Objective: This study examined the frequency of emergency department visits for syncope according to the day, week, and month. The frequency of syncope associated with holidays and the locations was also investigated. Methods: A retrospective study was performed on the frequency of patients discharged from the emergency department with a diagnosis of syncope from July 2016 to June 2017. Each 24-hour period was analyzed in four-hour intervals, and the frequency of occurrence was calculated for weekly and monthly time frames. In addition, the frequency of syncope associated with holidays and the locations where syncope occurred were analyzed for any possible trends. Results: For the 259 patients in this study, the frequency of the reflex syncope was significantly higher between 6 and 10 am (P=0.011), and showed a decreasing trend since that period (P=0.006). The number of reflex syncope visits on Mondays was significantly higher than on the other days (P<0.001) and a decreasing trend after Monday toward the weekend (P=0.023). A significant difference in the frequency of syncope associated with holidays was observed: 0.48 on weekdays, excluding the day after a holiday; 0.37 on a holiday; and 0.92 on the day after a holiday (P<0.001). Almost half of the reflex syncope events (44.3%) occurred in the subway. Conclusion The frequency of syncope was highest in the morning. In addition, reflex syncope showed a higher frequency on the day after a holiday, and the incidence was higher in the subway.

PURPOSE: This study aimed to identify the scores of postpartum depression(PPD) on the first day, 1st week, and 6th week after the delivery and to explore their related factors before and after delivery in postpartum women. METHODS: With a survey design, 293 postpartum women were recruited from a postpartum unit, Ilsin Christian hospital in Pusan via convenience sampling and were followed at 1st week and 6th week in the outpatient clinic. RESULTS: Results showed that the scores of PPD(EPDS score) were low at postpartum 1st day, 1st week and 6th week but prevalence of PPD(EPDS > or =13) was 3.1% at 1st day, 8.2% at 1st week and 7.5% at 6th week, respectively. The pre-delivery factors were experience of depression, and the post-delivery factors were baby's sex(1st day), no caregiver for baby(1st week), and no help and concern for taking care of baby from husband and family(1st day and 6th week). The greater satisfaction with becoming a mother and her life, and greater maternal attachment were related to lower level of PPD at the three time points. CONCLUSION: Regular screening for postpartum depression and supportive and informative education is needed for postpartum women visiting the outpatient clinic for follow-up.
Ambulatory Care Facilities ; Caregivers ; Depression ; Depression, Postpartum ; Female ; Follow-Up Studies ; Humans ; Mass Screening ; Mothers ; Postpartum Period ; Prevalence ; Spouses ; Tuberculin

PURPOSE: The purpose of this study was to evaluate the influence of porcelain re-firing on the formation of surface bubble and on the change in shade of metal-ceramic crown exposed to artificial saliva. MATERIALS AND METHODS: Thirty disk-shaped specimens were made in 10 mm diameter with 0.5 mm metal core thickness and 1 mm ceramic thickness. A spectroradiometer was used to determine the CIE Lab coordinates. The number and size of surface bubble were observed with a stereomicroscope. After the exposure to artificial saliva for 7 days, re-firing was performed at glazing temperature. After re-firing, the CIE Lab were calculated, and the number and size of surface bubble were observed again. The change in shade was expressed with DeltaE. Statistical analysis was done with paired t-test for the change in the number of surface bubble and student t-test for the change in the size of surface bubble (alpha= 0.05). RESULTS: Shade difference was calculated 2.14 DeltaE units. The mean number of surface bubble was 1.33 +/- 1.49 before re-firing, 3.27 +/- 2.90 after re-firing. After re-firing, the number of surface bubble was significantly increased (P<.05). The mean size of surface bubble was 81.97 +/- 32.03 microm before re-firing, 142.94 +/- 47.40 microm after re-firing. After re-firing, the size of surface bubble was significantly increased (P<.05). CONCLUSION: Shade change after re-firing was perceptible (DeltaE < 2.0) and clinically acceptable (DeltaE < 3.7). The number and size of surface bubble was significantly increased after re-firing. Further investigation to decrease the surface bubble on the extra oral repair of metal-ceramic crown, will be needed in future study.
Ceramics ; Crowns ; Dental Porcelain ; Humans ; Pyridines ; Saliva, Artificial ; Thiazoles

PURPOSE: Resonance frequency analysis, Periotest, and removal torque (RT) test were known as the methods to assess implant stability. The results of these methods are affected by the bone condition, implant diameter and shape. The purpose of this study is to access the meaning and the correlationship of the resonance frequency analysis, Periotest and RT test in osseointegration simulated acrylic resin when the engaged bone thickness and peri-implant bone defect are changed. MATERIALS AND METHODS: To simulate osseointegration, the fixture was fixed to an aluminum mold with a screw. Acrylic resin powder and liquid were poured into the mold for polymerization. The engaged resin thickness with implant was controlled. Simulated cortical bone thicknesses were 1, 3, 5 and 10 mm. Additional 1, 3 and 5 mm peri-implant bone defects were simulated. Three types of implants were used; 4 mm diameter implants of straight shape, 4 mm diameter implants of tapered shape and 5 mm diameter implants of tapered shape. Five fixtures per each type were tested in respective bone condition. Resonance frequency analysis and Periotest were evaluated in all bone conditions. Peak removal torque was measured at simulated cortical bone thicknesses of 1 and 3 mm. The statistical analysis was performed with the Kruskal-Wallis test, Mann-Whitney U test, and Spearman test using a 95% level of confidence. RESULTS: With increasing engaged bone depth, the Implant Stability Quotient (ISQ) values increased and the Periotest values (PTVs) decreased (P<.001, P<.001). With increasing peri-implant bone defect, ISQ values decreased and PTVs increased (P<.001). When the diameter of implant increased, ISQ values increased and Periotest values (PTV) decreased (P<.001). There was a strong correlation between ISQ values and PTVs (r = -0.99, P<.001). Furthermore, the peak removal torque values had weak correlations with both ISQ values and PTVs (r = 0.52, P<.001 ; r = -0.52, P<.001). CONCLUSION: This study confirmed favorable implant stability with increasing engaged bone depth and implant diameter and decreasing peri-implant bone defect. ISQ values and PTVs showed strong correlation with each other and not with the peak removal torque values.
Aluminum ; Fungi ; Osseointegration ; Polymerization ; Polymers ; Torque

PURPOSE: The aim of this study was to investigate effect of specimen preparation method on the microtensile bond strength of veneering ceramic to zirconia core. MATERIALS AND METHODS: Cylindrical Lava zirconia block (3M ESPE, Seefeld, Germany) was cut into discs using a diamond disc. After sintering, the core specimens were placed in an adjustable mold and veneered with Lava ceram (3M ESPE, Seefeld, Germany). The disc shaped specimen of group 1 was cut into microbars (1x1x7 mm3) using a low speed diamond disc under water cooling (n = 15). The specimen of group 2 was cut into microbars (1.2x1.2x7 mm3) in the same way. Whereafter the microbars were trimmed (1x1x7 mm3) using a thick diamond disc under water cooling (n = 15). The microtensile bond strength was tested in a microtensile tester (Instron 8848, Instro(R) Co., Norwood, USA). Fractured microtensile specimens were analyzed under a stereomicroscope (MZ6, Leica Microsystems GmbH, Wetzlar, Germany) at magnification x30. RESULTS: The microtensile bond strength of group 1 (28.8 +/- 7.0 MPa) was significantly higher than group 2 (11.0 +/- 3.3 MPa) (P=.00). CONCLUSION: It appears advisable to avoid the trimming action, especially high strength ceramic specimens.
Ceramics ; Diamond ; Fungi ; Water ; Zirconium

PURPOSE: The purpose of this study was to assess the marginal fit of three-unit bridges produced using LAVA CAD/CAM (computer-aided design/computer-aided manufacturing) system and conventional PFG in vitro. MATERIALS AND METHODS: #11, 13 resin teeth were prepared on dentiform, then duplicated. Twenty resin models were fabricated, ten for PFG 3-unit bridges and ten for LAVA 3-unit bridges. Each bridge was cemented on the resin model. Marginal discrepancy was measured with stereoscopic microscope (Nikon DS-Fi 1, Nikon, Japan) at a magnification of x75. Independent t-test was done for the statistical analysis. RESULTS: The mean marginal discrepancy values and standard deviations of the PFG bridges was 97.1 +/- 18.7 microm for incisors, 76.6 +/- 21.8 microm for canines; that of the LAVA bridges was 90.4 +/- 26.7 microm for incisor, 110.2 +/- 30.2 microm for canines. The mean marginal discrepancy between PFG and LAVA for incisor did not show significant difference (P>.05). But for canine, the mean marginal discrepancy of PFG bridges was smaller than that of LAVA bridges (P<.05). CONCLUSION: The LAVA CAD/CAM 3-unit bridges and the PFG 3-unit bridges showed clinically acceptable marginal discrepancy.
Incisor ; Tooth

STATEMENT OF PROBLEM: Various anodic oxidation techniques can be applied to dental implant surfaces. But the condition for optimal anodized surfaces has not been described yet. PURPOSE: The purpose of this investigation was to compare an implant that was oxidized by another method with TiUnite(TM) through resonance frequency analysis and histomorphometry. MATERIAL AND METHODS: Turned (control), TiUnite(TM) and another oxidized fixtures, which used Ca2+ solution for anodic oxidation, were placed in the tibiae of 5 New Zealand White rabbits. The bone responses were evaluated and compared by consecutive resonance frequency analysis once a week for 6 weeks and histomorphometry after a healing period of 6 weeks. RESULTS: At the first week, both oxidized implants showed significantly higher implant stability quotient (ISQ) values than the control. No significant differences in resonance frequency analysis were found between the two oxidized groups for 6 weeks. The means and standard deviations of bone-to-implant contact (BIC) ratios were 71.0 +/- 4.2 for TiUnite(TM), 67.5 +/- 10.3 for the Ca2+-based oxidation fixture, 22.8 +/- 6.5 for the control. Both oxidized implants were significantly superior in osseointegration to the turned one. There was, however, no statistically significant difference between the two oxidized implants. CONCLUSION: TiUnite(TM) and the Ca2+ -based oxidation fixture showed superior early bone response than the control with respect to resonance frequency analysis and histomorphometry. No significant differences between the oxidized groups, however, were found in this investigation using the rabbit tibia model.
Dental Implants ; Osseointegration ; Rabbits ; Tibia*

PURPOSE: Fracture of the veneering material of zirconia restorations frequently occurs in clinical situations. The purpose of this in vitro study was to compare the fracture strengths of zirconia crowns veneered with various ceramic materials by various techniques. MATERIALS AND METHODS: A 1.2 mm, 360degrees chamfer preparation and occlusal reduction of 2 mm were performed on a first mandibular molar, and 45 model dies were fabricated in a titanium alloy by CAD/CAM system. Forty-five zirconia copings were fabricated and divided into three groups. In the first group (LT) zirconia copings were veneered with feldspathic porcelain by the layering technique. In the second group (HT) the glass ceramic was heat-pressed on the zirconia coping, and for the third group (ST) a CAD/CAM-fabricated high-strength anatomically shaped veneering cap was sintered onto the zirconia coping. All crowns were cemented onto their titanium dies with Rely X(TM) Unicem (3M ESPE) and loaded with a universal testing machine (Instron 5583) until failure. The mean fracture values were compared by an one-way ANOVA and a multiple comparison post-hoc test (alpha=0.05). Scanning electron microscope was used to investigate the fractured interface. RESULTS: Mean fracture load and standard deviation was 4263.8+/-1110.8 N for Group LT, 5070.8+/-1016.4 for Group HT and 6242.0+/-1759.5 N for Group ST. The values of Group ST were significantly higher than those of the other groups. CONCLUSION: Zirconia crowns veneered with CAD/CAM generated glass ceramics by the sintering technique are superior to those veneered with feldspathic porcelain by the layering technique or veneered with glass ceramics by the heat-pressing technique in terms of fracture strength.
Alloys ; Ceramics ; Collodion ; Crowns ; Dental Porcelain ; Electrons ; Glass ; Molar ; Titanium ; Zirconium

PURPOSE: Unpredictable shrinkage of zirconia during sintering process causes discrepancy. Therefore, there have been attempts to reduce discrepancy by milling zirconia after sintering. However, due to the hardness of sintered zirconia, milling takes longer time, causes damage to the machine and causes chip formation. With customized zirconia block using the mean dimension of prepared natural dentition, it is expected to overcome these shortcomings. MATERIALS AND METHODS: The mean dimension of prepared natural dentition was analyzed as STL file after scanning of prepared teeth treated at SNUDH. The transverse, frontal and sagittal planes were set using Mimics and Photoshop. 3D volume was projected on each plane, and the outer line was measured through external tangent line, and the inner line was measured through inflection point of tangent line. RESULTS: The mean height of prepared incisal (N = 57) is 6.60 ± 1.05 mm, mesiodistal length is 2.98 ± 0.73 mm, buccolingual length is 2.04 ± 0.73 mm. The mean height of prepared premolar (N = 15) is 5.37 ± 1.49 mm, mesiodistal length is 4.10 ± 1.78 mm, buccolingual length is 5.86 ± 1.55 mm. And the mean height of prepared molar (N = 13) is 5.11 ± 1.29 mm, mesiodistal length is 6.80 ± 1.18 mm, buccolingual length is 7.34 ± 1.40 mm. CONCLUSION: Using the mean dimension of prepared natural dentition, it is expected to be able to fabricate customized zirconia block.
Bicuspid ; Dentition ; Hardness ; Molar ; Tooth*

People with class I intellectual disability need lifelong assistance and protection from their surroundings due to impaired adaptive functioning. They have poor oral health and show higher prevalence of dental caries, periapical inflammation and tooth loss that require proper prosthetic restoration. Because removable prostheses for intellectually disabled patients often lack stability, retention, and maintenance, fixed prostheses are essential and the only available option is dental implants. In this case, a 45 year-old male patient with class I intellectual disability had poor oral hygiene with most of his teeth missing and visited the clinic to recover his masticatory function. Due to such systemic conditions, the definitive restoration of choice was the implant-supported fixed dental prosthesis made of biocompatible and highly strong monolithic zirconia. In consequence of the treatment process, the patient was able to improve his oral environment aesthetically and functionally.
Dental Caries ; Dental Implants ; Dental Prosthesis ; Humans ; Inflammation ; Intellectual Disability* ; Male ; Mouth Rehabilitation* ; Mouth* ; Oral Health ; Oral Hygiene ; Prevalence ; Prostheses and Implants ; Tooth ; Tooth Loss