No abstract available.
Gait* ; Humans ; Spinal Cord Diseases*

Indirect composite resin are used as an popular effective esthetic material in prosthetic dentistry, often with metallic substructure that provides support for restorations. Recently, new indirect composite resins as a substitute of ceramic have been developed. These resins provide good esthetics, with a wide range of hue and chroma. And the flexural strength of those is in the range of 120-150MPa, which is higher than that of feldspathic ceramic, and similar tot hat of Dicor. Although it has many merits, one of the major clinical problems of composite resins is the bond failure between metal and resin due to insufficient interfacial bond strength. The purpose of this study was to evaluate shear bond strength of the reinforced indirect composite resin to dental alloys. Three different composite resin systems(Artglass . Sculpture , Targis ) as test groups and ceramic(VMK 68 ) as control group were bonded to Ni-Cr-Be alloy(Rexillium III ) and gold alloy(Dave 4). All specimens were stored at 37degrees C distilled water for 24 hours and the half of specimens were thermocycled 2000 times at temperature from 5degrees C to 60degrees C. The shear bond strengths of reinforced indirect composite resins to dental alloys were measured by using the universal testing machine, and modes of debonding were observed by stereoscope and scanning electron microscope. The results were as follows : 1. The shear bond strengths of reinforced indirect composit resins to dental alloys were approximately half those of ceramic to dental alloys(P<0.01). 2. There was no significant difference between the shear bond strength of several reinforced indirect composite resins to metal. 3. Alloy type did not affect on the shear bond strengths of resin to metal, but the shear bond strengths of ceramic to gold alloys were higher than those of ceramic to Ni-Cr alloys(P<0.05). 4. The shear bond strenghts of Artglass and Targis to gold alloys were significantly decreased after thermocycling treatment(P<0.01). 5. Sculpture showed cohesive, adhesive, and mixed failure modes, but Artglass and Targis showed adhesive or mixed failures. And ceramic showed cohesive and mixed failures.
Adhesives ; Alloys ; Ceramics ; Composite Resins* ; Dental Alloys* ; Dentistry ; Esthetics ; Gold Alloys ; Sculpture ; Water

Primary signet ring cell carcinoma of the prostate is extremely rare and about 18 cases have been reported in the literature. We report two cases of primary signet ring cell carcinoma of the prostate, arising in 79-year-old and 65-year-old men. Both cases were the poorly differentiated adenocarcinoma of the prostate with many signet ring cells. Signet ring cells were positive for prostatic specific antigen and prostatic acid phosphatase but negative for neutral and acid mucins. In summary, the signet ring cell carcinoma of the prostate is a rare variant of poorly differentiated adenocarcinoma of the prostate. The orgin of the prostate should be considered in cases of metastatic signet ring cell carcinoma, particularly when the signet ring cells are negative for neutral and acid mucins. Prostatic specific antigen and prostatic acid phosphatase should also be performed to confirm the primary signet ring cell carcinoma of the prostate.
Acid Phosphatase ; Adenocarcinoma ; Aged ; Carcinoma, Signet Ring Cell* ; Humans ; Male ; Mucins ; Prostate*

PURPOSE: Perianal lesions are common in Crohn disease, but their clinical course is unpredictable. Nevertheless, predicting the clinical course after surgery for perianal Crohn disease (PCD) is important because repeated operations may decrease patient's quality of life. The aim of this study was to predict the risk of reoperation in patients with PCD. METHODS: From September 1994 to February 2010, 377 patients with PCD were recruited in twelve major tertiary university-affiliated hospitals and two specialized colorectal hospitals in Korea. Data on the patient's demographics, clinical features, and surgical outcomes were analyzed. RESULTS: Among 377 patients, 227 patients were ultimately included in the study. Among the 227 patients, 64 patients underwent at least one reoperation. The median period of reoperation following the first perianal surgery was 94 months. Overall 3-year, 5-year, and 10-year cumulative rates of reoperation-free individuals were 68.8%, 61.2%, and 50.5%, respectively. In multivariate analysis (Cox-regression hazard model), reoperation was significantly correlated with an age of onset less than 20 years (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.07-3.48; P = 0.03), history of abdominal surgery (HR, 1.99; 95% CI, 1.08-3.64; P = 0.03), and the type of surgery. Among types of surgery, fistulotomy or fistulectomy was associated with a decreased incidence of reoperation in comparison with incision and drainage (HR, 0.19; 95% CI, 0.09-0.42; P < 0.001). CONCLUSION: Young age of onset and a history of abdominal surgery were associated with a high risk of reoperation for PCD, and the risk of reoperation were relatively low in fistulotomy or fistulectomy procedures.
Age of Onset ; Crohn Disease ; Demography ; Drainage ; Humans ; Incidence ; Inflammatory Bowel Diseases* ; Korea ; Multivariate Analysis ; Quality of Life ; Recurrence ; Reoperation* ; Risk Factors*

We experienced a case of arteriovenous hemangioma showing Dariers sign on the forehead of a 43-year-old man. He presented with a single, 1 * 1.5cm sized, violaceous, asymptomatic nodule with a history of an intermittent wheal at the lesional site. This skin lesion showed Dariers sign clinically and proliferation of mast cells histopathologically with the punch biopsy specirnen suggesting urticaria pig- mentosa. Howerer, we could diagnose it as a arteriovenous hemangioma on complete excision, as the specimen showed arteriovenous proliferation with increased mast cells in a perivascular pattern. This case showed confusing clinical signs and showed the importance of complete excision for the diagnosis of a small skin tumor especially when a vascular proliferating tumor is suspected.
Adult ; Biopsy ; Diagnosis ; Forehead ; Hemangioma* ; Humans ; Mast Cells ; Skin ; Urticaria

PURPOSE: To study the fundus findings in the peripheral retina using examination under general anesthesia in patients showing vitreoretinopathy in the unilateral posterior pole of the eye. METHODS: The records of 27 patients showing vitreoretinopathy in the unilateral posterior pole of the eye were retrospectively reviewed. Analysis of the records for the fundus finding was performed using indirect ophthlamoscopy at the outpatient clinic, fundus findings and results of fluorescein angiography during examination under general anesthesia. RESULTS: The viteroretinopathies in the unilateral posterior poles were retinal vascular and vitreous abnormality including avascular area in seven eyes (16%), retinal dragging in 14 eyes (32%), retinal folding in 21 eyes (48%), and total tractional retinal detachment in two eyes (5%). The final clinical diagnoses were familial exudative vitreoretinopathy in 33 patients, incontinentia pigmenti in four eyes, and idiopathic vitreoretinopathy in seven eyes. Abnormal findings in the peripheral retina of the contralateral eye were observed in 27 eyes (61%) when examined under general anesthesia. Leakage in fluorescein angiography was found in 17 contralateral eyes (39%). The treatment including diode laser photocoagulation and cryotherapy was performed in eyes showing active leakage. CONCLUSIONS: Examination of the bilateral fundus is important in patients showing vitreoretinopathy in the unilateral posterior pole. The examination under anesthesia was helpful for diagnosis, evaluation and treatment in patients showing vitreoretinopathy in the unilateral posterior pole of the eye.
Ambulatory Care Facilities ; Anesthesia ; Anesthesia, General ; Cryotherapy ; Eye ; Fluorescein Angiography ; Humans ; Incontinentia Pigmenti ; Lasers, Semiconductor ; Light Coagulation ; Retina ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Traction

The optimal treatment strategy for unresectable huge hepatocellular carcinoma (HCC) is yet to be established. Non-surgical monotherapy demonstrated insufficient oncologic outcomes in previously reported studies. To improve the clinical outcomes of unresectable huge HCC, combined locoregional treatments can be considered in selected cases. Here, we report a case of 58-year-old male patient who was treated with combined transarterial chemoembolization (TACE) and external beam radiotherapy for recurrent HCC after a previous hepatic resection. After combined TACE and radiotherapy for the intrahepatic lesion, two metastases were diagnosed in the pelvic bones and lung; each lesion was successfully treated with salvage radiotherapy. During the long-term follow-up period (around 8 years 7 months after combined TACE and radiotherapy for the recurrent huge HCC), no definite viable tumors were observed in any of the treated liver, bone, and lung lesions.

Vancomycin is a widely used glycopeptide antibiotic that requires therapeutic drug monitoring (TDM) owing to its narrow therapeutic window. It is primarily eliminated by renal excretion; thus, estimating the renal function of a patient is vital in the TDM of vancomycin. In patients with Duchenne muscular dystrophy (DMD), it is difficult to estimate the glomerular filtration rate using the serum creatinine level owing to the pathophysiological nature of the disease. Here, we report a case of a patient in whom TDM of vancomycin was performed, and explore the appropriate methods for evaluating renal function in patients with DMD based on serum levels of creatinine and cystatin C.
Creatinine ; Cystatin C ; Drug Monitoring* ; Glomerular Filtration Rate ; Humans ; Muscular Dystrophy, Duchenne* ; Renal Elimination ; Vancomycin*

OBJECTIVE: Atrophy and a high T2 signal of the hippocampus are known to be the principal MR imaging findings of hippocampal sclerosis. The purpose of this study was to determine whether or not individual MRI findings correlate with surgical outcome in patients with this condition. MATERIALS AND METHODS: Preoperative MR imaging findings in 57 consecutive patients with pathologically-proven hippocampal sclerosis who underwent anterior temporal lobectomy and were followed-up for 24 months or more were retrospectively reviewed, and the results were compared with the postsurgical out-come (Engel classification). The MR images included routine sagittal T1-weighted and axial T2-weighted spin-echo images, and oblique coronal T1-weighted 3D gradient-echo and T2-weighted 2D fast spin-echo images obtained on either a 1.5 T or 1.0 T unit. The images were visually evaluated by two neuroradiologists blinded to the outcome; their focus was the presence or absence of atrophy and a high T2 hippocampal signal. RESULTS: Hippocampal atrophy was seen in 96% of cases (55/57) [100% (53/53) of the good outcome group (Engel class I and II), and 50% (2/4) of the poor outcome group (class III and IV)]. A high T2 hippocampal signal was seen in 61% of cases (35/57) [62% (33/53) of the good outcome group and 50% (2/4) of the poor outcome group]. All 35 patients with a high T2 signal had hippocampal atrophy. `Normal' hippocampus, as revealed by MR imaging, occurred in 4% of patients (2/57), both of whom showed a poor outcome (Engel class III). The presence or absence of hippocampal atrophy correlated well with surgical outcome (p<0.01). High T2 signal intensity did not, however, significantly correlate with surgical outcome (p>0.05). CONCLUSION: Compared with a high T2 hippocampal signal, hippocampal atrophy is more common and correlates better with surgical outcome. For the prediction of this, it thus appears to be the more useful indicator.
Adult ; Atrophy ; Female ; Hippocampus/*pathology/*surgery ; Human ; *Magnetic Resonance Imaging ; Male ; Middle Age ; Predictive Value of Tests ; Retrospective Studies ; Sclerosis ; Support, Non-U.S. Gov't ; Treatment Outcome

Human carboxylesterase 1 (CES1) is a serine esterase that hydrolyzes various exogenous compounds. Single nucleotide polymorphisms (SNPs) of CES1 may lead to inter-individual metabolic variability of its substrates. The allele and haplotype frequencies of known SNPs have been demonstrated to vary among ethnic groups. We analyzed genetic variations of CES1 in a Korean population. Direct sequencing of all exons and flanking regions of the CES1 gene was performed on samples obtained from 200 Koreans. We identified 41 SNPs. The most frequent SNPs was -914G>C (frequency: 99.5%), followed by 4256G>A (frequency: 65.8%), -75T>G (frequency: 59.3%). Haplotype analysis using the identified SNPs revealed fifteen haplotypes (> or =1% haplotype frequency) in our samples. The most frequent haplotype was Hap1 (frequency: 15.4%). Among the identified 41 SNPs, nine of which are novel variants and 14 SNPs were nonsynonymous variants. Using the functional predictive software PolyPhen-2, the G19V, E221G, and A270S variants were predicted to be most likely damaging to the function and structure of CES1. In-vitro analyses for two of these variants have been previously performed; however, functional evaluation of E221G (11657A>G, rs200707504) still needs to be conducted. Therefore, further studies are warranted to characterize the functional impact of E221G on CES1 activity.
Alleles ; Asian Continental Ancestry Group ; Carboxylesterase* ; Ethnic Groups ; Exons ; Genetic Variation ; Haplotypes ; Humans ; Polymorphism, Genetic* ; Polymorphism, Single Nucleotide ; Serine