OBJECTIVE: To compare the differences and indications of three evaluation methods for fitness evaluation of removable partial denture (RPD). METHODS: A RPD was fabricated and seated on the stone cast of a partially edentulous mandible, and the spaces between RPD and stone cast were recorded with polyvinyl siloxane (PVS) impression material forming PVS replicas. Using cross sectional measurement, the average thicknesses of PVS replicas were measured under stereomicroscope with different numbers of selected measuring points in the denture base, major connector, occlusal rest of the RPD, and the average thicknesses of the PVS replicas measured with different numbers of measuring points were compared using one-way analysis of variance (ANOVA) and independent sample t test. Three kinds of method, including cross sectional measurement, three-dimensional analysis on the stone cast, and three-dimensional analysis on the polyether cast, were applied to measure the average thicknesses of the PVS replicas, and the average thicknesses of the PVS replicas measured by these three evaluation methods were compared with ANOVA. RESULTS: For cross sectional measurement, statistically significant differences were found in the average thicknesses of the PVS replicas in the denture base and the major connector among the different numbers of measuring points (P < 0.05), but no differences were found in the average thicknesses of the PVS replicas in the occlusal rest (P>0.05). There were significant differences among the average thicknesses of the PVS replicas measured by these three evaluation methods in each component of the RPD (P < 0.01). The average thickness measured by three-dimensional analysis on the stone cast and three-dimensional analysis on polyether cast were smaller than that measured by cross sectional measurement (P < 0.05). And there were no differences between the average thicknesses of PVS replicas measured by three-dimensional analysis on stone cast and three-dimensional analysis on polyether cast (P>0.05). CONCLUSION For cross sectional measurement, the average thickness of the PVS replicas was influenced by the number of measuring points, and the measurement accuracy of cross sectional measurement was not reliable enough. Three-dimensional analysis on stone cast which is suitable for evaluation in vitro and three-dimensional analysis on polyether cast which is suitable for evaluation in vivo can evaluate the fitness of RPD more comprehensively and effectively than that of cross sectional measurement.
Computer-Aided Design ; Cross-Sectional Studies ; Denture, Partial, Removable ; Exercise ; Research Design

Laparoscopic radical surgery for rectal can-cer involves total mesorectal excision (TME), D 3 lymphadenectomy, and pelvic autonomic nerve preservation, the goal of which is trying to achieve completely radical cure for cancer and urogenital function preservation. In the actual operation procedure, the understanding of fascial anatomy in abdominal and pelvic cavity will help us to improve the quality of TME surgery for rectal cancer and to preserve the pelvic autonomic nerves. When entering the pelvic cavity, the identification of fascia propria of mesorectum, visceral fascia, pre-hypogastric nerve fascia, presacral fascia, ligament structures around the rectum and the Denonvilliers′ fascia in front of the rectum will help us to protect the pelvic autonomic nerves and avoid surgical injury. So the authors focus on how to identify the pelvic fascia structure clearly in laparoscopic radical resection for rectal cancer, furthermore, to master the concepts of fascia anatomy to realize TME for rectal cancer and to achieve pelvic autonomic nerve preservation.

Objective To investigate the clinical efficacy of asymmetric osteotomy via posterior adjacent vertebrae in the treatment of traumatic thoracolumbar kyphotic scoliotic deformity.Methods A retrospective case series study was conducted on the clinical data of 16 patients with traumatic thoracolumbar kyphotic scoliotic deformity admitted to our department from January 2012 to January 2017.There were 10 males and six females,aged (42.5 ±7.6) years (range,20-62 years).According to the location of injured vertebrae,there were two patients with T11,five with T12,six with L1,and three with L2,all of which had scoliosis deformity and obvious low back pain.All patients underwent asymmetric osteotomy via posterior adjacent vertebrae.The operation time and intraoperative bleeding were recorded.The imaging parameters such as kyphosis Cobb angle,scoliosis Cobb angle,distance between C7 plumbline and central sacral vertebral line (C7-CSVL),and distance between C7 plumbline and sagittal vertical axis (SVA) were measured before and after operation.At the same time,the visual analogue scale (VAS),Oswestry dysfunction index (ODI),and SRS-22 scale were used to evaluate the clinical efficacy.The AISA score was used to evaluate the neurological function recovery before and after operation.Results All patients were followed up for (26.3 ± 16.8) months (range,15-65 months).The operation time was (6.0 ± 1.4) hours (range,4.5-9.0 hours),and the intraoperative bleeding was (900.5 ± 360.8)ml (range,800-1600 ml).The kyphosis Cobb angle was improved from (70.3 ± 9.8) °before operation to (12.2 ± 2.9) ° after operation (P ＜ 0.01).The scoliosis Cobb angle was improved from (47.6 ± 11.6) ° before operation to (4.0 ± 0.9) ° after operation (P ＜ 0.01).The C7-CSVL decreased from preoperative (3.1 ±0.8)cm to postoperative (1.2 ±0.4)cm (P ＜0.01),and the SVA decreased from preoperative (5.0 ± 0.9) cm to postoperative (2.9 ± 0.5) cm (P ＜ 0.01).No severe complications such as spinal cord and nerve injury occurred.The VAS decreased from preoperative (6.8 ± 1.0) to (1.9 ± 0.9) points at the last follow up.The ODI decreased from (54.6 ± 4.2) ％ before operation to (8.1 ± 2.5) ％ at the last follow up.The SRS-22 score was increased from (64.6 ±7.5) points before operation to (87.4 ± 3.2) points at the last follow-up.In terms of the ASIA classification,two patients were improved from grade C to grade D after operation,and six patients were improved from grade D to grade E.Conclusion Asymmetric osteotomy via posterior adjacent vertebrae is safe and effective in the treatment of traumatic thoracolumbar scoliosis,with high correction rate of scoliosis and kyphosis at the same time.

Rhabdomyolysis is a common clinical and laboratory syndrome resulting from reversible skeletal muscle injury, with release of muscle cell contents into the plasma. Cardioversion, and cardiopulmonary resuscitation may produce rhabdomyolysis and myoglobinuria. We report a 5-year-old boy surviving after cardiopulmonary resuscitation and repeated 5 times of cardioversion. He showed elevated serum BUN and creatinine levels, requiring hemodialysis treatment. We had tried 5 times of intermittent hemodialysis, but oliguria was continued and there was no change of serum BUN and creatinine. His urine output was less than 100 cc per day and he showed severe edema and weight gain of 7 kg, and so we started the continuous renal replacement therapy (Prismaflex(R), gambro). After 12 days of continuous venovenous hemodiafiltration (CVVHDF), his urine output recovered and his BUN, creatinine, liver enzyme, creatine kinase, and lactate dehydrogenase levels returned to normal. During the treatment of CVVHDF, he had shown persistent hypercalcemia, and so we changed dialysate and replacement solution from hemosol B0 to calcium free solution. The hypercalcemia was controlled successfully using this calcium free pharmacy-made bicarbonate solution.
Calcium ; Cardiopulmonary Resuscitation ; Creatine Kinase ; Creatinine ; Edema ; Electric Countershock ; Hemodiafiltration ; Humans ; Hypercalcemia ; L-Lactate Dehydrogenase ; Liver ; Muscle Cells ; Muscle, Skeletal ; Myoglobinuria ; Oliguria ; Plasma ; Preschool Child ; Renal Dialysis ; Renal Replacement Therapy ; Rhabdomyolysis ; Weight Gain

Common causes of acquired tracheoesophageal (T-E) fistula are blunt trauma on the neck or chest, malignancy, long-term mechanical ventilation, and post-intubation injury. Most of the cases are fatal due to severe respiratory infection. We experienced two cases of post-intubation T-E fistula in patients with a history of tracheostomy that developed earlier than usual. One case was caused by excessive cuff pressure and the other by avulsion injury during endotracheal intubation. We can get instructions from these cases that how to prevent T-E fistula because it is hard to treat and causes severe outcomes.
Fistula ; Humans ; Intubation ; Intubation, Intratracheal ; Neck ; Respiration, Artificial ; Thorax ; Tracheoesophageal Fistula ; Tracheostomy

BACKGROUND AND OBJECTIVES: Recently, internet-based applications of medicine are in the process of rapid development, where concepts of telemedicine and multimedia are important in these application. Hearing test is one of the essential procedures in the otologic field, especially in telediagnosis. A current study for tele-hearing test has some limitations in masking problems or making fully automated system. The aim of this study is to develop a digital air-conduction pure tone audiometer with automated making, which can be used through web-based or off-line to compare the threshold of hearing using conventional and digitalized audiometer in both normal and handicapped hearer. SUBJECTS AND METHOD: To develop an automated audiometer system, we prepared a test scenario data file according to the pure tone test procedure. This scenario was executed in the audiometer main, which is supported by sound card and keyboard (mouse) for output and feedback, respectively, for the examinee. Pure tone for test and white band noise for masking is generated in audiometer sound generation block. To compare this automated audiometer with the conventional one, 25 normal hearers (50 ears) and 25 handicapped hearers (50 ears) were tested. RESULTS: Easy Audiometer 1.0 was developed. The difference of hearing threshold between the two different system was 3-6 dB in the normal hearer group and 2.5-3.5 dB in the handicapped hearer group. Scatter plots showed a close relationship between these two different systems. CONCLUSION: Easy Audiometer 1.0 showed reliable results of hearing threshold in the patient with unilateral hearing who needs masking procedure. Screening and basic hearing tests may be conducted through this Easy Audiometer 1.0 and it could play a part in telediagnosis in the otologic field.
Information Storage and Retrieval ; Disabled Persons ; Hearing ; Hearing Tests ; Humans ; Masks* ; Mass Screening ; Multimedia ; Noise ; Telemedicine

BACKGROUND AND OBJECTIVES: Many researchers have attempted to correlate tumor marker expression with the response of chemoradiotherapy and prognosis of head and neck cancer. But no clear markers are available that can predict responses to treatment or survival in head and neck cancer. This study investigates the relationship between tumor marker expressions and prognosis. SUBJECTS AND METHOD: Thirty-eight patients who received cisplatin and 5-fluorouracil (5-FU) chemotherapy for the treatment of head and neck cancer were enrolled in this study. Author evaluated the relationship between the response of chemotherapy and the immunohistochemical expression of p53, Bcl-2, VEGF, PCNA. The relationship between survival and tumor marker expression was evaluated in twenty five patients who received chemotherapy and radiotherapy. RESULTS: Expression rates of p53, Bcl-2, VEGF, PCNA were 65%, 26%, 26%, 68%, respectively. Of the markers examined, while the expression of p53 was associated with chemosensitivity (p=0.02), other markers was not associated with chemosensitivity (p>0.05). The recurrent rate was 52%. T stage seemed to be associated with recurrence (p=0.07), tumor markers and other clinical parameters were not associated with recurrence (p>0.05). Five year survival rate was 60%. The primary site of tumor seemed to be associated with the overall survival rate of (p=0.07). Any other clinical characteristics and tumor markers were not associated with survival. CONCLUSION: The expression of p53 may be a clinically useful predictor of chemosensitivity in this group of patients. Further studies using a larger group is needed to establish the relationship between tumor markers and prognosis of head neck cancer.
Carcinoma, Squamous Cell* ; Chemoradiotherapy ; Cisplatin* ; Drug Therapy ; Fluorouracil ; Head and Neck Neoplasms ; Head* ; Humans ; Neck* ; Prognosis* ; Proliferating Cell Nuclear Antigen* ; Radiotherapy ; Recurrence ; Survival Rate ; Biomarkers, Tumor ; Vascular Endothelial Growth Factor A*

BACKGROUND AND OBJECTIVES: Treatment of head and neck cancer with cisplatin-based combination chemotherapy has yielded increased complete response rates. In spite of the initial good response, recurrent cancer after chemotherapy does not respond to cisplatin based chemotherapy. In recent years, the analogues of taxol have used in a new chemotherapy treatments for head and neck cancer. The purpose of this study was to develop the acquired resistance to cisplatin in head and neck cancer cell line and to study the cross-resistance of docetaxel and 5-fluorouracil (5-FU) as compared to the parental cells in vitro. SUBJECTS AND METHOD: Two different human head and neck cancer cell lines (PNUH-12, SNU-899) were studied. We developed two cisplatin resistant cell lines (PNUH-12 R1, SNU-899 R1) by exposing them to near continuous increasing concentration of cisplatin. The morphology, growth curve of resistant cell lines were studied and the resistance of these cell lines to the cisplatin, docetaxel and 5-FU were compared to that of parental cells by MTT assay. RESULTS: The pattern of growth and shape of PNUH-12 R1 and SNU 899 R1 cell lines showed similarity to their parent cell lines. The growth curve of these cell lines were suppressed when compared with the parental cells. When compared to the parental cells, PNUH-12 R1 cells were 2.0-fold, 3.8-fold, and 1.4-fold resistant, and SNU 899 R1 cells 3.5-fold, 6.7-fold, and 15.0-fold resistant to cisplatin, docetaxel and 5-FU, respectively. CONCLUSION: In our study, cisplatin resistant cell lines of head and neck cancer have strong cross-resistance to docetaxel. However, there was difference in cross-resistance to 5-FU between these cell lines.
Cell Line* ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination ; Fluorouracil ; Head and Neck Neoplasms* ; Head* ; Humans ; Paclitaxel ; Parents

BACKGROUND AND OBJECTIVES: Raman spectroscopy is a vibrational spectroscopic technique capable of providing details on the chemical composition, molecular structure and molecular interactions in cells and tissues. Its application of distinguishing normal and cancer tissue has been studied in a variety of sites, such as the cervix, lung, larynx and skin. The purpose was to explore spectral changes between normal and cancer tissue in the larynx using Raman spectroscopy to assess the feasibility of using Raman spectroscopy for the early diagnosis of laryngeal cancer. MATERIALS AND METHOD: Laryngeal tissue specimens (13 adjacent normal and 13 cancer tissues) were obtained from patients who underwent total laryngetomy or supracricoid laryngectomy with squamous cell carcinoma of the larynx. The specimens were stored -70 degrees C until use. These specimens were defrosted at room temperature. The Raman spectra from laryngeal tissue specimens could be obtained at 300 mW and 250 scan during 15 minutes of the signal acquisition time using FT-Raman spectroscopy (Bruker Co., Karsruhe, Germany). RESULTS: Raman spectra were different significantly between cancer and adjacent normal tissues of the larynx at 1446 cm-1, 1240 cm-1, 1335 cm-1, and 1655 cm-1 (p=0.007, 0.2, 0.2, 0.3, respectively). The difference of 1446 cm-1 means the change of CH2 bending mode in protein and lipid of malignant tissue. The change of 1335 cm-1 means a decrease in CH3CH2 to a wagging mode of collagen and polynucleotide chain of malignant tissue. The difference of 1240 and 1655 means a decrease in the alpha-helix conformation of collagen. CONCLUSION: This study demonstrates the differences of Raman units between laryngeal cancer and adjacent normal tissue using Raman spectroscopy. In future, Raman spectroscopy may become a useful tool of guided biopsy for accurate pathologic diagnosis and assessment of the adequacy of resection margins.
Biopsy ; Carcinoma, Squamous Cell ; Cervix Uteri ; Collagen ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Laryngeal Neoplasms ; Laryngectomy ; Larynx* ; Lung ; Molecular Structure ; Skin ; Spectrum Analysis ; Spectrum Analysis, Raman*

BACKGROUND AND OBJECTIVES: This study was designed to isolate bacteria and fungi from healthy ear canal in Koreans and compare with known pathogens. SUBJECTS AND METHOD: Specimens were collected from the external ear swab and cerumen of 45 healthy volunteers from February 2003 to May 2003. RESULTS: Forty-five subjects were cultured. In 8 subjects, we failed to obtain enough cerumen. Three canal and 11 cerumen showed no growth. Forty-two canal specimens yielded 72 microorganisms, of which 84.7% were gram positive bacteria. Twenty-six cerumen specimens yielded 43 microorganisms and 76.7% of them were gram positive. Staphylococci was 76.4% of canal bacteria and 74.4% of cerumen bacteria. In both canal and cerumen, the most commonly isolated microorganism was Staphylococcus capitis. Coryneform bacteria were 6.9% of bacteria in canal and were not isolated from cerumen. Two Aspergillus species and one Penicillium species were isolated from canal and cerumen. CONCLUSION: Coagulase-negative staphylococcus (CNS) were found to be the predominant microorganism and, in particular, Staphylococcus capitis was the most commonly isolated microorganism from the normal external auditory canal in Koreans.
Aspergillus ; Bacteria ; Cerumen ; Ear Canal* ; Ear* ; Ear, External ; Fungi ; Gram-Positive Bacteria ; Healthy Volunteers ; Penicillium ; Staphylococcus