No abstract available.
Cartilage*

STATEMENT OF PROBLEM: A scientific examination and understanding of overall aspects of the natural dentition is the first step involved in making a satisfactory selection in the shade of an aesthetic prosthesis. Proper natural shade selection of the prosthetic restoration that is in harmony with the remaining dentition is as important aesthetically, as harmony of form and function in the anterior dentition. Clinically, the most commonly applied method of shade selection has been visual, but because of the subjective nature inherent to this method, shade selection results are variable and can be influenced by such factors as the technician, the type of shade guide used, and the type and intensity of the lighting. PURPOSE: The purpose of this study was to develop a more objective and scientific approach to examining and understanding the shade of teeth, which has in turn lead to the development of a number of shade analysis devices that present a more objective method of shade analysis. MATERIAL AND METHOD: In this study, the shades of healthy anterior teeth were examined and analyzed using the recently developed digital shade analysis of the ShadeScan(TM) System. The study examined 80 individuals in their twenties, 40 males and 40 females, presenting 6 healthy, unrestored maxillary anterior teeth. Tooth brushing and oral prophylaxis were performed prior to evaluation. The ShadeScan handpiece was used to acquire images of the 6 maxillary anterior teeth. These images were analyzed using the Vita/Classical mode of the ShadeScan(TM) Software, and shade maps of each tooth were acquired and divided into cervical, middle, and incisal thirds. The shade distribution of each third, left and right symmetry, and gender differences were investigated and analyzed. RESULTS: The results of the study are as follows: 1. An overwhelming majority of the examined teeth were found to possess shades belong to Group A, with the greatest variations occurring at the middle and cervical thirds of the maxillary central and lateral incisors, in both male and female subjects. 2. Canines of both male and female subjects showed left and right symmetry with uniform shade distribution of A4 and C4, while the lateral and central incisors showed left-right symmetry of the incisal 1/3 with a uniform shade distribution of A2 and A3 shades. 3. No significant differences in shade distribution were seen between genders in maxillary canines, whereas maxillary central and lateral incisors showed differences at the middle and cervical thirds between male and female subjects. The results of this study show that with the exception of maxillary canines, maxillary anterior teeth display a diverse shade distribution as well as gender differences. CONCLUSION: Clinically, when making a shade selection using the existing shade guide, one must consider the fact that even a single tooth consists of a variety of shades. The results of this study show that when selecting a shade from a number of groups is difficult, shades from A group are the most consistent with the natural shade of maxillary anterior teeth.
Dentition ; Female ; Humans ; Incisor ; Male ; Prostheses and Implants ; Tooth*

STUDY DESIGN: This is a retrospective study that focused on the perioperative complications when performing posterior arthrodesis for treating degenerative lumbar disorders in elderly patients. OBJECTIVES: We wanted to analyze the perioperative risk factors and the complications associated with posterior lumbar decompression and arthrodesis in patients who were sixty-five years of age or older. SUMMARY OF LITERATURE REVIEW: Lumbar arthrodesis is commonly done in elderly patients to treat degenerative spine problems. These patients may be at an increased risk for complications because of their age and their associated medical conditions. MATERIALS AND METHODS: We studied 111 patients who were over 65 years old and they were able to be followed up for more than 3 months after performing posterior arthrodesis during the recent 5 years. Sixty-one patients who had undergone posterolateral fusion (PLF) were classified as group A, and 50 patients who had undergone posterior lumbar interbody fusion (PLIF) using a PEEK cage were classified as group B. We analyzed their rates of complications and the causative factors, according to operative methods and age, and these complications occurred within 12 weeks after the operations. RESULTS: Complications occurred for 43 patients of group A, and for 26 patients of group B. The differences in the rates of complications were statistically significant, and group A had a more complications than did group B. The relations between medical problems and the incidence of perioperative complications were statistically significant for both groups. CONCLUSIONS: Elderly patients with medical problems should be made aware that they are at an increased risk for surgical complications, and attention hould be paid to controlling the blood loss and limiting the operative time. The PLIF using a PEEK cage was identified as a procedure that could reduce the perioperative complications.
Aged ; Arthrodesis ; Decompression ; Humans ; Incidence ; Ketones ; Operative Time ; Polyethylene Glycols ; Retrospective Studies ; Risk Factors ; Spine

BACKGROUND: Propofol is an alternative to thiopental as an intravenous induction agent for cesarean section. It is also used as a sedative for supplementation of regional blockade during cesarean section. It has been reported that propofol relaxes not only vascular smooth muscle but also other smooth muscles. The aim of this study was to investigate the effect of propofol on rat uterine smooth muscle in an isolated preparation in the rat. METHODS: Uterine smooth muscle tissues were obtained from rats (n = 21). The muscle strips were suspended in tissue baths and isometric tension was recorded. After spontaneous or oxytocin induced activity had been accomplished in the buffer solution as a control, propofol (1 to 20microgram/ml) in fat emulsion was applied cumulatively to the bath and the effects were continuously recorded. RESULTS: In vitro, propofol induced a dose-dependent inhibition of spontaneous as well as oxytocin induced myometrial contractile activity. Propofol concentration of 1microgram/ml had no significant effects on the resting tension, active tention, and frequency of contraction developed by spontaneous and oxytocin induced uterine contractility. However, Complete muscular relaxations on spontaneous and oxytocin induced contractility were obtained at a concentration of 10microgram/ml and 20microgram/ml, respectively. CONCLUSIONS: Propofol inhibits spontaneous and oxytocin-induced uterine smooth muscle contractions in dose dependent pattern.
Animals ; Baths ; Cesarean Section ; Female ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; Oxytocin ; Pregnancy ; Propofol* ; Rats* ; Relaxation ; Thiopental

PURPOSE: The aim of the this study was to evaluate the effect of various perinatal conditions on TSH and thyroid hormone levels in cord blood. METHODS: Cord blood samples were collected from 130 neonates immediately after birth. TSH, T3, and free T4 levels were measured by the radioimmunoassay(RIA) method. The effects of gestational age, sex, birth weight, delivery method, perinatal asphyxia, maternal diabetes mellitus(DM), and preeclampsia on TSH and thyroid hormone levels were assessed by ANOVA test, Student t-test, and multiple regression analysis. RESULTS: Birth weight and sex did not affect TSH and thyroid hormone levels. TSH level increased according to gestational age(P<0.05). TSH level was 4.42+/-0.66 microIU/mL in infants born vaginally, which was higher than that of cesarian section delivery(3.31+/-0.33 microIU/mL)(P<0.05). TSH level was 5.18+/-0.93 microIU/mL in asphyxiated newborns and 2.97+/-0.84 microIU/mL in non-asphyxiated newborns(P< 0.05). TSH level in infants with maternal DM(8.911+/-1.25 microIU/mL) was higher than that of infants without maternal DM(4.32+/-0.42 microIU/mL)(P<0.05). TSH level was 5.28+/-0.42 microIU/mL in infants with maternal preeclampsia and 3.65+/-0.46 microIU/mL in infants without maternal preeclampsia(P<0.05). Thyroid hormones were lower in infants with perinatal asphyxia(P<0.05). In asphyxiated infants, T3 level was 75.33+/-55.65 ng/mL and free T4 was 0.54+/-0.21 ng/mL. T3 and free T4 level was 109.85+/-41.77 ng/mL and 0.76+/-0.22 ng/mL each in infants without perinatal asphyxia. Among the perinatal factors, gestational age, 1 min Apgar score and maternal DM influenced TSH level independently. CONCLUSION: In our study, cord blood TSH and thyroid hormone levels were affected by perinatal stress events.
Apgar Score ; Asphyxia ; Birth Weight ; Fetal Blood* ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Parturition ; Pre-Eclampsia ; Thyroid Gland* ; Thyroid Hormones ; Thyrotropin

No abstract available.
Pregnancy*

A 72-year-old non-diabetic man was admitted to the intensive care unit because of liver abscess, cholecystitis, and septic shock. He underwent percutaneous catheter drainage and received intravenous antibiotics. Shock was improved, and the patient’s fever subsided. Klebsiella pneumoniae was isolated in blood and bile cultures. However, he suddenly developed dyspnea and oxygen desaturation. Chest computed tomography scan revealed multifocal ground-glass opacities with consolidation with peripheral preponderance. Appropriate antibiotic therapy was provided for 2 weeks. The patient recovered fully, and cholecystectomy was then performed. Herein, we report a case of K. pneumoniae-induced liver abscess complicated with septic pulmonary embolism in a non-diabetic patient.

OBJECTIVE: Oculo-cerebral syndrome is an intraocular hemorrhage and related ocular symptoms caused by sudden increase in intracranial pressure. The authors investigate the clinical significance of oculo-cerebral syndrome after spontaneous subarachnoid hemorrhage and analyze the characteristics of aneurysms which caused intraocular hemorrhage in order to help the treatment of intracranial aneurysm patients. METHODS: From January 2000 to May 2001, 103 patients were admitted to our hospital and diagnosed as spontaneous subarachnoid hemorrhage. We divided the patients into two groups:81 patients without intraocular hemorrhage(non-IOH) and 22 patients with intraocular hemorrhage(IOH). The authors prospectively analyzed the prognostic factors of spontaneous subarachnoid hemorrhage by chi-square test. RESULTS: The initial neurologic state was poor in the IOH group(p<0.001). The Fisher's grade was higher than non-IOH group(p<0.001), and intracranial hemorrhage was great in the IOH group(p<0.001). The prognosis was poor in the IOH group at discharge(p<0.001). The most common rupture site in the IOH group was the anterior communicating artery(p<0.001). Frontal intracerebral hematoma was specific to intraocular hemorrhage(p<0.05). There was a positive correlation between intraocular hemorrhage and rebleeding(p<0.001). CONCLUSION: The authors suggest that oculo-cerebral syndrome is clinically significant with a poor prognostic factor in patients with spontaneous subarachnoid hemorrhage.
Aneurysm ; Hematoma ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Intracranial Pressure ; Prognosis ; Prospective Studies ; Rupture ; Subarachnoid Hemorrhage*

The development of a retropharyngeal hematoma following a trivial blunt trauma is a rare occurrence. A lateral c-spine X-ray or a cervical CT image that shows marked widening of the prevertebral space is sufficient evidence for the clinical diagnosis of retropharyngeal hematoma. When this complication does occur, it can become life-threatening if the airway is compromised. But the diagnosis is obscure and initially veiled in complaints of sore throat or hoarseness, suggesting infection. Thorough investigation of such complaints is necessary especially in patients receiving anticoagulation therapy. We now report a case of retropharyngeal hematoma that occurred as a delayed-onset consequence of a trivial blunt trauma with no evidence of a bony cervical spine injury. It occurred in a 52-year-old man who had been taking warfarin. We also reviewed the literature.
Hematoma ; Hoarseness ; Humans ; Middle Aged ; Pharyngitis ; Spine ; Warfarin

BACKGROUND: Advanced glycation end products (AGE) are independent risk factors in the development and progression of diabetic nephropathy. Receptor for AGE(RAGE) is considered the main receptor involved in AGE-induced cell activation. Galectin-3, another AGE receptor, has recently been found upregulated in mesangial cells(MC) cultured under high glucose and in diabetic rat kidneys. N epsilon(carboxymethyl)lysine(CML) is a well characterized AGE but its role in MC activation is unknown. The present study examined the effects of CML on MC proliferation and extracellular matrix(ECM) secretion. METHODS: Synchronized rat MC were stimulated with different concentrations of CML-bovine serum albumin(BSA), control BSA, and transforming growth factor-beta(TGF-beta) for up to 72 hours. Cell proliferation was measured by [3H]-thymidine incorporation. Fibronectin, TGF-beta, plasminogen activator inhibitor(PAI)-1 secreted into the media and RAGE and galectin-3 expression in MC were measured by Western blot analysis and ELISA. RESULTS: 1,000 micro /mL of CML-BSA decreased [3H]-thymidine incorporation by MC at 48 hours and 10 ng/mL TGF-beta at 24 and 48 hours. CML-BSA 100 and 1,000 micro /mL, control BSA 1,000 micro /mL, and TGF-beta 10 ng/mL increased fibronectin secretion at 48 hours. CML-BSA up to 1,000 micro /mL did not affect TGF-beta or PAI-1 secretion. TGF-beta 10 ng/mL, however, significantly increased PAI-1 secretion. Cultured MC expressed both RAGE and galectin-3. CML-BSA 100 micro /mL upregulated galectin-3 expression. CONCLUSION: CML-BSA decreased MC proliferation and increased fibronectin secretion, suggesting that CML may lead to ECM accumulation and glomerulosclerosis in diabetic animals. MC express RAGE and galectin-3 constitutively and CML-induced galectin-3 upregulation may have a role in AGE-induced MC activation.
Animals ; Blotting, Western ; Cell Proliferation ; Diabetic Nephropathies ; Enzyme-Linked Immunosorbent Assay ; Fibronectins ; Galectin 3 ; Glucose ; Glycosylation End Products, Advanced ; Kidney ; Mesangial Cells* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Rage ; Rats ; Risk Factors ; Transforming Growth Factor beta ; Up-Regulation ; Advanced Glycosylation End Product-Specific Receptor