OBJECTIVES: This clinical study evaluated the effect of light activation on the whitening efficacy and safety of in-office bleaching system containing 15% hydrogen peroxide gel. MATERIALS AND METHODS: Thirty-three volunteers were randomly treated with (n = 17, experimental group) or without light activation (n = 16, control group), using Zoom2 white gel (15% H2O2, Discus Dental) for a total treatment time of 45 min. Visual and instrumental color measurements were obtained using Vitapan Classical shade guide and Shadepilot (DeguDent) at screening test, after bleaching, and 1 month and 3 month after bleaching. Data were analyzed using t-test, repeated measure ANOVA, and chi-squared test. RESULTS: Zoom2 white gel produced significant shade changes in both experimental and control group when pre-treatment shade was compared with that after bleaching. However, shade difference between two groups was not statistically significant (p > 0.05). Tooth shade relapse was not detected at 3 months after bleaching. The incidence of transient tooth sensitivity was 39.4%, with being no differences between two groups. CONCLUSIONS: The application of light activation with Zoom2 white gel system neither achieved additional whitening effects nor showed more detrimental influences.
Humans ; Hydrogen ; Hydrogen Peroxide ; Hypersensitivity ; Incidence ; Light ; Mass Screening ; Recurrence ; Tooth ; Tooth Bleaching

PURPOSE: The purpose of this study was to investigate the predictors of nonsentinel lymph node (NSLN) metastasis in breast cancer and to evaluate the usefulness of the scoring systems and nomograms. METHODS: In this analysis, we reviewed the clinicopathologic features of 70 patients who had undergone sentinel lymph node (SLN) biopsy and axillary lymph node dissection. The clinical features of patients, histologic parameters and hormonal receptor status of primary tumor and histopathologic features of SLN metastasis were noted retrospectively. Furthermore, the receiver operating characteristic (ROC) curve was drawn and the area under the ROC curve (AUC) was calculated to assess the discriminative power of the scoring systems and nomograms. RESULTS: The metastatic tumor size in SLN (P<0.001), extracapsular invasion (P=0.002), percentage of positive SLNs among the removed SLNs (P=0.011), primary tumor size (P=0.038) were associated significantly with NSLN metastasis, statistically, in univariate analysis. Based on multivariate logistic regression, the metastatic tumor size was the only prognostic factor of NSLN metastasis (P=0.012). The AUC of Memorial Sloan-Kettering Cancer Center scoring system was greater than other systems, significantly (P=0.004). CONCLUSION: We have shown in this study that it would be possible to predict NSLN status based on the metastatic tumor size in SLN. Although the significance was not achieved in multivariate analysis, the size of primary tumor, extracapsular invasion of metastasis in SLN, percentage of positive SLNs among the removed SLNs had the potential to be a predictive factor of NSLN metastasis. MSKCC scoring system appears to be more effective and accurate than other scoring systems for selecting patients for whom axillary lymph node dissection can be avoided.
Area Under Curve ; Biopsy ; Breast ; Breast Neoplasms ; Humans ; Logistic Models ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Nitriles ; Nomograms ; Pyrethrins ; Retrospective Studies ; ROC Curve

Malignant atrophic papulosis (MAP), also known as Degos' disease, is a rare and often fatal occlusive thrombotic vasculopathy, with fewer than seven cases reported in Korea. MAP is characterized by porcelain-white, atrophic, papular skin lesions and multi-organ system involvement, especially the gastrointestinal (GI) tract and nervous system. Involvement of the GI tract is usually associated with a poor prognosis. To date, no treatment has been shown to be effective in the treatment of MAP. We describe a 52-year-old man who presented with a 5-month history of abdominal angina and a 2-year history of multiple skin lesions on the trunk and extremities. The skin lesions were papules, 4-6 mm in diameter, with a porcelain-white center and a slightly raised erythematous telangiectatic rim. A biopsy of a skin lesion showed a wedge-shaped degeneration of collagen in the dermis and atrophic epidermis. An explorative laparoscopy revealed multiple, yellow-white plaques scattered throughout the small bowel. A biopsy of the small bowel showed sclerotic vascular alterations containing intravascular fibrin thrombi. He was started on aspirin (100 mg daily) and has survived for 24 months since the onset of gastrointestinal symptoms.
Aspirin ; Biopsy ; Collagen ; Dermis ; Epidermis ; Extremities ; Fibrin ; Gastrointestinal Tract ; Humans ; Korea ; Laparoscopy ; Malignant Atrophic Papulosis ; Middle Aged ; Nervous System ; Prognosis ; Skin

Malignant atrophic papulosis (MAP), also known as Degos' disease, is a rare and often fatal occlusive thrombotic vasculopathy, with fewer than seven cases reported in Korea. MAP is characterized by porcelain-white, atrophic, papular skin lesions and multi-organ system involvement, especially the gastrointestinal (GI) tract and nervous system. Involvement of the GI tract is usually associated with a poor prognosis. To date, no treatment has been shown to be effective in the treatment of MAP. We describe a 52-year-old man who presented with a 5-month history of abdominal angina and a 2-year history of multiple skin lesions on the trunk and extremities. The skin lesions were papules, 4-6 mm in diameter, with a porcelain-white center and a slightly raised erythematous telangiectatic rim. A biopsy of a skin lesion showed a wedge-shaped degeneration of collagen in the dermis and atrophic epidermis. An explorative laparoscopy revealed multiple, yellow-white plaques scattered throughout the small bowel. A biopsy of the small bowel showed sclerotic vascular alterations containing intravascular fibrin thrombi. He was started on aspirin (100 mg daily) and has survived for 24 months since the onset of gastrointestinal symptoms.
Aspirin ; Biopsy ; Collagen ; Dermis ; Epidermis ; Extremities ; Fibrin ; Gastrointestinal Tract ; Humans ; Korea ; Laparoscopy ; Malignant Atrophic Papulosis ; Middle Aged ; Nervous System ; Prognosis ; Skin

PURPOSE: The definite indications of laparoscopic adrenalectomy (LA) and the limitations of minimally invasive surgery have yet to be determined. To verify the benefit and safety of LA, we compared the results of LA with those of open adrenalectomy (OA) and we further analyzed the clinical results of LA in accordance with the time period of performing this surgery. METHODS: We retrospectively reviewed 69 patients who received adrenalectomy between 1997 and 2008. We compared LA with OA. The LA was divided into subsets of the early and late groups, and the transperitoneal approach and retroperitoneal approach groups, and we compared and analyzed the results of each group, along with the results of the OA and LA groups. For each of the groups, we analyzed the following factors; age, gender, tumor size, tumor location, the operative time, the time under anesthesia, the amounts of blood loss and transfusion, the time to first oral intake, the length of the postoperative hospital stay and the complications. RESULTS: LA (25 cases), as compared to OA (20 cases), showed better results for the amount of transfusion, the time to first oral intake, the length of the postoperative hospital stay and the complication rates (p=0.032; p=0.017; p=0.02). As for CA (4 cases), the time to first oral intake and the length of the postoperative hospital stay were significantly longer than that of LA (p=0.001; p=0.021). LA done in the late period demonstrated less blood loss and a shorter time to first oral intake as compared to the LA of the early period (p=0.032; p=0.019). There were no significant statistical differences between the results of the peritoneal or retroperitoneal approaches. CONCLUSION: LA has the merits of a shortening hospital stay and decreased complication. Furthermore, as the experience with this type of surgery accumulates, these merits are likely to become stronger. Thus, surgeons are expected to carefully decide on choosing the surgical methods by fully understanding the benefits and indications of LA.
Adrenal Gland Neoplasms ; Adrenalectomy ; Anesthesia ; Humans ; Length of Stay ; Operative Time ; Retrospective Studies

The typical radiographic findings of pulmonary edema from the increased hydrostatic pressure shows centrally localized consolidation, which is known as a "butterfly or bat's wing" pattern. These terms describe the anatomic distribution of edema that uniformly involve the hilum and medulla of the lung but not the peripheral region of the lung parenchyma (cortex). We present a case of butterfly wing-like pulmonary edema on a chest radiograph by mitral regurgitation due to an idiopathic chordal rupture.
Butterflies ; Chordae Tendineae ; Edema ; Hydrostatic Pressure ; Lung ; Mitral Valve Insufficiency ; Pulmonary Edema* ; Radiography, Thoracic ; Rupture*

The gradual loss of telomeric DNA can contribute to replicative senescence and thus, having longer telomeric DNA is generally considered to provide a longer lifespan. Maintenance and stabilization of telomeric DNA is assisted by binding of multiple DNA-binding proteins, including those involved in double strand break (DSB) repair. We reasoned that declining DSB repair capacity and increased telomere shortening in aged individuals may be associated with decreased expression of DSB repair proteins capable of telomere binding. Our data presented here show that among the DSB repair proteins tested, only the expression of Ku70 and Mre11 showed statistically significant age-dependent changes in human lymphocytes. Furthermore, we found that expressions of Ku70 and Mre11 are statistically correlated, which indicate that the function of Ku70 and Mre11 may be related. All the other DSB repair proteins tested, Sir2, TRF1 and Ku80, did not show any significant differences upon aging. In line with these data, people who live in the regional community (longevity group), which was found to have statistically longer average life span than the rest area, shows higher level of Ku70 expression than those living in the neighboring control community. Taken together, our data show, for the first time, that Ku70 and Mre11 may represent new biomarkers for aging and further suggest that maintenance of higher expression of Ku70 and Mre11 may be responsible for keeping longer life span observed in the longevity group.
Telomere/genetics ; Middle Aged ; Longevity ; Humans ; DNA-Binding Proteins/*metabolism ; DNA Repair/*genetics ; DNA/genetics ; Cell Aging/*physiology ; CD4-Positive T-Lymphocytes/metabolism ; Antigens, Nuclear/*metabolism ; Aging/*physiology ; Aged, 80 and over ; Aged ; Adult

BACKGROUND: No outbreak of Enterohemorrhagic Escherichia coli (EHEC) infection has occurred as a group in Korea. On July 2004, an outbreak of EHEC infection occurred in an elementary school in Gwangju metropolitan city. Epidemic investigation was undertaken to track the source of infection and the mode of transmission of EHEC. METHODS: All students and staffs of the elementary school were interviewed and completed questionnaires. We surveyed their clinical symptoms and the foods that they ate. Microbiologic examinations were also carried out on the above school-related persons and many environmental specimens. We also investigated the facilities of the school, some suppliers of food materials, and other associated institutions. All the EHEC-positive persons were isolated in 5 hospitals and tested everyday for verotoxin until they turned out to be negative twice in succession, and their family were also interviewed and tested for EHEC. Pulsed-field gel electrophoresis (PFGE) was performed to find out the genetic relationship between isolates. RESULTS: Of the 1,643 school-related persons, 77 persons (4.7%) were positive for EHEC. Most of them were asymptomatic. All the isolated strains were non-O157 EHEC. Serotype O91 was the most frequent serotype (68 isolates), and the isolates revealing O91 serotypes showed identical PFGE patterns. The school meal was significantly associated with this outbreak (relative risk=13.29, p=0.00). CONCLUSIONS: This is the first EHEC outbreak occurred as a group in Korea, All the isolated strains were non-O157 serotypes and the mode of transmission was most likely by school meal.
Electrophoresis, Gel, Pulsed-Field ; Enterohemorrhagic Escherichia coli* ; Gwangju ; Humans ; Korea ; Meals ; Shiga Toxins ; Surveys and Questionnaires

PURPOSE: Gallbladder cancer, which is the most common malignancy of the biliary tract, is frequently associated with poor prognosis. The aim of this study was to evaluate outcomes with gallbladder cancer according to the surgical treatment, pathologic stage, and prognostic factors. METHOD: The medical records of 52 consecutive patients with gallbladder cancer treated at our institution from June 1996 through June 2005 were reviewed retrospectively. Survival was analyzed using the Kaplan-Meier method (mean followed period 60 months) and the log-rank test. Prognostic factors were analyzed using Cox regression. RESULTS: Mean patient age was 67 years. Fiftysix percent of patients were female. Twentyeight patients (56%) underwent curative resection (5 simple cholecystectomies and 23 radical cholecystectomies). There were no procedure-related deaths. The Overall 5-year survival was 18%. Patients who underwent curative resection had a higher 5-year survival rate (40%) than patients who underwent palliative surgery (0%; P=0.0001). The palliative surgery, high T stage, positive lymph node metastasis were significant factors predictive of worse survivial. CONCLUSION: The good long-term survival may be achieved by an early diagnosis and radical resection.
Biliary Tract ; Cholecystectomy ; Early Diagnosis ; Female ; Gallbladder Neoplasms* ; Gallbladder* ; Humans ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Palliative Care ; Prognosis ; Retrospective Studies ; Survival Rate

Primary fallopian tube carcinoma is a rare tumor, accounting for approximately 1% of all female genital tract malignancies. Its histologic appearance and clinical behavior resemble that of primary ovarian carcinoma, with a reported 5-year survival rate of about 30% to 50%. Presenting symptoms are variable, so pre-operative diagnosis of fallopain tube carcinoma is seldom made. Evaluation and treatment are also essentially the same as that of ovary cancer. Two postmenopausal women presented with pelvic mass and vaginal bleeding. One case was initially diagnosed as endometrioma, the other as endometritis but postoperatively pathologic examination of resected specimen revealed primary adenocarcinoma of the fallopian tube in debulking operation. We have experienced two cases of primary carcinoma of fallopian tube and reported with brief review of literature.
Adenocarcinoma ; Diagnosis ; Endometriosis ; Endometritis ; Fallopian Tubes* ; Female ; Humans ; Ovarian Neoplasms ; Survival Rate ; Uterine Hemorrhage