No abstract available.
Denture, Partial, Fixed*

BACKGROUND: Total intravenous anesthesia with propofol can cause respiratory depression and apnea especially during induction of anesthesia. To study the possibility of reversal of respiratory depression during anesthesia with propofol, pretreated with nabuphine or not, the respiratory effects of doxapram to spontaneously ventilating patients were investigated. METHODS: Patients were divided into 4 groups - saline-propofol-saline group (SPS), saline-propofol- doxapram group (SPD), nalbuphine-propofol-saline group (NPS), and nalbuphine-propofol-doxapram group (NPD). After saline or nalbuphine pretreatment, anesthesia was induced with propofol and then doxapram or saline was intravenously injected. Apneic time interval, blood pressure, heart rate, respiratory rate, minute ventilation, end tidal CO2 partial pressure and oxygen saturation were measured in every minutes during induction of anesthesia. Percent changes of each values were compared. RESULTS: There is no differences in apneic time intervals in each groups. The percent change of first minute ventilation in SPD group after doxapram injection unchanged significantly compared with those depressions of SPS, NPS and NPD group (p<0.05). Respiratory rates increased in SPD and SPS groups after laryngeal mask insertion. There is no differences in minute ventilation, respiratory rate and end-tidal CO2 concentration between nalbuphine pretreated groups regardless of doxapram injection. CONCLUSIONS: Doxapram has effect in increasing minute ventilation after propofol induction within first few minutes, but it cannot reverse respiratory depression during propofol induction pretreated with nalbuphine.
Anesthesia ; Anesthesia, Intravenous* ; Apnea ; Blood Pressure ; Depression ; Doxapram* ; Heart Rate ; Humans ; Laryngeal Masks ; Nalbuphine* ; Oxygen ; Partial Pressure ; Propofol* ; Respiratory Insufficiency ; Respiratory Rate ; Ventilation

No abstract available.

PURPOSE: This study was a meta-analysis designed to identify effects of Cognitive Behavioral Therapy (CBT) interventions in alleviating main symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among school-aged children in Korea. METHODS: Examination of several databases including Research Information Sharing Service, Korean Studies Information Service System, Data Base Periodical Information Academic and hand-searched article references, resulted in identification of 1,298 studies done between 2000 and 2013 of which 21 met the inclusion criteria. Comprehensive Meta-Analysis version 2.0 was used to analyze effect sizes, explore possible causes of heterogeneity, and check publication bias with a funnel plot and its trim-and-fill analysis. RESULTS: Overall effect size of CBT intervention was large (g=1.08) along with each outcome of self-control (g=1.26), lack of attention (g=1.02), social skills (g=0.92), and hyperactivity (g=0.92). For heterogeneity, moderator analysis was performed, but no significant differences were found between the RCT (Randomized Controlled Trials) group and the NRCT (Non RCT) group. Also, meta-regression was performed using sample size, number of sessions, and length of session as predictors, but no statistically significant moderators were found. Finally, a funnel plot along with trim-and-fill analysis was produced to check for publication bias, but no significant bias was detected. CONCLUSION: Based on these findings, there is clear evidence that CBT intervention has significant positive effects on the main symptoms of school-aged children suffering ADHD. Further research is needed to target diverse age groups with ADHD along with more RCT studies to improve the effectiveness of the CBT intervention.
Attention ; Attention Deficit Disorder with Hyperactivity/*therapy ; Child ; *Cognitive Therapy ; Databases, Factual ; Humans ; Psychomotor Agitation ; Republic of Korea ; Self-Control/psychology ; Social Skills

Authors have experienced a case of long standing chronic gonorrheal orbital cellulitis in a 50 years old Korean male. Surgical evacuation of pus discharges and microscopcially confirmed the gram negative intncellular and extracellular gonococcus. A brief review of the related literatures is present.
Humans ; Male ; Middle Aged ; Neisseria gonorrhoeae ; Orbit* ; Orbital Cellulitis* ; Suppuration

Indirect composite resin are used as an popular effective esthetic material in prosthetic dentistry, often with metallic substructure that provides support for restorations. Recently, new indirect composite resins as a substitute of ceramic have been developed. These resins provide good esthetics, with a wide range of hue and chroma. And the flexural strength of those is in the range of 120-150MPa, which is higher than that of feldspathic ceramic, and similar tot hat of Dicor. Although it has many merits, one of the major clinical problems of composite resins is the bond failure between metal and resin due to insufficient interfacial bond strength. The purpose of this study was to evaluate shear bond strength of the reinforced indirect composite resin to dental alloys. Three different composite resin systems(Artglass . Sculpture , Targis ) as test groups and ceramic(VMK 68 ) as control group were bonded to Ni-Cr-Be alloy(Rexillium III ) and gold alloy(Dave 4). All specimens were stored at 37degrees C distilled water for 24 hours and the half of specimens were thermocycled 2000 times at temperature from 5degrees C to 60degrees C. The shear bond strengths of reinforced indirect composite resins to dental alloys were measured by using the universal testing machine, and modes of debonding were observed by stereoscope and scanning electron microscope. The results were as follows : 1. The shear bond strengths of reinforced indirect composit resins to dental alloys were approximately half those of ceramic to dental alloys(P<0.01). 2. There was no significant difference between the shear bond strength of several reinforced indirect composite resins to metal. 3. Alloy type did not affect on the shear bond strengths of resin to metal, but the shear bond strengths of ceramic to gold alloys were higher than those of ceramic to Ni-Cr alloys(P<0.05). 4. The shear bond strenghts of Artglass and Targis to gold alloys were significantly decreased after thermocycling treatment(P<0.01). 5. Sculpture showed cohesive, adhesive, and mixed failure modes, but Artglass and Targis showed adhesive or mixed failures. And ceramic showed cohesive and mixed failures.
Adhesives ; Alloys ; Ceramics ; Composite Resins* ; Dental Alloys* ; Dentistry ; Esthetics ; Gold Alloys ; Sculpture ; Water

Patient noncompliance with the physician's prescribed therapeutic regimen is a serious problem in glaucoma because of the possibility of blindness. In this report the compliance with medical treatment of 67 patients with chronic glaucoma was studied for 2 years and 45% of the patient was identified as noncomplier. The authors' observations relative to noncompliance were lack of the knowledge of disease and its prognosis, little concern about disease, side effects of medication, improper timing and increased number of medication dosage, long-term use of medication, improperties of the physician-patient interaction, and other serious medical disorder, etc. The noncompliance does not correlate with the patient's age, sex, education, marital status, previous surgery for glaucoma,concerh of family, and increased waiting time to see the doctor.
Blindness ; Compliance* ; Education ; Glaucoma* ; Humans ; Marital Status ; Patient Compliance ; Prognosis

No abstract available.
Gaucher Disease*

PURPOSE: We evaluated the outcomes of a tubularized incised plate (TIP) urethroplasty on reoperative hypospadias repairs. MATERIALS AND METHODS: A total of 17 reoperative hypospadias repairs were performed. We retrospectively reviewed the medical records of all patients, which included the level of meatus, technique of repair, age at surgery and complications. The mean patient age and number of prior repairs were 6.3 years and 1.6 times, respectively. Before the reoperation the level of meatus was the anterior type in 2, the middle type in 7 and the posterior type in 8 patients. RESULTS: The follow-up periods ranged from 1 to 35 months (average 18.5 months). The success rates, according to the type of hypospadias, were 2/2 (100%) in the anterior type, 4/7 (57.1%) in the middle type and 6/8 (75%) in the posterior type (70.6% overall success rate). The patients had undergone TIP repairs (5), Denis-Brown-Crawford flaps (2), Thiersch-Duplay tubes (2), Mathieu repairs (1), onlay island flaps (1), transverse prepubital island flaps (TPIF) (1), a TPIF and Mathieu repair (1) and Flip-flaps (1), with an unknown (3) as the primary procedures. An urethrocutaneous fistula occurred in 3 patients, and 1 each of meatal stenosis and a glans repair breakdown also occurred (29.4% overall complication rate). Fistula repairs were successfully performed 7, 9 and 10 months later in the 3 patients. The patient with meatal stenosis was treated with simple dilatation. CONCLUSIONS: This preliminary experience provides further proof of the versatility of TIP urethroplasty, showing its potential use following a reoperative hypospadias repair.
Constriction, Pathologic ; Dilatation ; Female ; Fistula ; Follow-Up Studies ; Humans ; Hypospadias* ; Inlays ; Male ; Medical Records ; Reoperation* ; Retrospective Studies ; Surgical Flaps

BACKGROUND: Critical care physician staffing is a crucial element of the intensive care unit (ICU) organization, and is associated with better outcomes in ICUs. Adult ICUs in Korea have been suffering from inadequate full-time intensivists and nurses because of insufficient reimbursement rates (<50% of the original critical care cost) from the National Health Insurance System. Recently, full-time intensivists have been introduced as a prerequisite for adult ICUs of tertiary hospitals in Korea. The purpose of this study was to examine the perception of intensivist staffing among critical care program directors regarding the barriers and solutions when implementing an intensivist model of critical care in Korea. METHODS: An email survey of critical care program directors in designated teaching hospitals for critical care subspecialty training by the Korean Society of Critical Care Medicine was performed. The survey domains included vision, culture, resources, barriers, and potential solutions to implementing intensivist physician staffing (IPS). RESULTS: Forty-two critical care program directors were surveyed. A total of 28 directors (66.7%) responded to email queries. Of these, 27 directors (96.4%) agreed that IPS would improve the quality of care in the ICU, although half of them reported a negative perception of relevant clinical colleagues for the role of full-time intensivists and poor resources for IPS in their hospitals. Increased financial burden due to hiring full-time intensivists and concerns regarding exclusion from the management of their critically ill patients in the ICU, together with loss of income for primary attending physicians were stated by the respondents to be major barriers to implementing IPS. Financial incentives for the required cost from the health insurance system and enhancement of medical law relevant to critical care were regarded as solutions to these issues. CONCLUSIONS: Critical care program directors believe that intensivist-led critical care can improve the outcome of ICUs. They indicated the financial burden due to IPS and underestimation of a full-time intensivist's role to be major barriers. The program directors agreed that a partnership between hospital leaders and the Ministry of Health and Welfare was needed to overcome these barriers.
Adult* ; Critical Care ; Critical Illness ; Electronic Mail ; Hospitals, Teaching ; Humans ; Insurance, Health ; Intensive Care Units ; Jurisprudence ; Korea ; Motivation ; National Health Programs ; Personnel Staffing and Scheduling ; Surveys and Questionnaires ; Tertiary Care Centers