Patients with hypertrophic cardiography often complain of chest pain and have electrocardioagrams suggesting myocardial damage or ischemia. Some of three patients have associated coronary arterial atherosclerosis. Transmural myocardial infarction may occur in patients with hypertrophic cardiomyopathy in the absence of significant atherosclerosis of the extramural coronary arteries, about which several pathophysiologic exlpanations were discussed. Presented here, a case of 49-year-old man with hypertrophic cardiomyopathy accompanied with myocardial infarction and angiographically normal coronary arteries is reported. Asymmetric septal hypertrophy, characteristic morphologic abnormality of hypertrophic cardiomyopathy, was progressed to dilated cardiomyopathy after the occurrence myocardial infarction.
Atherosclerosis ; Cardiomyopathy, Dilated ; Cardiomyopathy, Hypertrophic* ; Chest Pain ; Coronary Vessels ; Humans ; Ischemia ; Middle Aged ; Myocardial Infarction*

The effect of oral nicorandil were evaluated by a 9-day double-blind cross-over protocol on 16 subjects with angina pectoris referred to our cardiology clinic from June '84 through September '85. total daily doses were 15-45mg. The effects were measured by 3 seperate treadmill exercise EKG tests and symptom reviews on each patient. The following results were obtained. 1) The mean age of the patients was 57.4+/-7.2 years. These were 14 male and 2 female patients. 2) Resting heart rate on nicorandil was 73.6+/-14.0 beats/min and 70.5+/-14.0 beats/min in placebo(P<0.05). There were no significant effects of nicorandil on resting blood pressure and heart rate-blood pressure product. 3) Peak exercise heart rate was 126.4+/-22.5 beats/min on nicorandil and 121.8+/-21.4 beats/min on placebo(P<0.05). There were no significant effects of nicorandil on blood pressure after exercise and peak heart rate-blood pressure product(x10(-3)) after nocorandil was 20.2+/-5.0 and 18.9+/-4.6 on placebo(P>0.05). 4) Exercise duration was 485.8+/-107.7 sec on nicorandil and 423.3+/-101.9 sec on placebo(P<0.001). 5) The exercise duration was prolonged in 11 cases(68.7%), showed on change in 2 cases(12.5%), and shortened in 3(18.8%). 6) There were attacks of chest pain during placebo period in 2 cases, but none developed during nicorandil period. 7) Headache was noted in 2 patients, and in one of them, it was so severe as to discontinue nicorandil stydy. No other side effects were noted. In conclusion, additional therapeutic benefit can be obtained by nicorandil in patients with severe angina in spite of conventional antianginal agents already being administered.
Angina Pectoris* ; Blood Pressure ; Cardiology ; Chest Pain ; Cross-Over Studies* ; Electrocardiography ; Female ; Headache ; Heart ; Heart Rate ; Humans ; Male ; Nicorandil*

Excessive concentration of stress which is occurred in occlusion around the implant in case of the implant supported fixed partial denture has been known to be the main cause of the crestal bone destruction. Therefore, it is essential to evaluate the stress analysis on supporting tissue to get higher success rates of implant. The purpose of this study was to evaluate the effects of stress distribution and deformation in 3 different types of three-unit fixed partial denture supported by two implants, using a three dimensional finite element analysis in a three dimensional model of a whole mandible. A mechanical model of an edentulous mandible was generated from 3D scan, assuming two implants were placed in the left premolars area. According to the position of pontic, the experiments groups were divided into three types. Type I had a pontic in the middle position between two implants, type II in the anterior position, and type III in the posterior position. A 100-N axial load was applied to sites such as the central fossa of anterior and posterior implant abutment, central fossa of pontic, the connector of pontic or the connector between two implants, the mandibular boundary conditions were modeled considering the real geometry of its four-masticatory muscular supporting system. The results obtained from this study were as follows; 1. The mandible deformed in a way that the condyles converged medially in all types under muscular actions. In comparison with types, the deformations in the type II and type III were greater by 2-2.5 times than in the type I regardless of the loading location. 2. The values of von Mises stresses in cortical and cancellous bone were relatively stable in all types, but slightly increased as the loading position was changed more posteriorly. 3. In comparison with type I, the values of von Mises stress in the implant increased by 73% in Type II and by 77% in Type III when the load was applied anterior and posterior respectively, but when the load was applied to the middle, the values were similar in all types. 4. When the load was applied to the centric fossa of pontic, the values of von Mises stress were nearly 30~35% higher in the type III than type I or II in the cortical and cancellous bone. Also, in the implant, the values of von Mises stress of the type II or III were 160~170% higher than in the type I. 5. When the load was applied to the centric fossa of implant abutment, the values of von Mises stress in the cortical and cancellous bone were relatively 20~25% higher in the type III than in the other types, but in the implant they were 40-45% higher in the type I or II than in the type III. According to the results of this study, musculature modeling is important to the finite element analysis for stress distribution and deformation as the muscular action causes stress concentration. And the type I model is the most stable from a view of biomechanics. Type II is also a clinically acceptable design when the implant is stiff sufficiently and mandibular deformation is considered. Considering the high values of von Mises stress in the cortical bone, type III is not thought as an useful design.
Bicuspid ; Biomechanics ; Denture, Partial, Fixed ; Finite Element Analysis ; Mandible

Excessive concentration of stress which is occurred in occlusion around the implant in case of the implant supported fixed partial denture has been known to be the main cause of the crestal bone destruction. Therefore, it is essential to evaluate the stress analysis on supporting tissue to get higher success rates of implant. The purpose of this study was to evaluate the effects of stress distribution and deformation in 3 different types of three-unit fixed partial denture supported by two implants, using a three dimensional finite element analysis in a three dimensional model of a whole mandible. A mechanical model of an edentulous mandible was generated from 3D scan, assuming two implants were placed in the left premolars area. According to the position of pontic, the experiments groups were divided into three types. Type I had a pontic in the middle position between two implants, type II in the anterior position, and type III in the posterior position. A 100-N axial load was applied to sites such as the central fossa of anterior and posterior implant abutment, central fossa of pontic, the connector of pontic or the connector between two implants, the mandibular boundary conditions were modeled considering the real geometry of its four-masticatory muscular supporting system. The results obtained from this study were as follows; 1. The mandible deformed in a way that the condyles converged medially in all types under muscular actions. In comparison with types, the deformations in the type II and type III were greater by 2-2.5 times than in the type I regardless of the loading location. 2. The values of von Mises stresses in cortical and cancellous bone were relatively stable in all types, but slightly increased as the loading position was changed more posteriorly. 3. In comparison with type I, the values of von Mises stress in the implant increased by 73% in Type II and by 77% in Type III when the load was applied anterior and posterior respectively, but when the load was applied to the middle, the values were similar in all types. 4. When the load was applied to the centric fossa of pontic, the values of von Mises stress were nearly 30~35% higher in the type III than type I or II in the cortical and cancellous bone. Also, in the implant, the values of von Mises stress of the type II or III were 160~170% higher than in the type I. 5. When the load was applied to the centric fossa of implant abutment, the values of von Mises stress in the cortical and cancellous bone were relatively 20~25% higher in the type III than in the other types, but in the implant they were 40-45% higher in the type I or II than in the type III. According to the results of this study, musculature modeling is important to the finite element analysis for stress distribution and deformation as the muscular action causes stress concentration. And the type I model is the most stable from a view of biomechanics. Type II is also a clinically acceptable design when the implant is stiff sufficiently and mandibular deformation is considered. Considering the high values of von Mises stress in the cortical bone, type III is not thought as an useful design.
Bicuspid ; Biomechanics ; Denture, Partial, Fixed ; Finite Element Analysis ; Mandible

Noonan syndrome is featured by short stature, mental retardation, facial dysmorphia, webbed neck, and heart defects. The phenotype has some similarities with Turner syndrome, but the karyotype is normal and males can be affected. We used Bonfils fiberscope for intubation because we suspected the difficult airway. We report the experience of anesthetic management for osteotomy of calcaneonavicular coalition in a patient with Noonan syndrome.
Heart ; Humans ; Intellectual Disability ; Intubation ; Karyotype ; Male ; Neck ; Noonan Syndrome* ; Osteotomy ; Phenotype ; Turner Syndrome

Brain abscess is a rare, extremely aggressive, life-threatening infection. It may occur following : infection of contiguous structure, hematogenous spread, or cranial trauma/ surgery. Dental pathology and/or treatment have been linked to a small number of brain abscesses as possible source of infection. 50-year-old male patient was presented with a brain abscess caused by Streptococcus viridans. In the case presented, the significant oral findings were chronic periapical and periodontal infection due to root remnant of lower right 3rd molar. A case history and brief literature review of brain abscess related odontogenic infection was presented after successful treatment with antibiotics and craniotomy.
Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Craniotomy ; Humans ; Male ; Middle Aged ; Molar ; Pathology ; Viridans Streptococci

Brain abscess is a rare, extremely aggressive, life-threatening infection. It may occur following : infection of contiguous structure, hematogenous spread, or cranial trauma/ surgery. Dental pathology and/or treatment have been linked to a small number of brain abscesses as possible source of infection. 50-year-old male patient was presented with a brain abscess caused by Streptococcus viridans. In the case presented, the significant oral findings were chronic periapical and periodontal infection due to root remnant of lower right 3rd molar. A case history and brief literature review of brain abscess related odontogenic infection was presented after successful treatment with antibiotics and craniotomy.
Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Craniotomy ; Humans ; Male ; Middle Aged ; Molar ; Pathology ; Viridans Streptococci

PURPOSE: This study was designed to identify creation of intellectual capital and factors influencing the creation of intellectual capital in hospital organizations. METHODS: A cross-sectional design was used, with a convenience sample of 300 nurses from three general hospitals in Gwangju and South Cholla province. The tools used for this study were scales measuring creation of intellectual capital (8 items), social capital (20 items), knowledge management (8 items). Data was analyzed with descriptive statistics, Pearson's correlation coefficient and regression using the SPSS WIN 18.0 program. RESULTS: There were significantly positive relationships between social capital and knowledge management with creation of intellectual capital. The mean score for creation of intellectual capital in hospital organizations was 4.59 points. Factors influencing creation of intellectual capital in hospital organization were identified as knowledge management (beta=.625), shared values & action (beta=.166), and participation in civic activities (beta=.118). These factors explained 59.3% of the variance in creation of intellectual capital in hospital organizations. CONCLUSION: The results indicate which factors are major factors influencing creation of intellectual capital and therefore, serve as predictors of creation of intellectual capital in hospital organizations.
Hospitals, General ; Knowledge Management ; Regression Analysis ; Weights and Measures

Orbital infection or inflammation is a rare but serious complication of an odontogenic infection. Odontogenic infection can spread to the orbit by one or more of several paths. Such extension is potentially dangerous and can lead to loss of vision or worse. 5-cases of orbital infection and inflammation secondary to infection from upper or lower molar teeth, which extended to the subperiosteal or the retrobulbar region of the orbit, are presented in this report. The infections spreaded to the infratemporal and temporal fossa or the ethmoidal labyrinth, and then to the orbit via the inferior orbital fissure or the lamina papyracea. The clinical presentation, differential diagnosis, route of spread, value of serial CT scanning, treatment and possible complications are reviewed.
Abscess ; Cellulitis ; Diagnosis, Differential ; Ear, Inner ; Inflammation ; Molar ; Orbit* ; Tomography, X-Ray Computed ; Tooth

Crowns ; Dental Implants ; Finite Element Analysis ; Prostheses and Implants