No abstract available.
Child* ; Humans ; Scrub Typhus*

Recently, alteration on chemical treatment on the root and removal of pathologic bacteria, which is the main reason for periodontal disease, by complete removal of infected cementum layer was been emphasied In this study, teeth extracted due to periodontal disease were root planed using periodontal curette and roto bur. Then they were treated with different concentration of Tetracycline HCl at different time. The state of root surface and change in the pre and post treatment was observed. The results were as follows. 1. The group treatment with periodontal curette and saline showed remaining plaque, debris and irregular surface and no dentianl tubule orifice could be seen. 2. The group treatment with periodontal curette and tetracycline HCl showed process compoed with decacified material and there was concanity seemed to be a lacunae of cementocyte. 3. The group treatment with roto bur and saline, there was no remaning plaque and partial dentinal tubule orifice could be seen but smear layer covering them. 4. The group treatment with roto bur and tetracycline HCl showed various shape and size dentinal tubule orifice could be seen. From the results, roto bur showed cleaner surfaces than treatment with periodontal curette. But still smear layer existed. Thus for regeneration of periodontal tissue, chemical treatment using tetracycline HCl should follow roto bur treatment. And it is considered that the treatment time is more important than the concentration of tetracycline HCl.
Bacteria ; Dental Cementum ; Dentin ; Periodontal Diseases ; Regeneration ; Root Planing* ; Smear Layer ; Tetracycline* ; Tooth

BACKGROUND: A thoracic epidural combined with general anesthesia may reduce the oxygen demand of the heart by cardiac sympathetic blockade, but it may also reduce the systemic and cardiac oxygen delivery due to hypoperfusion which is critical to patients with significant coronary lesions. This study was done to investigate the effects of thoracic epidural anesthesia on the systemic and cardiac oxygen supply/demand balance during coronary occlusion in dogs. METHODS: In 10 dogs, the left circumflex coronary artery was occluded, and then thoracic epidural anesthesia was given at the T5-6 or T6-7 level with 5 ml of 0.5% bupivacaine to block T1-T12 through the surgically introduced epidural catheter. Hemodynamic parameters and arterial, mixed venous and coronary sinus blood samples were obtained at baseline and 30 minutes after coronary occlusion. The same parameters were also measured at 30, 60, 90, 120 and 150 minutes after the epidural blockade. An epicardial 2D-echocardiogram was done by a cardiologist at baseline, 30 minutes after occlusion and 1 hour after the epidural blockade. RESULTS: Systemic oxygen delivery (O2 flux) was decreased after epidural anesthesia (p < 0.05), but oxygen consumption (VO2) was maintained throughout the experimental periods. Although the systemic oxygen extraction ratio (O2ER) was not changed, cardiac O2ER was increased at 90, 120 and 150 minutes after epidural anesthesia (p < 0.05). The end-diastolic noncontractile area of the left ventricle was increased, pulmonary capillary wedge pressure was increased 90 minutes after epidural anesthesia and cardiac output was decreased 120 minutes after epidural anesthesia (p < 0.05). CONCLSIONS: In the experimental canine model of coronary occlusion, thoracic epidural anesthesia induces diminished systemic oxygen delivery without deteriorating oxygen supply/demand balance. However, as PsO2 and SsO2 diminished and the noncontractile left ventricular area increased after epidural anesthesia in the setting of acute coronary occlusion, perioperative use of thoracic epidural anesthesia in patients of coronary disease should be done carefully in order not to aggravate myocardial ischemia.
Anesthesia, Epidural* ; Anesthesia, General ; Animals ; Bupivacaine ; Cardiac Output ; Catheters ; Coronary Disease ; Coronary Occlusion* ; Coronary Sinus ; Coronary Vessels ; Dogs* ; Heart ; Heart Ventricles ; Hemodynamics ; Humans ; Myocardial Ischemia ; Oxygen Consumption ; Oxygen* ; Pulmonary Wedge Pressure

PURPOSE: To determine (1) the relationship between the cortical defects seen on 99 mTc-DMSA renal scans and age, and (2) the presence and degree of vesicoureteral reflux, and then to depict the risk factors for cortical defects in children with acute urinary tract infection (UTI). Furthermore, to assess the diagnostic value of VCUG in predicting a defect on 99 mTc-DMSA renal scans. MATERIALS AND METHODS: We studied 134 kidneys in 67 children aged 15 days-10 years (M:F=39:28) in whom symptomatic UTI was present. In all these children, both DMSA renal scans and voiding cystourethrography (VCUG) were performed. Scanning took place within 7 days of diagnosis and VCUG was performed after one month of diagnosis. Scintigraphic findings were graded according to the extent and number of cortical defects. We evaluated the relationships between the cortical defects seen on DMSA scans and age, and the grade of vesicoureteral reflux. The diagnostic value of VCUG in predicting cortical defects was analysed. Results: The prevalence of cortical defects was greater in patients older than two years (38/54, 70%) than in those aged less than two (38/80, 48%). The frequency of cortical defects was related to vesicoureteral reflux (p<0.05) and grade of reflux (p<0.05). As this latter increased, the extent of cortical defects also increased (p<0.05), and DMSA scans revealed the presence of these in 76 of the 134 kidneys (57%) with acute UTI. In 30 of these 76 (39.5%), VCUG demonstrated the presence of vesicoureteral reflex. On the other hand, vesi-coureteral reflex was found in 36 of the 134 kidneys (27%), and in 30 of these 36 (83%), cortical defects were noted. The sensitivity of VCUG in predicting cortical defect was 39.5%, while specificity was 89.7%. The positive predictive value for defects was 83.3%, and the negative predictive value was 53.1%. The relative risk of cortical defect in the presence of vesicoureteral reflux was 1.78. CONCLUSION: Renal cortical defects are significantly related to age and grade of vesicoureteral reflux. Risk factors for developing cortical defects were older age (> or =2yrs) at the time of acute UTI, and high grade of vesicoureteral reflux. The specificity of VCUG in predicting cortical defects is relatively high but the sensitivitiy is low, and a significant proportion of cortical defects therefore occurred in the absence of vesicoureteral reflux.
Child* ; Diagnosis ; Hand ; Humans ; Kidney ; Prevalence ; Radionuclide Imaging* ; Reflex ; Risk Factors* ; Sensitivity and Specificity ; Succimer* ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

The purpose of this study was to evaluate clinical changes in graft size after treatment with strip gingival autograft in human. 57 premolar teeth in 27 patients having the following mucogingival problems were selected. The width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth were measured at the initial examination, 2, 12 and 24 weeks following the strip gingival autograft and free gingival autograft. The change of width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth according to healing process in both graft procedures was statistically analyzed by repeated measure ANOVA test and independent t-test using SPSS program. The results were as follows : 1. The change of keratinized gingiva in both graft procedures was increased significantly at 24 weeks post-op. 2. The clinical sulcus depth exhibited no marked changes throughout the entire investigation in both graft procedures. 3. No dimensional variation was seen in graft size in both graft procedures. 4. Shrinkage did not differ significantly in both graft procedures. From the day of grafting to 24 weeks after surgery the percentages of shrinkage were : strip gingival autograft 28% and free gingival autograft 29%.
Autografts* ; Bicuspid ; Gingiva ; Humans ; Tooth ; Transplants*

PURPOSE: We investigated the effect on MK 801 on the development on brain damage, spontaneous recurrent seizures and mossy fiber sprouting in the pilocarpine induced status epilepticus animal model. Methods: Fifty two adult Sprague Dawley male rats(180-240gm) were studied under ketamine/xylazine(87mg/13mg/kg, IP) anesthesia and were implanted at the F3, P3, F4, P4 areas for recording EEG. With a single intraperitoneal(IP) administration of pilocarpine hydrochloride(360mg/kg), 70% developed status epilepticus(SE). When SE was not induced within 1 hour after injection of pilocarpine, the second dose of pilocarpine(175mg/kg, IP) was injected, with 86.6% of success. Results: All studied animals were divided into two large groups, one group was treated with NMDA receptor antagonist, the other was control group. The mean duration of SE was 62.00+/-6.80 minutes in the MK 801(1mg/kg, IP, 30 minutes after SE) treated group, and 61.10+/-7.37 minutes in the control group without any signigicant differences(P>0.05). Neuronal loss(necrosis dominantly) was observed at CA1 and CA3 areas in the control group, with more loss after 6 weeks than 24 or 72 hrs specimens. However, there was no neuronal loss in MK 801 treated group. The protective effect of MK 801 for neuronal injury suggested the glutamate receptor activation was involved in the neuronal injury induced by repeated seizure attack. Spontaneous recurrent seizures(SRS) were observed 70% of animals in the control group, but there were no SRS observed in the MK 801 treated group. The mean scores of mossy fiber sprouting were significantly higher in the control group(2.05+/-0.47) than MK 801 treated group(0.4+/-0.32)(P<0.05). Conclusion: These results suggested that SRS and mossy fiber sprouting were associated with NMDA receptor activation, and NMDA receptor activation had a key role in the epilepsy development.
Adult ; Anesthesia ; Animals* ; Brain* ; Dizocilpine Maleate* ; Electroencephalography ; Epilepsy ; Humans ; Male ; Models, Animal* ; N-Methylaspartate ; Neurons ; Pilocarpine* ; Receptors, Glutamate ; Seizures* ; Status Epilepticus*

PURPOSE: The purpose of this study was to evaluate the efficacy of contrast-enhanced MR angiography for follow-up examinations after metallic stent placement and to examine the effects of change of imaging parameters used for contrast-enhanced MR angiography. MATERIALS AND METHODS: After four metallic stents (Passager, Ninitol, Wallstent, and Memotherm) were placed in an abdominal aorta shaped vascular phantom, efGRE (enhanced fast gradient recalled echo) 3-D MR angiography was performed, using a 1.5T unit. The four metallic stents were graded 1-3 according to the width and length of their high signal intensity. Variations in the degree of high signal intensity were evaluated according to imaging parameters. RESULTS: The width and length of high signal intensity with the Passager stent and Nitinol stent were greater than with the Wallstent and Memotherm. The larger the field of view, the smaller the matrix number, the larger the flip angle, the greater the width and length of high signal intensity in the metallic stent. CONCLUSION: Contrast-enhanced MR angiography may be a useful follow-up procedure after the placement of Passager and Ninitol metallic stents. The signal intensity of stent lumen varies according to imaging parameters, and the selection of optimal parameters is therefore important.
Angiography* ; Aorta, Abdominal ; Follow-Up Studies ; Stents*

PURPOSE: To investigate the nature of edematous lesions seen on MR images during acute episodes of hypertensive encephalopathy(HTE) with particular attention to the findings of diffusion-weighted imaging (DWI). MATERIALS AND METHODS: A total of 17 MR examinations in fourteen patients with hypertensive encephalopathy were performed. The diagnoses were idiopathic HTE in eight cases, eclampsia in three, and cyclosporin-induced HTE in three. The apparent diffusion coefficients(ADCs) of edematous lesions and normal white matter revealed by DWI were assessed and compared, and the changes observed at follow-up MR imaging were analysed. RESULTS: DWI obtained within one week of the appearance of acute neurological symptoms revealed the edema as iso-intense in all patients with eclampsia and cyclosporin-induced HTE, and in five of eight patients with idiopathic HTE. In the other three patients with idiopathic HTE, DWI demonstrated slightly hyperintense edema. The ADCs of edematous lesion in patients with idiopathic HTE, eclampsia and cyclosporin-induced HTE were 1.21 +/-0.34, 1.08 +/-0.28, and 1.28 +/-0.22 mm 2 /ms, respectively, while for normal white matter the corresponding figures were 0.77 +/-0.25, 0.71 +/-0.22, and 0.68 +/-0.27mm 2 /ms The differences in ADCs between edema and normal white matter were thus significantly different between the three patient groups (p<0.05), while the ADCs of edematous lesions showed no sisgnificant variation between these groups (p<0.05). Follow-up MRI revealed that in three cases, edematous lesions were reversible and there were no residual signal changes. CONCLUSION: Vasogenic rather than cytotoxic edema is present during the acute stage of HTE.
Diagnosis ; Diffusion ; Eclampsia ; Edema ; Female ; Follow-Up Studies ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Pregnancy

The actions and side effcts of the benzodiazepine antagonist flumazenil were evaluated in a clinical study in which midazolam was used as an anesthetir induction agent. Anesthesia was maintained with nitrous oxide-oxygen-fentanyl. Sixty-five adult surgical patients received either 0.3 mg (3 ml) of flumazenil (33 cases) or 3 ml of saline (32 cases) at the conclusion of surgery. Blood pressure, pulse rate, and respiratory rate were checked before premedication, just before, 5 minutes, 30 minutes, and 120 minutes after the administration flumazenil or saline. Also level of consciouseness, orientation in time and space, and cooperativeness along with end tidal carbon dioxide and hemoglobin oxygen saturation were evaluated. Various larboratory parameters were checked before premedication and 24 hours after operation. The results were as follows: 1) The flumazenil group revealed improved level of consciousness, orientation in time and space, and cooperativeness which began just after the administration, and was maintained 30 minutes thereafter. 2) There was no difference in the changes of laboratory parameters between the two groups. 3) The changes of blood pressure, pulse rate, respiratory rate, and SaO2 showed no difference between those two groups. 4) The end tidal concentrations of carbon dioxide after drug administration were significantly lower in the flumazenil group than those of the saline group. 5) Tolerance to flumazenil (0.3 mg) was good without any side effect.
Adult ; Anesthesia* ; Benzodiazepines ; Blood Pressure ; Carbon Dioxide ; Consciousness ; Flumazenil* ; Heart Rate ; Humans ; Midazolam* ; Oxygen ; Premedication ; Respiratory Rate

Obesity-associated focal segmental glomerulosclerosis(OB-FSGS) has been known to progress into advanced renal insufficiency, and its clinicopathological features include obesity, FSGS lesions with glomerulomegaly and, nephrotic-range proteinuria without edema. A 14- year old girl with Prader-Willi syndrome showed nephrotic-range proteinuria without hypoalbuminemia or edema. The renal biopsy revealed focal segmental glomerulosclerosis together with glomerular hypertrophy and an increased mesangial matrix. We report here a case of OB-FSGS as one of the renal problems of Prader-Willi syndrome, and we came to the conclusion that Prader-Willi syndrome is one of the possible disease entities that can lead to renal insufficiency through obesity.
Biopsy ; Child* ; Edema ; Female ; Glomerulosclerosis, Focal Segmental* ; Humans ; Hypertrophy ; Hypoalbuminemia ; Obesity ; Prader-Willi Syndrome* ; Proteinuria ; Renal Insufficiency