BACKGROUND: For autologous hematopoietic stem cell transplantation (HSCT), the volume of infused and DMSO contained in graft are the major causes of complications related to infusion. In this study, we evaluated feasibility of cryopreserving peripheral blood stem cell collects (PBSCC) at high cell concentration. METHODS: PBSCC from 40 patients with multiple myeloma or lymphoma were split and cryopreserved at two different concentrations of TNCs; one for standard concentration (SC) (2x108 cells/mL) and the other for high concentration (HC) (3x108 cells/mL). The viability of total nucleated cells and CD34+ cell count were examined before cryopreservation and after thawing. CFU-GM was examined with thawed products. Data were analyzed as two groups between good mobilizer (GM) and poor mobilizer (PM). RESULTS: There were no differences in TNC viability between SC and HC of all patients (P=0.0656) and PM (P=0.9658), however HC of GM showed significantly lower viability than SC (P=0.0314). CD34+ cell viability did not differ between SC and HC. CD34+ cell recovery was decreased in HC of all patients (P=0.459) and GM (P=0.0164), but no differences between SC and HC in PM (P=0.9658). CFU-GM clonogenic efficiency between SC and HC was not different in all patients (P=0.0635) and PM (P=0.8984), but was decreased in HC of GM (P=0.0427). CONCLUSION: Cryopreservation of PBSCC at 3x108 cells/mL seems to have minimal adverse effect on the quality of PBSC after thawing, particularly in PM. This approach may help to reduce infusion related complications while decreasing the cost of processing and storage of PBSCC.
Antigens, CD34 ; Cell Count ; Cell Survival ; Cryopreservation ; Dimethyl Sulfoxide ; Feasibility Studies* ; Granulocyte-Macrophage Progenitor Cells ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphoma ; Multiple Myeloma ; Peripheral Blood Stem Cell Transplantation ; Stem Cells* ; Transplants

PURPOSE: The prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) has increased worldwide. The aim of this study was to estimate the proportion of MRMP in a tertiary hospital in Korea, and to find potential laboratory markers that could be used to predict the efficacy of macrolides in children with MRMP pneumonia. METHODS: A total of 95 patients with M. pneumoniae pneumonia were enrolled in this study. Detection of MRMP was based on the results of specific point mutations in domain V of the 23S rRNA gene. The medical records of these patients were reviewed retrospectively and the clinical course and laboratory data were compared. RESULTS: The proportion of patients with MRMP was 51.6% and all MRMP isolates had the A2063G point mutation. The MRMP group had longer hospital stay and febrile period after initiation of macrolides. The levels of serum C-reactive protein (CRP) and interleukin-18 in nasopharyngeal aspirate were significantly higher in patients who did not respond to macrolide treatment. CRP was the only significant factor in predicting the efficacy of macrolides in patients with MRMP pneumonia. The area under the curve for CRP was 0.69 in receiver operating characteristic curve analysis, indicating reasonable discriminative power, and the optimal cutoff value was 40.7 mg/L. CONCLUSION: The proportion of patients with MRMP was high, suggesting that the prevalence of MRMP is rising rapidly in Korea. Serum CRP could be a useful marker for predicting the efficacy of macrolides and helping clinicians make better clinical decisions in children with MRMP pneumonia.
Biomarkers ; C-Reactive Protein* ; Child* ; Drug Resistance, Microbial ; Genes, rRNA ; Humans ; Interleukin-18 ; Korea ; Length of Stay ; Macrolides* ; Medical Records ; Mycoplasma pneumoniae* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Point Mutation ; Predictive Value of Tests ; Prevalence ; Retrospective Studies ; ROC Curve ; Tertiary Care Centers

PURPOSE: Lymphomatoid papulosis (LyP) is one of the primary cutaneous CD30-positive lymphoproliferative disorders. LyP of the eyelid has rarely been reported. Herein, a case of typical LyP of the medial canthal area is reported. In addition, a literature review was performed. CASE SUMMARY: A 40-year-old female presented with a skin mass in the medial canthal area of the left eye that developed 2 months earlier. Initially, a focal skin lesion developed, and even with conservative treatment at a local clinic, progressed to a mass lesion having a central ulceration and adjacent edema. After 6 weeks, the adjacent edema had gradually decreased. On ophthalmic examination, the left medial canthal lesion was a 6 x 6 mm sized elevated mass with a central crater covered by crust. The clinical impression was keratoacanthoma. The lesion was widely excised and reconstructed by a full-thickness skin graft after an incisional biopsy. Histopathologic findings showed dermal infiltration of various inflammatory cells with atypical lymphocytes showing positivity to the CD30 antigen, and LyP was diagnosed. Systemic evaluation showed no evidence of systemic lymphoma and the patient has remained free of recurrence or systemic disease after a 1-year follow-up.
Antigens, CD30 ; Biopsy ; Edema ; Eye ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Keratoacanthoma ; Lymphocytes ; Lymphoma ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders ; Recurrence ; Skin ; Transplants ; Ulcer

PURPOSE: Laparoscopic surgery on the adrenal gland is a highly specific procedure that requires mastery of laparoscopic surgery. From January 2000 to October 2008, 66 laparoscopic adrenalectomies on 65 patients were performed by a single surgeon. This study was done to summarize our experience and to evaluate the safety and effectiveness of laparoscopic adrenalectomy. METHODS: A retrospective review of the patient records was carried out. The patients' demographics, the tumor characteristics, the open conversion rate, the operating time, the length of the hospital stay and other clinical outcomes were studied. RESULTS: There were 8 conversions out of 65 patients. The indications for surgery included functional tumors in 42 patients (19 pheochromocytomas in 18 patients, 14 patients of primary aldosteronism and 10 patients of Cushing syndrome), and 23 nonfunctional tumors. The average tumor size was 3.5 cm. The mean operating time was 163 min. The average length of the hospital stay was 4.1 days. Postoperative complications occurred in 8 patients with no perioperative mortality, and most of the complications could be considered as minor. During follow-up, two patients had adrenal insufficiency and port site hernia, and none had recurrence of hormonal excess. CONCLUSION: Laparoscopic adrenalectomy has several advantages such as minimal postoperative pain, few surgical complications, a short hospital stay and an early return to work. The results confirm that laparoscopic adrenalectomy is the procedure of choice for resection of various benign adrenal neoplasms.
Adrenal Gland Neoplasms ; Adrenal Glands ; Adrenal Insufficiency ; Adrenalectomy ; Demography ; Follow-Up Studies ; Hernia ; Humans ; Hyperaldosteronism ; Laparoscopy ; Length of Stay ; Pain, Postoperative ; Pheochromocytoma ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Return to Work

OBJECTIVES : Administration methods of antibiotics implements a variety for indications and diseases. Therefore, it is impossible to produce a single guideline. Many antibiotics have been prescribed without specific index, by practicians for a long period of time. In general dental practice and oral and maxillofacial surgical practice, there is not a guidelines for antibiotics. Therefore, there is a dependency on pre-existent methods rather than following an exact guideline. Consequently, a controversy was issued that prescription of antibiotics tend to be misused or abused. And it is also direct relation to the tolerance of antibiotics as well. Moving forward, in this review we will be analyzing the exact usage and indication of antibiotics in dental treatment. MATERIALS AND METHODS : 29 published articles of both domestic and international were researched through Pubmed and Kormed, and the review from these articles were performed accordingly. We examined the administration of antibiotics through the objective usage, that classified prophylactic and therapeutic. RESULTS : For therapeutic usage, empirical prescription is mandatory for the first step. Next is to moderate the empirical prescription depending upon the result of its culture. Administration of antibiotics must be kept for 2days after the symptoms disappear. For a prophylactic use, we can generally pr escribe antibiotics to prevent local infection or systemic infection. Although the method of prescription and neccessity of antibiotics to prevent local in fection are controversial, exact guidelines of antibiotics to prevent systemic infection are established by AHA. CONCLUSION : Most crucial concept for prescript antibiotics is to determine if it is adequately suitable for all circumstances. In this decision making, a guideline for prescription of antibiotics in various dental surgical practice is necessary. This guideline can reduce the misusage and disusage of a ntibiotics in general dental practices and oral and maxillofacial surgical practices.
Anti-Bacterial Agents ; Decision Making ; Dependency (Psychology) ; Prescriptions ; Resin Cements

BACKGROUND AND OBJECTIVES: The purpose of this study is to evaluate the validity and reliability of the whispered voice test, which has been suggested as a screening test tool for hearing in the elderly group. SUBJECTS AND METHOD: A prospective multicenter trial has been designed. One hundred and seventy two elderly subjects from four university hospitals were included in this study. A whispered voice test using a number list and number/word list was performed by two testers for each elderly subject. To evaluate their test-retest reliability, a second whispered voice test was done 1-2 weeks later. The result of the whispered voice test was analyzed with the criteria of 26 dB and 40 dB hearing level, checked by pure tone audiometry. Sensitivity, specificity, and cut-off point of whispered voice test at each gold standard, inter-observer reliability and test-retest reliability have been investigated. RESULTS: There were significant differences with respect to correctly answered numbers in the whispered voice test between the normal and impaired hearing group at both criteria of 26 dBHL and 40 dBHL. With the 26 dB criteria of hearing level which showed higher inter-observer reliability of the number/word list, the whispered voice test has 86.0% sensitivity and 58.9% specificity with the cut-off point of 3 out of six on the number set. The test-retest reliability of whispered voice test using the number list was as high as 0.9 of correlation coefficient. However, the inter-observer reliability of whispered voice test was less than 0.6 (Cohen's kappa value). CONCLUSION: As a screening test for hearing in the elderly group, the whispered voice test has quite high sensitivity and test-retest reliability. The environmental sound level and test method for each tester, however, should be monitored to get better specificity and inter-observer reliability.
Aged ; Audiometry ; Hearing ; Hospitals, University ; Humans ; Mass Screening ; Prospective Studies ; Reproducibility of Results ; Sensitivity and Specificity ; Voice

This study investigated the hypothesis that the dentin bond strength of self-etching adhesive (SEA) might be improved by applying additional layer of bonding resin that might alleviate the pH difference between the SEA and the restorative composite resin. Two SEAs were used in this study; Experimental SEA (Exp, pH: 1.96) and Adper Prompt (AP, 3M ESPE, USA, pH: 1.0). In the control groups, they were applied with two sequential coats. In the experimental groups, after applying the first coat of assigned SEAs, the D/E bonding resin of All-Bond 2 (Bisco Inc., USA, pH: 6.9) was applied as the intermediate adhesive. Z-250 (3M ESPE, USA) composite resin was built-up in order to prepare hourglass-shaped specimens. The microtensile bond strength (MTBS) was measured and the effect of the intermediate layer on the bond strength was analyzed for each SEA using t-test. The fracture mode of each specimen was inspected using stereomicroscope and Field Emission Scanning Electron Microscope (FE-SEM). When D/E bonding resin was applied as the second coat, MTBS was significantly higher than that of the control groups. The incidence of the failure between the adhesive and the composite or between the adhesive and dentin decreased and that of the failure within the adhesive layer increased. According to the results, applying the bonding resin of neutral pH can increase the bond strength of SEAs by alleviating the difference in acidity between the SEA and restorative composite resin.
Adhesives* ; Dentin* ; Hydrogen-Ion Concentration ; Incidence ; Oceans and Seas

The purpose of this study is to evaluate prospectively the effect of different bonding systems and retention grooves on the clinical performance of resin restorations in non-carious cervical lesions (NCCLs). Thirty-nine healthy adults who had at least 2 NCCLs in their premolar areas were included in this study. One hundred and fifty teeth were equally assigned to six groups: (A) Scotchbond Multi-Purpose (SBMP, 3M ESPE, St. Paul, MN, USA, 4th generation bonding system) without retention grooves; (B) SBMP with retention grooves; (C) BC Plus (Vericom Co., Anyang, Gyeonggido, Korea, 5th generation bonding system) without retention grooves; (D) BC Plus with retention grooves; (E) Adper Prompt (3M ESPE, Seefeld, Germany, 6th generation bonding system) without retention grooves; (F) Adper Prompt with retention grooves. All cavities were filled with a hybrid composite resin, Denfil (Vericom Co., Anyang, Gyeonggido, Korea) by one operator. Restorations were evaluated at baseline and at 6-month recall, according to the modified USPHS (United States Public Health Service) criteria. Additionally, clinical photographs were taken and epoxy resin replicas were made for SEM evaluation. At 6-month recall, there were some differences in the number of alpha ratings among the experimental groups. But, despite the differences in the number of alpha ratings, there was no significant difference among the 3 adhesive systems (p > 0.05). There was also no significant difference between the groups with or without mechanical retention (p > 0.05). Follow-ups for longer periods than 6 months are needed to verify the clinical performance of different bonding systems and retention grooves.
Adhesives ; Adult ; Bicuspid ; Follow-Up Studies ; Germany ; Gyeonggi-do ; Humans ; Korea ; Prospective Studies* ; Public Health ; Tooth ; United States Public Health Service

Recently, the number of facial contouring surgery such as angle reduction or malarplasty in Oral and maxillofacial surgery is increasing steadly as the demand for maxillofacial esthetic surgery of the patients is growing. Looking around international trend of oral and maxillofacial surgery, nowadays workshop or symposium about facial soft esthetic surgery such as corrective rhinoplasty, blepharoplasty, face lift are held. This means that maxillofacial esthetic surgery is new scope which oral and maxillofacial surgeons should develope. Therefore the authors present cases of blepharoplasty which got hardly used to oral and maxillofaical surgeon with literature review in order to raise the concern about maxillofacial esthetic surgery.
Blepharoplasty* ; Education ; Humans ; Rhinoplasty ; Rhytidoplasty ; Surgery, Oral ; Surgery, Plastic

PURPOSE: Protein C deficiency is an autosomal recessive disorder, which predisposes the patient to potentially blinding and widespread lethal thromboembolic complications, especially in the homozygous type. We here report the first Korean case of ophthalmic involvement and its surgical treatment in homozygous protein C deficiency. METHODS: A 3.4kg, full term girl was born by normal delivery but showed bilateral leukocoria on day 2. Laboratory results disclosed a very low protein C activity level (10%) in the patient and moderately decreased levels in the other family members. Ophthalmic examination showed bilateral corneal opacity and shallow anterior chamber. B-scan ultrasonography which showed intravitreal mass lesions without microphthalmos and a funnel-shaped retinal detachment suggested bilateral retinal dysplasia. RESULTS: As the eyes were under progression of secondary glaucoma, bilateral lensectomies were performed at 2 months old and corneal opacity was regressed to some degree. However, at 14 months old, the left eye showed moderate corneal opacity with a band keratopathy. CONCLUSIONS: Although visual outcome was very poor after surgery, we could impede or slow down the progression of secondary glaucoma and save the eyeballs in the infant with homozygous protein C deficiency.
Anterior Chamber/ultrasonography ; Cataract/etiology ; Female ; Glaucoma/*etiology ; *Homozygote ; Humans ; Infant, Newborn ; Lens, Crystalline/surgery ; Protein C Deficiency/*complications/*genetics ; Retinal Diseases/*etiology