No abstract available.
Hemangioma, Cavernous*

BACKGROUND: Pain on injection of propofol is a common problem, the cause of which remains unKnown. We evaluated the optimum time of a tourniquet with intravenous lidocaine, to decrease the intensity of pain during intravenous propofol injection. METHODS: In 72 patients undergoing general anesthesia, we subdivided all patients into 4 groups. Patients in group 1 (n = 18) received propofol only (1 mg/Kg IV) without a tourniquet, patients in group 2 (n = 18) received 1% lidocaine 20 mg IV with an upper arm tourniquet inflated to 50 mmHg applied for 1 minute followed by propofol (1 mg/Kg IV). We applied a tourniquet to patients in group 3 (n = 18) and 4 (n = 18) for 3 minutes and 5 minutes respectively. The intensity of pain along the forearm was classified in 4 degrees (none, mild, moderate, severe) by the patients and the observer simultaneously. The mean arterial pressure and heart rate were recorded before injection and at the time when the patient complained of pain. RESULTS: All groups were similar in age, sex, weight and height. The group with the tourniquet applied for 5 minutes followed by a lidocaine injection showed the lowest intensity of pain. However, between the group with 3 minutes and 5 minutes, the difference of the pain score was not statistically significant. CONCLUSIONS: We conclude that intravenous lidocaine administered after a tourniquet has been inflated to 50 mmHg for 3 minutes before propofol injection attenuates profoundly the pain associated with intravenous propofol injection.
Anesthesia, General ; Arm ; Arterial Pressure ; Forearm ; Heart Rate ; Humans ; Lidocaine* ; Propofol* ; Tourniquets*

The purpose of this study was to quantify the amount of remaining gutta-percha/sealer on the walls of root canals when three types of nickel-titanium rotary instruments(Profile, ProTaper and K3) and a hand instrument(Hedstrom file) used to remove these materials. The results of this study were as follows: 1. In the total time for gutta-percha removal, Profile group was the fastest and followed by K3, Protaper, Hedstrom file group. 2. In case of the evaluation of the volume of remained gutta-percha from radiograph, K3 group got the highest score and followed by Protaper, Hedstrom file, Profile group in the apical 1/3. 3. In case of the evaluation of the volume of gutta-percha remained from stereomicroscope, K3 group got the highest score and followed by Protaper, Hedstrom file, Profile group in the apical 1/3. These results showed that instrumentation using nickel-titanium rotary instrument groups was faster than that using hand instrument group. The effect of gutta-percha removal using Profile group was better than that using Protaper and K3 group in the nickel-titanium rotary instrument groups.
Dental Instruments ; Dental Pulp Cavity ; Gutta-Percha* ; Hand

Myotonic dystrophy is a multisystemic disorder inherited as an autosomal dominant trait. The characteristic clinical features include the presence of myotonia, atrophy of the muscles of the face and the sternocleidomastoids and numerous nonmusclar manifestations such as cataracts, frontal baldness, gonadal dysfunctions and cardiac abnormalities. We experienced one case of myotonic dystrophy with prolonged atrial flutter in 30-year-old male who was admitted because of palpitation. We present this case with reviewing literatures.
Adult ; Alopecia ; Atrial Flutter* ; Atrophy ; Cataract ; Gonads ; Humans ; Male ; Muscles ; Myotonia ; Myotonic Dystrophy*

STATEMENT OF PROBLEM: It is not clear how to make a stable bonding between zirconia ceramic and resin cement. And the study about surface treatment of zirconia ceramic or bonding resin cement are not enough. PURPOSE: To measure and compare the shear bond strength of some resin cements on zirconia ceramic after different surface treatments. MATERIAL AND METHOD: 48 ceramic discs were made of 3 ceramic materials, zirconia ceramics Zi-Ceram), heat-pressed ceramics (IPS Empress 2) and slip cast alumina ceramics (In-Ceram). According to the surface treatments of ceramic specimens and resin cements, specimens were classified into 6 groups and each group was composed of 8 specimens. For the surface treatment of Zi-Ceram group (test group), sandblasting and diamond bur preparation were applied and Superbond C&B and Panavia F were bonded respectively. For IPS Empress 2 group (control group), Variolink II was bonded after sandblasting, acid etching, silanization and for In-Ceram ALUMINA group (control group), Panavia F was bonded after sandblasting. After storing specimens in distilled water for 24 hours, the shear bond strength was measured by the universal testing machine. RESULTS AND CONCLUSION: 1. Zi-Ceram group with Superbond C&B cement showed higher bond strength than with Panavia F cement regardless to the surface treatments (p<0.05). 2. In Zi-Ceram group with Superbond C&B cement, sandblasting treatment group (12.1MPa) showed higher bond strength than diamond bur treatment group (7.7MPa) (p<0.05). In Zi-Ceram group with Panavia F cement, there were no significant differences in the bond strength according to the surface treatments (p>0.05). 3. Zi-Ceram group with sandblasting and Superbond C&B cement (12.1MPa) showed the highest bond strength. The bond strength of this group was not significantly different from In-Ceram ALUMINA group (10.4MPa) (p>0.05) and lower than IPS Empress 2 group (15.9MPa) (p<0.05).
Aluminum Oxide ; Ceramics* ; Dental Instruments ; Resin Cements* ; Water

OBJECTIVES: Doppler optical coherence tomography (DOCT) is useful for both, the spatially resolved measurement of the tympanic membrane (TM) oscillation and high-resolution imaging. We demonstrated a new technique capable of providing real-time two-dimensional Doppler OCT image of rapidly oscillatory latex mini-drum and in vivo rat TM and ossicles. METHODS: Using DOCT system, the oscillation of sample was measured at frequency range of 1–4 kHz at an output of 15 W. After the sensitivity of the DOCT system was verified using a latex mini-drum consisting of a 100 μm-thick latex membrane, changes in displacement of the umbo and contacted area between TM and malleus in normal and pathologic conditions. RESULTS: The oscillation cycles of the mini-drum for stimulus frequencies were 1.006 kHz for 1 kHz, 2.012 kHz for 2kHz, and 3.912 kHz for 4 kHz, which means that the oscillation cycle of the mini-drum become short in proportional to the frequency of stimuli. The oscillation cycles of umbo area and the junction area in normal TM for frequencies of the stimuli showed similar integer ratio with the data of latex mini-drum for stimuli less than 4 kHz. In the case of middle ear effusion condition, the Doppler signal showed a tendency of attenuation in all frequencies, which was prominent at 1 kHz and 2 kHz. CONCLUSION: The TM vibration under sound stimulation with frequencies from 1 kHz to 4 kHz in normal and pathologic conditions was demonstrated using signal demodulation method in in vivo condition. The OCT technology could be helpful for functional and structural assessment as an optional modality.
Animals ; Ear, Middle ; Latex ; Malleus ; Membranes ; Methods ; Otitis Media with Effusion ; Rats ; Tomography, Optical Coherence ; Tympanic Membrane ; Vibration

BACKGROUND: The management of postoperative pain with traditional narcotic analgesic regimen is associated with an unacceptably high failure rate and at best has represented a cautious compromise between adequate analgesia and the risk of complications, particularly that of respiratory depression. The purpose of this investigation was to compare the efficacy and safety of nalbuphine given by patient-controlled analgesia (PCA) with differential dosages after total knee replacement. METHODS: A double-blind clinical trial of 75 patients who received intravenous nalbuphine with patient- controlled analgesia during the postoperative first 48 hours after total knee replacement, was carried. Patients were assigned to three groups by the concentration of nalbuphine: Group 1 (n = 25), 2 mg/ml; Group 2, 4 mg/ml; Group 3, 6 mg/ml. The settings of PCA in three groups were same. RESULTS: Visual analog scale (VAS) scores were used to assess pain. Group 2 and 3 patients reported significant lower VAS over the postoperatively 6 hours and 12 hours at either rest or movement compared to group 1. PCA demands, delivered doses and PCA nalbuphine dosage per hours except supplemental analgesic doses in the first 48 hours were lower in group 2 and 3 compared to group 1. There were significant differences among groups at postoperatively 6 and 12 hours in nausea, vomiting and sedation of the side effects. CONCLUSIONS: IV PCA with nalbuphine is thought to be potent and safe for postoperative pain relief without the major morbidity like respiratory depression, in addition, the careful observation and treatment on the side effect like nausea, vomiting and sedation, is surely needed.
Analgesia ; Analgesia, Patient-Controlled* ; Arthroplasty, Replacement, Knee ; Humans ; Nalbuphine* ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Respiratory Insufficiency ; Visual Analog Scale ; Vomiting

Mitral ring motion and indices of left ventricular diastolic filling were measured by M-mode and Doppler echocardiography in apical 4 chamber view in 11 dilated cardiomyopathy patients and 9 normal subjects without clinical evidence of heart disease. The mean age of patients was 52 years and average heart rate was 76 beats/min. The parameters of mitral annulus motion include earley relaxation amplitude(ER), late atrial contraction amplitude(AC) and A2-peak excursion(A2-PE). Transmitral flow velocity parameters include peak flow velocity of early diastolic flow velocity(PFVE), peak flow velocity of late atrial contraction(PFVA), the ratio between early and late peak flow velocity(PFVE/PFVA), Acceleration rate of early diastolic peak flow(AR), deceleration rate of early diastolic peak flow(DR), time velocity integral of early diastolic flow velocity(TVIE), time velocity integral of late atrial contraction flow velocity(TVIA) and ratio between early diastolic and late atrial flow velocity integral(TVIE/TVIA). In patients with dilated cardiomyopathy, ER(4.5+/-2.3mm) and AC(2.3+/-1.6mm) were significantly decreased than normal(10.7+/-2.6mm, 6.6+/-1.6mm, p<0.01, p<0.01, respectively), whereas ER/AC(1.7+/-0.7) was not significantly different than normal subjects(1.6+/-0.5). A2-PE(100+/-80 msec) was significantly delayed in dilated cardiomyopathy patients than normal subjects(35+/-25 msec, p<0.01). In analysis of transmitral flow velocities, PFVE, PFVA and PFVE/PFVA, etc were not significantly different compared to normal subjects in patients with dilated cardiomyopathy. Mitral ring motion amplitude was decreased and A2-peak excursion time interval(A2-PE) was delayed in patients with dilated cardiomyopathy, but transmitral flow velocities were not significantly different from normal subjects in patients with dilated cardiomyopathy. These results reflect the facts that early diastolic relaxation amplitude is decreased by the change of compliance of LV and late atrial contractin amplitude is decreased by decrease of atrial contractility and increased stiffness of LA and LV. Despite of decreased mitral ring motion, transmitral flow velocity is not significantly different compared to normal subjects in patients with dilated cardiomyopathy. From these evidences, not only transmitral flow velocity affected by multiple factors but also mitral ring motion affected by LA and LV function are considered in assessment of LV diastolic dysfuction.
Acceleration ; Blood Flow Velocity* ; Cardiomyopathy, Dilated* ; Compliance ; Deceleration ; Echocardiography, Doppler ; Heart Diseases ; Heart Rate ; Humans ; Relaxation

Intradural extramedullary tuberculoma of the spinal cord is a rare manifestation of the spinal tuberculosis, with a few cases described so far. Recently, we have experienced two cases of extensive intradural extramedullary tuberculoma at the thoracic spine. So, we report these cases with review of the literatures.
Spinal Cord ; Spine ; Tuberculoma ; Tuberculosis, Spinal