The aim of this study was to clarify whether bonding/debondmg procedure will affect the occurance of enamel crack. The frequency of enamel crack was compared between before-bonding and after-debonding on 200 human extracted teeth Each facial surface of the tooth was divided in 9 fragments A presence of crack, which was classified by its direction as vertical, horizontal and oblique crack, was surveyed in each fragment. Number of all cracks in facial surface was 1355 at before-bonding, and 1605 at after-debonding, so it revealed significant increase rate of 18.5%, but compared by fragment, cracks were significantly increased in OC, OD, CC and GC fragments. All kinds of cracks were significantly increased, especially increase rate of oblique crack reached 54.9%. The increase rate of cracks was not superior at any fragment or region, but some evidence was seen in CC fragment. Judging from the above, increase of crack is unavoidable with bonding/debonding procedures.
Dental Enamel* ; Humans ; Tooth*

The purpose of this study was to investigate the force mechanism of Multiloop Edgewise Arch Wire and the intensity and distribution of stresses with vertical and intermaxillary elastics. The obtained results were as follows. 1. When plain wires were inserted and vertical and intermaxillary elastics were used in the upper and lower arch, the stresses of the anterior and posterior ends of wires were observed greatly but the stresses of the premolar were very small. 2. When MEAW were inserted in upper and lower arch, the upper 1st and 2nd premolar and the lower 1st premolar were extruded greatly. 3. In the area of the upper 1st molar and the lower 2nd premolar and the lower 1st molar, any stresses were not observed. 4. The vertical elastic counteracted the intrusion force of the MEAW in the anterior teeth but could not affect on posterior teeth. Using with the Class II elastics, the distal tipping force and extrusion force were exerted in the upper anterior teeth and the intrusion forces of the lower anterior teeth were relieved. Using with the Class III elastics, the extrusion force were exerted in the upper and lower anterior teeth, the distal tipping force were increased in the lower posterior teeth. 5. The Class II elastic counteracted the anterior intrusion force of the MEAW and extruded and tipped mesially the lower 2nd molar. The intrusion force of the MEAW also could not overcome the extrusion force of the class II elastics. 6. When the Class III elastics were engaged, the upper 2nd molar was extruded in spite of the intrusion forces of the MEAW and the extrusion forces of the lower anterior teeth and distal tipping forces in the posterior teeth were observed.
Bicuspid ; Molar ; Tooth

Hepatocellular calcinoma (HCC) is the fifth most common cancer and the third leading cause of cancer-related deaths worldwide. It is important to diagnose HCC exactly before management is attempted. But, the clinical presentations and radiologic findings of liver abscess, HCC, and metastatic tumor to the liver may be quite similar, and procedures such as serum tumor marker assay, computerized tomography, and ultrasonography of the liver cannot make a specific diagnosis. We report a case of HCC successfully diagnosed by surgery which was misconceived as liver abscess and not improved by medical treatment.
Carcinoma, Hepatocellular/complications/*diagnosis/pathology ; Humans ; Liver/ultrasonography ; Liver Abscess/complications/*diagnosis/pathology ; Liver Neoplasms/complications/*diagnosis/pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed

PURPOSE: This study evaluated the feasibility of acoustic radiation force impulse (ARFI) elastography and characterized the sonographic features of lymph nodes (LNs) with Kikuchi disease in pediatric patients. METHODS: Seventy-six cervical LN biopsies were performed for the diagnosis of cervical lymphadenopathy. ARFI imaging was performed, and the characteristic ultrasound features of the biopsied LNs and the contralateral LNs were analyzed. We also reviewed clinical and conventional ultrasonographic findings. RESULTS: On histology, 56 patients were diagnosed with Kikuchi disease. These LNs were large and elongated, with increased perinodal echogenicity and capsular thickening. In 38 of them, ARFI elastography was performed, and the median shear wave velocity (SWV) of the biopsied LNs with Kikuchi disease (2.19 m/sec; range, 1.45 to 4.57 m/sec) was higher than of the contralateral LNs (1.72 m/sec; range, 0.95 to 2.65 m/sec; P < 0.001). In patients with reactive hyperplasia, the mean SWV of the biopsied LNs (2.00 m/sec; range, 1.49 to 2.26 m/sec) was higher than that of the contralateral LNs (1.55 m/sec; range, 1.21 to 2.32 m/sec; P=0.031). CONCLUSION: The SWV of LNs with Kikuchi disease was significantly higher than that of the contralateral LNs. Morphologically, LNs with Kikuchi disease showed an enlarged, elongated, and oval shape, increased perinodal echogenicity, and capsular thickening. In addition to the conventional ultrasonographic findings, the application of ARFI is feasible even in pediatric patients for the evaluation of cervical lymphadenopathy.
Acoustics* ; Biopsy ; Diagnosis ; Elasticity Imaging Techniques* ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Hyperplasia ; Lymph Nodes ; Lymphatic Diseases ; Pediatrics ; Ultrasonography

BACKGROUND AND OBJECTIVES: The combination of platelet glycoprotein IIb/IIIa inhibitors and a low dose thrombolytic agent may produce early Thrombolysis In Myocardial Infarction (TIMI) 3 flow and a high rate of ST elevation resolution in an ST elevation acute myocardial infarction (STEMI). The clinical effect of tirofiban combined with low dose alteplase, prior to primary percutaneous coronary intervention (PCI) in STEMI, were evaluated on the ST elevation resolution, TIMI flow and 30-day clinical outcomes. SUBJECTS AND METHODS: Following aspirin, clopidogrel and standard heparin, 45 patients with STEMI were randomized into 2 groups; tirofiban administration (Group I; n=23, 64+/-10 years; 15 male) or combined administration of tirofiban with 40 mg alteplase prior to primary PCI (Group II; n=22, 59+/-11 years; 19 male). The pre- and post-interventional TIMI flow grades, ST elevation resolution and bleeding complications were compared between the two groups. The major adverse cardiac events (MACE) were compared between the two groups during 30-days of clinical follow-up. RESULTS: Group II had a higher pre-interventional TIMI flow (TIMI flow> or =2: 34.8% vs. 90.9%, p<0.0001) and rate of ST elevation resolution (49.0+/-27.8% vs. 66.6+/-27.2%, p=0.045) than Group I. A major bleeding complication developed in 1 (5.0%) Group II patient, and minor bleeding complications developed 1 patient from each group (Group I; 9.5% vs. Group II; 10%, p=0.959). CONCLUSION: Combined administration of tirofiban with alteplase prior to primary PCI leads to a higher TIMI flow and more frequent ST elevation resolution, without bleeding complications, compared to a single administration of tirofiban.
Angioplasty ; Aspirin ; Blood Platelets ; Electrocardiography ; Follow-Up Studies ; Glycoproteins ; Hemorrhage ; Heparin ; Humans ; Myocardial Infarction* ; Percutaneous Coronary Intervention* ; Thrombolytic Therapy ; Tissue Plasminogen Activator*

Telemedicine is a health care system that contains new-media techniques and medical special knowledge, using information techniques such as audio, moving picture, and communication provided to patients in distant areas with medical service such as diagnosis, consultation, education. Especially during medical transportation, it is possible that transferred patient can be rapidly taken care of by telemedicine. Our study reports 65 cases between a doctor in a hospital on ground and a patient during medical evacuation by telephone, e-mail and facsimile. Sixteen of 65 cases (25%) were immediately transferred to a hospital by sailing or helicopter. Other 49 cases were successfully taken care of by telemedicine.Telemedicine is economic and reasonable solving medical problems that may occur during medical evacuation where access to medical facilities is impossible.
Aircraft ; Delivery of Health Care ; Diagnosis ; Education ; Electronic Mail ; Humans ; Telemedicine* ; Telephone ; Transportation

Caring for people with dementia is associated with multiple devastating social, financial, physical, and psychological challenges. There is strong evidence that multicomponent tailored caregiver intervention is effective in improving caregiver well-being and delaying institutionalization. In US, the government is actively funding for developing caregiver program and to prove its efficacy through randomized controlled trials (RCTs) to translate into practice. Even with the introduction of Korean Long-term Care Plan, still, the most of the patients with dementia are being cared by the family members. The distress of caregiving is enormous, but structured therapeutic intervention program which efficacy is proven through RCT is very insufficient in Korea. The purpose of this article is to review the caregiver intervention programs of ongoing clinical trials comparing US and Korea, and to propose a tailored, therapeutic intervention program (I-CARE; A multicenter, randomized trial to assess efficacy of therapeutic intervention programs for decreasing caregiver burden in dementia caregiver) for hospital-care in Korea.
Caregivers* ; Dementia* ; Financial Management ; Humans ; Institutionalization ; Korea ; Long-Term Care

We would like to correct the grant information.

Mirizzi syndrome (MS) is a rare complication of cholecystolithiasis that is characterized by obstruction of the common hepatic duct due to mechanical compression by impacted stones in the neck of the gallbladder or the cystic duct. Treatment of MS is surgical, and operative procedure would vary depending on its classification type. Biliary stricture after surgical treatment of MS is an unusual complication and endoscopic approach is not possible for patients who have undergone bilioenteric anastomosis. We report a case of a 60-year-old patient with biliary anastomotic stricture after surgical management of MS who was successfully treated with long-term percutaneous transhepatic biliary drainage.
Cholecystectomy ; Cholecystolithiasis ; Choledochostomy ; Classification ; Constriction, Pathologic* ; Cystic Duct ; Drainage* ; Gallbladder ; Hepatic Duct, Common ; Humans ; Middle Aged ; Mirizzi Syndrome* ; Neck ; Postoperative Complications ; Surgical Procedures, Operative

PURPOSE: This study was conducted in order to determine the characteristics and risk factors of pediatric eye injury patients in the emergency department and to offer strategies for prevention of pediatric eye injury. METHODS: This prospective study was conducted by use of a standardized eye injury survey of patients under the age of 16 years who were treated for ocular injury at nine emergency medical centers, from March to September of 2010. The following data were collected; general characteristics of the study population, type and location of injury, causative activities, and materials of injury. Risk factors associated with open-globe injury were analyzed by logistic regression. RESULTS: A total of 1,151 patients were enrolled in the study; 75% were male. The highest incidence was observed between the age of 11 and 16 years (34.5%); 79.2% of patients had closed globe injury. The most common type of injury was contusion (65.4%) in closed globe injury and penetration (5.1%) in open-globe injury. Eye injury occurred most commonly at home (48.6%), followed by school/institution (19.4%). The most common causative activity and material were play (42.4%) and person/animal/plant (17%). Application of eye protective equipment (odds ratio: 24.33; 95% CI: 11.32~52.29) was found to be a statistically significant factor for occurrence of an open-globe injury. CONCLUSION: Establishment of safety measures considering gender and age is important since characteristics of pediatric eye injury differ based on such risk factors. The risk of open-globe eye injury increased with application of personal protective equipment, therefore, public education and promotion to use protective equipment of adequate level would be considered important.
Contusions ; Cross-Sectional Studies* ; Education ; Emergencies ; Emergency Service, Hospital* ; Eye Injuries* ; Humans ; Incidence ; Logistic Models ; Male ; Pediatrics ; Prospective Studies ; Risk Factors*