Competition will usually develop between the opposing walls as the restorative resin shrinks during polymerization. Magnitude of this phenomenon may be depended upon cavity configuration and volume. The purpose of this sturdy was to evaluate the effect of cavity configuration and volume on microleakage of composite resin restoration that has margins on the enamel site only. The labial enamel of forty bovine teeth was ground using a model trimmer to expose a flat enamel surface. Four groups with cylindrical cavities were defined, according to volume and configuration factor (Depth x Diameter / C-factor) - Group I: 1.5 mm x 2.0 mm / 4.0, Group II: 1.5 mm x 6.0 mm / 2.0, Group III: 2.0 mm x 1.72 mm / 5.62, Group IV: 2.0 mm x 5.23 mm / 2.54. After treating with fifth-generation one-bottle adhesive - BC Plus(TM) (Vericom, AnYang, Korea), cavities were bulk filled with microhybrid composite resin - Denfill(TM) (Vericom). Teeth were stored in distilled water for one day at room temperature and were finished and polished with Sof-Lex system. Specimens were thermocycled 500 times between 5degrees C and 55degrees C for 30 second at each temperature. Teeth were isolated with two layers of nail varnish except the restoration surface and 1 mm surrounding margins. Electrical conductivity (microA) was recorded in distilled water by electrochemical method. Microleakage scores were compared and analyzed using two-way ANOVA at 95% level. The results were as follows: 1. Small cavity volume showed lower microleakage score than large one, however, there was no statistically significant difference. 2. There was no relationship between cavity configuration and microleakage. Factors of cavity configuration and volume did not affect on microleakage of resin restorations with enamel margins only.
Adhesives ; Dental Enamel* ; Electric Conductivity ; Gyeonggi-do ; Paint ; Polymerization ; Polymers ; Tooth ; Water

A new hypolipidemic agent, lovastatin, hydroxy-methyl-gultaryl coenzyme A reductase inhibitor was administred to 25 patients with primary hyperlipidemia 20 to 40 mg daily for 12 weeks and sequential changes of serum lipid profile were analysed as follow. 1) Mean average at baseline period of serum total cholesterol, triglyceride, HDL and low desity lipoprotein cholesterol were 271, 179, 51 and 185 mg/dl respectively. 2) Total cholesterol showed 20% decrease at 4th week and 23% decrease at the end of 12th week while low density lipoprotein cholesterol decreased 31% and 33% respectively. 3) Triglyceride dropped 7% at 8th week and 3% at 12th week. High density lipoprotein cholesterol increased 4% at 4th week and showed 2% decrease at the end of study. 4) Only one patient complained of moderate abdominal pain, which subsided after 2 weeks drug withdrawal. In conclusion, lovastatin was well tolerated and effective, in the treatment of primary hyperlipidemia.
Abdominal Pain ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Coenzyme A ; Humans ; Hyperlipidemias* ; Lipoproteins ; Lovastatin ; Oxidoreductases ; Triglycerides

A 35-year-old multigravida woman received triple marker screening tests in 16weeks 2days of gestation. MSAFP and MShCG values were increased, whereas MSuE3 value was decreased. So we performed amniocentesis for karyotyping and confirmed male fetus with 47,XYY,inv(9)(p11:q13). A neonatal survey showed the incidence of XYY male to be approximately 1:1000, the majority of cases are phenotypically normal. XYY males are taller than normal and show delayed mental development. A pericenteric inversion of chromosome 9 that extends from p11 to q13 is considered a normal chromosome variant, but the carrier is at high risk to produce abnormal offspring. As she did not want to terminate her pregnancy, she delivered vaginally in 39weeks 6days of gestation. As a result of physical examination, the neonate showed a normal phenotype. We report it with brief review.
Adult ; Amniocentesis ; Chromosomes, Human, Pair 9 ; Female ; Fetus* ; Humans ; Incidence ; Infant, Newborn ; Karyotyping ; Male ; Mass Screening ; Phenotype ; Physical Examination ; Pregnancy

Cystic lymphangioma of the broad ligament is very rare benign cystic lesion. They rarely present in adult life. We present the case of a 37-year-old female with a history of chronic recurrent left lower abdominal dull pain over a period of several months. Clinical presentation of these tumors varies greatly from an asymptomatic mass to serious complications. The therapy of choice is a complete excision, unless vital structures were involved. Once excised, the prognosis is excellent. Our patient had complete excision of her lesion with a good outcome.
Adult ; Broad Ligament* ; Female ; Humans ; Lymphangioma, Cystic* ; Prognosis

Bacterial endocarditis has been well recognized as an important complication of congenital heart disease, such as ventricular septal defect, patent ductus arteriosus or pulmonary stenosis. The incidence of right sided bacterial endocarditis is lesser than left sided bacterial endocarditis. Also, pulmonic valve vegetation has been thought to be relatively uncommon. So in a patient with fever and evidence of recurrent pulmonary infarction, changing heart murmurs and scattered pneumonic infiltrates, one should direct attention to the heart as a possible source of the infection. Echocardiography with M-mode, 2-D and Doppler mode represents the only noninvasive technic available for detecting vegetations in bacterial endocarditis. In fact, the technic is more sensitive in identifying these lesions than angiography. We experienced a case of ventricular septal defect with bacterial endocarditis, pulmonic valve vegetation and multiple pulmonary embolism diagnosed with Echocardiogram and lung scan, and confirmed by operation. Patch repair of ventricular septal defect, resection of pulmonic valve and vegetation and artificial valve formation with pericardium were done.
Angiography ; Ductus Arteriosus, Patent ; Echocardiography ; Endocarditis, Bacterial* ; Fever ; Heart ; Heart Defects, Congenital ; Heart Murmurs ; Heart Septal Defects, Ventricular* ; Humans ; Incidence ; Lung ; Pericardium ; Pulmonary Embolism ; Pulmonary Infarction ; Pulmonary Valve Stenosis

Blunt trauma to the chest may result in various cardiac injuries. But traumatic myocardial infarction with coronary artery fistula as a complication of chest trauma has been reported in very few cases. The etiology of myocardial infarction is not entirely clear. A 40 years old male was admitted after a traffic accident. He complained of acute retrosternal pain of about one hours duration. There was an area of contusion over the right sternal border. The ECQ showed deep Q wave and elevated ST segments in leads 2, 3 and aVF. There was a considerable increase in creatine kinase(CK) peak level and a CK-MB fraction. Coronary angiography revealed a total proximal occlusion of the right coronary that communicated directly with the right atrium. The left ventridulogram showed hypokinesia of the inferior wall. He was managed with conservative treatments and has remained well sebsequently. We reported a middle aged man who developed an acute transmural inferior wall myocardial infarction associated with coronary artery fistula secondary to blunt cheat trauma in an automobile accident.
Accidents, Traffic ; Adult ; Automobiles ; Contusions ; Coronary Angiography ; Coronary Vessels* ; Creatine ; Fistula* ; Heart Atria ; Humans ; Hypokinesia ; Inferior Wall Myocardial Infarction* ; Male ; Middle Aged ; Myocardial Infarction ; Thorax*

BACKGROUND AND PURPOSE: The present study was designed to investigate whether 24 h of SD negatively affects the attention and working memory and increases the serum concentrations of stress hormones, glucose, and inflammatory markers. METHODS: The acute effects of sleep deprivation (SD) on cognition and the stress hormones were evaluated in six healthy volunteers (all men, age 23-27 years). All were good sleepers, had no history of medical or neuropsychiatric diseases, and were not taking any kind of medication. All of the volunteers were subjected to the Continuous Performance Test (CPT) for attention and working memory of cognition and blood tests both before and after 24 h of SD. Electroencephalographic monitoring was performed during the study to confirm the wakefulness of the subjects. RESULTS: SD significantly elevated the serum concentrations of stress hormones (cortisol, epinephrine, and norepinephrine), but serum levels of glucose and inflammatory markers were not changed compared to baseline. For easier steps of the CPT the subjects performed well in giving correct responses after SD; the correct response scores decreased only at the most difficult step of the CPT. However, the subjects performed consistently poor for the error responses at all steps after SD. There was no correlation between the CPT scores and stress hormone levels. CONCLUSIONS: The 24 h of SD significantly heightened the levels of stress hormones and lowered attention and working memory. The acute SD condition seems to render the subject more susceptible to making errors.
Cognition ; Epinephrine ; Glucose ; Hematologic Tests ; Humans ; Male ; Memory, Short-Term ; Sleep Deprivation ; Wakefulness

Syndrome of inappropriate antidiutetic hormone(SIADH) secretion is the most common cause of hyponatremia in clinical medicine. Before diagnosis of the SIADH is made, other causes for a decreased diluting capacity and nonosmotic stimuli for AVP release need to be rule out. Disorders associated with SIADH can be divided into 4 major etiologic groups: malignancies, pulmonary diseases, central nervous disorders, and drugs. A 45-year-old woman was admitted due to maculopapular skin eruption and fever after taking medications for fever and myalgia. Generalized tonic clonic seizure was developed nine days later, and laboratory results showed marked hyponatremia. During the evaluation, treatment, and subsequent follow-up, the diagnosis of SIADH was confirmed, but the definitive cause was obscure. With fluid restriction, sodium replacement and demeclocycline therapy, she recovered completely 6 months later. We suggest that the SIADH might be related to drug-induced generalized maculopapular rash via menmgitis-like reaction in CSF as one of systemic adverse side effects to drugs rather than direct effect of related drugs.
Clinical Medicine ; Demeclocycline ; Diagnosis ; Exanthema* ; Female ; Fever ; Follow-Up Studies ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome* ; Lung Diseases ; Middle Aged ; Myalgia ; Seizures ; Skin ; Sodium

BACKGROUND AND PURPOSE: There is growing interest in high-frequency oscillations (HFO) as electrophysiological biomarkers of the epileptic brain. We evaluated the clinical utility of interictal HFO events, especially their occurrence rates, by comparing the spatial distribution with a clinically determined epileptogenic zone by using subdural macroelectrodes. METHODS: We obtained intracranial electroencephalogram data with a high temporal resolution (2000 Hz sampling rate, 0.05-500 Hz band-pass filter) from seven patients with medically refractory epilepsy. Three epochs of 5-minute, artifact-free data were selected randomly from the interictal period. HFO candidates were first detected by an automated algorithm and subsequently screened to discard false detections. Validated events were further categorized as fast ripple (FR) and ripple (R) according to their spectral profiles. The occurrence rate of HFOs was calculated for each electrode contact. An HFO events distribution map (EDM) was constructed for each patient to allow visualization of the spatial distribution of their HFO events. RESULTS: The subdural macroelectrodes were capable of detecting both R and FR events from the epileptic neocortex. The occurrence rate of HFO events, both FR and R, was significantly higher in the seizure onset zone (SOZ) than in other brain regions. Patient-specific HFO EDMs can facilitate the identification of the location of HFO-generating tissue, and comparison with findings from ictal recordings can provide additional useful information regarding the epileptogenic zone. CONCLUSIONS: The distribution of interictal HFOs was reasonably consistent with the SOZ. The detection of HFO events and construction of spatial distribution maps appears to be useful for the presurgical mapping of the epileptogenic zone.
Biomarkers ; Brain ; Electrodes ; Electroencephalography ; Epilepsies, Partial ; Epilepsy ; Humans ; Neocortex ; Seizures

BACKGROUND: Some patients with obstructive sleep apnea (OSA) remain sleepy despite adequate use of nasal positive airway pressure (PAP). To investigate the clinical and polysomnographic factors related to residual daytime sleepiness in OSA patients with adequate PAP-treatment for more than 3 months. METHODS: We enrolled consecutively 101 patients, who were diagnosed with moderate to severe OSA by overnight polysomnography. All of them complained of daytime sleepiness and started using nasal Auto-PAP (APAP). Patients who had used APAP adequately (> or =70% of nocturnal sleep time, > or =5 days a week) for more than 3 months were divided into a group with residual excessive sleepiness (RES; Epworth sleepiness scale, ESS > or =10) and a group without RES (Non-RES) (ESS<10). Clinical and polysomnographic variables were compared between two groups. RESULTS: Fifty-six patients (55.4%, 56/101) who had used APAP adequately (mean 9.6 months) were enrolled finally. Twenty (35.7%) had RES (mean ESS: 15.2 decreased to 12.4 after PAP therapy) while 36 had no RES (mean ESS: 13.1-->6.0). Hypertension was more frequent in RES patients. Furthermore, RES patients were sleepier than Non-RES ones before APAP treatment started. Other clinical, demographic, polysomnography findings and compliance of APAP were not different between two. On multivariate logistic analysis regression, baseline ESS (odd ratio [OR] 1.34 [1.07-1.67]), history of hyperlipidemia (OR 5.04 [1.14-22.33]) were significantly associated with RES. CONCLUSIONS: Our findings showed that 35.7% of OSA patients remained sleepy after an adequate PAP therapy. Predictors of RES were a history of hyperlipidemia and a higher baseline ESS.
Acetaminophen ; Compliance ; Continuous Positive Airway Pressure ; Humans ; Hyperlipidemias ; Hypertension ; Polysomnography ; Prevalence ; Sleep Apnea, Obstructive