PURPOSE: The cortical bone thickness on the anterior region is important for achieving implant stability. The purpose of this study was to examine the thickness of the cortical and cancellous bones on the anterior region of the maxilla and mandible. MATERIALS AND METHODS: Twenty-five cadaver heads were used (16 male and 9 female; mean death age, 56.7 years). After the long axis of alveolar process was set up, it was measured in 5 levels starting from 2 mm below the cementoenamel junction (L1) at intervals of 3 mm. All data was analysed statistically by one-way ANOVA at the .05 significance level. RESULTS: The cortical bone thickness according to measurement levels in both the labial and lingual sides increased from L1 to L5, and the lingual side below L3 was significantly thicker than the labial side on the maxilla and mandible. In particular, the labial cortical bone thickness in the maxilla was the thinnest compared to the other regions. The cancellous bone thickness according to measurement levels increased from L1 to L5 on the maxilla, and on the mandible it was the thinnest at the middle level of the root. CONCLUSION: For implant placement on the anterior region, a careful evaluation and full knowledge on the thickness of the cortical and cancellous bone are necessary, therefore, these results may provide an anatomic guideline to clinicians.
Alveolar Process ; Axis, Cervical Vertebra ; Cadaver ; Head ; Humans ; Male ; Mandible ; Maxilla ; Tooth Cervix

STUDY DESIGN: A retrospective study OBJECTIVES: To introduce the technique of minimally invasive transforaminal lumbar interbody fusion and examine its clinical and radiologic results. SUMMARY OF LITERATURE REVIEW: Transforaminal lumbar interbody fusion with a mini-incision using a tubular retractor was recently developed. The aim of this procedure is to reduce the approach-related morbidity and achieve better results in an effective and safe manner. MATERIALS AND METHODS: Thirty eight patients were followed up for more than 1 year. Their mean age was 57 years and the mean follow-up was 19 months. The diagnosis was spinal stenosis, spondylolisthesis and recurred herniated nucleus pulposus in 22, 14 and 2 patients, respectively. The Oswestry disability index, intervertebral disc space height, fusion rate and complications were evaluated. RESULTS: The Oswestry disability index improved from 30 points (range, 50~16 points) to 10 points (range, 2-24 points) at the last follow-up. Thirty-four patients (90%) showed excellent or good results. The intervertebral disc space height increased from 8.7 mm to 10.8 mm. Two cases showed nonunion but the clinical results were good. Complications included one case of infectious spondylitis requiring antibiotics, one case of cage dislodgement requiring additional surgery and one case of a pedicle screw malposition showing no clinical symptoms. CONCLUSIONS: Minimally invasive transforaminal lumbar interbody fusion reduced the soft tissue injury and blood loss and shortened the recovery period compared to the traditional open techniques.
Anti-Bacterial Agents ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Retrospective Studies ; Soft Tissue Injuries ; Spinal Stenosis ; Spondylitis ; Spondylolisthesis

BACKGROUND AND OBJECTIVES: We sought to characterize the lesion characteristics of mitral valve prolapse (MVP), which is being increasingly recognized as a cause of mitral regurgitation (MR) in Koreans SUBJECTS AND METHODS: 497 Patients with MVP that was diagnosed by echocardiography in 13 university-affiliated hospitals from Jan to Dec 2003 were prospectively enrolled in our study. RESULTS: A total of 497 patients (270 males, 54%) were enrolled and their mean age was 52+/-17 years. Grade 4 MR was present in 272 patients (54.7%); grade 3, 2 and 1 MR as present in 30.2%, 10.7% and 4.2%, respectively. MVP of the anterior and posterior mitral leaflet was present in 170 patients (34.2%) and 223 patients (44.9%), respectively; MVP developed in both leaflets in 104 patients (20.9%). In 37 patients (7.4%), MVP developed in all 6 segments of the mitral leaflet and these patients were younger (37+/-14 versus 54+/-16 years, respectively, p<0.05) and had a lower prevalence of chordae rupture and severe MR compared to the other patients. Among the 266 mitral segments showing prolapse in the 132 patients (26.6%) who underwent transesophageal echocardiography, the posterior medial scallop was the most frequently diseased one (26%), and this was followed by the posterior middle scallop (18%), the medial (17%), lateral (14%) and middle (13%) part of the anterior leaflet, and the posterior lateral scallop (12%). Younger patients with a mean age <45 years showed a lower prevalence of single segment prolapse, hypertension, severe MR and chordae rupture compared to the older patients (p<0.001, each). CONCLUSION: The medial part of both mitral leaflets was the predilection site for the development of MVP in Koreans and the lesion characteristics were different according to the patients' age.
Echocardiography* ; Echocardiography, Transesophageal ; Humans ; Hypertension ; Korea* ; Male ; Mitral Valve Insufficiency ; Mitral Valve Prolapse* ; Mitral Valve* ; Pectinidae ; Prevalence ; Prolapse ; Prospective Studies* ; Rupture

PURPOSE: The purpose of this study was to evaluate the machining accuracy and consistency of implant/abutment/screw combination of internal connection type. MATERIAL AND METHODS: In this study, each two randomly selected internal implant fixtures from ITI, 3i, Avana, Bicon, Friadent, Astra, and Paragon system were used. Each abutment was connected to the implant with 32Ncm torque value using a digital torque controller or tapping. All samples were cross-sectioned with grinder-polisher unit (Omnilap 2000 SBT Inc) after embeded in liquid unsaturated polyester (Epovia, Cray Valley Inc). Then optical microscopic and scanning electron microscopic(SEM) valuations of the implant-abutment interfaces were conducted to assess quality of fit between the mating components. RESULTS: 1) Generally, the geometry of the internal connection system provided for a precision fit of the implant/abutment interface. 2) The most precision fit of the implant/abutment interface was provided in the case of Bicon System which has not screw. 3) The fit of the implant/abutment interface was usually good in the case of ITI, 3I and Avana system and the amount of fit of the implant/abutment interface was similar to each other. 4) The fit of the implant/abutment interface was usually good in the case of Friadent, Astra and Paragon system. The case of Astra system with the inclined contacting surface had the most intimate contact among them. 5) Amount of intimate contact in the abutment screw thread to the mating fixture was larger in assembly with two-piece type which is separated screw from abutment such as Friadent, Astra and Paragon system than in that with one-piece type which is not seperated screw from abutment such as ITI, 3I and Avana system. 6) Amount of contact in the screw and the screw seat of abutment was larger in assembly of Friadent system than in asembly of Astra system or Paragon system. CONCLUSION: Although a little variation in machining accuracy and consistency was noted in the samples, important features of all internal connection systems were the deep, internal implant - abutment connections which provides intimate contact with the implant walls to resist micromovement, resulting in a strong stable interface. From the results of this study, further research of the stress distribution according to the design of internal connection system will be required.
Polyesters ; Torque

OBJECTIVES: To identify changes in blood markers of oxidative stress among dementic and healthy aged persons, and to compare levels of peripheral markers of oxidative stress between dementia of the Alzheimer's type (DAT) and vascular dementia (VD), and finally to analyze factors affecting those. DESIGN: Some antioxidants had been known to reduce the risk of dementia, while increase of 4-hydroxy-nonenal and decrease of heme oxygenase in DAT had been reported. Recently increased free radical activities were also found in VD. Therefore, this study was tried to search for a blood markers to discriminate DAT and VD. MATERIALS AND METHOD: The blood levels of total antioxidant capacity (TAC) and catalase activity of 50 patients with DAT and 50 patients with VD were compared with those of 56 healthy aged controls. In addition, variables including risk factors of dementia, degree of dementia measured by MMSE, Hasegawa Dementia Scale, GDS and CDR, and activities of daily living were also assessed. RESULTS: 1) The levels of TAC were significantly (p<0.01) lower in dementia than normal aged controls (1.47+/-0.08 mmol/L), while the catalase activities were significantly (p<0.01) higher in dementia than normal aged controls (45.61+/-11.67 kU/L). 2) The TAC levels were significantly (p<0.01) lower while the catalase significantly (p<0.01) higher in DAT (1.24+/-0.09 mmol/L, 133.42+/-58.45 kU/L respectively) than VD (1.31+/-0.08 mmol/L, 81.33+/-24.65 kU/L respectively). 3) The TAC and catalase activities were significantly (p<0.01) correlated with duration of dementia, behavior symptoms, activities of daily living, and the severity of dementia. CONCLUSIONS: Peripheral blood markers of oxidative stress were significantly different in dementia from normal aged controls. Furthermore, the difference was more severe in DAT than VD, which means the effect of oxidative stress is more in DAT than in VD. Therefore, they might be clinically useful to assess and discriminate dementia.
Activities of Daily Living ; Antioxidants ; Catalase ; Dementia* ; Dementia, Vascular ; Heme Oxygenase (Decyclizing) ; Humans ; Oxidative Stress* ; Risk Factors

Tuberous sclerosis(TS) is a disorder of aberrant neuronal differentiation and proliferation manifesting as multiple central nervous system(CNS) hamartomas. Seizures in patients with TS are often intractable to anticonvulsant therapy. Although TS shows various lesions including multiple tubers, many patients with well localized epileptic focus to some tubers may have a benefit from epileptic surgery. We experienced three cases who had clinical improvement after epileptic surgery in intractable epilepsy complicated by TS. We report three cases and the brief review of literatures.
Epilepsy* ; Hamartoma ; Humans ; Neurons ; Seizures ; Tuberous Sclerosis*

The nephrotic syndrome has been reported in association with a wide variety of neoplastic disease. The relationship between early gastric cancer and glomerulonephritis has not been well elucidated. Only 6 cases (5 cases in Korea and 1 case in Japan) have been reported associated with glomerulonephritis by this time. 5 cases in Korea included three cases of membranous glomerulonephritis, one case of IgA nephropathy and membranoproliferative glomerulonephritis. Four out of six cases including presented case were mucin secreting adenocarcinomas of stomach. Minimal change disease associated with solid tumors has been reported very rarely. Three cases of colon adenocarcinoma have been reported in association with minimal change disease by this time. Complete remission of nephrotic syndrome with tumor resection without corticosteroid therapy was reported in one of three cases, but two of them had to be on corticosteroid therapy in addition to tumor resection to get complete remissions. We report a 44-year-old man case with nephrotic syndrome associated with early gastric cancer. Renal biopsy findings were indicative of minimal change disease but with scanty IgA deposition. Low grade IgA nephropathy was suggested. Endoscopic biopsy on stomach demonstrated the adenocarcinoma with signet ring cells. Serum IgA concentration was 543 mg/dL, and decreased to 336 mg/dL after tumor resection. But, owing to persistent proteinuria and acute renal failure complicated, corticosteroid therapy was applied on the 30th day after operation. So we could not prove definite relationship between early gastric cancer and the development of IgA nephropathy mimicking minimal change disease. But, it is regarded that normalized serum IgAlevel and the complete remission of nephrotic syndrome with tumor resection and corticosteroid therapy can be indirect evidences for the relationship between early gastric cancer and the development of IgA nephropathy mimicking minimal change disease.
Acute Kidney Injury ; Adenocarcinoma ; Adult ; Biopsy ; Colon ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Humans ; Immunoglobulin A* ; Korea ; Mucins ; Nephrosis ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Proteinuria ; Stomach ; Stomach Neoplasms*

Autosomal dominant nocturnal frontal lobe epilepsy(ADNFLE) is a recently identified partial epilepsy. This disorder is characterized by a variable age of onset(mostly in childhood), autosomal dominant inheritance, clusters of brief frontal nocturnal seizures, negative findings on neuroimaging, and fairly good prognosis. Carbamazepine is known to be the most useful drug in this type of epilepsy. We experienced a case of 5-year-old boy who had unusual arousal and irritability every night for 3 years and had sharp & wave discharges from frontal lobe region in long-term video-EEG monitoring, who was suspected as an autosomal dominant nocturnal frontal lobe epilepsy. We report a case with a brief review of literatures.
Arousal ; Carbamazepine ; Child, Preschool ; Epilepsies, Partial ; Epilepsy ; Epilepsy, Frontal Lobe* ; Frontal Lobe* ; Humans ; Male ; Neuroimaging ; Prognosis ; Seizures ; Wills

OBJECTIVES: The purpose of this study is to evaluate the clinical applicability of cognitive evoked potentials (CEPs) to identify the cognitive disorder in cerebrovascular diseases (CVD). METHODS: The P3 latencies, amplitudes and latency to amplitude ratios (LARs) of CEPs were measured in 25 healthy controls and 35 patients with CVD. The association of CEPs with variables including age, sex, Mini-Mental State Examination (MMSE), CVD types, loci of hemiplegic limbs, duration, education, Brief Psychiatric Rating Scale (BPRS), and Instrumental Activities of Daily Living (IADL) were also analyzed. RESULTS: 1) The P3 latencies (447.87+/-113.06 msec) and LARs (65.83+/-43.25) were prolonged in CVD (p<0.01), while the amplitudes (8.18+/-2.51 microV) were not changed. 2) The P3 latencies (537.31+/-101.14 msec) and LARs (94.89+/-46.44) in CVD with MMSE <24 were prolonged, and the amplitudes (6.45+/-1.98 microV) were reduced significantly (p<0.01, respectively), as compared with those in CVD with MMSE> or =24 (363.39+/-19.67 msec, 38.40+/-8.37 and 9.81+/-1.76 microV, respectively). 3) The BPRS and IADL in CVD with MMSE<24 were significantly (p<0.01) different from those in CVD with MMSE> or =24. 4) On analyzing the association of CEPs with variables in CVD, the P3 latencies were correlated positively with age, BPRS and IADL, while negatively with MMSE and DLFA. The amplitudes were correlated positively with MMSE, while negatively with age, BPRS and IADL. The LARs were correlated positively with age, BPRS and IADL, while negatively with MMSE. 5) On analyzing the association of CEPs with variables in CVD with MMSE> or =24, the P3 latencies were correlated positively with age, while negatively with MMSE. The amplitudes and LARs were not correlated with variables. 6) On analyzing the association of CEPs with variables in CVD with MMSE<24, the P3 latencies were correlated positively with BPRS, while negatively with MMSE. The amplitudes were positively correlated with age. The LARs were positively correlated with IADL. CONCLUSIONS: The P3 latencies and LARs of cognitive evoked potentials seemed to a useful clinical measures to assess cognitive disorders in CVD.
Activities of Daily Living ; Brief Psychiatric Rating Scale ; Education ; Evoked Potentials* ; Extremities ; Humans

Carbamazepine is widely used to manage of seizures and symptomatic treatment of trigeminal neuralgia and central pain. We experienced two cases of exceedingly rare but potentially fatal side effects following carbamazepine administration. One traumatic brain injured patient developed pancytopenia 3 weeks after beginning to take carbamazepine for prophylactic management of seizure and the other C6 incomplete spinal cord injured patient receiving carbamazepine for the management of central pain sequentially developed syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 1 week after administration. Because of more frequent indications of carbamazepine, these side effects must be borne in mind and cautious administration will be desirable.
Brain ; Carbamazepine* ; Humans ; Inappropriate ADH Syndrome* ; Pancytopenia* ; Seizures ; Spinal Cord ; Trigeminal Neuralgia