OBJECTIVES: This study evaluates the change of the left atrial appendage function before and after electrical cardioversion to understand the mechanism involved in systemic thromboembolism of atrial fibrillation. BACKGROUND: Systemic thromboembolism associated with electrical cardioversion of atrial fibrillation is thought to originate from the left atrium or left atrial appendage, or both.However, the mechanism involved is poorly understood. METHOD: We studied left atrial appendage function funcction with transesophageal echocardiography in 15 patients with atrial fibrillation before and after successful electrical cardioversion. We measured left atrial appendage emptying and filling velocities and left atrial appendage areas. Also we analysed the characteristic Dopper flow pattern of LAA. RESULT: Left atrial appendage emptying velocities before cardioversion were greater in patients without(32.0+/-13.2cm/sec) than in those with(21.4+/-7.6cm/sec) spontaneous echo contrast(SEC). Furthermore emptying velocities after cardioversion were significantly reduced group with (21.4+/-7.6 vs 12.2+/-9.6, p<0.05) and the groupwithout(32.0+/-13.2 vs 18.1+/-10.2, p<0.05)SEC. CONCLUSION: After electrical cardioversion for atrial fibrillation left atrial appendage function is impaired. These observations suggest that stunned left atrial appendage after cardioversion may predispose to thrombus formation, which may play a role in the mechanism involved in the occurrence of thromboembolism after cardioversion.
Atrial Appendage* ; Atrial Fibrillation* ; Echocardiography, Transesophageal* ; Electric Countershock* ; Heart Atria ; Humans ; Thromboembolism ; Thrombosis

Angioedema is a disorder characterized by well-demarcated nonpitting edema involving the tongue, floor of the mouth, larynx, lips, and face. The incidence of angiotensin converting enzyme(ACE) inhibitor related angioedema has been reported to be about 0.1% to 0.2%, and the time of onset is usually during the first week of therapy. These ACE inhibitors include captopril, enalapril, and lisinopril. A 53-year old man with an 8 month history of hypertension previously controlled with atenolol, was presented to the dermatologic department with angioedema of the face and tongue. He had begun therapy with captopril one day before this episode. Even though he was treated with epinephrine and methylprednisolone sodium succinate, the edema gradually progressed and finally dyspnea developed. He was urgently intubated and treated with steroids and pheniramine maleate in the intensive care unit. The edema resolved after 24 hours.
Angioedema* ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Atenolol ; Captopril* ; Dyspnea ; Edema ; Enalapril ; Epinephrine ; Humans ; Hypertension ; Incidence ; Intensive Care Units ; Larynx ; Lip ; Lisinopril ; Methylprednisolone Hemisuccinate ; Middle Aged ; Mouth ; Pheniramine ; Steroids ; Tongue

BACKGROUND: Topical vitamine D analogues have been reported to bean effective treatment in patients with psoriasis. Calcipotriol, a new vitamin D analogue, is effect ve and at least 100 times less calcemic than calcitriol. OBJECTIVE: Our purpose was to study the clinical efficacy, safety and tolerability of calcipotriol ointment in the treatment of psoriasis. METHODS: Twenty five patients with chronic poriasis were treated with calcipotriol ointment(50pg/g) twice daily. Efficacy as meaaured by the clinical degree of erythcimor, scale and thickness of the lesions, and safety were assessecl every 2 weeks. RESULTS: The total score of erythema, scale and thickness of the lesions decreased in 6 weeks from 8.52+0.76 to 3.80+1.7 with calcipotriol. Some patients developed mild and transient local side effects. The laboratory tests including serum calcium remained unchanged. CONCLUSION: Topical applicalion of calcipotriol ointment for 6 week was found to bean effective and safe treatment of psoriasis vulgaris.
Calcitriol ; Calcium ; Erythema ; Humans ; Psoriasis* ; Vitamin D ; Vitamins

BACKGROUND: Topical vitamine D analogues have been reported to bean effective treatment in patients with psoriasis. Calcipotriol, a new vitamin D analogue, is effect ve and at least 100 times less calcemic than calcitriol. OBJECTIVE: Our purpose was to study the clinical efficacy, safety and tolerability of calcipotriol ointment in the treatment of psoriasis. METHODS: Twenty five patients with chronic poriasis were treated with calcipotriol ointment(50pg/g) twice daily. Efficacy as meaaured by the clinical degree of erythcimor, scale and thickness of the lesions, and safety were assessecl every 2 weeks. RESULTS: The total score of erythema, scale and thickness of the lesions decreased in 6 weeks from 8.52+0.76 to 3.80+1.7 with calcipotriol. Some patients developed mild and transient local side effects. The laboratory tests including serum calcium remained unchanged. CONCLUSION: Topical applicalion of calcipotriol ointment for 6 week was found to bean effective and safe treatment of psoriasis vulgaris.
Calcitriol ; Calcium ; Erythema ; Humans ; Psoriasis* ; Vitamin D ; Vitamins

All ceramic restorations have had a more limited life expectancy than metal ceramic crowns because of their lower strength. The relatively lower strength has limited the use of all-ceramic crowns to the areas where occlusal loads are lower. Therefore many researches have been done to increase the strength of all-ceramic crowns. IPS Empress 2 is a new type of lithium disilicate glass-ceramic with enhanced physical characteristics which has been in use clinically since 1998. Previous researches reported that the flexural strength of all-ceramic material was greater than 300MPa, and all-ceramic crowns can be used in staining or layering technique. The objective of this study was to investigate the influence of the thickness of IPS Empress 2 ceramic on fracture strength. Both staining technique and layering technique was investigated. Vita VMK was used as control. For all three groups, five specimens each of 0.8mm, 1.0mm, 1.4mm, 1.8mm, and 2.2mm thickness (a total of 75 specimens) were prepared. Control group: Vita VMK Porcelain specimens were prepared with dentine ceramic and liquid glazing was done. Group I: IPS Empress 2 were prepared with staining technique and stained twice and glazed once. Group II : IPS Empress 2 were prepared with layering technique and glazed after wash firing. The thickness and diameter of the specimen were measured and controlled after specimen preparation. Biaxial Flexure Test (ASTM Standard F394-78) was adopted as this test method produces results least affected by the edge condition of the specimens. Fracture strength was measured with Instron Universal Testing Machine. Conclusions are as follow : 1. The fracture strength was increase in order of control group, test group I, test group II. 2. Fracture strength of the group I(Empress 2 Staining) was 65.54 N in 0.8mm, 155.2 N in 1.0mm, 233.5 N in 1.44mm, 434.5 N in 1.8mm, and 600.1 N in 2.2mm. 3. Fracture strength of the group II (Empress 2 Layering) was 190.0 N in 0.8mm, 283.5 N in 1.0mm, 437.2 N in 1.4mm, 732.0 N in 1.8mm, and 1115.0 N in 2.2mm. 4. No statistical difference was found in flexural strengths according to thickness in a specified group(p>0.05).
Ceramics* ; Crowns ; Dental Porcelain ; Dentin ; Fires ; Life Expectancy ; Lithium

STATEMENT OF PROBLEM: Macroscopic and especially microscopic properties of implant surfaces play a major role in the osseous healing of dental implants. Dental implants with modified surfaces have shown stronger osseointegration than implants which are only turned (machined). Advanced surface modification techniques such as anodic oxidation and Ca-P application have been developed to achieve faster and stronger bonding between the host bone and the implant. PURPOSE: The purpose of this study was to investigate the effect of surface treatment of titanium dental implant on implant stability after insertion using the rabbit tibia model. MATERIAL AND METHODS: Three test groups were prepared: sandblasted, large-grit and acid-etched (SLA) implants, anodic oxidized implants, and anodized implants with Ca-P immersion. The turned implants served as control. Twenty rabbits received 80 implants in the tibia. Resonance frequencies were measured at the time of implant insertion, 2 weeks and 4 weeks of healing. Removal torque values (RTV) were measured 2 and 4 weeks after insertion. RESULTS: The implant stability quotient (ISQ) values of implants for resonance frequency analysis (RFA) increased significantly (P < .05) during 2 weeks of healing period although there were no significant differences among the test and control groups (P > .05). The test and control implants also showed significantly higher ISQ values during 4 weeks of healing period (P < .05). No significant differences, however, were found among all the groups. All the groups showed no significant differences in ISQ values between 2 and 4 weeks after implant insertion (P > .05). The SLA, anodized and Ca-P immersed implants showed higher RTVs at 2 and 4 weeks of healing than the machined one (P < .05). However, there was no significant difference among the experimental groups. CONCLUSION: The surface-modified implants appear to provide superior implant stability to the turned one. Under the limitation of this study, however, we suggest that neither anodic oxidation nor Ca-P immersion techniques have any advantage over the conventional SLA technique with respect to implant stability.
Dental Implants ; Imidazoles ; Immersion ; Nitro Compounds ; Osseointegration ; Rabbits ; Tibia ; Titanium ; Torque

BACKGROUND: Although most dermatologic laser systems were developed to damage target tissue selectively, the epidermal injury has been a major problem in treating skin lesions of colored people. Recently, to minimize the epidermal damage during laser treatment, superficial cooling is being used. Cooling is one of the well known methods to reduce pain sensation. OBJECTIVE: The purpose of this study was to evaluate the effectiveness of an air cooling in reducing pain associated with Q-switched Nd:YAG laser and pulsed dye laser treatment. METHODS: We measured the temperature of normal skin during air cooling and studied 13 patients treated with a 1064 nm Q-switched Nd:YAG laser or 585 nm pulsed dye laser treatment with and without air cooling system. The degrees of pain reduction rates with and without cooling were assessed by the visual analogue scales. RESULTS: 1. It was shown that cold air flow from 2 cm distance for 10 sec decreased skin temperature about 10.6 degreeC to 17.2 degreeC depending on the body sites. 2. The average of the pain scores was 38.08+/-21.05 on the cooled site as compared to 70.77+/-15.76 on the uncooled site. CONCLUSIONS: The cold air decreased the skin surface temperature like the other epidermal cooling system and it was very effective to reduce the pain on the cooled site associated with dermatologic laser treatment.
Humans ; Lasers, Dye ; Sensation* ; Skin ; Skin Temperature ; Weights and Measures

BACKGROUND: Although most dermatologic laser systems were developed to damage target tissue selectively, the epidermal injury has been a major problem in treating skin lesions of colored people. Recently, to minimize the epidermal damage during laser treatment, superficial cooling is being used. Cooling is one of the well known methods to reduce pain sensation. OBJECTIVE: The purpose of this study was to evaluate the effectiveness of an air cooling in reducing pain associated with Q-switched Nd:YAG laser and pulsed dye laser treatment. METHODS: We measured the temperature of normal skin during air cooling and studied 13 patients treated with a 1064 nm Q-switched Nd:YAG laser or 585 nm pulsed dye laser treatment with and without air cooling system. The degrees of pain reduction rates with and without cooling were assessed by the visual analogue scales. RESULTS: 1. It was shown that cold air flow from 2 cm distance for 10 sec decreased skin temperature about 10.6 degreeC to 17.2 degreeC depending on the body sites. 2. The average of the pain scores was 38.08+/-21.05 on the cooled site as compared to 70.77+/-15.76 on the uncooled site. CONCLUSIONS: The cold air decreased the skin surface temperature like the other epidermal cooling system and it was very effective to reduce the pain on the cooled site associated with dermatologic laser treatment.
Humans ; Lasers, Dye ; Sensation* ; Skin ; Skin Temperature ; Weights and Measures

Pulmonary edema is a rare adverse reaction to the iodinated contrast medium. Complaining of huge abdominal mass, a 52 years-old female was admitted to the Hangang Sungsim Hospital. On physical examination, the patient appeared to be healthy. She had stable vital Signs, i.e. BP: 120/80 mmHg, pulse rate: 80/min. etc. An adult head sized mass was palpated in the left mid and lower abdomen. Otherwise nonspecific. On laboratory studies, the positive findings were 8-10 WBC/HPF in urine, 25.6 mg/dl for BUN and PVC in EKG. It was negative for urine protein, serum creatinine and liver function test. We injected 100ml and 30 ml for Urografin 60 through the abdominal aortadividing 3 times and major branches of the abdominal aorta, respectively. Immediately after completing angiography, interstitial pulmonary edema was found, showing blurring of the vascular margins, perivascular haziness and thickening of the interiobular septal lines in the both lower lung fields. The blood pressure was dropped to 80/60 mmHg, but pulse rate was normal. She did not complian of dyspnea, and cyanosis was not developed. The urine volume was normally maintained. She was treated for pulmonary edema, which was completely absorbed after 20 hours. And the blood pressure was also normalized. We has experienced a case of pulmonary edema developed after intraarterial injection of the iodinated contrast medium without underlying cardiac, renal and hepatic problems, and reviewed the literatures on mechanisms of pulmonary edema caused by intravascular injection of the iodinated contrast materials.
Abdomen ; Adult ; Angiography ; Aorta, Abdominal ; Blood Pressure ; Contrast Media ; Creatinine ; Cyanosis ; Diatrizoate Meglumine ; Dyspnea ; Electrocardiography ; Female ; Head ; Heart Rate ; Humans ; Injections, Intra-Arterial ; Liver Function Tests ; Lung ; Physical Examination ; Pulmonary Edema ; Vital Signs

Purpose: To identify inflammatory factors that may serve as biomarkers for dry eye syndrome using a hyperosmotic dry eye syndrome model. Methods: Cultured human conjunctival epithelial cells were subjected to 400, 450, 500, and 550 mOsm/L NaCl, and cell viability was assessed in response to osmolarity. The relative expression of inflammatory factors was evaluated by real-time polymerase chain reaction of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, metalloproteinase (MMP)-2, and MMP-9 according to the NaCl concentration. Results: An increase in the concentration of NaCl led to a notable decrease in cell viability (p < 0.05). IL-8, TNF-α, and MMP-9 expression levels increased significantly in proportion to NaCl concentration (p < 0.05). Conclusions IL-8, TNF-α, and MMP-9 may serve as effective biomarkers in dry eye studies.