If the bond strength is sufficient to resist orthodontic force, orthodontic brackets can be bonded to restorations. Orthodontic brackets were bonded to composite resin and glass ionomer cement restorations wtih no-mix adhesive or glass ionomer cement. The shear bond strength of adhesives bonded to restorations was studied in vitro. Orthodontic brackets were bonded to 10 extracted natural teeth, 40 composite resin restorations and 40 glass ionomer restorations. The surfaces of composite resin restorations were roughened or applied with bonding agent (Scothbond) after surface roughening. The surfaces of glass ionomer cement restorations were conditioned with acid etching or applied with Scotchbond to etched surface. The adhesive was no-mix resin or glass ionomer cement. The shear bond strength was measured. The results were as follows: 1. Orthodontic brackets could be bonded to composite resin restorations effectively as they could be bonded to acid etched enamel with no-mix adhesive. The shear bond strength was sufficient to resist orthodontic force and was not affected by bonding agent greatly. 2. The shear bond strength of no-mix adhesive bonded to acid etched glass ionomer cement restorations was sufficient to resist orthodontic force. However, the fracture risk of glass ionomer cement restorations was increased during debonding. The bonding agent couldn't increase the shear bond strength greatly. 3. The shear bond strength of glass ionomer cement bonded to glass ionomer cement restorations was lower than that of no-mix adhesive. The shear bond strength was sufficient to resist orthodontic force and was greatly decreased by bonding agent. 4. The shear bond strength of glass ionomer cement bonded to composite resin restorations was too low to resist orthodontic force.
Adhesives* ; Dental Enamel ; Glass Ionomer Cements* ; Glass* ; Orthodontic Brackets ; Tooth

Pulmonary edema is a recognized complication of acute airway obstruction, laryngospasm, especially after endotracheal extubation. It usually follows relief of the obstruction and is likely to be of noncardiogenic origin. The mechanism by which an upper airway obstruction causes pulmonary edema is likely due to the combination of the increased reduction of intrapulmonary pressure, increased capillary permeability and hypoxia. We present a case of pulmonary edema that occurred in an adult patient after upper airway obstruction following extubation of the trachea.
Adult ; Airway Extubation* ; Airway Obstruction* ; Anoxia ; Capillary Permeability ; Edema ; Humans ; Laryngismus ; Lung ; Pulmonary Edema* ; Trachea

BACKGROUND: Tracheal extubation, as well as intubation, causes hypertension and tachycardia. The aim of this study was to compare the effect of verapamil, lidocaine to lidocaine-verapamil combination in attenuating the cardiovascular changes following tracheal extubation and emergence from anesthesia. METHODS: Eighty patients (ASA physical status 1) were randomly assigned to one of four groups (n=20 each) ; saline (control), 1 mg/kg lidocaine, 0.05 mg/kg verapamil and lidocaine-verapamil combination. These medication were given intravenously 2 min before tracheal extubation. Changes in blood pressure and heart rate were measured following tracheal extubation. RESULTS: Lidocaine, verapamil and their combination all attenuated the changes of heart rate and blood pressure. The inhibitory effect on changes of heart rate and blood pressure were miximum in group of the combination of lidocaine and verapamil. CONCLUSION: We conclude that the verapamil 0.05 mg/kg and lidocaine 1 mg/kg given iv concomitantly 2 min before tracheal extubation is a more effective prophylaxis than verapamil or lidocaine for attenuating the cardiovascular changes associated with tracheal extubation.
Airway Extubation* ; Anesthesia ; Blood Pressure* ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Intubation ; Lidocaine* ; Tachycardia ; Verapamil*

BACKGROUND: Gastroesophageal reflux disease (GERD) is considered to be less common in the Orient compared to the West, but epidemiological data on GERD in Korea are rare. The aim of this study was to determine the prevalence of symptoms of gastroesophageal reflux in routine check-up subjects. METHODS: We analyzed 2243 subjects (male 716, female 1527; age range 20-69 yr) visited health promotion center for routine check-up. Subjects were given a validated self-reported questionnaire, which measured the presence, duration and severity of typical symptoms (heartburn, acid regurgitation); and the presence of atypical symptoms. At least weekly symptoms of heartburn and/or acid regurgitation were characterized as the definition of GERD. RESULTS: The prevalence of heartburn for at least monthly, at least weekly and at least daily episodes was 6.2%, 3.4% and 3.1%, respectively. The corresponding figures for acid regurgitation were 6.1%, 2.1% and 0.7%. The prevalence of GERD was 8.5%, and was more common in female (p< 0.01). Sixty eight percent of subjects with GERD reported the symptoms as having been present for less than 5 years. Seventy four percent of subjects with GERD reported these symptoms to be mild to moderate in severity. Heartburn and acid regurgitation were significantly associated with dyspepsia, chest pain, dysphagia and globus sensation (p< 0.01), but not with hoarseness or chronic cough. CONCLUSION: The prevalence of heartburn and/or acid regurgitation experienced at least weekly is 8.5% in routine check-up subjects. Heartburn and acid regurgitation were associated with epigastric pain, chest pain, dysphagia and globus sensation.
Chest Pain ; Cough ; Deglutition Disorders ; Dyspepsia ; Epidemiology ; Female ; Gastroesophageal Reflux* ; Health Promotion ; Heartburn ; Hoarseness ; Humans ; Korea ; Prevalence* ; Sensation ; Surveys and Questionnaires

BACKGROUND: Adipokines are associated with various metabolic disorders including insulin resistance, obesity and dyslipidemia. Metabolic disorders have also been reported to be associated with nonalcoholic fatty liver disease (NAFLD). We aimed to estimate changes in serum adipokines levels according to the degrees of steatosis and to determine independent factors influencing serum adipokines levels in Korean male patients with NAFLD. METHODS: 65 Korean male patients were subjected. The degrees of steatosis were stratified into the three groups, Group I: normal liver (27 subjects), Group II: mild fatty liver (24 subjects) and Group III: moderate to severe fatty liver (14 subjects), according to ultrasonographic liver findings. The anthropometric parameters, fasting serum adipokine levels including leptin, adiponectin and resistin were measured in all subjects. The level of insulin resistance was estimated using the HOMA-IR. RESULTS: Serum leptin levels were significantly different among the three groups (mean+/-SD: Group I (2.052+/-1.071), Group II (2.879+/-1.016), Group III (4.457+/-1.965 ng/mL), p<0.001). Serum adiponectin and resistin levels were not significantly different among the three groups (p=0.184, p=0.649, respectively). BMI and HOMA-IR were independent factors of changes in serum leptin levels (p=0.026, p=0.001, respectively), but independent factors of changes in serum adiponectin and resistin levels were not observed. CONCLUSIONS: Our study support a indirect role to induce metabolic disorder for leptin in the pathogenesis of NAFLD, but do not support roles for adiponectin and resistin in the pathogenesis of NAFLD. BMI and HOMA-IR were only independent factors of changes in serum leptin levels.
Adipokines* ; Adiponectin ; Dyslipidemias ; Fasting ; Fatty Liver* ; Humans ; Insulin Resistance ; Leptin ; Liver ; Male* ; Obesity ; Resistin

BACKGROUND: Liver cirrhosis may be considered one of the most common cause of acquired immunodeficiency. Alcohol abuse may be predisposing factor to infections in patients with liver cirrhosis, so we compared the rate of spontaneous bacterial peritonitis (SBP) and other bacterial infections in alcoholic and viral liver cirrhosis. METHODS: We studied 188 patients who had been diagnosed with liver cirrhosis from January 1995 to June 2000 and evaluated the frequency of bacterial infections (SBP, pneumonia, urinary track infection, bacteremia, infectious colitis) retrospectively according to cause and degree of cirrhosis. RESULTS: Among 188 patients (alcoholic 76, viral 112), 64 patients (34%) presented with bacterial infection at hospitalization, 33 (43%;33/76) of 64 subjects were alcoholic and 31 (28%;31/112) of 64 subjects were viral liver cirrhosis. The rate of bacterial infections was higher in alcoholic liver cirrhosis than viral cirrhosis (p<0.05). The rate of SBP and other bacterial infections were more frequent in patients of Child-Pugh class C than in those of Child-Pugh class A and B (p<0.01, p<0.05) respectively. Patients of alcoholic liver cirrhosis were more susceptible to bacterial infection than those of viral liver cirrhosis with Child-Pugh class A/B (p<0.05), but no difference was noted in patients of Child-Pugh class C (p>0.05). CONCLUSION: This results suggest that the rate of bacterial infections are more common in alcoholic than viral liver cirrhosis in relatively early stage and it may be influence the prognosis of liver cirrhosis.
Alcoholics* ; Alcoholism ; Bacteremia ; Bacterial Infections* ; Causality ; Fibrosis* ; Hospitalization ; Humans ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic ; Peritonitis ; Pneumonia ; Prognosis ; Retrospective Studies

Achalasia can be provoked by organic causes, and it is called secondary achalasia. Sometimes it is very difficult to distingush secondary achalasia from primary achalasia. We report a case of secondary achalasia due to recurrence of stomach cancer. A 45-year-old man came to our hospital due to three months history of dysphagia and regurgitation. Barium esophagogram showed concentric narrowing at the distal esophagus and dilatation of proximal esophagus. The esophagogastroduodenoscopy showed stenosis of gastroesophageal junction and the endoscope could not pass through it, but there was no evidence of malignancy. Esophageal manometry showed aperistalsis, compatible with achalasia. Abdominal CT showed soft tissue density near the gastroesophageal junction. However it was not possible to differentiate whether it was due to adhesion or malignancy. For correct diagnosis and treatment, explorolaparotomy was performed and it was diagnosed as secondary achalasia due to recurrence of stomach cancer.
Barium ; Constriction, Pathologic ; Deglutition Disorders ; Diagnosis ; Dilatation ; Endoscopes ; Endoscopy, Digestive System ; Esophageal Achalasia* ; Esophagogastric Junction ; Esophagus ; Humans ; Manometry ; Middle Aged ; Recurrence* ; Stomach Neoplasms* ; Stomach* ; Tomography, X-Ray Computed

BACKGROUND: Recently, ghrelin has been reported to be associated with insulin resistance. Nonalcoholic fatty liver disease (NAFLD) is a condition in which insulin resistance relatively plays a pivotal role. The aim of this study was to evaluate the change of serum ghrelin concentration according to severity of hepatosteatosis. METHODS: Sixty five apparently normal male adults who underwent health screen examinations were classified into three groups, Group I: normal (27 subjects), Group II: mild (24 subjects) and Group III: moderate to severe fatty liver (14 subjects), according to ultrasonographic findings of liver. We analyzed the association between serum ghrelin concentration and severity of hepatosteatosis by ANOVA test. And the independent correlation between serum ghrelin concentration and insulin resistance related factors, HOMA (homeostatic model assessment), BMI (body mass index), WC (waist circumference), HC (hip circumference), WHR (waist to hip circumference ratio) were analyzed by multiple linear regression analysis. RESULTS: Serum ghrelin concentration tended to decrease according to severity of hepatosteatosis (Group I: 230.9+/-94.3, Group II: 195.2+/-97.2, Group III: 164.3+/-71.4 pmol/L). But this was statistically insignificant (p=0.081). The independent correlation between serum ghrelin concentration and insulin resistance related factors were not observed. CONCLUSIONS: Our study did not prove the correlation between insulin resistance related factors and serum ghrelin concentration in NAFLD according to severity of hepatosteatosis. However, we found a tendency to decrease serum ghrelin concentration according to severity of hepatosteatosis. So, further studies are required for certification these correlations.
Adult ; Certification ; Fatty Liver ; Ghrelin* ; Hip ; Humans ; Insulin Resistance ; Linear Models ; Liver ; Male

While endovascular aneurysm repair (EVAR) is prevailing for the treatment of abdominal aortic aneurysm (AAA) in modern vascular practice, PURPOSE: we conducted nationwide questionnaire survey to investigate the current status of AAA treatment and their results in Korea. METHOD: We reviewed the replies from 28 hospitals (33 departments) to the questionnaire inquiring annual number, clinical features, mode of treatment and results of AAA patients during the period from Jan. 2000 to Jul. 2004. Results: 980 AAA patients were reported including 292 ruptured AAA (29.8%) and 688 non-ruptured AAA (70.2%). For treatment of AAA, 834 (85.1%) surgical repairs (SRs) and 111 (11.3%) endovascualr aneurysm repairs (EVARs) were performed while 35 patients (3.6%) died of AAA rupture before operation. The locations of AAA were infrarenal in 889 (90.7%), juxtarenal in 62 (6.3%), and suprarenal in 29 patients (3.0%). Among 834 patients undergoing SR, 577 patients (69.2%) had non-ruptured AAAs and 257 patients (30.8%) had ruptured AAAs. Mean operative mortality rate was 4.1% after elective SRs, 30.7% after SR for ruptured AAAs, and 2.3% after EVARs. The reported brand name of stent graft devices were various including domestic custom-made in 56 (50.5%), imported brand in 18 (16.2%) while 37 (33.3%) stent grafts were not reported their brand name. The frequencies of type I and III endoleaks after EVAR were reported 5.8% and 5.8% respectively in 86 patients with an available data. CONCLUSION: SR has been used as a major treatment option in Korea for the treatment of AAA patients while EVAR is increasing. The mortality rate of SR of AAA was comparable to western multi-center trial reports but mortality or morbidity rates of EVAR were unable to know in this questionnaire survey.
Aneurysm ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Endoleak ; Humans ; Korea* ; Mortality ; Questionnaires* ; Rupture ; Treatment Outcome