Hyperreactio luteinalis is a rare disease characterized by marked cystic enlargement of the ovary due to multiple benign theca lutein cyst. The cause of this disease is not well known but is believed to be induced by high serum levels of human chorionic gonadotropins (hCG). It occurs usually in gestational trophoblastic disease, multiple pregnancies, and rarely in normal pregnancy. In nature, hyperreactio luteinalis is a benign condition. Therefore, the appropriate management is conservative, but surgical intervention is definitely indicated to remove infarcted tissue, control hemorrhage, or decrease androgen production in virilized patients. Here we report a case of hyperreactio luteinalis which was diagnosed at 11 weeks gestation. Lower abdominal pain was developed and progressed. Emergent right wedge oophorectomy and left salpingoophorectomy was performed due to probable torsion of left ovarian cyst and the pregnancy maintained. Theca lutein cysts were confirmed on pathologic examination.
Abdominal Pain ; Chorionic Gonadotropin ; Female ; Gestational Trophoblastic Disease ; Hemorrhage ; Humans ; Lutein ; Ovarian Cysts ; Ovariectomy ; Ovary ; Pregnancy* ; Pregnancy, Multiple ; Rare Diseases

This study evaluated the marginal microleakage of five single step adhesives. Class V cavity preparations with occlusal margins in enamel and gingival margins in dentin were prepared on both buccal and lingual surfaces of extracted human molar teeth. Prepared teeth were randomly divided into five groups and restored using one of the single step adhesives and composite resins: Prompt L-Pop/Filtek Z-250 (Group 1), AQ Bond/Metafil CX (Group 2), One-Up Bond F/Palfique Toughwell (Group 3), Futurabond/Admira (Group 4), Xeno III/Spectrum TPH (Group 5). The restored teeth were thermocycled. Microleakage was assessed by dye penetration using 2% methylene blue dye solution. The teeth were bisected buccolingually and evaluated for microleakage under steromicroscope. The data were statistically analysed by Kruskal-Wallis test and Mann-Whitney tests. The results of this study were as follows; 1. Microleakage of enamel margins in group 3 was statistically higher than that in groups 1, 2, 4, 5 (p < 0.05). 2. Microleakage of dentin margins in group 1 was statistically higher than that in groups 2, 5, and that in group 3 was statistically higher than that in groups 2, 4, 5 (p < 0.05). 3. Dentin marginal microleakage was higher than enamel marginal microleakage in all experimental groups. In conclusion, Prompt L-Pop showed the least leakage at enamel margin, and AQ Bond showed at dentin margin in this study. Marginal miroleakage in dentin was higher than that in enamel.
Adhesives* ; Composite Resins ; Dental Enamel ; Dentin ; Humans ; Methylene Blue ; Molar ; Tooth

This study investigated that the effect of rewetting agent on dentinal microtensile bond strength (microTBS). Human molars were sectioned to expose the superficial dentin surfaces. Samples were divided into two groups according to type of adhesives-Single Bond (S) and One-Step (O)], and again subdivided into five groups by different dentin surface treatment-dry for 15s (D), blot dry (BD) or dry for 15s, and rewet with different rewetting agents [distilled water (DW), Gluma Desensitizer (GD) and Aqua-Prep (AP)] for 30s. After application of adhesive, composite resin was built up on the bonding surface. Each tooth was sectioned to obtain stick with 1 mm2 cross sectional area and the microTBS was determined by EZ test. In the S group, the mean microTBS of GD, AP and BD group was significantly higher than that of DW and D group (p < 0.05). In the O group, the mean microTBS of AP, GD, BD and DW group was significantly higher than that of D group (p < 0.05). The data suggested that Gluma Desensitizer and Aqua-Prep could be successfully used as rewetting agents, and Distilled water could be acceptable in aceton based adhesive system only.
Adhesives ; Dentin* ; Humans ; Molar ; Tooth ; Water

This study evaluated the influence of application time of self-etching primers on microtensile bond strength (microTBS) to dentin using three self-etching primer adhesive systems. Dentin surfaces were exposed from forty-eight human molars. They were conditioned with three self-etching primers (Clearfil SE Bond [SE], Unifil Bond [UF], Tyrian SPE + One Step Plus [TY]) and different primining times (10s, 20s, 30s and 40s). Composite resins were bonded to dentin surfaces and specimens were made. microTBS was tested and statistically compared using by one-way ANOVA and Tukey's Test The results of this study presented that priming time for 10s in SE and UF groups and for 30s and 40s in TY group was highly decreased microTBS to dentin.
Adhesives ; Composite Resins ; Dentin* ; Humans ; Molar

The purpose of this study was to evaluate the effect of immediate or delayed composite resin filling on dentinal microtensile bond strength (microTBS) after applied the adhesive. The coronal dentin of human third molars was exposed. Single-Bond or One-Step was applied on the dentin surfaces, and composite resin were constructed immediately (group 1) or 5 min., 10 min., 15 min., 20 min. and 30 min. (groups 2-6) after an adhesive was applied. The specimens were sectioned and made bar-shaped. Each surface area of them was about 1mm2. The microTBS test was performed by EZ test. The results were analysed by One-way ANOVA and Tukey's test at 95% significance level. The results suggested that the microTBS of Single-Bond to dentin was decreased when the composite resin was constructed 20 min. and 30 min. after Single-Bond was applied. But the microTBS of One-Step was not affected by delayed composite resin filling.
Adhesives ; Dentin ; Humans ; Molar, Third

This study evaluated the microleakage and interfacial gap between enamel and composite resin under the dry and wet condition of the enamel surface. V shaped class 5 cavities were prepared on the occlusal portion of extracted human molars. Samples were divided into three groups: D group (air dry for 10-15 s), BD group (blot dry with moist cotton pellet), and DR group (air dry for 10-15 s and rewet with Aqua-Prep F for 20 s). Cavities were filled using Aelitefil composite resin after applied One-Step. Microleakage was tested by 2% methylene blue dye solution and the data were statistically analysed by Kruskal-Wallis test and Mann-Whitney test. Also Enamel-resin interface was observed under SEM. Group BD showed statistically lower microleakage than group D (p < 0.05), but there was no statistically significant difference between group BD and DR (p > 0.05). At the enamel-resin interface, group D showed the gap of 2 microm thickness, but group BD and DR showed close adaptation. In conclusion, the use of blot dry and rewetting agent (Aqua-Prep F) resulted in decreased microleakage and improved adhesion between enamel and resin when using One-Step.
Dental Enamel* ; Humans ; Methylene Blue ; Molar

The purpose of this study was to compare the microhardness and the fluoride content of enamel and dentin around fluoride- or non fluoride-containing restorations. Forty extracted human teeth were used and prepared cervical cavities on proximal surface. Experimental teeth were divided into five groups. Group 1 : Prime & Bond NT and Z100, Group 2 : Prime & Bond NT and F2000, Group 3 : Scotchbond Multi-Purpose and Z100, Group 4 : Scothcbond Multi-purpose and F2000, Group 5 : Fuji II LC. The cavities were filled with dentin adhesives and restorative materials. After each tooth was bisected, one half was tested microhardness and the other half was analyzed the fluoride at the enamel and dentin by an EPMA-WDX device. The results were as follows: 1. There was no statistical difference among the microhardness of enamel surface in all group. 2. The microhardness at dentin of 100 microm point in Group 2 and 20 microm point in Group 4 was lower than that of normal dentin (p>0.05). 3. There was no statistical difference among the fluoride content of enamel surface in all group. 4. The fluoride content at the dentin of 30 microm point in Group 2 and 5 were higher than those at 100 microm and 200 microm point in Group 2 and normal dentin (p<0.05). 5. At the dentin of 30 microm point, Group 2 showed higher fluoride content than Group 1 and 3, and Group 5 showed higher fluoride content than other groups.
Adhesives ; Dental Enamel ; Dentin ; Fluorides* ; Humans ; Tooth*

Syndrome pattern (SP) is a core concept of Chinese medicine (CM) and is used to diagnose and treat patients based on an overall analysis of symptoms and signs. This study aimed to systematically review randomized controlled trials (RCTs) using the SP concept and to demonstrate how the SP concept could be applied to the study design of parallel RCTs, considering a gold standard of clinical research. After conducting a brief systematic review by way of a PubMed search, we analyzed how the SP concept was applied to the design of RCT in a CM herbal medicine trial. We then formulated possible research questions, applied the SP concept to answer the research questions, and suggested possible RCT designs to be used for conducting future trials. Fourteen RCTs were included in our systematic review, and three key points of the SP concept were formulated for the design of parallel RCTs: the time point of SP diagnosis between before and after randomization; the relationship between the international classification of diseases (ICD) and SP for the inclusion of target population; and the proper diagnostic method of SP. In this study, we formulated three possible research questions and then suggested perspectives for five possible RCT models arrived at using SP concepts. Future trials applying SP concept to RCTs should overcome the shortcomings of past SP trials, moving CM forward from experience-based to evidence-based medicine.
Humans ; Randomized Controlled Trials as Topic ; Research Design ; Syndrome ; Treatment Outcome

BACKGROUND: This study aimed to evaluate the usefulness of preoperative placement of intraaortic balloon pump(IABP) in reducing operative risk and facilitating posterior vessel OPCAB in high risk patients with left main disease(>75 % stenosis), intractable resting angina, postinfarction angina, or left ventricular dysfunction(ejection fraction<35 %). MATERIAL AND METHOD: One hundred eighty- nine consecutive patients who underwent multi-vessel OPCAB including posterior vessel revascularization were studied. The patients were divided into group I(n=74) that received preoperative or intraoperative IABP and group II(n=115) that did not receive IABP. In group I, there were 39 patients with left main disease, 40 patients with intractable resting angina, 14 patients with left ventricular dysfunction and 7 patients with postinfarction angina. Ten patients received intraoperative IABP support due to hemodynamic instability during OPCAB. RESULT: There was one operative mortality in group I and two mortalities in group II. The average number of distal anastomoses was not different between group I and group II(3.5+/-0.9 vs 3.4+/-0.9, p=ns). There were no significant differences in the number of posterior vessel anastomosis per patient between the two groups. There were no differences in ventilator support time, length of hospital stay, and morbidity between the two groups. There was one case of IABP-related complication in group I. CONCLUSION: IABP facilitates posterior vessel OPCAB in high risk patients, with comparable surgical results to low risk patients.
Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Hemodynamics ; Humans ; Length of Stay ; Mortality ; Transplants* ; Ventilators, Mechanical ; Ventricular Dysfunction, Left

BACKGROUND: Epidural anesthesia has been shown to a have direct sedative effect and to markedly reduce the amount of hypnotic agents required for sedation. A Bispectral Index (BIS) is a useful monitor of the level of sedation and loss of consciousness for several anesthetics including propofol. In this study, we investigated whether BIS monitoring could detect the sedative effect of epidural anesthesia during propofol induction. METHODS: Twenty patients scheduled for elective lower abdominal surgery were included. A Target controlled infusion (target effect concentration 5micro gram/ml, induction time 3 min) of propofol was administered to the patients with or without epidural anesthesia (2% lidocaine 15 ml) at the L2-3 level. The OAA/S scale and BIS were evaluated 20 min after epidural injection. Hypnotic requirements of propofol were determined using loss of eye opening in response to verbal command as an endpoint. At the time of induction of hypnosis, the target concentration, target effect concentration and BIS were recorded. RESULTS: Epidural lidocaine significantly decreased the hypnotic dose of propofol (1.0 +/- 0.2 micro gram/ml vs. 1.3 +/- 0.1 micro gram/ml; P = 0.0008), hypnotic calculated concentration (3.3 +/- 0.6 micro gram/ml vs. 4.1 +/- 0.3 micro gram/ml; P = 0.0007), and the hypnotic effect concentration (0.7 +/- 0.3micro gram/ml vs. 1.1 +/- 0.1 micro gram/ml; P = 0.0007). In the patients with epidural anesthesia, the OAA/S scale was decreased without a change of the BIS after epidural anesthesia and BIS recorded at the time of induction of hypnosis was much higher in patients with epidural anesthesia than in patients without epidural anesthesia (92.7 +/- 2.2 vs. 85.5 +/- 6.2; P = 0.0029) CONCLUSIONS: Epidural anesthesia induced a sedative effect without a change of the BIS and then induced the hypnosis with lesser dose of propofol. At the time of hypnosis, a higher BIS was noticed with epidural anestheia. These results concluded that BIS monitoring could not detect the sedative effect induced with epidural anesthesia.
Anesthesia, Epidural* ; Anesthetics ; Consciousness Monitors* ; Humans ; Hypnosis ; Hypnotics and Sedatives* ; Injections, Epidural ; Lidocaine ; Propofol ; Unconsciousness