This article reviewed the literatures which demonstrated correlations between therapeutic relationship variables and treatment outcomes in children and adolescents, and also examined factors which affect a positive therapeutic relationship. Results from this review revealed that a positive therapeutic relationship is essential for cognitive-behavioral treatment (CBT) with children and adolescents, and also indicated that the therapeutic effect is the most powerful when a therapist maintains a collaborative relationship. Finally, basic strategies for maintaining a collaborative relationship have been suggested. These include strategies such as ; 1) setting a goal for therapy focusing on enhanced motivation for therapy ; 2) facilitating the engagement of parents in the treatment process ; 3) creating a collaborative atmosphere ; 4) educating the client about therapy ; 5) liciting feedback ; 6) making creative and innovate modifications of traditional CBT methods ; and, 7) providing choices for the client.
Adolescent ; Atmosphere ; Child ; Humans ; Motivation ; Parents

Recently the 2nd generation laboratory composite resins were introduced. Although the mechanical properties of these composite resins have been improved, there were some disadvantages such as discoloration, low abrasion resistance and debonding between metal and resin. The purpose of this study was to evaluate the tensile bond strength between non-pecious dental alloy(verabond) and four veneering reinforced composite resins: Targis(Ivoclar Co.,U.S.A.), Artglass(Kulzer CO., Gemany). Sculpture(Jeneric Pentron Co., U.S.A.), and Estenia(Kurary Co., Japan). All test metal specimens were polished with #1,000 SiC paper, and sandblasted with 250micrometer aluminum oxide. After then, according to manufacturer's instructions metal adhesive primer and veneering resins were applied. All test specimens were divided into two groups. One group was dried in a desiccator at 25degrees C for 3 days, the other group was subjected to thermal cycling(2,000x) in water(5/55degrees C). Tensile bond strength was measured using Instron Universal Testing machine and the fractured surface was examined under the naked eyes and scanning microscope. Within the limitations imposed in this study, the following conclusions can be drawn: 1. in no-thermal cycling groups, there were no significant differences between Estenia and VMK68 but there were significant differences between Targis, Artglass, Sculpture and VMK68(p<0.05). 2. in no-thermal cycling resin groups, the highest tensile bond strength was observed in Estenis and there were significant differences between Estenia and the other resins(p<0.05). 3. Before and after thermal cycling, there were significant differences in tensile bond strength of Targis and Artglass(p<0.05). The tensile bond strength of Artglass was decreased and that of Targis was increased. 4. in no-thermal cycling groups, Artglass showed mixed fracture modes(95%), but after thermal cycling, Artglass showed adhesive fracture modes(75%).
Adhesives ; Aluminum Oxide ; Composite Resins* ; Dental Alloys* ; Sculpture

No abstract available.
Drug Therapy*

Objective: Although the Clinical Dementia Rating (CDR) scale was originally developed to stage Alzheimer’s dementia (AD), it is now used globally for various types of dementia. The aim of this study was to investigate the characteristic pattern of CDR domains and its association with neuropsychological findings and activities of daily living (ADL) in patients with vascular dementia (VaD) and patients with AD. Methods: We recruited very mild to mild VaD and AD patients who were age-matched among the first visitors to a dementia clinic. All subjects underwent a standardized clinical interview, physical and neurological examinations, and laboratory tests, including brain magnetic resonance imaging, according to the protocol of the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease assessment battery. Results: A total of 105 pairs of VaD and AD patients participated in this study. Although the adjusted scores on Korean version of the Mini-Mental State Examination were similar between the two groups, the VaD patients performed better on the Boston Naming Test, Word List Memory, Word List Recall, Word List Recognition, and Constructional Recall Test. However, the scores on global CDR, CDR sum of boxes, and ADL-related CDR domains were higher in VaD patients than in AD patients (p<0.001). The VaD patients also showed poor performances on the Disability Assessment for Dementia Scale, Frontal Assessment Battery, Executive Clock Drawing Task, and Stroop tests. Conclusion Despite similar general cognitive function and better memory function, patients with VaD tend to be staged as severer dementia on the CDR scale than patients with AD because of more impaired ADL associated with executive dysfunction.

It is very useful to evaluate the content and 3D distribution of extracellular matrix non-destructively in tissue engineering. This study evaluated the feasibility of using micro-computed tomography (µCT) with Hexabrix to measure quantitatively sulfated glycosaminoglycans (GAGs) of engineered cartilage. Rabbit chondrocytes at passage 2 were used to produce artificial cartilages in polyglycolic acid scaffolds in vitro. Engineered cartilages were incubated with Hexabrix 320 for 20 min and analyzed via µCT scanning. The number of voxels in the 2D and 3D scanning images were counted to estimate the amount of sulfated GAGs. The optimal threshold value for quantification was determined by regression analysis. The 2D µCT images of an engineered cartilage showed positive correlation with the histological image of Safranin-O staining. Quantitative data obtained with the 3D µCT images of 14 engineered cartilages showed strong correlation with sulfated GAGs contents obtained by biochemical analysis (R² = 0.883, p < 0.001). Repeated exposure of engineered cartilages to Hexabrix 320 and µCT scanning did not significantly affect cell viability, total DNA content, or the total content of sulfated GAGs. We conclude that µCT imaging using Hexabrix 320 provides high spatial resolution and sensitivity to assess the content and 3D distribution of sulfated GAGs in engineered cartilages. It is expected to be a valuable tool to evaluate the quality of engineered cartilage for commercial development in the future.
Cartilage* ; Cell Survival ; Chondrocytes ; DNA ; Extracellular Matrix ; Glycosaminoglycans* ; In Vitro Techniques ; Ioxaglic Acid ; Polyglycolic Acid ; Tissue Engineering

The treatment modalities of the intramural hematoma (IMH) remain controversial. Nowadays, the IMH of the descending thoracic aorta is generally classified in the medical treatment category. We describe a patient with IMH of the descending thoracic aorta who received the medical treatment. During the follow-up, we speculated that the IMH had been aggravated leading to an aortic rupture including hemothorax. Therefore, we performed an emergency operation. Contrary to our expectations, operative findings showed a well-organized aortic wall and serous pleural effusion. The exact diagnosis was IMH of the descending thoracic aorta with penetrating atherosclerotic ulcer (PAU). This case reminded us of the importance of accurate diagnosis and proper treatment.
Aorta ; Aorta, Thoracic* ; Aortic Rupture* ; Diagnosis ; Emergencies ; Follow-Up Studies ; Hematoma* ; Hemothorax ; Humans ; Pleural Effusion ; Ulcer

A 15-year-old male was admitted with right-sided chest pain and cough for one month. On chest computed tomographic scan, a 10 x 15 x 16 cm-sized huge mediastinal mass was occupied in the right hemithorax. Radiologically, it seemed that the tumor was severely adhesive on the heart and the superior vena cava. Therefore we decided on chemotherapy and radiotherapy first instead of surgery. The tumor marker was nearly normalized afterwards, but the tumor size was seemed to be bigger on chest tomographic scan. This suggests the growing teratoma syndrome. After the successful resection, he showed symptomatic improvement and is being followed up without any symptoms in an out patient department up to now.
Adhesives ; Adolescent ; Chest Pain ; Cough ; Drug Therapy ; Heart ; Humans ; Male ; Mediastinal Neoplasms ; Radiotherapy ; Teratoma* ; Thorax ; Vena Cava, Superior

BACKGROUND: The video-assisted thoracic surgery (VATS) with 2 mm thoracoscopy in primary spontaneous pneumothorax (PSP) was known to be unreliable in its accuracy and recurrence rate. We compared 10 mm VATS with 2 mm VATS in the results of operation. MATERIAL AND METHOD: From Sept. 1998 to Dec. 2002, 176 cases (10 mm VATS; 73 cases, 2 mm VATS; 103 cases) of PSP were treated by VATS bleb resection at Korea University Ansan Hospital. 10 mm thoracoscope, 5 mm port, and 5 mm instruments were used in 10 mm VATS group, and 2 mm thoracoscope, 2 mm ports and 2 mm instruments used in 2 mm VATS group. In the two groups, staples were inserted through 11.5 mm port for chest tube. RESULT: The mean follow-up duration was 20.8+/-16.1 months in 10 mm VATS group, and 13.9+/-8.2 months in 2 mm VATS. The most common indication of operation was a recurrent pneumothorax (34%) in 10 mm VATS and patient's desire (40%) in 2 mm VATS, respectively. The operation time, number of staples used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. Other significant variables affecting the operation time in linear regression analysis were the number of staples that used in operation, the presence of pleural adhesion, and type of pleurodesis and thoracoscope used in operation. However, R2 values were lower than 0.1. The postoperative recurrence rate was 2.7% in 10 mm VATS and 2.9% in 2 mm VATS. It was not significant statistically. Recurrent cases developed within 1 year in both groups but the difference was statistically insignificant. CONCLUSION: Although there were differences in follow-up duration between two groups, the operation time, number of staples that used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. And in 2 mm VATS, there were no technical difficulties during operation and no differences in recurrence rate from 10 mm VATS. As a result, we suggest that 2 mm VATS can be used in the treatment of PSP.
Blister ; Chest Tubes ; Drainage ; Follow-Up Studies ; Gyeonggi-do ; Hospitalization ; Korea ; Linear Models ; Pleurodesis ; Pneumothorax* ; Recurrence ; Thoracic Surgery, Video-Assisted* ; Thoracoscopes ; Thoracoscopy*

Focal subarachnoid hemorrhage occasionally presents as transient focal neurologic episodes mimicking transient ischemic attack (TIA). Unless properly diagnosed, it may aggravate cerebral hemorrhage by administering antithrombotic agents. Therefore, clinicians need to be aware that such focal subarachnoid hemorrhage sometimes cannot be detected on noncontrast computed tomography and blood-sensitive magnetic resonance imaging can detect even a small amount of hemorrhage. We describe an 85-year-old woman with focal subarachnoid hemorrhage and possible cerebral amyloid angiopathy who presented transient left arm weakness recurrently, which mimicked TIA.
Aged, 80 and over ; Arm ; Cerebral Amyloid Angiopathy ; Cerebral Hemorrhage ; Female ; Fibrinolytic Agents ; Hemorrhage ; Humans ; Ischemic Attack, Transient ; Magnetic Resonance Imaging ; Subarachnoid Hemorrhage