Discoloration and radiopacity of white mineral trioxide aggregate with various radiopacifiers / 대한치과재료학회지

The use of the mineral trioxide aggregate (MTA) has been expanded as the material can be applied on various treatment of endodontic care, which also has many advantages including bioactivity. Still, the discolorations of the materials have been presented as a concern related to esthetic appearances, which is caused by the presence of radiopacifiers. Therefore, the aim of this study was to investigate the color stability and radiopacity of white MTA with various radiopacifiers. Four different radiopacifiers [bismuth oxide (BM), calcium tungstate (CT), barium oxide (BO), and zirconium oxide (ZO)] were used. The radiopacity was tested according to ISO 6876, and the color change before and after immersing in a 5% hypochlorite solution was tested using a spectrophotometer. The group with no radiopacifier (NR) was used as a negative control and ProRoot MTA (PR) was used as the commercial control. The immersion of the PR and BM in sodium hypochlorite resulted in a dark brown discoloration, in which the values were higher than the rest of the group (p0.05). In terms of the radiopacity, the NR showed the lowest value as expected (p<0.05). Meanwhile, the BM showed the highest value (p<0.05), followed by PR and BO (p<0.05). The NR showed the lowest radiopacity values. The result of this study will be useful for future development of MTA that would have clinically adequate radiopacity with minimum discoloration.

Predictors of transient congenital hypothyroidism in children with eutopic thyroid gland

PURPOSE: Congenital hypothyroidism (CH) is the most common cause of preventable mental retardation. Recently, the detection of CH cases with eutopic thyroid gland has increased due to neonatal screening programs. In this study, we aimed to identify and evaluate predictive factors that could distinguish between permanent and transient CH in patients with eutopic thyroid gland. METHODS: We retrospectively reviewed 100 children diagnosed with CH and with eutopic thyroid gland. All subjects were treated with levothyroxine and underwent re-evaluation after 3 years of age. RESULTS: Of the 100 CH patients, 35 (35.0%) were diagnosed with permanent CH (PCH) and 65 (65.0%) were diagnosed with transient CH (TCH). The initial thyroid stimulating hormone levels were significantly lower in the TCH subjects than in PCH subjects. In addition, the mean doses of levothyroxine (µg/kg/day) at the 1st, 2nd, and 3rd year of treatment were significantly lower in subjects with TCH than in PCH subjects with eutopic thyroid gland. Based on the receiver operating characteristic (ROC) curve, the optimal cutoff dose of levothyroxine at 3 years of 2.76 µg/kg/day could predict TCH, and was associated with 87.3% sensitivity and 67.6% specificity, with an area under the ROC curve of 0.769. CONCLUSION: The levothyroxine dose requirement during treatment period has a predictive role in differentiating TCH from PCH in CH patients with eutopic thyroid gland.

A Case of Neonatal Langerhans Cell Histiocytosis Presenting with Generalized Skin Involvement at Birth Evolving to Hepatic Involvement / 임상소아혈액종양

Langerhans cell histiocytosis (LCH) is a rare disease having an unknown etiology, but characterized by a disorder of antigen presenting cells and the mononuclear phagocytic system. Neonatal LCH, defined as LCH presenting within the first 4 weeks of life, accounts for less than 5-6% of the total LCH cases. Skin involvement of neonatal LCH tends to regress spontaneously, as has been shown in Hashimoto-Pritzker syndrome. We report a case of LCH that presented as whole body, polymorphic, generalized, erythematous, yellowish plaques at birth, with no evidence of other organ involvement. These skin lesions regressed spontaneously within 14 days. Two weeks later, however, the patient presented with hepatosplenomegaly, fever, hyperbilirubinemia, anemia and leukocytosis. LCH with liver involvement was shown on abdominal MRI findings, and the patient received systemic chemotherapy. Although neonatal LCH may initially only show skin manifestations, it should be followed up closely and periodically for other organ involvement.

A Case of Neonatal Langerhans Cell Histiocytosis Presenting with Generalized Skin Involvement at Birth Evolving to Hepatic Involvement / 임상소아혈액종양

Langerhans cell histiocytosis (LCH) is a rare disease having an unknown etiology, but characterized by a disorder of antigen presenting cells and the mononuclear phagocytic system. Neonatal LCH, defined as LCH presenting within the first 4 weeks of life, accounts for less than 5-6% of the total LCH cases. Skin involvement of neonatal LCH tends to regress spontaneously, as has been shown in Hashimoto-Pritzker syndrome. We report a case of LCH that presented as whole body, polymorphic, generalized, erythematous, yellowish plaques at birth, with no evidence of other organ involvement. These skin lesions regressed spontaneously within 14 days. Two weeks later, however, the patient presented with hepatosplenomegaly, fever, hyperbilirubinemia, anemia and leukocytosis. LCH with liver involvement was shown on abdominal MRI findings, and the patient received systemic chemotherapy. Although neonatal LCH may initially only show skin manifestations, it should be followed up closely and periodically for other organ involvement.

Evaluation of Unpreparedness When Issuing Copies of Medical Records in Tertiary Referral Hospitals / 대한의료정보학회지

OBJECTIVES: As a baseline study to aid in the development of proper policy, we investigated the current condition of unpreparedness of documents required when issuing copies of medical records and related factors. METHODS: The study was comprised of 7,203 cases in which copies of medical records were issued from July 1st, 2007 through June 30th, 2008 to 5 tertiary referral hospitals. Data from these hospitals was collected using their established electronic databases and included study variables such as unpreparedness of the required documents as a dependent variable and putative covariates. RESULTS: The rate of unpreparedness of required documents was 14.9%. Multiple logistic regression analysis revealed the following factors as being related to the high rate of unpreparedness: patient age (older patients had a higher rate), issuance channels (on admission > via out-patient clinic), type of applicant (others such as family members > for oneself > insurers), type of original medical record (utilization records on admission > other records), issuance purpose (for providing insurer > medical use), residential area of applicant (Seoul > Honam province and Jeju), and number of copied documents (more documents gave a lower rate). The rate of unpreparedness differed significantly among the hospitals; suggesting that they may have followed their own conventional protocols rather than legal procedures in some cases. CONCLUSIONS: The study results showed that the level of compliance to the required legal procedure was high, but that problems occurred in assuring the safety of the medical information. A proper legislative approach is therefore required to balance the security of and access to medical information.

MR Imaging of the Temporomandibular Joint in Patient with Acute Mandibular Condylar Fracture

PURPOSE: To analyze various MR imaging findings and thus evaluate the usefulness of MR imaging of the tem-poromandibular joint in patient with acute mandibular condylar fracture. MATERIALS AND METHODS: MR imaging was performed within 1week after trauma in 25 patients (total joints s-tudied=31) in whom condylar fracture had been diagnosed by simple radiographs. We analyzed the signal intensity of bone marrow and disk, displacement of bone fragment and disk, deformity. In addition, MRI findings of retrodiskal tissue, joint capsule and joint effusion were eualuated. RESULTS: No abnormal signal intensity was noted in bone marrow or disk. Displacement of a condylar fracture fragment was observed in 24 joints(77 %) (anteromedial, 63 %; medial, 25 %; anterior, 4%; anterolateral, 4 % ; and lateral, 4 %). Disk displacement occurred in 23 joints(74 %) (anteromedial, 65 %; medial, 9 %; anterior, 18%; anterolateral, 4 %; and lateral, 4 %). In 17 joints (55 %) the disk was displaced along with the fractured condylar fragment, and disk deformity was noted in five joints(16 %). MR imaging (T2WI) revealed a capsular tear(n=1), joint effusion(n=26), and high signal intensity in the retrodiskal tissue(n=6). CONCLUSION: MR imaging provided information concerning condylar fragments, disks, retrodiskal tissue, capsules, and joint effusion. In patients with acute mandibular condylar fracture, MRI is therefore useful for evaluation of the temporomandibular joint.

Measurement of Necrotic Portion in Legg-Clave-Perthes Disease: Comparison of MRI Volume Measurement Method andCatterall Classification

PURPOSE: The purpose of this study was to evaluate the extent of necrosis of the femoral head inLegg-Clave-Perthes (LCP) disease. This involved the use of MRI, followed by volume measurement and the use of theCatterall classification system; the difference between the grade obtained using each of these approaches was thendetermined. MATERIALS AND METHODS: We retrospectively reviewed 28 hip-joint MR images on which a diagnosis of LCPdisease had been based. According to the necrotic portion of femoral head, and on the basis of the catterallclassification, LCP was graded 1 to 4, as follows: Grade I=0~ <25%; II=2 5~ <50%; III=50~ <75; IV=75-100%. Using atransparent paper on which 1mm squares had been drawn, the necrotic area of each MR image was measured; thefollowing equation was then used to calculate the volume of the necrotic portion: volume=necrotic area x slicethickness. On the basis of this measurement, each femoral head was graded and the results were compared with thoseobtained using the Catterall classification. RESULTS: In 24 joints(85.7%), grades according to the Catterallclassification and MRI volume measurement were not the same. As compared with the volume measurement method, useof the Catterall classification led to grade overestimation in 18 joints (64.3%) and underestimation in six(21.4%). CONCLUSION: The grade according to the Catterall classification was different from that obtained usingthe volume measurement method. This study thus indicates the need for a new system of classifying LCP diseasebased on the volume measurement method and using MR imaging.

Human Brain Mapping of Language-Related Function on 1.5T Magnetic Resonance System: Focused on Motor Language Function

PURPOSE: To investigate the feasibility of functional MR imaging of motor language function and its usefulnessin the determination of hemispheric language dominance. MATERIALS AND METHODS: In order to activate the motorcenter of language, six subjects(5 right-handed, 1 left-handed; 3 males, 3 females) generated words. They wererequested to do this silently, without physical articulation, in response to English letters presented visually.Gradient-echo images (TR/TE/flip angle, 80/60/40o; 64x128 matrix; 10mm thickness) were obtained in three axialplanes including the inferior frontal gyrus. Functional maps were created by the postprocessing of gradient-echoimages, including subtraction and statistics. Areas of activation were topographically analyzed and numbers ofactivated pixels in each region were compared between right and left sides. The reproducibility of functional mapswas tested by repetition of functional imaging in the same subjects. RESULTS: Statistically significant activationsignals were demonstrated in five of six subjects, in whom the distribution of those signals was predominantly inboth frontal lobes. Hemispheric lateralization of activation, when activated pixels were compared between bothinferior frontal gyri, was in all cases on the left. In four subjects, functional maps were reproduced in asimilar fashion. CONCLUSION: Our results suggest that functional MR imaging can depict the activation of motorlanguage function in the brain and can be used as a useful non-invasive method for determining the hemisphericdominance of language.

Evaluation of the renal function using 99mTc dimercaptosuccinic acid (DMSA) / 대한비뇨기과학회지

99mTc-DMSA is a new renal scanning agent that provides a good quality of renal image as a result of preferential cortical accumulation and also makes feasible a quantitative assessment of separate kidney functions. Using 99mTc-DMSA renal scan. we evaluated renal functions in 26 patients who had unilateral non-functioning obstructed kidneys on intravenous pyelogram (IVP) and normal contralateral kidneys for recent 2 years and decided whether to perform surgeries for relief of obstructions or nephrectomies. In the patients who undertook surgeries for relief of obstructions for the recovery of renal functions, we compared renal functions of preoperative and postoperative obstructed kidneys. The results were as follows: 1. Etiologic diseases in 26 patients were urinary stones in 13. ureteropelvic junction obstructions in 7 and renal tuberculosis in 6. 2. Nephrectomies were performed in 13 patients who showed less than 15% of the total renal functions as determined by a preoperative 99mTc-DMSA scans. 3. Surgeries for relief of obstructions were performed in the other 13 patients for the recovery of the renal functions. The functions of the obstructed kidneys as determined by preoperative 99m Tc-DMSA scans were from 23% to 42% (mean 29.3%) and by postoperative 99mTc-DMSA scans were from 24% to 47 % (mean 34.4 %). The functions of the obstructed kidneys were recovered from 1% to 12% (mean 43.5 %) after surgeries for relief of obstructions. The follow-up periods were from 1 to 13 months (mean 6.6 month).

Immunohistochemical observations on the changes of autoimmune innervation of the human vas deferens after vasectomy / 대한비뇨기과학회지

Immunohistochemical study have been made to examine the autonomic innervation of the human vas dererens following vasectomy one to 7 years previously. Samples from sites on the proximal (testicular) and distal (urethral) sides of the original vasectomy have been compared with control specimens as to the arrangement and distribution of autonomic nerves containing vasoactive intestinal polypeptide (VIP), catecholamine, substance-P and enkephalin. In contrast with tissues from the urethral portion and from controls, the testicular specimens revealed a marked reduction in the catecholeminergic innervation of the muscular layer. In addition VIPergic nerves distributed at the subepithelial layer were nearly absent from the testicular side of the vas deferens. The degrees of denervation were independent of the obstructive interval between vasectomy and vasectomy reversal. Substance-P and enkephalin containing nerves were rarely found from both sides of the vas deferens. Therefore, these findings suggest that the consequences of denervation of vas deferens may play an important role in those patients in whom infertility persists despite evidence of satisfactory mechanical continuity achieved by vasectomy reversal.

Percutaneous Embolization of the Internal Spermatic Vein for Treatment of Varicocele: 4 Cases / 대한비뇨기과학회지

Percutaneous embolization of the internal spermatic vein under the phlebography is a new alternative method in the treatment of idiopathic varicocele. Embolization with the stainless steel coil was attempted in 4 cases of varicocele which showed passive reflux from the left renal vein to the internal spermatic vein on the phlebography. 3 cases were corrected by the percutaneous embolization successfully and no dislocation of the coil was observed on the follow-up films. In failure case, the renal catheter could not be engaged into the internal spermatic vein.

Renal Cell Carcinoma Occurred in One Family / 대한비뇨기과학회지

The etiology of renal cell carcinoma has not been clarified and the familial renal cell carcinoma accompanied with karyotypic abnormalities is very rarely reported in the world literatures. Recently the approaches to evaluate the etiology of renal cell carcinoma are now being tried but it's relationship with the chromosomal abnormalities has not yet been clearly identified. We report two cases of renal cell carcinoma occurred in sister and brother who were treated with radical nephrectomy. And also we studied the pedigree of the family and the karyotype of peripheral leukocytes from four siblings which shows normal chromosomal patterns

Renal Cell Carcinoma Occurred in One Family / 대한비뇨기과학회지

The etiology of renal cell carcinoma has not been clarified and the familial renal cell carcinoma accompanied with karyotypic abnormalities is very rarely reported in the world literatures. Recently the approaches to evaluate the etiology of renal cell carcinoma are now being tried but it's relationship with the chromosomal abnormalities has not yet been clearly identified. We report two cases of renal cell carcinoma occurred in sister and brother who were treated with radical nephrectomy. And also we studied the pedigree of the family and the karyotype of peripheral leukocytes from four siblings which shows normal chromosomal patterns