No abstract available.
Wegener Granulomatosis*

STATEMENT OF PROBLEM: Use of custom tray and tray adhesive is clinically recommended for elastomeric impression material. However there is not clear mention of drying time of tray adhesive in achieving appropriate bonding strength of tray material and impression material. PURPOSE: This study is to investigate an appropriate drying time of tray adhesives by evaluating tensile bonding strength between two types of polyvinylsiloxane impression materials and resin tray, according to various drying time intervals of tray adhesives, and with different manufacturing company combination of impression material and tray adhesive. MATERIAL AND METHODS: Adhesives used in this study were Silfix (Dentsply Caulk, Milford, Del, USA) and VPS Tray Adhesive (3M ESPE, Seefeld, Germany) and impression materials were Aquasil Ultra (monophase regular set, Dentsply Caulk, Milford, Del, USA) and Imprint II Garant (regular body, 3M ESPE, Seefeld, Germany). They were used combinations from the same manufacture and exchanged combinations of the two. The drying time was designed to air dry, 5 minutes, 10 minutes, 15 minutes, 20 minutes, and 25 minutes. Total 240 of test specimens were prepared by auto-polymerizing tray material (Instant Tray Mix, Lang, Wheeling, Il, USA) with 10 specimens in each group. The specimens were placed in the Universal Testing machine (Instron, model 3366, Instron Corp, University avenue, Nowood, MA, USA) to perform the tensile test (cross head speed 5 mm/min). The statistically efficient drying time was evaluated through ANOVA and Scheffe test. All the tests were performed at 95% confidence level. RESULTS: The results revealed that at least 10 minutes is needed for Silfix-Aquasil, and 15 minutes for VPS Tray Adhesive-Imprint II, to attain an appropriate tensile bonding strength. VPS Tray Adhesive-Imprint II had a superior tensile bonding strength when compared to Silfix-Aquasil over 15 minutes. Silfix-Aquasil had a superior bonding strength to VPS Tray Adhesive-Aquasil, and VPS Tray Adhesive-Imprint II had a superior tensile bonding strength to Silfix-Imprint II at all drying periods. CONCLUSION: Significant increase in tensile bonding strength with Silfix-Aquasil and VPS Tray adhesive-Imprint II combination until 10 and 15 minutes respectively. Tray adhesive-impression material combination from the same company presented higher tensile bonding strength at all drying time intervals than when using tray adhesive-impression material of different manufactures.
Adhesives ; Collodion ; Dental Impression Materials ; Elastomers ; Head ; Polymers ; Polymethyl Methacrylate ; Polyvinyls ; Siloxanes

BACKGROUND: Generalized immune aetivation occurs early in the course of many infectious diseases. Clinical investigations have known that immune activation can be qiantified by the measurement of soluble immune activation products, neopterin and elastase-a-antitypsm in serum. OBJECTIVE: The purpose of this study was to assess macrophage and neutrophil activation in patient with leprosy by measurement of neopterin and elhstase-a-antitrypin. METHODS: The study population consisted of 31 patients with subculoid leprosy and 71 patients with lepromatous leprosy (39 cases of M. leprae positive patients and 32 cases of M. leprce negative patients). Serum samples and clinical and laboratory data were collected form each patient and control. The levels of serum neopterin and elastase-a-antitrypsin were masured by a sandwich enzyme immunoassay. RESULTS: The serum neopterin levels were significantly raised in patients with leprosy and significantly higher in lepromatous leprosy than tuberculoid leprosy. The sejum elastase-a-antitrypsin levels were significantly increased in pat,ients with leprosy, but did not vary significantly between tuberculoid and lepramatous leprosy. There was also no significant correlation between the neopterin and elastase-a-antitrypsin levels and bacterial index in patients with lepromatous prosy. CONCLUSION: These data suggest that non-specific activation of macrophages and neutrophiles occurs in leprosy and high titers of ineopterin and elastase-a-antitrypsin alore, in the absenee of a functioning T cell response, do not appee,r to confer resistance against Mycobacterium leprae.
Communicable Diseases ; Humans ; Immunoenzyme Techniques ; Leprosy ; Leprosy, Lepromatous ; Leprosy, Tuberculoid ; Macrophages ; Mycobacterium leprae ; Neopterin* ; Neutrophil Activation ; Neutrophils ; Pancreatic Elastase* ; Syphilis ; Treponema pallidum

BACKGROUND: Generalized immune aetivation occurs early in the course of many infectious diseases. Clinical investigations have known that immune activation can be qiantified by the measurement of soluble immune activation products, neopterin and elastase-a-antitypsm in serum. OBJECTIVE: The purpose of this study was to assess macrophage and neutrophil activation in patient with leprosy by measurement of neopterin and elhstase-a-antitrypin. METHODS: The study population consisted of 31 patients with subculoid leprosy and 71 patients with lepromatous leprosy (39 cases of M. leprae positive patients and 32 cases of M. leprce negative patients). Serum samples and clinical and laboratory data were collected form each patient and control. The levels of serum neopterin and elastase-a-antitrypsin were masured by a sandwich enzyme immunoassay. RESULTS: The serum neopterin levels were significantly raised in patients with leprosy and significantly higher in lepromatous leprosy than tuberculoid leprosy. The sejum elastase-a-antitrypsin levels were significantly increased in pat,ients with leprosy, but did not vary significantly between tuberculoid and lepramatous leprosy. There was also no significant correlation between the neopterin and elastase-a-antitrypsin levels and bacterial index in patients with lepromatous prosy. CONCLUSION: These data suggest that non-specific activation of macrophages and neutrophiles occurs in leprosy and high titers of ineopterin and elastase-a-antitrypsin alore, in the absenee of a functioning T cell response, do not appee,r to confer resistance against Mycobacterium leprae.
Communicable Diseases ; Humans ; Immunoenzyme Techniques ; Leprosy ; Leprosy, Lepromatous ; Leprosy, Tuberculoid ; Macrophages ; Mycobacterium leprae ; Neopterin* ; Neutrophil Activation ; Neutrophils ; Pancreatic Elastase* ; Syphilis ; Treponema pallidum

Moyamoya disease is a rare, progressive, occlusive cerebrovascular disorder characterized by bilateral stenosis of the intracranial portion of the internal carotid artery. Symptoms including transient ischemic attacks, seizures, intracranial hemorrhage and cerebral infarction, are variable. There are few case reports of moyamoya disease in pregnancy. Since hyperventilation-induced cerebral ischemia and hypertension are provoked by active labor, cesarean section has been recommended to avoid neurologic complications for pregnant women with moyamoya disease. The optimal anesthetic management for cesarean section in these patients has not been discussed. We report a case of moyamoya disease in a patient presenting for cesarean section at 40 weeks' gestation. Epidural anesthesia was administered using 0.5% bupivacaine and fentanyl. Intraoperative hemodynamic state was stable. The patient has no significant postoperative complications.
Anesthesia* ; Anesthesia, Epidural ; Brain Ischemia ; Bupivacaine ; Carotid Artery, Internal ; Cerebral Infarction ; Cerebrovascular Disorders ; Cesarean Section* ; Constriction, Pathologic ; Emergencies* ; Female ; Fentanyl ; Hemodynamics ; Humans ; Hypertension ; Intracranial Hemorrhages ; Ischemic Attack, Transient ; Moyamoya Disease* ; Postoperative Complications ; Pregnancy ; Pregnant Women ; Seizures

Purpose: Dislocation is the second most common cause of failure, after implant loosening, in revisional THA (Total hip arthroplasty), and its evaluation and treatment still remain controversial issue. This study was undertaken to evaluate the risk factors after THA using the posterolateral approach and posterior soft tissue repair. Materials and Methods: Between January 1998 and May 2003, 211 consecutive primary total hip replacement arthroplasties using the posterolateral approach and posterior soft tissue repair were performed by the same surgeon. To compare the dislocation groups (6 cases) with the non-dislocation groups (205 cases), we randomized 120 of the non-dislocation cases. The risk factors for hip dislocation were categorized into patient factors and surgical factors. Patient factors included gender, age, preoperative diagnosis, underlying systemic disease, and alcoholic history. Surgical factors included position of the component (acetabular version and inclination, femoral anteversion), leg length discrepancy, and sum of anteversions of the cup and stem. Their parameters were measured on postoperative radiographs. Statistics were performed with Fishe`s Exact test and T test. Results: Dislocations occurred at an overall incidence rate of 2.8% (6/211cases). There were 4 (1.9%) cases of anterior dislocations and 2 (0.9%) cases of posterior dislocations. Dislocations occurred on average at postoperative day 6.1 and all dislocated hips were reduced with the closed method, except for one case that was treated surgically. There was no statistical significance in patient factors between the two groups, except for neurologic disease and alcoholic history. However, the sum of the acetabular and femoral anteversions in the anterior dislocation group was larger than that of the non-dislocation group by approximately 19 degrees. Conclusion: Our results demonstrated that by using the posterior approach and repair of soft tissue, the posterior dislocation rate after total hip replacement arthroplasty can be reduced and the sum of the acetabular and femoral anteversions had more influence on dislocations after THAs than did either anteversion alone.
Acetabulum ; Alcoholics ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Diagnosis ; Dislocations ; Hip Dislocation* ; Hip* ; Humans ; Incidence ; Leg ; Risk Factors*

There have long been a lot of controversies on the treatment of unstable thoracolumbar spine fracture, and the role of decompression is also controversial. Compression of the neural elements by retropulsed bone fragments can be relieved indirectly by the reduction with posterior instrumentation or directly by the exploration of the spinal canal through a posterolateral or anterior approach. There is no universal agreement about the indications for each of these method. Authors analyzed the result of 24 cases of thoracolumbar spine fracture which had been operated by anterior decompression and Kaneda instrumentation from the February 1990 to May 1993 at Inha general hospital. The results were as follows: 1. The most common cause of injury was falling from a height, 20 cases (83.3%). And the 12 cases were in the 4th decade, with an average age of 37.7 years. 2. According to McAfee classification, there were 7 stable(29.2%) and 15 unstable bursting fractures(62.5%). And the most common level of injury was L1(11 cases, 45.8%). 3. Neurologic status was improved one or more grade(Frankel grade) in 21 cases except one case of complete paraplegia. 4. The average correctional angle of kyphotic deformity was 13.1° immediate postoperatively, and the loss of correction(average, 6.7°) was observed during the follow-up period. 5. The segmental instability was found at the level below the fusion in three cases during the follow-up period. 6. There was neither failure of instrument, dislodgement of graft bone nor lateral wedging during the follow-up period.
Accidental Falls ; Classification ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Hospitals, General ; Methods ; Paraplegia ; Spinal Canal ; Spine ; Transplants

OBJECTIVE: In the case of internal carotid-posterior communicating (ICPCom) artery aneurysm it is possible to successfully clip the aneurysmal neck without any difficulty. However, if the aneurysmal neck is wide, the aneurysmal sac is giant, the aneurysmal sac is hidden by the anterior clinoid process (ACP), or its dome is located in ventral portion or low-lying ICPCom aneurysm, it is difficult to open the proximal aneurysmal neck and we encounter a barrier in controlling bleeding in case of premature rupture of the aneurysm. They need to be resected the ACP for successful aneurysmal clipping. We propose angiographic criteria for predicting necessity of resection of the ACP before clipping of the ICPCom artery aneurysm. METHODS: Between 1999 and 2003, 16 patients with ICPCom artery aneurysm were treated with the resection of the ACP prior to applying the clip on the neck of the aneurysm. We retrospectively analyzed the preoperative cerebral angiographies, and the clinical and operative findings. We measured various radiometric parameters to reveal the angiographic characteristics. RESULTS: The mean value of the radiographic measurement in case of the cerebral angiography in 16 patients is as follows: angle A (the angle between the midline of the skull and the axis of the C1 segment on A-P view) ranged from 15 to 80 degrees (mean+/-SD, 42+/-5 degrees), angle B (the angle between the axes of the C1 and C2 segments on A-P view) ranged from 70 to 150 degrees (mean+/-SD, 110+/-15 degrees), and distance C (the distance between the tip of the ACP and the most proximal portion of the aneurysmal neck on the lateral view) ranged from 2 to 9 mm (mean+/-SD, 4.5+/-1 mm). CONCLUSION: We have resected the ACP in 16 of the 40 ICPCom aneurysms. The mean values of angle A, angle B, and distance C is 42+/-5 degrees, 110+/-15 degrees, and 4.5+/-1 mm, respectively. We did not encounter any difficulty in clipping in all the cases in which there was no premature rupture of the aneurysm. Most of cases had a good outcome.
Aneurysm* ; Arteries* ; Axis, Cervical Vertebra ; Cerebral Angiography ; Hemorrhage ; Humans ; Neck ; Retrospective Studies ; Rupture ; Skull

No abstract available.
Child* ; Humans ; Staphylococcus aureus* ; Staphylococcus*

PURPOSE: To introduce a new convenient and accurate method to measure the angle kappa using ultrasound biomicroscopy (UBM) and corneal topography. METHODS: Data from 42 eyes (13 males and 29 females) were analyzed in this study. The angle kappa was measured using Orbscan II and calculated with UBM and corneal topography. The angle kappa of the dominant eye was compared with measurements by Orbscan II. RESULTS: The mean patient age was 36.4 ± 13.8 years. The average angle kappa measured by Orbscan II was 3.98°± 1.12°, while the average angle kappa calculated with UBM and corneal topography was 3.19°± 1.15°. The difference in angle kappa measured by the two methods was statistically significant (p < 0.001). The two methods showed good reliability (intraclass correlation coefficient, 0.671; p < 0.001). Bland-Altman plots were used to demonstrate the agreement between the two methods. CONCLUSIONS: We designed a new method using UBM and corneal topography to calculate the angle kappa. This method is convenient to use and allows for measurement of the angle kappa without an expensive device.
Corneal Topography* ; Humans ; Male ; Methods ; Microscopy, Acoustic* ; Ultrasonography*