STATEMENT OF PROBLEM: More than 70% of patients who need the implant supported restoration are parially edentulous. The principles of design for implant supported fixed partial denture in mandibular posterior region are many and varied. Jurisdiction for their use is usually based on clinical evaluation. There are several areas of interest regarding the design of implant supported fixed partial denture in mandibular posterior region. 1) Straight and tripod configuration in implant placement, 2) Two restoration types such as individualized and splinted restorations. PURPOSE: The purpose of this study was to compare the amount and distribution of stress around the implant fixtures placed in the mandibular posterior region with two different arrangements and to evaluate the effects of splinting using the photoelastic stress analysis. MATERIALS AND METHODS: 1) Production of study model: Mandibular partially edentulous model was waxed-up and duplicated with silicone and two models were poured in stone. 2) Fixture installation and photoelastic model construction: Using surveyor(Ney, USA), 3 fixtures(two 4.0x13 mm, one 5.0x10 mm, Lifecore, USA) were installed in straight and tripod configurations. Silicone molds were made and poured in photoelastic resin (PL-2. Measurements group, USA). 3) Prostheses construction: Four 3-unit bridges (Type III gold alloy, Dongmyung co., Korea) were produced with nonhexed and hexed UCLA abutments and fitted with conventional methods. The abutments were tightened with 30 Ncm torque and the static loads were applied at 12 points of the occlusal surface. 4) Photoelastic stress analysis: The polarizer analyzer system with digital camera(S-2 Pro, Fujifilm, Japan) was used to take the photoelastic fringes and analysed using computer analysis program. RESULTS: Solitary hexed UCLA restoration developed different stress patterns between two implant arrangement configurations, but there were no stress transfer to adjacent implants from the loaded implant in both configurations. However splinted restorations showed lesser amount of stresses in the loaded implants and showed stress transfer to adjacent implants in both configurations. Solitary hexed UCLA restoration with tripod configuration developed higher stresses in anterior and middle implants under loading than implants with straight configurations. Splintied 3 unit fixed partial dentures with tripod configuration showed higher stress development in posterior implant under loading but there were no obvious differences between two configurations. CONCLUSIONS: The tripod configuration of implant arrangement didn't show any advantages over the straight configuration. Splinting of 3 unit bridges with nonhexed UCLA abutments showed less stress development around the fixtures. Solitary hexed UCLA restoration developed tilting of implant fixture under offset loads.
Alloys ; Denture, Partial, Fixed ; Fungi ; Humans ; Prostheses and Implants* ; Silicones ; Splints ; Torque

STATEMENT OF PROBLEM: Several prosthetic options are available for the restoration of multiple adjacent implants. A passively fitting prosthesis has been considered a prerequisite for the success and maintenance of osseointegration. Passivity is a particular concern with multiple implants because of documented inaccuracies in the casting and soldering process. One way to avoid this problem is to restore the implants individually, however, the restorations of individual adjacent impants requires careful adjustment of interproximal contacts. PURPOSE: The purpose of this study was to compare the stress distribution pattern and amount surrounding Bicon implants with individual crowns and splinted restorations. MATERIAL AND METHOD: A photoelastic model of a human partially edentulous left mandible with 3 Bicon implants(4*1 mm) was fabricated. For non-splinted restorations, individual crowns were fabricated on 3 abutments (4.0*6.5 mm, 0 degree, 2.0 mm post, Bicon Inc., Boston, USA) After the units were cemented, 4 levels of interproximal contact tightness were evaluated: open, ideal (8 micrometershim stock drags without tearing), medium(40 micrometer), and heavy(80 micrometer). Splinted 3-unit fixed partial dentures were fabricated and cemented to the model. Changes in stress distribution under simulated non-loaded and loaded conditions(7.5, 15, 30 lb) were analyzed with a circular polaricope. RESULTS: 1. Stresses were distributed around the entire body of fin in Bicon implants. 2. Splinted restorations were useful for distribution of stress around implants especially with higher loads. 3. By increasing the contact tightness between the individually restored three implants, the stress increased in the coronal portion of implants. CONCLUSIONS: Ideal adjustment of the contact tightness was important to reduce the stresses around individually restored Bicon implants.
Crowns ; Denture, Partial, Fixed* ; Humans ; Mandible ; Osseointegration ; Prostheses and Implants ; Splints

PURPOSE: The purpose of this study was to evaluate the pattern and the magnitude of stress distribution in the supporting tissues surrounding three different types of implants(ITI, 3i, and Bicon implant system). MATERIAL AND METHOD: Photoelastic models were made with PL-2 resin(Measurements Group, Raleigh, USA) and three implants of each kind were placed in the mandibular posterior edentulous area distal to the canine . For non-splinted restorations, individual crowns were fabricated on three titanium abutments. For splinted restorations, 3-unit fixed partial dentures were fabricated. Photoelastic stress analyses were carried out to measure the fringe order around the implant supporting structure under simulated loaded conditions(15 lb, 30 lb). CONCLUSION: The results were as follows; 1. Regardless of the implant design, stresses were increased in the apex region of loaded implant when non-splinted restorations were loaded. While relatively even stress distribution occurred with splinted restorations. Splinting was effective in the second implant. 2. Strain around Bicon implant were lower than those of other implants, which confirmed the splinting effect. The higher the load, the more the stress occurred in supporting tissue, which was most obvious in the Bicon system. 3. Stress distribution in the supporting tissue was favorable in the ITI system, while the other side of 3i system tended to concentrate the stress in some parts.
Crowns ; Denture, Partial, Fixed ; Splints ; Titanium

PURPOSE: The purpose of this study was to evaluate the pattern and the magnitude of stress distribution in the supporting tissues surrounding three different types of implants(ITI, 3i, and Bicon implant system). MATERIAL AND METHOD: Photoelastic models were made with PL-2 resin(Measurements Group, Raleigh, USA) and three implants of each kind were placed in the mandibular posterior edentulous area distal to the canine . For non-splinted restorations, individual crowns were fabricated on three titanium abutments. For splinted restorations, 3-unit fixed partial dentures were fabricated. Photoelastic stress analyses were carried out to measure the fringe order around the implant supporting structure under simulated loaded conditions(15 lb, 30 lb). CONCLUSION: The results were as follows; 1. Regardless of the implant design, stresses were increased in the apex region of loaded implant when non-splinted restorations were loaded. While relatively even stress distribution occurred with splinted restorations. Splinting was effective in the second implant. 2. Strain around Bicon implant were lower than those of other implants, which confirmed the splinting effect. The higher the load, the more the stress occurred in supporting tissue, which was most obvious in the Bicon system. 3. Stress distribution in the supporting tissue was favorable in the ITI system, while the other side of 3i system tended to concentrate the stress in some parts.
Crowns ; Denture, Partial, Fixed ; Splints ; Titanium

No abstract available.
Asian Americans ; Asian Continental Ancestry Group ; Diabetes Mellitus, Type 2 ; Humans ; Insulin Resistance ; Insulin ; Thigh

No abstract available.
Humans ; Hypoglycemia* ; Tertiary Care Centers*

BACKGROUND: Hypoxemia during one lung ventilation (OLV) for thoracotomy in patients in the lateral position remains a clinical problem. And thoracic epidural anesthesia (TEA) during one lung ventilation recently has been combined with general anesthesia in our clinical practice for thoracic surgery. Then the effects of TEA combined with general anesthesia on PaO2 remains controversial. The aim of this study to investigate whether thoracic epidural anesthesia (TEA) affect PaO2 and pulmonary shunt during one lung anesthesia. METHODS: Fifteen patients undergoing lobectomy with one lung ventilation were examined. Each group was injected normal saline (control group, n = 7) or 1% lidocaine (TEA group, n = 8) 8 ml through thoracic epidural catheter after induction. We compared pulmonary shunt fraction (Qs/Qt) after OLV 30, 60 minutes and after two lung ventilation (TLV). RESULTS: We found the significant increases of intrapulmonary shunt fraction (%) in the TEA group compared to control group at each event, OLV30, 60 and TLV. And significant increase of intrapulmonary shunt was found after one lung ventilation in the both groups. CONCLUSIONS: These results suggest that TEA may influence hypoxic pulmonary vasoconstriction (HPV) by blockade of sympathetic activity during OLV.
Anesthesia* ; Anesthesia, Epidural* ; Anesthesia, General ; Anoxia ; Catheters ; Humans ; Lidocaine ; Lung* ; One-Lung Ventilation ; Tea ; Thoracic Surgery ; Thoracotomy ; Vasoconstriction ; Ventilation

One of the indications of outpatient surgery is chemical peeling of the face. It usually requires deep sedation with analgesia of short duration. For this purpose we tried to use ketamine(1 mg/kg) and midazolam(0.1 mg/kg) but experienced frequent hypertension and tachycardia. We tried to use beta blocker, esmolol for the of control blood pressure and heart rate. The patients were divided into two groups. In control group, eighty-five patients were anesthetized with bolus intravenous injection of I mg/kg of ketamine and 0.1 mg/kg of midazolam. In esmolol group, eighty-three patients reed a continuous infusion of esmolol(500 mcg/kg/min for initial dose, followed by 200 mcg/kg/min for maintenance) in addition to midazolam(0.1 mg/kg) and ketamine(1 mg/kg). During operation, we observed systolic, diastolic blood pressure and peripheral oxygen saturation(SaO2). All patients were allowed to breathe spontaneously. There was no case of airway obstruction and SaO2 value was over 98% in most cases. So we investigated the effects of esmolol on blood pressure,heart rate,emergence sequelae and patients acceptance in the anesthesia with ketamine and midazolam in the patient of facial chemical peeling. The results were as follows: 1) No one could recall. 2) There were no differences on the status of mood, emotion and patient's positive acceptance between two groups 3) Blood pressure and heart rate were increased during anesthesia with midazolam and ketamine. But esmolol attenuated this response, significantly(P<0.05). We concluded that esmolol added benefits of control of blood pressure and heart rate in the anesthesia of facial chemical peeling. But the control of the high blood pressure is not so easy, so it is needed to find out the optimal dosage of esmolol for complete blocking of the sympathetic response without complications.
Airway Obstruction ; Ambulatory Surgical Procedures ; Analgesia ; Anesthesia* ; Blood Pressure ; Deep Sedation ; Heart Rate ; Humans ; Hypertension ; Injections, Intravenous ; Ketamine* ; Midazolam* ; Oxygen ; Tachycardia

This study was conducted to investigate the nursing diagnosis applying to rehabilitation unit. The subject of this was consisted of 101 nurses who have been working over 1 year in rehabilitation unit. The clssification of nursing diag-nosis used NANDA's system and analysis of the validity was based on Fehring's model. In summury of this study, some dirrerences were found in related factors in nursing diagnosis between rehabilitation and general unit. Major re-lated factors of nursing diagnosis were physical factors associated with neuromuscular disorder. Valid related factors in altered nutrition: more than body requirements was not found for re-habitation unit. It is helpful for the nurses who work at re-habilitation unit to apply the nursing diagnosis validated in this study. This finding can be used as the database for accomplished nursing diag-nosis appropriate for improving the rehabilitation nursing practice.
Nursing Diagnosis* ; Nursing* ; Rehabilitation Nursing* ; Rehabilitation*

PURPOSE: Developing a curriculum(DACUM) is a method of analyzing job focused competency, which is obtained from the data of an expert belonging to a certain career. In this study the DACUM method was used to analyze the jobs of operating room nurses. METHOD: Through the DACUM workshop which was arranged by two DACUM facillitators, a definition of the role of operating room nurses was developed and then duties and tasks of operating room nurses' were identified. For the workshop, a DACUM committee with 10 operating room nurses was organized. Finally, the duties and tasks which were identified were validated by 422 nurses for importance, difficulty, and frequency. RESULTS: Thirteen duties and 105 tasks were identified on the DACUM chart, where importance, difficulty, and frequency of tasks were represented by alphabet letters A, B, and C as higher degree of importance. The determinant coefficient(DC) showed that the most important duty was assisting with operations(DC=6.61), and the least, managing operating materials(DC=4.22). For tasks, the most important ones were assisting in orthostatic surgery(DC=7.60), and assisting in thoracic surgery(DC=7.38), and the least important making gauze ball(DC=2.39), and saving of operation site((DC=3.27). CONCLUSION: The results suggest a need to develop an education program using the DACUM chart as a basis for the development and as a clinical career ladder and for curriculum of operating room nursing.
Career Mobility ; Curriculum ; Job Description ; Operating Room Nursing ; Operating Rooms