PURPOSE: The purpose of this study was to evaluate the machining accuracy and consistency of implant/abutment/screw combination of internal connection type. MATERIAL AND METHODS: In this study, each two randomly selected internal implant fixtures from ITI, 3i, Avana, Bicon, Friadent, Astra, and Paragon system were used. Each abutment was connected to the implant with 32Ncm torque value using a digital torque controller or tapping. All samples were cross-sectioned with grinder-polisher unit (Omnilap 2000 SBT Inc) after embeded in liquid unsaturated polyester (Epovia, Cray Valley Inc). Then optical microscopic and scanning electron microscopic(SEM) valuations of the implant-abutment interfaces were conducted to assess quality of fit between the mating components. RESULTS: 1) Generally, the geometry of the internal connection system provided for a precision fit of the implant/abutment interface. 2) The most precision fit of the implant/abutment interface was provided in the case of Bicon System which has not screw. 3) The fit of the implant/abutment interface was usually good in the case of ITI, 3I and Avana system and the amount of fit of the implant/abutment interface was similar to each other. 4) The fit of the implant/abutment interface was usually good in the case of Friadent, Astra and Paragon system. The case of Astra system with the inclined contacting surface had the most intimate contact among them. 5) Amount of intimate contact in the abutment screw thread to the mating fixture was larger in assembly with two-piece type which is separated screw from abutment such as Friadent, Astra and Paragon system than in that with one-piece type which is not seperated screw from abutment such as ITI, 3I and Avana system. 6) Amount of contact in the screw and the screw seat of abutment was larger in assembly of Friadent system than in asembly of Astra system or Paragon system. CONCLUSION: Although a little variation in machining accuracy and consistency was noted in the samples, important features of all internal connection systems were the deep, internal implant - abutment connections which provides intimate contact with the implant walls to resist micromovement, resulting in a strong stable interface. From the results of this study, further research of the stress distribution according to the design of internal connection system will be required.
Polyesters ; Torque

After portal vein occlusion, portal to portal collaterals (hepatopetal) develop from preexisting periportal vessels or recanalization of the thrombosed portal vein, undergo compensatory enlargement, bypass the obstructed extrahepatic occlusion and reconstitute the intrahepatic portal branches. Angiographically, collateral veins are seen as multiple tortous winding veins in the porta hepatis and are described as a cavemous transformation of the portal vein. When the common bile duct or gall bladder is compressed by collateral veins, a cholangiogram demonstrates multiple smooth intramural defects and jaundice can develop due to the partial obstruction of the bile duct. Demonstration of the cavernous transformation of the portal vein can be done by ultrasonography, abdominal computed tomography and nuclear magnetic resonance, but Doppler ultrasonography and direct or indirect portography are needed to evaluate its hemodynamic change. We present a 35-year-old female patient complaining repeated jaundice, in whom common bile duct and gall bladder varices accompanied by cavernous transformation of the portal vein and intrahepatic stones were diagnosed by ultrasonography, abdominal computed tomography, ERCP, and Doppler ultrasonograpy and confirmed by surgery. ERCP demonstrated the irregular contour of the common bile duct and gall bladder due to multiple smooth intramural defects. Doppler utrasongraphy revealed the unique flow signal of portal vasculature from the tortous vessls in the porta hepatis and from the vascular structures on the wall of the gall bladder.
Adult ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct* ; Female ; Hemodynamics ; Humans ; Jaundice ; Magnetic Resonance Spectroscopy ; Portal Vein ; Portography ; Ultrasonography ; Ultrasonography, Doppler* ; Urinary Bladder* ; Varicose Veins* ; Veins ; Wind

OBJECTIVE: To investigate the changes of bone mineral density (BMD), biochemical bone markers, and lipid profiles according to the duration of menopause in postmenopausal osteoporosis patient receiving continuous hormonal replacement therapy (c-HRT). METHOD: Sixty seven patients with postmenopausal osteoporosis who have been under c-HRT for more than two years were used as subjects and divided into two groups according to the time past menopause: group I (0~10 years), group II (over 10 years). The changes of BMD, biochemical bone markers, lipid profiles on one year and two years of c-HRT were comparatively analyzed in each group. RESULTS: 1) BMD of lumbar vertebra was increased and biochemical bone markers were decreased after c-HRT in both groups, but BMD of femur from both groups showed no statistical significant changes. 2) The changes in lumbar vertebra, deoxypyridinoline and osteocalcin were significantly higher after first one year than next one year of c-HRT in both groups, with no statistical differences between two groups. 3) Total cholesterol and LDL-cholesterol were decreased, but HDL-cholesterol and triglyceride showed no significant changes after c-HRT in both groups. CONCLUSION: The effects of c-HRT on BMD, biochemical bone markers, lipid profiles were not influenced by postmenopausal period. And the effects of c-HRT during first one year were more prominent than those of c-HRT during next one year.
Bone Density* ; Cholesterol ; Female ; Femur ; Humans ; Menopause* ; Osteocalcin ; Osteoporosis ; Osteoporosis, Postmenopausal ; Postmenopause ; Spine ; Triglycerides

Upper gastrointestinal bleeding in cirrhotic patients is a serious emergency which is associated with high mortality. Cirrhotic patients commonly have, in additian to esophageal varices, other upper gastrointestinal lesions which accont for occasional bleeding episodes. Since the theapy of bleeding esophageal varices differs from the treatment of nonvariceal bleeding, delay and inaccuracy in determining the source of bleeding contribute ta high mortality. (continue...)
Emergencies ; Esophageal and Gastric Varices* ; Hemorrhage ; Humans ; Mortality

Autosomal dominant nocturnal frontal lobe epilepsy(ADNFLE) is a recently identified partial epilepsy. This disorder is characterized by a variable age of onset(mostly in childhood), autosomal dominant inheritance, clusters of brief frontal nocturnal seizures, negative findings on neuroimaging, and fairly good prognosis. Carbamazepine is known to be the most useful drug in this type of epilepsy. We experienced a case of 5-year-old boy who had unusual arousal and irritability every night for 3 years and had sharp & wave discharges from frontal lobe region in long-term video-EEG monitoring, who was suspected as an autosomal dominant nocturnal frontal lobe epilepsy. We report a case with a brief review of literatures.
Arousal ; Carbamazepine ; Child, Preschool ; Epilepsies, Partial ; Epilepsy ; Epilepsy, Frontal Lobe* ; Frontal Lobe* ; Humans ; Male ; Neuroimaging ; Prognosis ; Seizures ; Wills

OBJECTIVE: To determine whether estradiol (E2), lipid profile, biochemical markers, and bone mineral density (BMD) are related according to postmenopausal period. METHOD: One hundred fifty four women were divided into four groups according to the time past menopause: group I (0~5 years), group II (6~10 years), group III (11~15 years), group IV (more than 16 years). Group I, II, III were subdivided into osteoporosis group (t-score< 2.5) and non-osteoporosis group (t-score> or = 2.5). E2, lipid profile, osteocalcin, alkaline phosphatase, deoxypyridinoline, and BMD by DEXA were measured in all groups. RESULTS: There were significant inverse correlation between BMD and postmenopausal period (p<0.05). Deoxypyridinoline and osteocalcin were correlated with postmenopausal period but there was no statistical significance. Deoxypyridinoline and osteocalcin were increased in osteoporosis group compared to non-osteoporosis group but there was no statistical significance. E2 had significant inverse correlations with postmenopausal period (p<0.05). E2 had no correlation with factors such as biochemical markers and lipid profile in group I, II, III but had adverse correlation with deoxypyridinoline in group IV. CONCLUSION: No specific biochemical markers regarding the duration of menopause were found. Regardless of the duration of menopause, checking both osteocalcin and deoxypyridinoline was statistically significant for the evaluation of postmenopausal osteoporosis.
Alkaline Phosphatase ; Biomarkers* ; Bone Density* ; Estradiol* ; Female ; Humans ; Menopause ; Osteocalcin ; Osteoporosis ; Osteoporosis, Postmenopausal ; Postmenopause*

Carbamazepine is widely used to manage of seizures and symptomatic treatment of trigeminal neuralgia and central pain. We experienced two cases of exceedingly rare but potentially fatal side effects following carbamazepine administration. One traumatic brain injured patient developed pancytopenia 3 weeks after beginning to take carbamazepine for prophylactic management of seizure and the other C6 incomplete spinal cord injured patient receiving carbamazepine for the management of central pain sequentially developed syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 1 week after administration. Because of more frequent indications of carbamazepine, these side effects must be borne in mind and cautious administration will be desirable.
Brain ; Carbamazepine* ; Humans ; Inappropriate ADH Syndrome* ; Pancytopenia* ; Seizures ; Spinal Cord ; Trigeminal Neuralgia

A 45-year-old man with a long history of nephrotic syndrome presented with low back pain and progressive weakness of both legs for one day. Physical examination showed an acutely ill-appearing patient with a loss of both femoral artery pulses. Immediate digital subtraction angiography of abdominal aorta revealed total occlusion of the distal abdominal aorta. Transvascular embolectomy using urokinase was undertaken 6 hours later. Digital subtraction angiography after embolectomy revealed both common ilicac arteries to be patent with good distal flow. Electrodiagnostic examinations (post embolectomy 5th and 45th day) revealed peripheral polyneuropathy of both lower extremity. Anticoagulation therapy was continued and the patient was discharged several months later. During this period, there was improvement in both lower limbs from power of grade 1 to 4 except for both ankle dorsiflexors which had not recovered. We report a rare case of peripheral ischemic polyneuropathy of both lower extremities as the result of acute abdominal aortic occlusion.
Angiography, Digital Subtraction ; Ankle ; Aorta, Abdominal ; Arteries ; Embolectomy ; Femoral Artery ; Humans ; Leg ; Low Back Pain ; Lower Extremity ; Middle Aged ; Nephrotic Syndrome ; Physical Examination ; Polyneuropathies* ; Urokinase-Type Plasminogen Activator

OBJECTIVES: To identify changes in blood markers of oxidative stress among dementic and healthy aged persons, and to compare levels of peripheral markers of oxidative stress between dementia of the Alzheimer's type (DAT) and vascular dementia (VD), and finally to analyze factors affecting those. DESIGN: Some antioxidants had been known to reduce the risk of dementia, while increase of 4-hydroxy-nonenal and decrease of heme oxygenase in DAT had been reported. Recently increased free radical activities were also found in VD. Therefore, this study was tried to search for a blood markers to discriminate DAT and VD. MATERIALS AND METHOD: The blood levels of total antioxidant capacity (TAC) and catalase activity of 50 patients with DAT and 50 patients with VD were compared with those of 56 healthy aged controls. In addition, variables including risk factors of dementia, degree of dementia measured by MMSE, Hasegawa Dementia Scale, GDS and CDR, and activities of daily living were also assessed. RESULTS: 1) The levels of TAC were significantly (p<0.01) lower in dementia than normal aged controls (1.47+/-0.08 mmol/L), while the catalase activities were significantly (p<0.01) higher in dementia than normal aged controls (45.61+/-11.67 kU/L). 2) The TAC levels were significantly (p<0.01) lower while the catalase significantly (p<0.01) higher in DAT (1.24+/-0.09 mmol/L, 133.42+/-58.45 kU/L respectively) than VD (1.31+/-0.08 mmol/L, 81.33+/-24.65 kU/L respectively). 3) The TAC and catalase activities were significantly (p<0.01) correlated with duration of dementia, behavior symptoms, activities of daily living, and the severity of dementia. CONCLUSIONS: Peripheral blood markers of oxidative stress were significantly different in dementia from normal aged controls. Furthermore, the difference was more severe in DAT than VD, which means the effect of oxidative stress is more in DAT than in VD. Therefore, they might be clinically useful to assess and discriminate dementia.
Activities of Daily Living ; Antioxidants ; Catalase ; Dementia* ; Dementia, Vascular ; Heme Oxygenase (Decyclizing) ; Humans ; Oxidative Stress* ; Risk Factors

OBJECTIVES: The purpose of this study is to evaluate the clinical applicability of cognitive evoked potentials (CEPs) to identify the cognitive disorder in cerebrovascular diseases (CVD). METHODS: The P3 latencies, amplitudes and latency to amplitude ratios (LARs) of CEPs were measured in 25 healthy controls and 35 patients with CVD. The association of CEPs with variables including age, sex, Mini-Mental State Examination (MMSE), CVD types, loci of hemiplegic limbs, duration, education, Brief Psychiatric Rating Scale (BPRS), and Instrumental Activities of Daily Living (IADL) were also analyzed. RESULTS: 1) The P3 latencies (447.87+/-113.06 msec) and LARs (65.83+/-43.25) were prolonged in CVD (p<0.01), while the amplitudes (8.18+/-2.51 microV) were not changed. 2) The P3 latencies (537.31+/-101.14 msec) and LARs (94.89+/-46.44) in CVD with MMSE <24 were prolonged, and the amplitudes (6.45+/-1.98 microV) were reduced significantly (p<0.01, respectively), as compared with those in CVD with MMSE> or =24 (363.39+/-19.67 msec, 38.40+/-8.37 and 9.81+/-1.76 microV, respectively). 3) The BPRS and IADL in CVD with MMSE<24 were significantly (p<0.01) different from those in CVD with MMSE> or =24. 4) On analyzing the association of CEPs with variables in CVD, the P3 latencies were correlated positively with age, BPRS and IADL, while negatively with MMSE and DLFA. The amplitudes were correlated positively with MMSE, while negatively with age, BPRS and IADL. The LARs were correlated positively with age, BPRS and IADL, while negatively with MMSE. 5) On analyzing the association of CEPs with variables in CVD with MMSE> or =24, the P3 latencies were correlated positively with age, while negatively with MMSE. The amplitudes and LARs were not correlated with variables. 6) On analyzing the association of CEPs with variables in CVD with MMSE<24, the P3 latencies were correlated positively with BPRS, while negatively with MMSE. The amplitudes were positively correlated with age. The LARs were positively correlated with IADL. CONCLUSIONS: The P3 latencies and LARs of cognitive evoked potentials seemed to a useful clinical measures to assess cognitive disorders in CVD.
Activities of Daily Living ; Brief Psychiatric Rating Scale ; Education ; Evoked Potentials* ; Extremities ; Humans