Full-mouth rehabilitation with increasing minimum vertical dimension in the patient with severely worn dentition and deep bite / 대한치과보철학회지

Full-mouth rehabilitation with increasing vertical dimension can be used for patients with severely worn teeth. In severely worn teeth also, the alveolar process can be elongated to compensate for the reduced vertical dimension, and the patient’s vertical dimension of occlusion can be kept constant. However, full-mouth rehabilitation with increasing vertical dimension must be carefully chosen, because the vertical dimension can be reduced by tooth wear. It is important to establish a treatment plan with the systematic diagnosis of the change in the vertical dimension and gain space for the prosthesis. It is necessary to change the vertical dimension to secure the restoration space and select the minimum vertical dimension elevation for the esthetic and functional goal. In this case report, the patient complained of difficulty during chewing due to a worn dentition and wanted esthetic improvement of the short mandibular anterior teeth. After systematic evaluation and diagnosis, we performed full-mouth rehabilitation with minimum vertical dimension elevation to obtain the space for restoration. This resulted in a stable and harmonious occlusion, and the functional and esthetic problems of the patient were solved after treatment. The patient was satisfied with the results of the treatment and maintained stable occlusion during the follow-up period.

Development of an Enzyme-linked Immunosorbent Assay Using Vitellin for Vitellogenin Measurement in the Pale Chub, Zacco platypus

OBJECTIVES: Fish vitellogenin (VTG) is produced in the female liver during oogenesis through the estradiol cycle and produced in the male liver by endocrine disrupting chemicals (EDCs) such as alkylphenols. In this study, we propose that the VTG concentration in the pale chub could be detected using monoclonal antibodies and polyclonal antibodies against vitellin (Vn) in a VTG enzyme-linked immunosorbent assay (ELISA) system. METHODS: Monoclonal antibodies and polyclonal antibodies were produced using the Vn extracted from the matured ovum of the ovary. The VTG was extracted from the plasma of the male pale chub. The Vn and VTG were confirmed by measuring the molecular weight of their proteins using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and the specificity of the antibodies was checked through western blotting methods. The assay system was validated with respect to optimal assay concentrations, specificity, recovery, and intra- and inter-assay variations. RESULTS: The Vn consisted of two protein bands with apparent molecular weights of 64 and 37 kDa. The SDS-PAGE indicated protein weights of 146 and 77 kDa in the VTG. The assay range was 15.6 ng/mL to 2,000 ng/mL, and the value of the intra- and inter-assay variations were within 10.0% and 14.7%, respectively. The recovery rate was 99.5+/-5.5%. CONCLUSIONS: A sandwich ELISA was developed that could be used to qualify the VTG of pale chub in screening for EDCs. Pale chub is an ideal species for observing estrogen activity in the environment because of its extensive habitat and extensive food chain. The ELISA developed here would be more favorable than those for other species for determining the effect of long-term food chain accumulation of EDCs in aquatic environments.

Analysis of the Treatment of Two Types of Acute Urinary Retention

PURPOSE: This study analyzed the type of acute urinary retention (AUR) and evaluated the treatments used, including trial without catheter (TWOC). MATERIALS AND METHODS: This study was based on 299 patients who were treated for AUR from January 2007 to August 2009. The patients were classified into the spontaneous AUR group (group S) and the precipitated AUR group (group P), in which AUR was consecutive to triggering events. The treatment modalities including TWOC, the success rate of TWOC, age, prostate-specific antigen (PSA) levels, the volume of the prostate, and the drained volume at catheterization were analyzed in each group. RESULTS: Of 299 men with AUR, 160 (54%) had spontaneous AUR and 139 (46%) had precipitated AUR. Compared with group P, patients in group S were more likely to be treated by surgery, either immediately (16.9% vs. 3.6%, p or =70 years) and in those with enlarged prostates (> or =50 ml), higher PSA levels (> or =3 ng/ml), and a large drained volume at catheterization (> or =1,000 ml). CONCLUSIONS: In this group of AUR patients, there were slightly more patients with spontaneous AUR (54%) than with precipitated AUR (46%). The success rate of TWOC was more than 70% regardless of the type of AUR. Although TWOC is recommended primarily in the treatment of AUR, early surgical intervention should be considered if the patient has an enlarged prostate (> or =50 ml) or a large drained volume at catheterization (> or =1,000 ml).

Relationship between Exhaled Nitric Oxide and Levels of Asthma Control in Asthma Patients Treated with Inhaled Corticosteroid / 결핵및호흡기질환

BACKGROUND: While asthma control is defined as the extent to which the various manifestations of asthma are reduced by treatment, current guidelines of asthma recommend assessment of asthma control without consideration of airway inflammation. Our aim was to investigate the relationships between fractional exhaled nitric oxide (FeNO), a reliable marker of airway inflammation, and levels of asthma control in patients treated with inhaled corticosteroids (ICS). METHODS: We enrolled 71 adult patients with asthma who had been treated with ICS for more than four months. FeNO was measured and spirometry was performed at the time of enrollment. Asthma control was assessed (a) by the physician based on the Global Initiative for Asthma guidelines, (b) by the patients, and (c) by using the Asthma Control Test (ACT). Statistical analyses were done to analyze the relationships between (i) FeNO and (ii) measures of asthma control and clinical indices for asthma manifestations. RESULTS: There was no significant difference in FeNO levels between the three groups according to levels of asthma control (controlled, partly controlled and uncontrolled) as determined by the physician (p=0.81), or by the patients (p=0.81). In addition, FeNO values were not significantly correlated with the ACT scores (r=0.031, p=0.807), while FeNO showed a correlation with peripheral blood eosinophil counts (p<0.001). CONCLUSION: These findings demonstrate that FeNO levels are not associated with measures of asthma control in patients treated with ICS. Information on airway inflammation from FeNO concentrations seems to be unrelated to levels of asthma control.

Laparoscopic Excision of a Congenital Seminal Vesicle Cyst and Coexisting Ipsilateral Renal Agenesis / 대한남성과학회지

Seminal vesicle cyst (SVC) with ipsilateral renal agenesis is a rare congenital anomaly. When the patient is symptomatic, surgical treatment may be necessary. The open surgical approach, traditionally considered the definite form of treatment, has been associated with a high rate of morbidity. The laparoscopic approach for the management of SVCs has recently been described. A 18-year-old man presented with a 2-year history of dysuria and perineal pain. The diagnostic evaluation revealed a 45x35x48 mm sized left seminal vesicle cyst. In addition, he had a solitary, right, functioning kidney, with left renal agenesis. Transperitoneal laparoscopic excision of the cyst was performed successfully. The patient was discharged from the hospital on the fourth postoperative day and did not present with any complaints or complications.

Arterial Injury Associated with Tension-Free Vaginal Tapes-SECUR Procedure Successfully Treated by Radiological Embolization / 대한배뇨장애요실금학회지

Various postoperative complications have been reported after the use of tension-free vaginal tapes (TVT). The transobturator approach was introduced to minimize the potential complications. The next generation of recently introduced TVT-SECUR is intended to minimize the incidence of complications. Herein we report a case of internal pudendal artery injury sustained during this procedure that was successfully treated by radiological embolization. Angiography with vessel embolization, when available, should be considered when the arterial injury is suspected.

Diagnosing Acute Pyelonephritis with CT, (99m)Tc-DMSA SPECT, and Doppler Ultrasound: A Comparative Study

PURPOSE: With growing interest in early imaging, the aim of our study was to define the most practical modality for routine clinical use for the diagnosis of acute pyelonephritis (APN). We compared the sensitivity of enhanced computerized tomography (CT), dimercaptosuccinic acid (DMSA) scintigraphy, and Doppler ultrasonography (DUS) by using clinical findings as the standard of reference. MATERIALS AND METHODS: A total of 207 APN patients (191 women, 16 men; mean age, 49.4 years; range, 17-88 years) were enrolled in this study. All the patients underwent imaging modalities during hospitalization. SPECT images were obtained 4 hours after injection of (99m)Tc-DMSA. Transverse and coronary CT images were obtained before and after injection of the contrast agent. DUS was performed in the longitudinal, transverse, and coronal planes. All the images were read independently by a single radiologist and a nuclear medicine specialist. The sensitivity of each modality for detecting APN was compared. RESULTS: CT showed significantly superior sensitivity compared with that of DUS (81.0% vs. 33.3%, respectively, n=147). DMSA scintigraphy also showed significantly superior sensitivity compared with that of DUS (74.7% vs. 33.3%, respectively, n=150). Compared with DMSA scintigraphy, CT showed superior sensitivity, but the difference was not statistically significant (81.0% vs. 74.8%, respectively, n=147, p=0.163). CONCLUSIONS: For cases of clinically suspected APN, CT and DMSA scintigraphy appear to be equally sensitive and reliable for detecting APN, although CT is more practical in various fields. DUS was significantly less sensitive.

Antimicrobial Effect of Lactobacillus in a Rat Model of Escherichia coli Urinary Tract Infection: A Preliminary Study

PURPOSE: Urinary tract infection (UTI) is one of the most common infectious diseases. There are reports that loss or destruction of normal urinary flora such as Lactobacillus increases UTI, and in more recent reports, human urinary epithelial cells have been found to competitively block uropathogen conjugation. We investigated the blocking effect of the Lactobacillus rhamnosus in a rat model of UTI caused by Escherichia coli. MATERIALS AND METHODS: Thirty-two adult female Sprague-Dawley rats weighing 250 to 350 g (Samtako BioKorea, Osan, South Korea) were randomly divided into 4 groups (Group I, control group; Group II, Lactobacillus group; Group III, E. coli group; Group IV, E. coli and Lactobacillus group). After 3 weeks, the urine and bladder were cultured for microbiological study and the bladder was examined histopathologically. RESULTS: Microbiological culture of urine demonstrated no significant differences in the four groups, but there were significantly fewer bacteria in group IV than in group III (p<0.05). The bacterial growth of the bladder tissue showed the same result. Histological exam of the bladder of group IV showed decreased infiltration of leukocytes and less submucosal edema than in group III. CONCLUSIONS: We were able to confirm the blocking effect of L. rhamnosus on E. coli growth. More studies are needed to further identify the therapeutic effect of Lactobacillus and to determine the optimal lactobacilli species, dose, and method of administration.

Preventive Effect on Inflammation and Anti-Inflammatory and Anti-Microbial Effects of Garlic Extract in a Rat Model of Chronic Bacterial Prostatitis

PURPOSE: Garlic has anti-microbial and anti-inflammatory effects. We investigated its actions and preventive effects on chronic bacterial prostatitis (CBP) using a rat model. MATERIALS AND METHODS: Bacterial suspension was inserted into the prostatic urethra of 75 rats. Then 15 were grouped as garlic group, and 60 as control group. Garlic and saline were given to each group for 4 weeks, respectively. After partial resection of the prostate, microbiological culture and histological examination were done. The incidence of CBP was compared between two groups. To evaluate the anti-microbial and anti-inflammatory effect of garlic, the 41 rats proved as CBP models among the control group were divided into 4 groups randomly: I, control; II, garlic; III, ciprofloxacin; IV, garlic plus ciprofloxacin. After 3 weeks of treatment, microbiological cultures of urine, prostate and histological examination of prostate were done. RESULTS: In study of the preventive effects, 5 rats in garlic treatment group and 41 rats in control group were shown to be CBP models. In anti-microbial and anti-inflammatory evaluation, positive urine culture rate and prostate tissue show no significant difference among four groups, but bacterial growth in urine and prostate tissue were lower in groups II, III, and IV than group I. Bacterial growth was the slowest in prostate tissue of group IV. Histologic findings were more improved in groups II, III and IV than group I, with Group IV being the most improved. CONCLUSIONS: These results show that garlic has preventive and therapeutic effects on CBP. Combination treatment with antibiotics may be considered in the future.

Urethral Diverticulum with Endometriosis / 대한비뇨기과학회지

The differential diagnosis for women presenting with chronic genitourinary symptoms is extensive. Urethral diverticulum has long been thought to be responsible for these symptoms in some women. Although the etiology of urethral diverticulum in women is unclear, a number of different theories have been advanced for the formation of diverticula including either a congenital or acquired etiology. A few cases of acquired urethral diverticulum have been reported that resulted from endometriosis; however, there have been no such cases reported in Korea. We recently treated a 58-year-old woman who presented with complaints of a protruding mass through the vaginal wall. A diagnosis of urethral diverticulum secondary to endometriosis was finally made. The patient underwent surgical repair. Here we report this case and review the medical literature.

Cavernous Hemangioma in the Renal Pelvis / 대한비뇨기과학회지

Hemangioma in the urinary tract is a very rare benign tumor that usually causes painless or painful gross hematuria. Its preoperative diagnosis is extremely difficult or even impossible. A female 47-year old patient presented with painless gross hematuria that she'd experience for 4 days. The patient underwent abdominal ultrasound, intravenous pyelography (IVP), cystoscopy, urine cytology, retrograde pyelography (RGP), kidney dynamic computed tomography (CT) and surgical excision. She was finally diagnosed with cavernous hemangioma in the renal pelvis.

Cavernous Hemangioma in the Renal Pelvis / 대한비뇨기과학회지

Hemangioma in the urinary tract is a very rare benign tumor that usually causes painless or painful gross hematuria. Its preoperative diagnosis is extremely difficult or even impossible. A female 47-year old patient presented with painless gross hematuria that she'd experience for 4 days. The patient underwent abdominal ultrasound, intravenous pyelography (IVP), cystoscopy, urine cytology, retrograde pyelography (RGP), kidney dynamic computed tomography (CT) and surgical excision. She was finally diagnosed with cavernous hemangioma in the renal pelvis.

Effect of Teenage Physical Activity on Areal Bone Mineral Density in Healthy Premenopausal Women of Korea

BACKGROUND: There have been many studies on osteoporosis, which is one of the most important cause of fracture in adults. However, whether moderate physical activity during youth confers lasting benefits for bone is unclear. Thus, we are here concerned with the relation of teenage physical activity and bone mineral density in Korean premenopausal women. METHODS: From March to June 2007, 75 clients who visited a general hospital for medical check-up were enrolled in this study. The subjects reported physical activity for four age periods (12~18, 19~34, 35~49, current) using self reporting questionnaire. And they completed two 3-day food records, had measurements of height and weight, and aBMD assessed using dual-energy X-ray absorptiometry at the lumbar spine (L2-4) and femoral neck. RESULTS: There was a significant relation of teenage physical activity (especially weight bearing physical activity) and aBMD in both sites (lumbar spine r=0.42, P<0.01; femoral neck r=0.33, P<0.01). But the activity during other age periods was not associated with the current aBMD at both sites. CONCLUSION: Our results suggest that moderate physical activity during the teen years appears to have lasting benefits for lumbar spine and femoral neck aBMD in Korean premenopausal women.

Melatonin and Cranberry Attenuate Infection-induced Apoptotic Renal Damage in a Vesicoureteral Reflux Rabbit Model / 대한비뇨기과학회지

PURPOSE: We evaluated the protective effects of melatonin and cranberry on infection-induced renal damage in a rabbit model of vesicoureteral reflux(VUR). MATERIALS AND METHODS: Thirty-six New Zealand male rabbits were divided into the following 5 groups: 1) control, 2) VUR, 3) E. coli, 4) cranberry, and 5) melatonin. After creating unilateral VUR, infection was induced by intravesical instillation of an E. coli suspension. Cranberry powder was supplied with the feed. Melatonin was injected into the peritoneal cavity. Three weeks after surgery, the rabbits were sacrificed, and the kidneys were extirpated and examined histopathologically to evaluate inflammation, fibrosis, and tubular changes. Apoptosis in the renal tissue was assessed with a terminal deoxynucleotidyl transferase(TdT)-mediated deoxyuridine triphosphate(dUTP) in situ nick-end labeling(TUNEL) study. RESULTS: Grossly, the refluxing kidney was larger than the contralateral normal kidney, and the refluxing ureter was dilated and tortuous. Microscopic examination of the kidneys from the E. coli group showed an apparent periglomerular mononuclear cell infiltration, tubular dilatation and atrophy, and interstitial fibrosis. The kidneys from the reflux, cranberry, and melatonin groups showed mild mononuclear cell infiltration without interstitial fibrosis. The mean number of apoptotic cells in the kidneys of the E. coli group was significantly higher than that in the control, cranberry, and melatonin groups(p<0.05), but there was no significant difference between the cranberry and the melatonin groups. CONCLUSIONS: This study demonstrates that the balance of apoptotic activity may play a key role in the development of reflux nephropathy. Melatonin and cranberry may prevent infection-induced renal damage by attenuating apoptosis.

Analysis of Lower Urinary Tract Symptoms Associated with Prostate Findings in Occupational Taxi Drivers and Office Workers in Uijeongbu, Korea

PUROPOSE: To analyze lower urinary tract symptoms associated with prostate findings in occupational taxi drivers compared to office workers in Uijeongbu, Korea. MATERIAL AND METHODS: A population-based cross-sectional survey was conducted among drivers and office workers in Uijeongbu, Korea. All participants filled out the International Prostate Symptom Score (IPSS) questionnaire and the age, career, height and body weight were also recorded. They had uroflowmetry (UFM), transrectal ultrasound (TRUS) and prostatic cancer screening testing (PSA). We evaluated the parameters and compared them between the two groups. RESULTS: There was no significant difference in age, career and BMI between the two groups (p<0.01). For each group, the IPSS was closely related to the maximal flow rate (Qmax) (p<0.01). The mean value of the IPSS was 13.53+/-7.70 in the taxi drivers and 9.71+/-5.72 in office workers; therefore, the IPSSs showed a difference between the two groups (p=0.041). However, there were no significant differences among the other parameters between two groups. The value of Qmax was not significantly different in the comparisons between the two groups (p=0.973). CONCLUSIONS: Although the IPSS in taxi drivers was higher than in office workers, the objective parameters studied were not significantly different between the two groups. Therefore, there was no clinical evidence of higher morbidity associated with prostate abnormalities in taxi drivers compared to office workers.

Protective Effects of Cranberry on Infection-induced Oxidative Renal Damage in a Vesicoureteral Reflux Rabbit Model / 대한비뇨기과학회지

PURPOSE: We evaluated the protective effects of cranberry, which is known as a fruit with anti-oxidative effects, on infection-induced oxidative renal damage with using a rabbit vesico-ureteral reflux (VUR) model. MATERIALS AND METHODS: New Zealand male rabbits were divided into 5 groups (the control group, VUR group, E. coli group, cranberry group and melatonin group). VUR was created and confirmed at 2 weeks after the operation. Infection was induced by intravesical instillation of an E. coli suspension. Cranberry powder was supplied with the feed. Melatonin was injected into the peritoneal cavity. The rabbit kidneys were obtained 3 weeks after the operation. Histopathologic examination was performed to evaluate for inflammation, fibrosis and the tubular change. The oxidative renal damage was evaluated by measuring malondialdehyde (MDA) in the renal tissue. RESULTS: Grossly, the refluxing kidney was larger than the contralateral normal kidney and the refluxing ureter was dilated and tortuous. The microscopic observation of the kidneys from the E. coli group showed apparent periglomerular mononuclear cell infiltration, tubular dilatation and atrophy, and interstitial fibrosis. The kidneys from the reflux group, cranberry group and melatonin group showed mild mononuclear cell infiltration without interstitial fibrosis. The MDA level in the kidneys of the E. coli group was significantly higher than that in the control, cranberry and melatonin groups (p<0.05). The MDA level in the cranberry and melatonin groups didn't significantly differ from that in the sterile group. CONCLUSIONS: This study demonstrates that cranberry has an anti-inflammatory effect due to an anti-oxidative function and it may prevent infection-induced oxidative renal damage. But application of cranberry in children with VUR needs more clinical studies.

Synergistic Effect between Ginsenoside or Urovaxom(R) with Ciprofloxacin on Chronic Bacterial Prostatitis Rat Model / 대한비뇨기과학회지

PURPOSE: Chronic bacterial prostatitis(CBP) is one of the most common urological diseases in adult males, for which antibiotic therapy is the gold standard treatment. However, long-term therapy has many side effects and results in antibiotic resistance. For these reasons, a new treatment modality, which can replace the traditional antibiotic therapy, is required. Ginsenoside has various confirmed bacterial clearance effects in the respiratory system and on immune modulation. Urovaxom(R) also has confirmed effects on immune modulation, with a preventive effect on recurrent urinary tract infection(UTI). Therefore, the anti-bacterial and synergistic effects of ginsenoside and Urovaxom(R) were evaluated for the treatment of CBP in an animal model. MATERIALS AND METHODS: The 60 rats demonstrating CBP were randomly divided into 6 groups; the control, ciprofloxacin, ginsenoside, Urovaxom(R), ciprofloxacin with ginsenoside, and ciprofloxacin with Urovaxom(R) groups. All drug treatments were conducted for 2 weeks. After treatment, the results were analysed microbiologically and histopathologically. RESULTS: The microbiological cultures of the prostate and urine samples and the histological findings of the prostate demonstrated reduced bacterial growth and improved inflammatory responses in all the experimental groups compared with the control group. The ciprofloxacin, and Urovaxom(R) with ciprofloxacin groups showed statistically significant decreases in bacterial growth and improvements in inflammatory responses compared to the control group(p0.05), but the mean difference was very large. CONCLUSIONS: Ginsenoside and Urovaxom(R) may be effective materials in CBP treatment, and has synergistic effects as a combination treatment. Therefore, the combination therapy of ginsenoside with ciprofloxacin or Urovaxom(R) with ciprofloxacin will be effective treatments of CBP.

Congenital Prepubic Sinus: A Variant of Urethral Duplication / 대한비뇨기과학회지

Congenital prepubic sinus(CPS) is an extremely rare congenital anomaly of the external genitalia of uncertain etiology. Herein, a case of CPS, where immunohistochemical staining was performed to elucidate the etiology of the sinus, is reported. The results of the immunohistochemical study demonstrated the lining epithelium was transitional proximally and squamous distally. These findings suggest that CPS is a variant form of dorsal urethral duplication.

A case of a solid pseudopapillary tumor in a male child / 대한내과학회지

A solid pseudopapillary tumor is usually located on the pancreatic tail or body, mainly in young females. It is benign in nature and is rarely associated with local invasion, lymph node involvement or distant metastasis. A solid pseudopapillary tumor in children is extremely rare and there are only 40 reports worldwide with no domestic cases reported at all. An abdominal CT and endoscopic ultrasonography revealed a pancreatic head mass in a 12-year-old male child. An exploratory laparotomy was performed for accurate diagnosis and treatment. The tumor was pathologically diagnosed as a solid pseudopapillary tumor. We present here a case of a solid pseudopapillary tumor that was diagnosed in a 12-year-old male child, with a review of the literature.

The meaning of warning symptoms in the patients with dyspepsia / 대한내과학회지

BACKGROUND: We tried to assess whether the presence of warning symptoms and age could be useful indicators for performing endoscopy in patients who suffer from various organic gastrointestinal diseases. METHODS: Between May 2005 to August 2005, 827 subjects who visited the health care center were studied via questionnaires and performing upper endoscopy. The questionnaires evaluated the presence and pattern of dyspepsia and the warning symptoms. RESULTS: A total of 808 patients were enrolled. The mean age of patients was 44.6+/-8.9 years (mean+/-SD) with a male to female ratio of 1.2:1. 153 patients (18.9%) were diagnosed with confirmed organic diseases and 52 patients (6.4%) were diagnosed with definite organic diseases. The total number of organic diseases and definite organic diseases (gastroduodenal ulcer, reflux esophagitis and advanced gastric cancer) was statistically higher in the male population (p=0.001 in both). The relative risk of dyspepsia, the presence of warning symptoms and each warning symptom for the organic disease and definite organic diseases were not consistently higher for the males or females. The males over fifty years and the males over sixty years age had a relative risk of 2.046 (95% CI: 1.27~3.30) and 3.105 (95% CI: 1.39~6.95) for organic disease and 1.913 (95% CI: 0.97~3.77) and 5.333 (95% CI: 2.15~13.22) for definite organic disease, respectively. For the male patients over fifty or sixty years old with dyspepsia or warning symptoms, there were tendencies to increase the relative risk of definite organic disease rather than organic disease. CONCLUSIONS: The relative risk of organic diseases in the presence of warning symptoms in males of over fifty years or sixty years age was not sufficiently significant for differentiating organic diseases. Thus, warning symptoms, old age and presence of dyspepsia alone can not be used as a predictor to guide endoscopic examination.