In order to compare the accuracy of impression technique using the addition silicone putty and improved heavy body material, impression were taken for the natural 6 maxillary anterior teeth, and for the metal mast model that has full arch shape with 4 cylindrical abutment teeth, Marginal gingiva was retracted by routine method using retraction cord, and two techniques were tried to compare the length of impression materials in the gingival sulcus. This was aimed to see the effect of viscosity and hydraulic pressure of impression materials for the subgingival impression. Impressions for the full arch-shaped metal master model were taken to compare the linear stability of the different impression materials and their related techniques. The conclusions were as belows : 1. The one-step impression technique showed longer extension of impression material in gingival sulcus than two-step impression technique. 2. High viscosity and hydraulic pressure of impression material were useful to take subgingival impression. 3. There was no statistically significant difference for the two-dimensional accuracy of impression technique, but two-step technique showed better trend than one-step technique.
Gingiva ; Silicones ; Tooth ; Viscosity

The relationship between visual acuity, the level of visual field impairment, visual functioning, and the quality of life was evaluated in Korean patients with glaucoma. Forty-three consecutive glaucoma patients from the glaucoma service at Severance Eye and Ear Hospital were included in this study. Each subject underwent a vision-specific functional status questionnaire (VF-14), a modified VF-14 (VF'-14) and general quality-of-life questionnaires of the Medical Outcomes Study 36-Items Short Form Health Survey (SF-36). The visual acuity and visual field measurements with a Humphrey automated perimeter were taken within one month of the initial visit. The mean age of the subjects was 57.9 +/- 17.8. Among these patients, there were 23 males and 20 females. The mean deviation (MD) and the corrected pattern standard deviation (CPSD) by the automated perimeter in the eye with the better visual acuity were -5.87 +/- 5.16 dB and 3.92 +/- 2.74 dB respectively. The VF-14 and SF-36 scores were 41.28 +/- 14.56 and 52.39 +/- 6.61 respectively. There were significant correlations between the VF-14, VF'-14, and the MD of the better eye (p < 0.05). In Korean patients with glaucoma, the VF-14 and VF'-14 have significant relationship with the MD of the better eye in the visual field.
Female ; Glaucoma/physiopathology/*psychology ; Health Surveys ; Human ; Korea ; Male ; Middle Aged ; Quality of Life/*psychology ; Questionnaires ; Visual Acuity/*physiology ; Visual Fields

BACKGROUND: Hypothermia protects the brain by suppressing the cerebral metabolism and it is performed well enough before the total circulatory arrest(TCA) in the operation of aortic disease. Generally, TCA has been performed depending on the rectal or nasopharyngeal temperatures; however, there is no definite range of optimal temperature for TCA or an objective indicator determining the temperature for safe TCA. In this study, we tried to determine the optimal range of temperature for safe hypothermic circulatory arrest by using the intraoperative electroencephalogram(EEG), and studied the role of EEG as an indicator of optimal hypothermia. MATERIAL AND METHOD: Between March, 1999 and August 31, 2000, 27 patients underwent graft replacement of the part of thoracic aorta using hypothermia and TCA with intraoperative EEG. The rectal and nasopharyngeal temperatures were monitored continuously from the time of anesthetic induction and the EEG was recorded with a ten-channel portable electroencephalography from the time of anesthetic induction to electrocerebral silence(ECS). RESULT: On ECS, the rectal and nasopharyngeal temperatures were not consistent but variable(rectal 11degree C -25degree C, nasopharynx 7.7degree C -23degree C). The correlation between two temperatures was not significant(p=0.171). The cooling time from the start of cardiopulmonary bypass to ECS was also variable(25-127min), but correlated with the body surface area(p=0.027). CONCLUSION: We have found that ECS appeared at various body temperatures, and thus, the use of rectal or nasopharyngeal temperature were not useful in identifying ECS. Conclusively, we can not fully assure cerebral protection during hypothermic circulatory arrest in regards to the body temperatures, and therefore, the intraoperative EEG is one of the necessary methods for determining the range of optimal hypothermia for safe circulatory arrest.
Aorta, Thoracic ; Aortic Diseases ; Body Temperature ; Brain ; Cardiopulmonary Bypass ; Electroencephalography* ; Humans* ; Hypothermia ; Metabolism ; Nasopharynx ; Transplants

In deep sclerectomy, collagen implant has been used to maintain space under the scleral flap. However, the effect of other implants has not been studied. In this retrospective study, we compared surgical outcomes between small collagen and chromic catgut used as implants in deep sclerectomy. Deep sclerectomy was performed on 23 patients (25 eyes) who either had an open angle and a high intraocular pressure (IOP) (> 22 mmHg) in spite of receiving the maximal tolerable medical treatment, or who were intolerant to medications. Our study consisted of 14 patients (15 eyes) in the small collagen group and 8 (9 eyes) in the chromic catgut group. The mean follow-up period was 8.6 +/- 3.3 months in the small collagen group and 4.4 +/- 1.2 months in the chromic catgut group. The mean preoperative IOP was not significantly different between the two groups. The complete success rate of the small collagen group was significantly better than that of the chromic catgut group at the final follow-up when data were analyzed using the Kaplan-Meier survival curve (87% versus 30%; P = .01). As for the qualified success rate, the small collagen group showed significantly better results at the final follow-up (93% versus 80%; P = .046). The mean number of postoperative medications was significantly lower in the small collagen group (0.26 versus 1.10; P < .05). These results confirmed that the use of small collagen implant in deep sclerectomy produced a higher success rate and a lowered need for postoperative medication compared to the use of chromic catgut implant. Because equal sized implants were used, the difference in biochemical properties, particularly the severity of inflammation caused by the implant, is presumed to be the cause of the different surgical outcomes.
*Absorbable Implants ; Adolescent ; Adult ; Aged ; *Catgut ; *Collagen ; Comparative Study ; Female ; Glaucoma, Open-Angle/*surgery ; Human ; Male ; Middle Aged ; *Postoperative Complications ; Retrospective Studies ; Sclerostomy/*methods ; Treatment Outcome

PURPOSE: Flush high ligation of the saphenofemoral or saphenopopliteal junction combined with invaginated stripping of the greater saphenous vein to just below the knee or perforate invaginate stripping of the proximal lesser saphenous vein appears to be the method of choice for good clinical results and low incidence of damage to the saphenous or sural nerve, and is important in the prevention of recurrence. METHOD: From January 2001 to August 2001, we performed 84 operations for 72 patients with varicose veins. Among them, 77 flush high ligations (62 saphenofemoral and 15 saphenopopliteal) and 64 invaginated strippings (55 greater and 9 lesser saphenous veins) were performed. RESULT: Seventy seven flush high ligations were successfully performed in all patients, but 2 invaginated strippings were failed due to their large branches of greater saphenous veins. All of 9 proximal invaginated strippings for lesser saphenous veins were completely performed without any complications. As early postoperative complications related with invaginated strippings for greater saphenous veins, 24 (43.6%) cases of ecchymosis and 5 (9.1%) cases of paresthesia were occurred at thigh. One case of wound infection at popliteal fossa and 3 cases of wound inflammation at inguinal area were occurred. But those complications were recovered within 10 days. CONCLUSION: The results show that the invaginated stripping is very useful for patients with varicose veins, especially in stripping of lesser saphenous veins and the flush high ligation is safe for the treatment of junctional incompetence.
Ecchymosis ; Humans ; Incidence ; Inflammation ; Knee ; Ligation* ; Paresthesia ; Postoperative Complications ; Recurrence ; Saphenous Vein ; Sural Nerve ; Thigh ; Varicose Veins* ; Wound Infection ; Wounds and Injuries

PURPOSE: Though it has been well known that the autologous vein graft is conduit of choice for infragenicular leg artery bypass, it is still less clear for above-knee femoro-popliteal artery bypass. We attempted to evaluate the outcomes of reversed saphenous vein graft in comparison with polytetrafluoroethylene (PTFE) graft in above-knee femoro-popliteal bypasses for the patients with chronic arterial occlusive disease. METHOD: In a period of 7 years and 9 months, 108 above-knee femoro-popliteal bypasses were performed in 96 patients (91 male, 5 female, mean age 67.3 years). The indications for bypass operation were short distance claudication in 54 (50%), rest pain in 36 (33%), and toe, foot ulcer or gangrene in 18 (17%) limbs. As bypass conduit, autologous reversed saphenous vein was used in 67 limbs, and PTFE graft in 41 limbs. We compared early (<30 days) postoperative complications, primary patency rates of grafts, and late outcomes of the limbs with proven graft occlusion between 2 patients groups (vein graft group vs. PTFE graft group). Primary cumulative graft patency rate were determined by Kaplan Meier method and compared them with log-rank test. RESULT: Early postoperative complications were not significantly different between two groups. During the follow-up period, 20 (18.5%) grafts were lost to follow-up and 14 patients were dead. Primary cumulative patency rates at 1, 3, 5 years were 97.44 +/- 2.53%, 91.11 +/- 4.94%, and 75.92 +/- 14.46% for vein grafts and 81.76 +/- 7.49%, 36.15 +/- 13.42, and 36.15 +/- 13.42% for PTFE grafts respectively. CONCLUSION: In the patients underwent autologous vein graft for above-knee femoro-popliteal bypass, we experienced significantly better long-term patency, less serious surgical complication and less severe recurrent ischemic symptom after graft occlusion than in patients with PTFE graft.
Arterial Occlusive Diseases ; Arteries ; Extremities ; Female ; Follow-Up Studies ; Foot Ulcer ; Gangrene ; Humans ; Leg ; Lost to Follow-Up ; Male ; Polytetrafluoroethylene ; Postoperative Complications ; Saphenous Vein ; Toes ; Transplants* ; Veins*

PURPOSE: Femoro-infrapopliteal bypass is usually indicated for the patients with critical leg ischemia and when below- knee femoro-popliteal bypass is not available. Considering the technical difficulties and requirement of longer vein graft, inferior surgical outcomes are anticipated after femoro-infrapopliteal bypass compared to below-knee femoro-popliteal bypass. We attempted to compare the early and late outcomes between the patients who underwent below-knee femoro-popliteal and femoro-infrapopliteal bypasses. METHODS: Among 285 autologous reversed vein grafts implanted for the patients with chronic atherosclerotic leg arterial occlusion, the data base of 119 below-knee femoro-popliteal and 97 femoro-infrapopliteal bypasses (4 tibioperoneal trunk, 52 posterior tibial, 10 anterior tibial, 20 peroneal, and 11 inframalleolar arteries) were retrospectively reviewed to compare the patients characterisitics and surgical outcomes. To compare early postoperative outcome, operative mortality (<30 days), ankle-brachial pressure index, early graft failure, wound complication, and major limb amputation were compared and to compare late outcome, primary cumulative patency rates of vein grafts were compared between 2 groups. Cumulative patency rates were determined by Kaplan-Meier method and compared with log-rank test between 2 groups. RESULTS: Demographic features and frequencies of comorbidities including diabetes, coronary artery disease, chronic obstructive lung disease and cerebrovascular disease were not different between 2 groups except renal insufficiency which is more frequent in femoro-infrapopliteal bypass group. And femoro-infrapopliteal bypasses were more commonly indicated for the patients with ischemic tissue loss and as repeated bypass and requiring spliced vein graft more commonly. There revealed no significant differences in the frequencies of operative mortality (<30 days), early graft failure, wound complication, and major limb amputation and the amount of ABI increase between 2 groups. Primary cumulative patency rates at 1, 3, and 5 years were 88.1 +/-3.5%, 77.3+/-5.1%, and 64.5+/-7.4% after B-K femoro- popliteal bypasses and 87.9+/-4.1%, 72.5+/-6.3%, and 60.4+/-10.1% after femoro-infrapopliteal bypasses, respectively revealing no significant differences between 2 groups. CONCLUSION: In spite of anatomical and technical disadvantages associated with femoro-infrapopliteal bypasses, there revealed no significant difference in early and late outcomes between below-knee femoro-popliteal and femoro- infrapopliteal bypasses with autologous reversed vein graft.
Amputation ; Comorbidity ; Coronary Artery Disease ; Extremities ; Humans ; Ischemia ; Knee ; Leg ; Mortality ; Pulmonary Disease, Chronic Obstructive ; Renal Insufficiency ; Retrospective Studies ; Saphenous Vein* ; Transplants* ; Veins ; Wounds and Injuries

Nesidioblastosis in one of the causes of hyperinsulinemic hypoglysemia in infancy. The most important goal of treatment for persistent hypoglycemia is the prevention of permanent brain damage. The early surgical management is satisfactory to this goal in nesidioblastosis and maintains normal blood sugar level without administration of drugs or supplement of sugar postperatively in many cases. We experienced a female infant of 3 months old who has suffered from persistent hypoglysemia due to hyperinsulinism and was suspected nesidioblastosis for ' its cause clinically. She underwent 95% distal pancreatectomy. The histologic findings of nesidioblastosis was confirmed postoperatively. No postoperative complication was occured and her blood sugar levels were maintained within normal range without medical treatment.
Blood Glucose ; Brain ; Female ; Humans ; Hyperinsulinism ; Hypoglycemia ; Infant ; Nesidioblastosis ; Pancreatectomy ; Postoperative Complications ; Reference Values

OBJECTIVES: The aim of this study was to evaluate the surface color of indirect resin restoration according to the layering placement of different shade of incisal composite. MATERIALS AND METHODS: In this study, CIE L*a*b* value of 16 Body composite of Tescera ATL (Bisco, Schaumburg IL,USA) was measured by spectrophotometer (NF999, Nippon Denshuku, Japan), and compared to CIE L*a*b* value of Vitapan shade guide. Nine shade Incisal composite of Tescera ATL were build-up to 1 mm thickness on Body composites inlay block, and CIE L*a*b* value was measured. Incisal composite was ground to 0.5 mm thickness and CIE L*a*b* value was re-measured. Color difference between Body composite and Incisal composites layered on Body composite was calculated as a function of thickness. RESULTS: Color difference between corresponding shade of Tescera Body composite and Vitapan shade guide was from 6.88 to 12.80. L* and b*value was decreased as layering thickness of Incisal composite on Body composite was increased. But, a* value did not show specific change tendency. CONCLUSIONS: Surface color difference between Body composites and Incisal composites layered on Body composite was increased as the layering thickness of Incisal composite increased (p < 0.05).
Composite Resins ; Inlays

The protein encoded by the Bcl-2 proto-oncogene has been shown to prolong cell su-rvival by preventing cell death(Apoptosis) induced by many insults including cancer therap-eutic drugs. Recently many researches have elucidated the bcl-2 expression in several hu-man solid cancers. However, there is still a few avaiable data to determine the role of Bcl-2 expression in the ovarian carcinogenesis and its prognostic significance in ovarian can-cers. Hence, we examined the expression of Bcl-2 in 68 ovarian epithelial cancers using immunohistochemistry and determined whether Bcl-2 expression has prognostic significance in the ovarian epithelial cancers. We found Bcl-2 expression(>5% positive cell) in 31 patients(40%). Bcl-2 expression were exclusively negative in the mucinous type of the ovarian epithelial cancer. Bcl-2 exp- ression was not correlated with tumor stage(stage I & II vs III & IV, p=0.63). The patients with Bcl-2 positivity had lower recurrence rate than the patients with negativity at the se- cond look operation(p<0.01). Although there was a trend that the patients with Bcl-2 posi- tivity had better acturial survival than the patient with negativity, the stastical significance was not present(3 years acturial survival;+vs-;63%, 29%;p>0.05). These results sug- gest the Bcl-2 expression appears an early event in the ovarian carcinogenesis and has an inhibiting role in progression of ovarian tumor.
Carcinogenesis ; Humans ; Immunohistochemistry ; Mucins ; Ovarian Neoplasms* ; Proto-Oncogenes ; Recurrence