The effects of pretreatment of Co-Cr alloy, including two adhesive primers that contain either MDP or MAC-10, and silicoating on the bond. The results obtained as follows : Strength of 4-META/MMA-TBB resin were investigated using FT-IR SEM, and EDAX. in the SEM observation of surface morphologies, the sandblasted specimen exibited a very rough surface, whereas the surfaces of the two groups primed with either MDR or MAC-10 were covered with a layer of primer, and the surface morphology of the silicoated specimen remained almost the same after sandblasting. Before the thermocycling tests, the group treated with MDP demonstrated the highest mean tensile bond strength and the sandblasted group showed the lowest bond strength. After 20,000 themocyling, the mean tensile bond strength of the sandblasted group exhibited a 50% reduction in bond strength, while the other showed a 20~30% reduction. Observation of the metal-resin interface revealed that in all groups the resin permeated the rough surface formed by sandblasting thereby producing a mechnical bond between the metal and the resin, It was also found that thermocycling resulted in a gap formation at the metal-resin interface of the specimens, and the sandblasted group exhibited a larger gap width than the other groups. in fracture mode, all specimens indicated a cohesive fracture within the resin before thermocycling. However, thermocyling produced adhesive failure at the edge of the resin-metal interface in most specimens, The sandblasted group, which exhibited the lowest bond strength after thermocycling, also demonstrated the largest area of adhexive failure.
Adhesives ; Alloys*

Inverted papilloma of the urinary bladder is a rare urothelial neoplasm, almost benign in its histologic morphology and clinical behavior. It occurs mainly in males and in the region of the trigone of bladder, or posterior urethra. But, it may arise in the renal pelvis. The characteristic downward proliferation of urothelial cells within the underlying lamina propria is of such magnitude as to an exophytic papillomatous tumor. The lesion may be easily mistaken for a low- grade papillary transitional cell carcinoma, although the histologic appearance is distinctly different, as is its subsequent behavior. Because of distinctive histologic features and patterns of growth it is possible to differentiate between two basic types of inverted papillomatous which were termed "trabecular" and "glandular". The trabecular type consists of widely branched, anastomosing cords of urothelial cells originating directly from the overlying transitional epithelium. The glandular type develops apparently from a proliferative cystitis cystica and glandularis which, therefore, should be considered a potentially preneoplastic lesion. The malignant tendency is now being reported with inverted papillomas of urinary tract and therefore they are no longer regarded as innocuous benign neoplasms. We report the 3 cases of inverted papilloma of the urinary bladder with a brief review of literature.
Carcinoma, Transitional Cell ; Cystitis ; Epithelium ; Humans ; Kidney Pelvis ; Male ; Mucous Membrane ; Papilloma, Inverted* ; Urethra ; Urinary Bladder* ; Urinary Tract

No abstract available.
Anesthesiology* ; Education* ; Publications*

Renal cell Carcinoma is an unusual cancer with the propensity to invade not only the renal vein but to propagate into the inferior vena cava(IVC) as a tumor thrombus. No tumor thrombus extending to the IVC was seen in a renal cell carcinoma less than 4.5 cm in the greatest diameter among 431 consecutive patients in the Mayo Clinic from January 1976 to January 1992. The present case was a 3.5 cm in size small renal cell carcinoma on the right upper pole which had a tumor thrombus which extended to the inferior vena cava.
Carcinoma, Renal Cell* ; Humans ; Renal Veins ; Thrombosis* ; Vena Cava, Inferior*

No abstract available.
Diarrhea* ; Korea*

BACKGROUND: In patients with coronary artery disease, dysfunctional hypoperfused myocardium at rest may represent either nonviable or viable hibernating myocardium. Two-dimensional echocardiography can detect regional wall motion abnormalities resulting from myocardial ischemia by dobutamine infusion. The purpose of the present study was to identify the prediction of improvement of regional left ventricular (LV) function after surgical revascularization. MATERIALS AND METHODS: Sixteen patients with chronic regional LV dysfunction underwent dobutamine stress echocardiography (DSE) (dobutamine: baseline, 5, 10, 20microgram/kg/min) before coronary artery bypass grafting (CABG) and underwent echocardiography at least 2 months after CABG. RESULTS: All patients were male with mean age of 58 years ranging from 42 to 73 years. The mean LV ejection fraction was 41.8% with a range from 19% to 55%. During DSE, there were no complications, also, there were no operative morbidities or mortalities. Improvement of wall motion within the dysfunctional myocardium was found in 8 (50%) of 16 patients in DSE. Among them, 6 patients (75%) showed functional recovery after CABG. Another 8 patients did not show improvement of wall motion in DSE. But among them, 3 patients (38%) showed functional recovery after CABG. 84 dysfunctional segments were found in 256 segments of 16 patients. Improvement of wall motion was found in 34 of 84 segments in DSE. Among them, 23 segments (74%) showed functional recovery after CABG. Another 53 segments did not show improvement of wall motion in DSE. But among them, 12 segments (23%) showed functional recovery after CABG. The sensitivity and specificity of DSE for the prediction of postoperative improvement of segmental wall motion were 66% and 84%, respectively. The positive and negative predictive value of DSE were 74% and 77%, respectively. In patients with chronic regional LV dysfunction, think that DSE is a good predictor of the improvement of dysfunctional segments after CABG.
Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Humans ; Male ; Mortality ; Myocardial Ischemia ; Myocardium* ; Sensitivity and Specificity

Epidural anesthesia is widely practiced for lower abdominal operation and delivery in many hospital and its complication in minimal compared with spinal anesthesia. Lidocaine has been used extensively for epidural anesthesia with very satisfactory results. It has a very rapid onset of action, producing complete analgesia and has a reasonable duration of action(about 1-1(1/2)hr). A concentration of 1. 5% lidocaine causes effective sensory and autonomic blockade but it is unlikely to produce motor paralysis. More recently, bupivacaine(0.5%) has tended to supplement lidocaine as the drug of choice of epidural anesthesia. Firstly, the duration of action is longer. Secondly, it has better affinity for the tissue so that less will be absorbed into the circulation, thus reducing the risk of a toxic reaction. Thirdly, when used with a continuous technique, there is much chance of tachyphylaxis. Using a standardized anesthesia technic, we compared level of sensory anesthesia with a 0. 5% bupivacaine and 1. 5% lidocaine under elective and emergency surgery. When equal volume of local anesthetic solution were injected(20 ml of 0.5% bupivacaine and l. 5% lidocaine) there were no statistically significant differences in sensory level in bupivacaine and lidocaine, but the duration of anesthesia in bupivacaine from 2 to 3 times longer than lidocaine.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Anesthesia, Spinal ; Bupivacaine ; Emergencies ; Lidocaine ; Paralysis ; Tachyphylaxis

The segmental spread of epidural analgesia was measured in seventeen surgical patients aged between 17 and 52 years, and in fourteen patients between 60 and 77 years. The upper level in the young was 6.29(+/-1.56) thoracic vertebra level, but in the elderly was 4 (+/-0.65_ thoracic vertebra level at 20 minutes after epidural injection of 1.5% lidocaine 20 ml. A given volume of solution spreads to 0.9, 1.07, 1.54, 2.29 segments greater upper extent at 5, 10, 15, 20 minutes after epidural injection and 0.57, 1.07 segments greater lower extent at 5, 10 minutes in the elder than young. So with increasing age relatively small amounts of solution are required, to produce the same extent of anesthesia in the young.
Aged* ; Analgesia, Epidural* ; Anesthesia ; Humans ; Injections, Epidural ; Lidocaine ; Spine

No abstract available.
Adrenal Glands* ; Ganglioneuroma* ; Hyperplasia*

Epidural injection of 2.0 mg morphine with distilled water or 0.9 % normal saline 10 ml were given to a bladder cancer patient with severe chronic intraetable pain which radiated from low abdomen to gluteal and low leg region. The patient had absolute pain relief which began 2~3 minutes to onset, with 3~5 minutes of peak of action and was effective for 20~25 hours (mean 24 hours) without complications or continuous care as an ambulatory patient. It is suggested that the morphine reached the subarachinoid space through the membrane and produced its effect by direct action on the specific opiate receptors in the substantia gelatinosa of the posterior horn of the spinal cord.
Abdomen ; Animals ; Horns ; Humans ; Injections, Epidural ; Leg ; Membranes ; Morphine* ; Receptors, Opioid ; Spinal Cord ; Substantia Gelatinosa ; Urinary Bladder Neoplasms ; Water