OBJECTIVE: To evaluate the efficacy of radiofrequency ablation (RFA) in the treatment of loco-regional, recurrent, and well-differentiated thyroid carcinoma. MATERIALS AND METHODS: Thirty-five recurrent well-differentiated thyroid carcinomas (RTC) in 32 patients were treated with RFA, between March 2008 and October 2011. RTCs were detected by regular follow-up ultrasound and confirmed by biopsy. All patients had fewer than 3 RTCs in the neck and were at high surgical risk or refused to undergo repeated surgery. Average number of RFA sessions were 1.3 (range 1-3). Post-RFA biopsy and ultrasound were performed. The mean follow-up period was 30 months. Pre- and post-RFA serum thyroglobulin values were evaluated. RESULTS: Thirty-one patients with 33 RTCs were treated with RFA only, whereas 1 patient with 2 RTCs was treated with RFA followed by surgery. At the last follow-up ultrasound, 31 (94%) of the 33 RTCs treated with RFA alone completely disappeared and the remaining 2 (6%) RTCs showed decreased volume. The largest diameter and volume of the 33 RTCs were markedly decreased by 93.2% (from 8.1 +/- 3.4 mm to 0.6 +/- 1.8 mm, p < 0.001) and 96.4% (from 173.9 +/- 198.7 mm3 to 6.2 +/- 27.9 mm3, p < 0.001), respectively. Twenty of the 21 RTCs evaluated with post-RFA biopsies (95%) were negative for malignancy. One (5%) showed remaining tumor that was removed surgically. The serum thyroglobulin was decreased in 19 of 26 patients (73%). Voice change developed immediately after RFA in 6 patients (19%) and was spontaneously recovered in 5 patients (83%). CONCLUSION: Radiofrequency ablation can be effective in treating loco-regional, recurrent, and well-differentiated thyroid carcinoma in patients at high surgical risk.
Adult ; Aged ; Aged, 80 and over ; Carcinoma/*pathology/surgery/ultrasonography ; Catheter Ablation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Thyroglobulin/blood ; Thyroid Neoplasms/*pathology/surgery/ultrasonography ; Tomography, X-Ray Computed

PURPOSE: Therapeutic hypothermia (TH) has become a standard strategy for reducing brain damage in the postresuscitation period. The aim of this study is to investigate the outcomes and current performance of TH with out-of-hospital cardiac arrest (OHCA) survivors through the Korean hypothermia network (KORHN) registry. METHODS: We used the KORHN registry, a web-based, multicenter registry that includes 24 participating hospitals throughout the Republic of Korea. Adult comatose OHCA survivors treated with TH from 2007 to 2012 were included. The primary outcomes were neurologic outcome at hospital discharge and in-hospital mortality. The secondary outcomes were TH performance and adverse events during TH. RESULTS: A total of 930 patients were included; of these, 556 (59.8%) patients survived to discharge and 249 (26.8%) were discharged with good neurologic outcomes. The median time from return of spontaneous circulation (ROSC) to the start of TH was 101 (interquartile range (IQR): 46-200) minutes. The induction, maintenance, and rewarming durations were 150 (IQR: 80-267) minutes, 1440 (IQR: 1290-1440) minutes, and 708 (IQR: 420-900) minutes, respectively. The time from the ROSC to coronary angiography was 1,045 (IQR: 121-12,051) hours. Hyperglycemia (46.3%) was the most frequent adverse event. CONCLUSION: Over one quarter of OHCA survivors (26.8%) were discharged with good neurologic outcome. TH performance was managed appropriately in terms of the factors related to the timing of TH, which were the start time for cooling and the rewarming duration.
Adult ; Brain ; Coma ; Coronary Angiography ; Hospital Mortality ; Humans ; Hyperglycemia ; Hypothermia* ; Hypothermia, Induced ; Korea ; Out-of-Hospital Cardiac Arrest* ; Registries ; Republic of Korea ; Rewarming ; Survivors

No abstract available.
Apoptosis* ; Cell Line* ; Uterine Cervical Neoplasms*

BACKGROUND: The aim of this study was to investigate the prevalence, clinical and laboratory findings of hereditary hemolytic anemia (HHA) in Korea from 1997 to 2006 and to develop the appropriate diagnostic approach for HHA. METHODS: By the use of questionnaires, information on the clinical and laboratory findings ofHHA diagnosed from 1997 to 2006 in Korea was collected and analyzed retrospectively. A total of 431 cases were enrolled in this study from 46 departments of 35 hospitals. RESULTS: The overall frequency of HHA did not change through the 10-year period for pediatrics but did show an increasing tendency for internal medicine. The overall male to female sex ratio did not show sex predominance (1.17:1), but a significant male predominance with a ratio of 1.49:1 was seen for pediatrics while a significant female predominance with a ratio of 1:1.97 was seen forinternal medicine. Of the total cases, 74.2% (282/431) were diagnosed before the age of 15 years. The etiologies of HHA were classified as red cell membrane defects, hemoglobinopathies, red cell enzyme deficiencies and unknown causes. There were 382 cases (88.6%) of red cell membrane defects with 376 cases (87.2%) of hereditary spherocytosis and 6 cases (1.4%) of hereditary elliptocytosis, 20 cases (4.6%) of hemoglobinopathies with 18 cases (4.2%) of beta-thalassemia, a case (0.2%) of alpha-thalassemia and a case (0.2%) of Hemoglobin Madrid, 7 cases (1.6%) of red cell enzyme deficiencies with 5 cases (1.2%) of glucose-6- phosphate dehydrogenase (G-6-PD) deficiency, a case (0.2%) of pyruvate kinase (PK) deficiency and a case (0.2%) of enolase deficiency, and 22 cases (5.1%) of unknown causes. The most common chief complaint in pediatric patients was pallor and that in adult patients was jaundice. In the red cell membrane defect group of patients, the level of hemoglobin was significantly higher than in adult patients. The mean corpuscular volume, mean corpuscular hemoglobin, corrected reticulocyte count, total and indirect bilirubin level and lactate dehydrogenase levels in the hemoglobinopathy group of patients were significantly lower than the values in the red cell membrane defect group of patients. The mean concentration of G-6-PD was 0.8+/-0.7U/1012RBC in the G-6-PD deficient patients, PK was 1.7U/1010 RBC in the PK deficient patient, and the level of enolase was 0.04U/g of Hb in the enolase deficient patient. CONCLUSION: The most prevalent cause of HHA in Korea during 1997 to 2006 was hereditary spherocytosis, but HHA by other causes such as hemoglobinopathy and red cell enzyme deficiency gradually increased with the development of molecular diagnostic methods and increasing general interest. However, the etiologies of HHA need to be pursued further in 5.1% of the patients. An systematic standard diagnostic approach is needed in a nationwide prospective study for correct diagnoses and appropriate management of HHA.
Adult ; alpha-Thalassemia ; Anemia, Hemolytic, Congenital* ; beta-Thalassemia ; Bilirubin ; Cell Membrane ; Diagnosis ; Elliptocytosis, Hereditary ; Erythrocyte Indices ; Female ; Hemoglobinopathies ; Humans ; Internal Medicine ; Jaundice ; Korea* ; L-Lactate Dehydrogenase ; Male ; Oxidoreductases ; Pallor ; Pathology, Molecular ; Pediatrics ; Phosphopyruvate Hydratase ; Prevalence ; Pyruvate Kinase ; Reticulocyte Count ; Retrospective Studies* ; Sex Ratio ; Surveys and Questionnaires

Alveolar ridge defects may limit or restrict placement of implants. The purpose of this study was to evaluate clinical and histopathologic results which occur following guided bone regeneration using platelet-rich plasma, bovine bone powder and e-PTFE membrane in the localized alveolar bone defects. Ten patients who required guided bone regeneration in implant placemnet, were slelected. Alveolar crest height and width were measured at baseline and, afer 2nd surgery 5 months later At 5 months , we obtained histopathological results as follows: 1. Alveolar crest height was an average of 8.20+/-3.74 mm preoperatively and decreased to an average of 7.40 +/-1.84 mm postoperatively. There was no significant difference. 2. Alveolar crest width was an average of 4.25+/-2.03 mm preoperatively and significantly increased to an average of 7.20+/-2.44 mm postoperatively (P<0.01) 3. The change of Alveolar crest height and width were 0.80+/-1.40 mm, 2.95+/-1.09 mm 4. Histopathological evaluations revealed new bone formation with graft material and laminated bone containing the presence of osteocyte-like cell In conclusion, guided bone regeneration using platelet-rich plasma, bovine bone powder and e-PTFE membrane would provide a viable therapeutic alternative for implant placement in the localized alveolar defect or implant failure
Alveolar Process ; Bone Regeneration ; Humans ; Membranes ; Osteogenesis ; Platelet-Rich Plasma* ; Transplants*

The current interest in periodontal tissue regeneration has lead to research in bone graft, root surface treatments, guided-tissue regeneration, administration of growth factors, and the use of enamel matrix protein as possible means of regenerating lost periodontal tissue. Several studies have shown that a strong correlation between platelet-rich plasma and the stimulation of remodeling and remineralization of grafted bone exits, resulting in a possible increase of 15-30% in the density of bone trabeculae. The purpose of this study was to study the histopathological results and differences between the use of platelet-rich plasma and the use of enamel matrix protein(Emdogain?) about bone regeneration at the implant. Implant fixtures were inserted and graft materials placed into the left femur in the experimental group, while the only implant fixtures placed in the control group. In the first experimental group, platelet-rich plasma and xenograft were placed at the supracrestally placed implant site, and in the second experimental group, Emdogain(R) and xenograft placed at the supracrestally placed fixture site. The degree of bone regeneration adjacent to the implant fixture was observed and compared histopathologically at 2, 4, and 8 weeks after implant fixture insertion. The results of the experiment are as follows: 1. The rate of osseointegration to the fixture threads was found to be greater in the experimental group compared to in the control group. 2. The histopathological findings showed that the bone regeneration, the partial osseointegration existed at 4 weeks, and that osseointegration and bone density increaced in the experimental groups at 8 weeks. 3. The results showed that new bone formation and bone remodeling increased in the area near to the fixture in the first and second experimental groups at 8 weeks than at 4 weeks. The results showed that in the area distant from the fixture, new bone formation did not increase and bone remodeling decreased in the first experimental group at 4, 8 weeks, and that new bone formation increased in the second experimental group. 4. The histopathological findings showed that AZ deposition in the first experimental group was remarkable at 2, 8 weeks, and in the second experimental group at 2, 4, 8 weeks in the area distant from the fixture threads.
Bone Density ; Bone Regeneration* ; Bone Remodeling ; Dental Enamel* ; Dental Implants* ; Femur ; Heterografts ; Intercellular Signaling Peptides and Proteins ; Osseointegration ; Osteogenesis ; Platelet-Rich Plasma* ; Regeneration ; Staphylococcal Protein A ; Transplants

PURPOSE: Diarsenic oxide, As2O3, has been reported to be effective in treating acute leukemia, and induce apoptosis in many tumor cells. In this study, the ability of a novel arsenical compound, As4O6 (tetraarsenic oxide), along with As2O3, for its ability to induce cell growth inhibition, as well as apoptosis, in human cervical cancer cells, SiHa cells, were evaluated in vitro. MATERIALS AND METHODS: To examine the levels of apoptosis, SiHa cells were given two sensitive doses, 0.5 and 1micrometer, of arsenical compounds, and a DNA fragmentation assay and FACS analysis were then conducted. In addition, a Western blotting assay was performed to identify target molecules for apoptosis. RESULTS: Both As2O3 and As4O6 induced dose-dependent inhibition of SiHa cell proliferation. In particular, As4O6 was more effective at suppressing SiHa cell growth than As2O3. In parallel with the inhibition of cell proliferation, As4O6 caused a significantly greater increase in the sub-G1 cell population than As2O3, as determined by propidium iodide DNA staining. This was confirmed by a DNA fragmentation assay and annexin V staining. The Western blotting analysis also showed that the expression of proliferating cell nuclear antigen (PCNA) was suppressed to a significantly greater extent by As4O6 than As2O3 at a dose of 0.5micrometer. However, the apoptosis-related protein, Bax, was expressed to a significantly greater extent due to As4O6 than As2O3. CONCLUSIONS: Taken together, these findings suggest that a novel arsenic compound, As4O6, possesses more potent anti-proliferative effects on human cervical cancer cells, with the induction of apoptosis also, at least via the activation of Bax protein in vitro.
Annexin A5 ; Apoptosis* ; Arsenic ; bcl-2-Associated X Protein ; Blotting, Western ; Cell Line* ; Cell Proliferation ; DNA ; DNA Fragmentation ; Humans ; Leukemia ; Proliferating Cell Nuclear Antigen ; Propidium ; Uterine Cervical Neoplasms*

OBJECTIVE: To know the effect of adenosine 5'-triphosphate (ATP) on intracellular calcium level and cell proliferation in cervical cancer cells. METHODS: Study design: Four different human cervical cancer cell lines (Caski, C33A, HeLaS3 and SiHa) were used in this study. The change of intracellular calcium level, cell proliferation and the activity of proliferation- and calcium-related transcription factors by extracellular ATP were examined in these cell lines. RESULTS: Extracellular ATP induced calcium mobilization, cell proliferation and the activation of NF-kappa B in all cell lines used. CONCLUSION: These results suggest that calcium mobilization and NF-kappa B dependent signaling pathway play an important role in the cell proliferation by ATP in cervical cancer.
Adenosine Triphosphate ; Adenosine* ; Calcium* ; Cell Line ; Cell Proliferation ; Humans ; NF-kappa B* ; Transcription Factors ; Uterine Cervical Neoplasms*

The purpose of this study is to examine the effect of non-resorbable membrane such as e-PTFE which was used with DFDB in bone regeneration on dehiscence defect in peri-implant area. Amomg the patients, who have recieved an implant surgery at the department of Periodontics in Dan Kook University Dental Hospital, 12 patients showed implant exposure due to the dehiscence defect and 15 implants of these 22 patients were the target of the treatment. Periodontists randomly applied Gore-Tex(R) to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 15 cases, 1 membrane exposure was observed and in this case, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area 9.25+/-4.84 preoperatively and significantly increased to 11.48+/-7.52 postoperatively(P<0.05). 4. The increase of bone surface area in non-resorbable membrane was 2.23+/-3.38. 5. As a result of histopathological finding, DFDB surrounded by new bone formation and lamellate bone, resorption of DFDB and bone mineralization was found. Also, fibrosis of connective tissue beneath the membrane was found. This study shows that the surgical method using DFDB and non-resorbable membrane on dehiscence defect in peri-implant area is effective in bone regeneration.

The purpose of this study is to examine the effect of non-resorbable membrane such as e-PTFE which was used with DFDB in bone regeneration on dehiscence defect in peri-implant area. Amomg the patients, who have recieved an implant surgery at the department of Periodontics in Dan Kook University Dental Hospital, 12 patients showed implant exposure due to the dehiscence defect and 15 implants of these 22 patients were the target of the treatment. Periodontists randomly applied Gore-Tex(R) to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 15 cases, 1 membrane exposure was observed and in this case, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area 9.25+/-4.84 preoperatively and significantly increased to 11.48+/-7.52 postoperatively(P<0.05). 4. The increase of bone surface area in non-resorbable membrane was 2.23+/-3.38. 5. As a result of histopathological finding, DFDB surrounded by new bone formation and lamellate bone, resorption of DFDB and bone mineralization was found. Also, fibrosis of connective tissue beneath the membrane was found. This study shows that the surgical method using DFDB and non-resorbable membrane on dehiscence defect in peri-implant area is effective in bone regeneration.