The use of flowable composite resins as liners in class II packable composite restoration has been suggested by some manufacturers. However, the contributions of this technique are unproven. The purpose of this study was to compare the gingival microleakage in class II packable composite restorations with or without the use of flowable composite resins as liners. Slot cavities were prepared on both proximals of 80 extracted human molars and randomly assigned to 8 groups of 20 each. The gingival margins were located at 1mm above CEJ in 80 cavities (group1-4) and 1mm below CEJ in 80 cavities (group5-8). The prepared teeth were mounted in the customized tray with adjacent teeth to simulate clinical conditions and metallic matrix band (Sectional matrix) and wooden wedges were applied. After acid etching and application of Single Bond, each group was restored with the following materials using incremental placement technique: Group 1,5 (Filtek P60), group 2, 3, 4 and group 6, 7, 8 (AeliteFlo, TetricFlow, Revolution/Filtek P60). All specimens were thermocycled 500 times between 5degrees C and 55degrees C with 1 mimute dwell time, immersed 2% methylene blue dye for 24 hours and then rinsed with tab water. The specimens were embedded in clear resin and sectioned longitudinally through the center of restoration with a low speed diamond saw. Dye penetration at gingival margin was viewed at 20 magnification and analyzed on a scale of 0 to 4. Kruscal-Wallis One way analysis and Mann-Whitney Rank sum test were used to analyze the results. The results of this study were as follows. 1. The leakage values seen at the enamel margin were significantly lower than those seen at the dentin margin(P<0.05). 2. On the enamel margin, packable composite resins with flowable liners showed lower leakage than those without flowable liners, but there were no significant differences among the four groups(P>0.05). 3. On the dentin margin, four groups demonstrated moderate to severe leakage, and there were no significant differences in leakage values(P>0.05).
Bisphenol A-Glycidyl Methacrylate ; Composite Resins ; Dental Enamel ; Dentin ; Diamond ; Humans ; Matrix Bands ; Methylene Blue ; Molar ; Tooth ; Tooth Cervix ; Water

OBJECTIVES: The objective of this study is to measure and to compare the rate of depression, anxiety, self-esteem and the quality of life of the patients with chest pain. Based on the result of this study, the necessity of the psychiatric assessment and treatment of the patients with chest pain is emphasized. This study is a preliminary research for a larger scale investigation to be carried out in the future. METHODS: Thirty nine patients with chest pain who visited Cardiovascular Division of Dept. of Internal Medicine Pusan National University Hospital and fourty normal control group(NC) were included in this study. The patients were classified into typical chest pain group(TCP, N=19) and atypical chest pain group(ACP, N=20) based on the cause of the pain. The cause was determined by cardiac computed tomography, exercise stress test, coronary angiography, and questionaires by a cardiology specialist. The patients were assessed with Beck Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), Rosenberg Self-Esteem Scale(RSES) and Korean version of the Smith Klein Beecham 'Quality of Life' scale(KvSBQOL). RESULTS: 1) When the risk factors of cardiac disease is compared, most of the factors(Hypertension, Diabetes, Hyperlipidemia, Cerebral infarction) did not differ significantly among the two chest pain groups, except for the family history, for which TCP group showed higher risk than ACP group did. 2) As for the self-report questionaires scores, BDI score, which indicates the rate of depression, of both ACP group and TCP group was significantly higher than that of NC group in BDI for depression. STAI score, which measures anxiety, was also significantly high in both groups. Especially, STAI score was significantly higher in ACP group than TCP group. 3) In the aspect of self-esteem and quality of life, ACP group scored significantly lower than TCP group and NC group. The scores for TCP group and NC group did not differ significantly. CONCLUSIONS: The patients with chest pain showed more depression and anxiety than normal control group, regardless of the cause of the pain. However, TCP group did not show significantly larger drop in self-esteem and quality of life than ACP group did. This result implies that early psychiatric assessment and treatment is needed for the patients with such chest pain, since it is highly likely that the pain would lead to lower quality of life of the patients.
Anxiety ; Cardiology ; Chest Pain ; Coronary Angiography ; Depression ; Exercise Test ; Heart Diseases ; Humans ; Hyperlipidemias ; Internal Medicine ; Quality of Life ; Risk Factors ; Specialization ; Thorax

The objective of this study is to evaluate the effect of an additional application of bonding resin on the bond strength of resin luting cements in both the light-cure (LC) and self-cure (SC) modes by means of the microTBS tests. Three combinations of One-Step Plus with Choice, Single Bond with Rely X ARC, and One-Up Bond F with Bistite II were used. D/E resin and Pre-Bond resin were used for the additional application. Twelve experimental groups were made. Three mandibular 3rd molars were used in each group. Indirect composite blocks were cemented on the tooth surface. 1 x 1 mm2 dentin-composite beam for microTBS testing were made and tested. When total-etching dentin adhesives were used, an additional application of the bonding resin increased the bond strength (P < 0.05). However, this additional application didn't influence the bond strength of self-etching dentin adhesives (P > 0.05). In conclusion, the results suggest that an additional application of the bonding resin increases bond strength and enhances quality of bonding when using total-etching dentin adhesives.
Adhesives ; Dentin ; Dentin Permeability ; Molar ; Resin Cements* ; Tooth

Diagnosis and analysis of occlusal relationships are important factors in prosthetic treatment. A thorough occlusion analysis and evaluation should be performed before treatment to restore a stable interocclusal relationship. Analysis and evaluation are essential during the treatment process and at regular follow-ups. Recently, with the development of dental equipment and digital processing methods, new quantitative analysis methods that can record the patient’s occlusal relationship have been introduced. Among them, the T-Scan Novus (Tekscan Inc., S. Boston, MA, USA) displays the strength of the initial contact point and the occlusal contact point of the teeth using a pressure sensor. With this, occlusal contact time of the teeth, anteroposterior and left-right balance of occlusal force can be compared. The Dental prescale II (GC Co., Tokyo, Japan) scans the occlusal contact point using a pressure-sensing film and analyzes the density of the contact point.It can measure the distribution and strength of the occlusal force of the teeth in the most natural occlusion state. Based on this, appropriate prosthetic treatment (four-unit fixed partial denture, removable partial denture, complete denture, and complete oral restoration cases) was performed according to the area and extent of the patient’s tooth loss. The patient’s occlusion at the first visit, treatment stage, right after treatment, and regular follow-up were compared and evaluated using a quantitative method for appropriate occlusion analysis using T-Scan Novus and Dental prescale II. This report enhances the understanding of occlusion analysis during prosthetic restoration. The results satisfied both the clinician and patients in terms of function and aesthetics.

BACKGROUND/AIMS: The tumor-node-metastasis (TNM) staging is an useful system to assess the prognosis of any solid cancer. As new TNM staging classification of 7th stomach cancer was revised in 2009, we evaluated the prognostic predictability of the 7th International Union Against Cancer/American Joint Committee on Cancer (UICC/AJCC) TNM classification compared to 6th UICC/AJCC TNM classification in gastric cancer. METHODS: From January 2000 to December 2009, 5-year survival rates of 266 patients with gastric cancer were calculated by the 6th and 7th UICC/AJCC TNM classification. RESULTS: Using the 7th UICC/AJCC TNM classification, there was no significant difference in the 5-year cumulative survival rates (5 YSR) between stage IIA and IIB, IIB and IIIA, and IIIA and IIIB (70% vs. 71%, p=0.530; 71% vs. 80%, p=0.703; 80% vs. 75%, p=0.576, respectively) though significant differences of the survival rates were observed among stages of 6th edition. Using T stage of 7th edition, 5 YSR was not different between T2 and T3 (86% vs. 82%, p=0.655). Using N stage of 7th edition, 5 YSR were not different between N1 and N2, N3a and N3b (79% vs. 81%, p=0.506; 41% vs. 17%, p=0.895, respectively). CONCLUSIONS: The 7th UICC/AJCC TNM classification had poor prognostic predictability in gastric cancer compared to the 6th edition.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; *Neoplasm Staging ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/classification/*diagnosis/*mortality/pathology ; Survival Rate

A healthy 34-year-old man was admitted to the intensive care unit through the emergency room with a drowsy mentality and severe chilling. Following a diagnosis of septic shock of unknown origin, the patient was treated with broad spectrum antibiotics and massive hydration. After recovery of consciousness, he complained of a severe toothache that originated from the right lower teeth. Under dental consultation, he was diagnosed as having an acute periapical abscess of the right mandibular first molar. The patient underwent extraction and cyst enucleation. Gram negative bacilli isolated from blood culture on day 5 after admission were identified as Prevotella species. After receiving antibiotic treatment and undergoing dental procedures, the patient made a full recovery. We report on a case of septic shock due to infection by Prevotella species in association with an acute periapical abscess.
Adult ; Anti-Bacterial Agents ; Consciousness ; Emergencies ; Humans ; Intensive Care Units ; Molar ; Periapical Abscess ; Prevotella ; Shock, Septic ; Tooth ; Toothache

Ganglion cysts usually arise from the tendon sheaths and tissues around the joints. It is usually associated with degenerative arthritic changes in older people. Ganglion cyst in the spine is rare and there is no previous report on case that located in the intervertebral foramen and compressed dorsal root ganglion associated severe radiculopathy. A 29-year-old woman presented with severe left thigh pain and dysesthesia for a month. Magnetic resonance imaging revealed a dumbbell like mass in the intervertebral foramen between second and third lumbar vertebrae on the left side. The lesion was removed after exposure of the L2-L3 intervertebral foramen. The histological examination showed fragmented cystic wall-like structure composed of fibromyxoid tissue but there was no lining epithelium. A ganglion cyst may compromise lumbar dorsal root ganglion when it located in the intervertebral foramen. Although it is very rare location, ganglion cyst should be included in the differential diagnosis for intervertebral foraminal mass lesions.
Adult ; Diagnosis, Differential ; Epithelium ; Female ; Ganglia, Spinal ; Ganglion Cysts ; Humans ; Joints ; Longitudinal Ligaments ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Paresthesia ; Radiculopathy ; Spine ; Tendons ; Thigh

PURPOSE: End-tidal carbon dioxide (ETCO2) reflects pulmonary perfusion and ventilation of resuscitated cardiac arrest patients. Single use of ETCO2 has some limitations in predicting outcomes of cardiac arrest. We hypothesized the dead space ventilation ratio (Vdt/Vt) using arterial CO2 and ETCO2 difference (Pa-etCO2) can be used as a better prognostic indicator of survival in resuscitated cardiac arrest patients. METHODS: 94 patients were cardiac arrest in emergency department from January 2004 to october 2005. Patients were intubated in the emergency department and treated using the standard advanced cardiac life support protocol. 48 patients were resuscitated following cardiac arrest. Their ETCO2 were evaluated by using mainstream capnography. ETCO2 and simultaneously, blood gas studies were evaluated within 1 hour following return of spontaneous circulation (ROSC). 17 Patients were excluded because they had chronic pulmonary disease or they were cardiac arrest after cerebrovascular accident. RESULTS: There was no difference in mean age, arrest rhythm, systolic blood pressure, and base excess between patients that were discharged alive and patients that died in the hospital. Arterial pH of patients expired within 24 hours was significantly lower than that of survivors. The ETCO2 following ROSC averaged 19.7 +/- 10.73 mmHg in cases of hospital death with ROSC< 24 hours, 31.4 +/- 14.04 mmHg in cases of hospital death with ROSC> 24 hours and 26.2 +/- 5.22 mmHg in survivors (p=0.050). The VdA/Vt averaged 0.20 +/- 0.087 mmHg in alive discharges, 0.59 +/- 0.187 mmHg in hospital death with ROSC<24 hours and 0.36 +/- 0.176 mmHg in hospital deaths with ROSC> 24 hours (p=0.000). CONCLUSION: This study showed that high P(a-et)CO2 and high VdA/Vt suggest poor outcomes in arrest patients with ROSC. If future studies validate this model, the use of VdA/Vt that compare to ETCO2 may be a more useful adjunct in assessing the outcomes of cardiac arrest..
Advanced Cardiac Life Support ; Blood Pressure ; Capnography ; Carbon Dioxide ; Emergency Service, Hospital ; Heart Arrest* ; Humans ; Hydrogen-Ion Concentration ; Lung Diseases ; Perfusion ; Stroke ; Survivors ; Ventilation

OBJECTIVE: The aim of this study was to evaluate effect of pulsed radiofrequency (PRF) neuromodulation of suprascpaular nerve (SSN) in patients with chronic shoulder pain due to adhesive capsulitis and/or rotator cuff tear. METHODS: The study included 11 patients suffering from chronic shoulder pain for at least 6 months who were diagnosed with adhesive capsulitis (n=4), rotator cuff tear (n=5), or adhesive capsulitis+rotator cuff tear (n=2) using shoulder magnetic resonance imaging or extremity ultrasonography. After a favorable response to a diagnostic suprascapular nerve block twice a week (pain improvement >50%), PRF neuromodulation was performed. Shoulder pain and quality of life were assessed using a Visual Analogue Scale (VAS) and the Oxford Shoulder Score (OSS) before the diagnostic block and every month after PRF neuromodulation over a 9-month period. RESULTS: The mean VAS score of 11 patients before PRF was 6.4+/-1.49, and the scores at 6-month and 9 month follow-up were 1.0+/-0.73 and 1.5+/-1.23, respectively. A significant pain reduction (p<0.001) was observed. The mean OSS score of 11 patients before PRF was 22.7+/-8.1, and the scores at 6-month and 9 month follow-up were 41.5+/-6.65 and 41.0+/-6.67, respectively. A significant OSS improvement (p<0.001) was observed. CONCLUSION: PRF neuromodulation of the suprascapular nerve is an effective treatment for chronic shoulder pain, and the effect was sustained over a relatively long period in patients with medically intractable shoulder pain.
Adhesives ; Bursitis ; Chronic Pain ; Extremities ; Failed Back Surgery Syndrome ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Nerve Block ; Quality of Life ; Rotator Cuff ; Shoulder Pain* ; Shoulder* ; Spinal Cord Stimulation ; Ultrasonography

PURPOSE: Liver cell damage after ischemia and reperfusion injury has been a major cause of death after liver surgery. Yet there have been no exact and practical guidelines for assessing liver cell damage after ischemia and reperfusion injury. The aim of this study was to estimate the liver cell viability after ischemia and reperfusion injury. METHODS: A 70% partial liver occlusion model with employing Spraque Dawley Rats was used. The ATP content of the liver tissue, the palmitic acid metabolic rate and the histologic change (H/E, TUNEL stain) were all measured at 30 minute intervals to assess liver cell viability during 120 minutes of ischemia. At 24 hours reperfusion after 30, 60 and 120 minutes ischemia, the same parameters and the AST/ALT level in the blood were measured. RESULTS: The ATP content was decreased below 20% compared to normal liver after ischemia, but there were no significant changes in the histology and the palmitic acid metabolic rate during 120 minutes ischemia. At 24 hours reperfusion after 30, 60 and 120 minutes ischemia, the ATP content was decreased to around 50% in all the groups and the palmitic acid metabolic rate was decreased 90.9+/-2.4%, 80.0+/-5.3% and 79.1+/-7.7%, respectively, compared to the control liver. But histologic change was not as great as the change in the ATP content and the palmitic acid metabolic rate. CONCLUSION: Judging by these results, liver has relatively good tolerance during ischemia, but after reperfusion, the liver showed damage depending on the duration of ischemia. This study might be very helpful as a guide line of liver damage after ischemia and reperfusion in both clinical practice and basic research.
Adenosine Triphosphate ; Animals ; Cause of Death ; Cell Survival* ; In Situ Nick-End Labeling ; Ischemia* ; Liver* ; Palmitic Acid ; Rats* ; Reperfusion Injury* ; Reperfusion*