients for recovery in Korea. Methods: Demographic, anesthetic data, Aldrete PAR score and modified PADSS on 279 patients were recorded. The time to dicharge, from recovery room and postoperative complications were evaluated, also. Results: PAR score and modified PADSS are correlated to length of stay in ambulatory surgery center. 24hr after discharge, 16% patients complained postoperative complications. Pain was most frequent postoperative complication. The PAR score was correlated with the occurrence of the complication. Conclusion: PAR score and modified PADSS are useful scoring systems to evaluate patients and make a decision to discharge the patients from ambulatory surgery center in safe.
Ambulatory Surgical Procedures* ; Humans ; Korea ; Length of Stay ; Patient Discharge* ; Postoperative Complications ; Recovery Room

OBJECTIVE: Although several prior works showed the white matter (WM) integrity changes in amnestic mild cognitive impairment (aMCI) and Alzheimer's disease, it is still unclear the diagnostic accuracy of the WM integrity measurements using diffusion tensor imaging (DTI) in discriminating aMCI from normal controls. The aim of this study is to explore diagnostic validity of whole brain automated probabilistic tractography in discriminating aMCI from normal controls. METHODS: One hundred-two subjects (50 aMCI and 52 normal controls) were included and underwent DTI scans. Whole brain WM tracts were reconstructed with automated probabilistic tractography. Fractional anisotropy (FA) and mean diffusivity (MD) values of the memory related WM tracts were measured and compared between the aMCI and the normal control groups. In addition, the diagnostic validities of these WM tracts were evaluated. RESULTS: Decreased FA and increased MD values of memory related WM tracts were observed in the aMCI group compared with the control group. Among FA and MD value of each tract, the FA value of left cingulum angular bundle showed the highest area under the curve (AUC) of 0.85 with a sensitivity of 88.2%, a specificity of 76.9% in differentiating MCI patients from control subjects. Furthermore, the combination FA values of WM integrity measures of memory related WM tracts showed AUC value of 0.98, a sensitivity of 96%, a specificity of 94.2%. CONCLUSION: Our results with good diagnostic validity of WM integrity measurements suggest DTI might be promising neuroimaging tool for early detection of aMCI and AD patients.
Alzheimer Disease ; Anisotropy ; Area Under Curve ; Brain ; Diffusion Tensor Imaging ; Humans ; Memory ; Mild Cognitive Impairment* ; Neuroimaging ; Sensitivity and Specificity ; White Matter

Serum Ta and T were measured in 34 patients scheduled elective surgery with general anesthesia, who were divided into two groups (enflurane group' 12, propofol group' 22). No clinical signs of thyroid disturbances could be observed preoperatively in the patients. Anesthesia was induced with thiopental 5 mg/kg in enflurane group; propofol 2 mg/kg in propofol group, and maintained with Oz 2 L/min, NH 2 L/min, enflurane (1.0-2.596) in enflurane group,' 2 L/ min, N 4 L/min and continuous controlled infusion of pmpofol (50-150 mcg/kg/min) in propofol group. Blood samples were collected 5 minutes after arrival in operating room, 1 minute after induction, 5 minutes after intubation, 1 minute after skin incision, during operation and 10 minutes after extubation. Blood samples were centrifused and serum was taken from each sample. Determinations of Ta and T4 were performed using enhanced chemiluminescence immunoassay (ELIA). Comparisons of our results were made using repeated measuves analysis of variance, paired students t-test and statistically significant when p value was less than 0.05. The results are summarized as follows' 1) In enflurane group, serum Ta levels showed a decreasing tendency after extubation compared to baseline. Decreasing serum T4 after administration of thiopental could be considered statistically significant and serum T levels showed a decreasing tendency after extubation compared to baseline. 2) In propofol gnup, serum Tz levels showed a decreasing tendency after extubation compared to baseline. Rises in serum Te after incision and extubation could be considered statistically significant. Based on these results, no direct negative influence of propofol need be expected on Tg metabolism in euthyroid patients. However, the changes in these hormones, although with in the physiological range here, indicate that propofol may adversely influence their levels in the presence of manifested thyroid disease.
Anesthesia ; Anesthesia, General* ; Enflurane* ; Humans ; Immunoassay ; Intubation ; Luminescence ; Metabolism ; Operating Rooms ; Propofol* ; Skin ; Thiopental ; Thyroid Diseases ; Thyroid Gland ; Thyroxine ; Triiodothyronine

BACKGROUNDS/AIMS: Growth of tumors and their metastases is dependent on factors that stimulate vessel formation (angiogenesis). Vascular endothelial growth factor (VEGF) is closely related to angiogenesis in various human cancers. The aim of this study was to determine the value of serum VEGF levels in hepatocellular carcinomas as a tumor marker. METHODS: We measured serum VEGF levels, by enzyme immunoassay, and platelet counts in healthy controls (n=22), liver cirrhosis (LC; n=4) and hepatocellular carcinomas (HCC; n=14). RESULTS: The mean serum VEGF levels in controls and the patients with LC and HCC were 251.8+/-121.5 (mean+/-SD), 163.4+/-82.1 and 557.8+/-520.3pg/ml, respectively. The levels were significantly elevated in the HCC group, compared with the control group (p<0.05). Serum VEGF levels in the HCC group were highly correlated with platelet counts (r=0.915, p<0.05). Conclusions : We consider that serum VEGF is a possible tumor marker for HCC. Serum VEGF may be partly derived from platelets.
Carcinoma, Hepatocellular* ; Humans ; Immunoenzyme Techniques ; Liver Cirrhosis ; Neoplasm Metastasis ; Platelet Count ; Vascular Endothelial Growth Factor A*

To compare the first report of our anesthetic experiences with 16,457 Cases performed by the Department of Anerthesiology of Wonju Christian Hospital, Wonju Medical College, Yonsei University, from Nov. 1959 to Dec. 1977 which was published in 1980, the anesthetic experiences of 12,608 cases performed from Jan. 1978 to Dec. 1982 were analyzed, according to age, sex, department, physical status, emergency Procedureornotn, anesthetic agent, complication, and in addition, the ratio of medical insurance patients after enforcement of medical insurance patients. The results are as follows; 1) The number of cases receiving anesthesia tended, to increase year by year and the rate of increasi was remarkable for female patients. 2) Sexual distribution was 6049 males(48.0%), and 6559 females(52.0%). 3) 44.4% of patients were in the 2nd to 4th. decade of life and the patients over 60 years had increased markedly, 4) Among the departments General Surgery accounted for 30.7%, aner Obstetric sand Gynecology for 30.0%. 5) General anesthesia was use in 76.2% and regional anesthesia 23.8%. 6) The main anesthetic agent was halothane(47.9%). 7) Emergency operations were 37.6%, of the total. 8) Medical insurancs patients have increasied remarkably year by year. 9) Cardiac arrest in the operating room and the recovery room consisted of 4 cases. (0.032%).
Anesthesia ; Anesthesia, Conduction ; Anesthesia, General ; Emergencies ; Female ; Gangwon-do ; Gynecology ; Heart Arrest ; Humans ; Insurance ; Operating Rooms ; Recovery Room ; Silicon Dioxide

The use of steroid preparations by the external route was first employed in 1953 by Lievre. Since then a number of similar series have been published which confirm the value of the method. The present study was carried out in Wonju Christian hospital over a 4 year period. Of a total of 141 patients complaining of back pain and sciatica were treated by epidural in-jection .of methyl-prednisolone acetate(Depo-Medrol). The results were encouraging and this treatment seems to be a valuable adjunct to the management of lumbosciatic syndrome.
Back Pain* ; Epidural Space* ; Gangwon-do ; Humans ; Sciatica*

Recent researches on ALS pathogenesis are focusing on abnormal immunological factors, excitotoxic substances, neurotrophic factors, and oxidative stress. It is well known that glutamate and aspartate are major putative excitatory neurotransmitters and possess excitotoxic properties that lead to neuronal death. In this study the authors checked the plasma level of amino acids in ALS and control groups and tried to understand any association between excitotoxic amino acids and sporadic ALS. The concentration of amino acids was measured by the HPLC method in the fasting plasma of fifteen ALS and nine control subjects. When we evaluated 19 amino acids or their metabolites, none showed significant difference between ALS and control groups. The mean concentrations of glutamic acid in ALS and control groups were 42.3+26.7 mmol/L and 57.4+17.0 mmol/L respectively, which showed no significant difference (p>O. 05). It was not possible to compare the level of aspartic acid in ALS and control groups as the levels were very low in individuals of both groups. In conclusion, authors could not note any significant correlations between sporadic ALS and excitotoxic substances, such as glutamate and aspartate. However, further studies m the excitotoxic levels in cerebrospinal fluid, spinal cord and brain, could be helpful to understand the overexcitation character of motor neuron by excitatory amino acids.
Amino Acids* ; Amyotrophic Lateral Sclerosis* ; Aspartic Acid ; Brain ; Cerebrospinal Fluid ; Chromatography, High Pressure Liquid ; Excitatory Amino Acids ; Fasting ; Glutamic Acid ; Immunologic Factors ; Motor Neurons ; Nerve Growth Factors ; Neurons ; Neurotransmitter Agents ; Oxidative Stress ; Plasma ; Spinal Cord

In cases of severe alveolar bone atrophy in the posterior maxillary area, which has only a thin sinus floor, the autogenous tooth bone graft block (ABTB) was used to wrap the implant to enhance its primary stability and osseointegration in the sinus. These cases with four years of clinical follow-up demonstrate the applicability of the ABTB in maxillary sinus membrane elevation to improve the outcomes of implant placement.
Alveolar Bone Loss ; Follow-Up Studies ; Maxillary Sinus ; Membranes ; Osseointegration ; Tooth* ; Transplants*

OBJECTIVES: The aim of this study was to examine the change in attitudes and satisfaction level of North Korean defectors in South Korea over a 3 year period (2001-2004). METHODS: In our first study in 2001, a total of 200 defectors were interviewed. In the follow up study after 3 years, 151 defectors were re-interviewed by an in-person interview. RESULTS: The level of satisfaction to the governmental support policy to defectors decreased significantly. However, the general level of satisfaction increased slightly (from 3.52 to 3.56 ; 5-score scale). This shows that North Korean defectors are stably adapting to South Korean society. The level of satisfaction significantly correlated with the defectors' confusion of the different value systems, the defectors' understanding of the South Korean people, satisfaction with their physical and mental health, and the prejudice of South Korean people to defectors. In terms of the attitudes, the type of schooling, the military service and the communist party membership in North Korea were not related to the change in attitude. However, there was a significant correlation with gender and age. Women showed a greater change in attitude compared to men. Older people had difficulty in understanding the South Korean people, but they showed little psychological affiliation to North Korea. Moreover, they showed a high level of satisfaction with the economic situation in South Korea and had an optimistic viewpoint for their future than younger people. Even though many defectors attended churches, religion was not associated with the level of satisfaction or their change in attitude. CONCLUSION: The factors that influence the level of satisfaction and attitudes of North Korean defectors have changed over 3 years. Therefore, the government, nongovernmental organizations (NGOs) associated with defectors and the churches need to be more sensitive to these changes and make plans to support the adaptation of defectors to South Korean society.
Democratic People's Republic of Korea ; Female ; Follow-Up Studies* ; Humans ; Korea* ; Male ; Mental Health ; Military Personnel ; Prejudice ; Refugees ; Thinking*