PURPOSE: This in vitro study evaluated shear bond strengths of surface treatment porcelains with four porcelain repair systems simulating intraoral bonding of composite resin to feldspathic porcelain or pressable porcelain. MATERIAL AND METHODS: Eighty Porcelain disks were prepared. Group A: forty disk specimens were fabricated with Feldspathic Porcelain(Omega(R)900, Vident, Menlo Park, CA, USA). Group B: forty disk specimens were fabricated with Pressable Porcelain(IPS Empress 2 ingot, Ivoclar-Vivadent, Schaan, Liechtenstein, Germany). Each groups was divided into 4 subgroups and composite resin cylinders were bonded to specimen with one of the following four systems: Clearfil Porcelain Bond(L. Morita, Tustin, CA, USA), Ulradent Porcelain Etch.(Ultradent, Salt Lake City, UT, USA), Porcelain Liner-M(Sun Medical Co., Kyoto, Japan), Cimara Kit(Voco, Germany). After surface conditioning with one of the four porcelain repair systems, substrate surfaces of the specimen were examined microscopically(SEM). Shear bond strengths of specimens for each subgroup were determined with a universal testing machine (5mm/min crosshead speed) after storing them in distilled water at 37+/-1 degrees C for 24 hours. Stress at failure was measured in MPa, and mode of failure was recorded. Differences among four repair systems were analyzed with two way ANOVA and Duncan test at the 95% significance level. RESULTS: In the scanning electron photomicrograph of the treated porcelain surface, hydrofluoric acid etched group appeared the highest roughness. The shear bond strength of the phosphoric acid etched group was not significantly(p>0.05) different between feldspathic porcelain and pressable porcelain. But in no treatment and roughened with a bur group, the shear bond strength of the feldspathic porcelain was significantly higher than that of the pressable porcelain. In hydrofluoric acid etched group, the shear bond strength of the pressable porcelain was significantly higher(p<0.05). CONCLUSION: 1. Treatment groups showed significantly greater shear bond strengths than no treatment group(p<0.05). 2. Group with more roughened porcelain surface did not always show higher shear bond strengths. 3. In phosphoric acid etched group, there was no significant difference in shear bond strength between feldspathic porcelain and pressable porcelain(p>0.05). However in the other groups, there were significant differences in shear bond strengths between feldspathic porcelain and pressable porcelain(p<0.05).
Dental Porcelain* ; Hydrofluoric Acid ; Lakes ; Liechtenstein ; Water

Most of the basal cell carcinomas (BCCs) are effectively treated using standard conventional therapeutic modalities, but the complete removal of the tumor is difficult if the subclinical extension of BCCs is deep and wide. These difficulties are solved by Mohs micrographic surgery which provides the highest possible cure rates and the lowest normal tissue loss. Mohs micrographic surgery is an ideal method for the treatment of skin cancer in that it provides unsurpassed cure rates and maximum preservation of normal tissue by complete surgical margin control. We studied 40 patients with 40 basal cell carcinomas (22 primary, 18 recurrent) treated by Mohs micrographic surgery from January, 1992 through October, 1995 at Dong-A University Hospital. We evaluated the depth and lateral margins of excision by Mohs microgrphic surgery according to the anatomic locations, histologic type, size, and primary/recurrent state of basal cell carcinomas. There was no recurrence during follow-up period up to 3 years. We can draw the guidelines for complete surgical margin control out of our results. The guidelines are as follows. 1. The frist excision should be done with lateral safety margin of 2 mm in primary BBCs. 2. The frist excision should be done with lateral safety margin of 4 mm in recurrent BBCs. 3. The frist excision should be done with lateral safety margin of 4 mm in longer than 15 mm-sized BBCs. 4. The additional excision should be done with the every 2 mm lateral safety margin until the tumor completely removed. 5. The frist excision should be done with the surgical depth to periosteum, perichondrium especially in BBCs on nose.
Carcinoma, Basal Cell* ; Follow-Up Studies ; Humans ; Mohs Surgery* ; Nose ; Periosteum ; Recurrence ; Skin Neoplasms

Purpose: This study aimed to investigate the relative workload via a global positioning system (GPS) unit that was related to noncontact injuries in the lower extremities of college football player. Methods: Data were collected from 18 players who were enrolled in a university football team using a GPS unit during competitions. The noncontact injury in the lower extremities were recorded for each competition by well-trained medical practitioners. Players’ ratio of acute to chronic workload (ACWR) of each GPS variable was calculated by dividing the most recent 1 week (acute) workload by the prior 4 weeks (chronic) workload. The ACWR in the time of player’s injury (injury-related block) was compared to the time before the injury-related block (preinjury block) and from the beginning of the data collection to the point of injury (total injured average), and the end of the data collection (total non-injured average). Results: Eight players suffered 12 injures, indicating that an incidence rate was 13.28 injuries per 100 athlete exposures. Injured player had a higher ACWR of repeated high-intensity effort bouts (RHIE) and work-rest ratio (WRR) in the injury-related block compared to the preinjury block (F=3.151, p=0.039 and F=7.577, p=0.001, respectively). Also, they had a higher ACWR of maximal velocity (MV) in the injury-related block and total injured average compared to total non-injured average (F=5.592, p=0.004). Conclusion This study illustrated that the high ACWR in RHIE, WRR, and MV in the injury-related block may be related to noncontact injuries in the lower extremities of college football player. Many questions remain, but the results of this study may provide coaches and staffs in college football with useful quantitative information on preventive approach to sports-related injuries.

OBJECTIVE: To evaluate the effects of shoe lift to the unaffected limb on hemiplegic gait after stroke. METHOD: Three dimensional gait analysis was performed in 20 chronic hemiplegic patients with shoe lifts (5, 10, 15 mm) to the unaffected limb. The order of experimental series was randomized among subjects. Temporal gait parameters were measured and compared according to the height of shoe lifts in the affected and unaffected limbs. RESULTS: The stride time of both limbs and step time of the affected limb were decreased, and stride length of both limbs and step length of unaffected limb were increased after shoe lift apply (p<0.05). Thus walking velocity and cadence were increased. In gait cycle, there was decreased double limb support phase of affected limb (p<0.05). These improvement of gait patterns of hemiplegics was maximum after shoe lift of 10 mm height. CONCLUSION: Weight bearing with shoe lift may contribute to improved postural control and gait performance in hemiplegics. Furthermore, the study about long-term effects of shoe lifts to the unaffected limb may be necessary.
Extremities* ; Gait Disorders, Neurologic ; Gait* ; Humans ; Shoes* ; Stroke* ; Walking ; Weight-Bearing

The Angio-Seal is a widely used arterial closure device that helps achieve faster hemostasis and provide early ambulation to patients. However, it can cause various complications in clinical practice. We present the uncommon complication of popliteal artery occlusion following Angio-Seal deployment, and describe an effective interventional approach to its treatment. Because fluoroscopy-guided Fogarty embolectomy has the advantages of complete removal of the embolus without fragmentation, and clear visualization of the exact location of the embolus during the procedure, it is a suitable method for treating this complication.
Embolectomy/*instrumentation ; Embolism/radiography/*surgery ; Equipment Design ; Fluoroscopy/*methods ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; *Popliteal Artery ; Surgery, Computer-Assisted/*methods

BACKGROUND AND PURPOSE: Chronic daily headache (CDH) is defined as a headache disorder in which headaches occur on a daily or near-daily basis (at least 15 days/month) for more than 3 months. Chronic migraine (CM) and medication overuse headache (MOH) are very disabling headaches that remain underdiagnosed. The aim of this study was to establish the frequency of CDH and its various subtypes, and examine the associations with MOH among first-visit headache patients presenting at neurology outpatient clinics in Korea. METHODS: Eleven neurologists enrolled first-visit patients with complaints of headaches into outpatient clinics for further assessment. Headache disorders were classified according to the International Classification of Headache Disorder (third edition beta version) by each investigator. RESULTS: Primary CDH was present in 248 (15.2%) of the 1,627 included patients, comprising CM (143, 8.8%), chronic tension-type headache (CTTH) (98, 6%), and definite new daily persistent headache (NDPH) (7, 0.4%). MOH was associated with headache in 81 patients (5%). The association with MOH was stronger among CM patients (34.5%) than patients with CTTH (13.3%) or NDPH (14.3%) (p=0.001). The frequency of CDH did not differ between secondary and tertiary referral hospitals. CONCLUSIONS: The frequencies of CDH and MOH diagnoses were 15.2% and 5%, respectively in first-visit headache patients presented at secondary or tertiary referral hospitals in Korea. CM was the most common subtype of CDH and was most frequently associated with MOH.
Ambulatory Care Facilities ; Classification ; Diagnosis ; Epidemiology ; Headache Disorders* ; Headache Disorders, Secondary* ; Headache* ; Humans ; Korea* ; Migraine Disorders ; Neurology ; Prescription Drug Overuse* ; Research Personnel ; Tension-Type Headache ; Tertiary Care Centers

PURPOSE: An laparoscopic cholecystectomy (LC) is being increasingly performed for benign gallbladder disease. Accordingly, gallbladder carcinomas have been increasingly reported in patients after undergoing an LC. This study aims to reveal the clinicopathological features and prognosis of gallbladder carcinomas found after an LC. METHODS: Between April 1994 and March 2007, 2714 patients underwent an LC and 1.5% of the patients were diagnosed histologically as having a gallbladder carcinoma. We retrospectively evaluated the clinicopathological features and long-term survival of the patients. RESULTS: There were 19 male patients and 21 female patients, with a mean age of 60.7 degrees+/-12.3 years. The indications for LC included acute calculous cholecystitis, chronic calculous cholecystitis and polypoid lesions of the gallbladder (PLGs). An LC only was performed in 26 patients (13 pT1a, 7 pT1b and 6 pT2 cases) while additional surgery including gallbladder bed resection and lymph node dissection was performed in 14 patients (2 pT1a, 2 pT1b, 8 pT2 and 2 pT3 cases). The patients with a carcinoma associated with PLGs were younger, had more incidence of pT1a and had well differentiated carcinomas and a better 5-year survival rate as compared to patients with a non-polypoid carcinoma. Whereas no recurrences or deaths occurred for the 24 pT1 patients, two of the 14 pT2 patients had a recurrence. Both pT3 patients had a recurrence despite additional surgery. In patients with pT2 or more, additional surgery did not improve survival (p = 0.82). CONCLUSION: The polypoid morphology of gallbladder carcinoma, but not additional surgery, favorably affects survival of gallbladder carcinoma patients following an LC. However, a further multi-institutional study may be needed to determine the benefit of additional surgery.
Cholecystectomy, Laparoscopic* ; Cholecystitis ; Female ; Gallbladder Diseases ; Gallbladder* ; Humans ; Incidence ; Lymph Node Excision ; Male ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate

OBJECTIVE: This study compared the efficacy and tolerability of clonazepam with other benzodiazepines in patients with anxiety disorders. METHODS: Inclusion criteria were as follows: age >20 years, diagnosis of anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision (DSM-IV-TR) criteria, taking only one type of antidepressant, and prescribed one of three oral benzodiazepines (alprazolam, clonazepam, or lorazepam). At baseline and week 6, clinical benefit was evaluated using the Clinical Global Impression-Severity Scale (CGI-S), Clinical Global Impression-Anxiety Scale (CGI-anxiety), and Clinical Global Impression-Sleep Scale (CGI-sleep). RESULTS: Among 180 patients, no differences in demographic characteristics among the three benzodiazepine groups were noted. After six weeks of treatment, all benzodiazepine groups showed significant improvements in CGI-S, CGI-anxiety, and CGI-sleep scores (p<0.001). There were no differences in mean changes in CGI-S, CGI-anxiety and CGI-sleep among the three benzodiazepine groups. The incidence of side effects was significantly lower in the clonazepam group than with the other benzodiazepines. The incidences of adverse events for the clonazepam, alprazolam, and lorazepam groups were 26.7% (n=20), 48.4% (n=31), and 43.9% (n=18), respectively. CONCLUSION: The present study suggests that clonazepam is as efficacious as other benzodiazepines for the treatment of various anxiety disorders. Furthermore, the safety profile of clonazepam was superior to the other benzodiazepines in this study.
Alprazolam ; Anti-Anxiety Agents ; Antidepressive Agents* ; Anxiety Disorders* ; Anxiety* ; Benzodiazepines ; Clonazepam* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Incidence ; Lorazepam

PURPOSE: The SPAN, which is acronym standing for its four components: Startle, Physiological arousal, Anger, and Numbness, is a short post-traumatic stress disorder (PTSD) screening scale. This study sought to develop and validate a Korean version of the SPAN (SPAN-K). MATERIALS AND METHODS: Ninety-three PTSD patients (PTSD group), 73 patients with non-psychotic psychiatric disorders (psychiatric control group), and 88 healthy participants (normal control group) were recruited for this study. Participants completed a variety of psychiatric assessments including the SPAN-K, the Davidson Trauma Scale (DTS), the Clinician-Administered PTSD Scale (CAPS), and the State-Trait Anxiety Inventory (STAI). RESULTS: Cronbach's alpha and test-retest reliability values for the SPAN-K were both 0.80. Mean SPAN-K scores were 10.06 for the PTSD group, 4.94 for the psychiatric control group, and 1.42 for the normal control group. With respect to concurrent validity, correlation coefficients were 0.87 for SPAN-K vs. CAPS total scores (p<0.001) and 0.86 for SPAN-K vs. DTS scores (p<0.001). Additionally, correlation coefficients were 0.31 and 0.42 for SPAN-K vs. STAI-S and STAI-T, respectively. Receiver operating characteristic analysis of SPAN-K showed good diagnostic accuracy with an area under the curve (AUC) of 0.87. The SPAN-K showed the highest efficiency at a cutoff score of 7, with a sensitivity of 0.83, a specificity of 0.81, positive predictive value (PPV) of 0.88, and negative predictive value (NPV) of 0.73. CONCLUSION: These results suggest that the SPAN-K had good psychometric properties and may be a useful instrument for rapid screening of PTSD patients.
Humans ; *Psychological Techniques ; Republic of Korea ; Sensitivity and Specificity ; Stress Disorders, Post-Traumatic/*diagnosis/psychology

BACKGROUND AND OBJECTIVES: High dose rosuvastatin loading before percutaneous coronary interventions (PCI) reduces the myocardial damage and the incidence of adverse cardiac events in patients with stable angina and acute coronary syndrome. However, no studies are present yet about rosuvastatin loading in patients with ST-segment elevation myocardial infarction (STEMI) in a primary PCI setting. SUBJECTS AND METHODS: A total of 475 patients who underwent primary PCI for STEMI were studied. The study population was divided into two groups with 208 patients in the statin group=40 mg rosuvastatin loading before primary PCI and 267 patients in the control group=no statin pretreatment. At median 3 days after PCI a single-photon emission computed tomography (SPECT) was performed with technetium 99m tetrofosmin For this study were compared infarct size, corrected Thrombolysis in Myocardial Infarction (TIMI) frame count and the myocardial blush grade (MBG) between the both groups. RESULTS: Baseline clinical and procedural characteristics were similar between the groups. Infarct size, as assessed by SPECT, was significantly smaller (19.0+/-15.9% vs. 22.9+/-16.5%, p=0.009) in the statin group than in the control group. Patients of the statin group showed a lower corrected TIMI frame count (28.2+/-19.3 vs. 32.6+/-21.4, p=0.020), and higher MBG (2.49+/-0.76 vs. 2.23+/-0.96, p=0.001) than the patients of the control group. The multivariate analysis revealed that rosuvastatin loading {odds ratio (OR) 0.61}, pain to balloon time (OR 2.05), anterior myocardial infarction (OR 3.89) and final the MBG (OR 2.93) were independent predictors of a large infarct size. CONCLUSION: A high dose rosuvastatin loading before the primary PCI reduced the infarct size by microvascular myocardial perfusion improvement.
Acute Coronary Syndrome ; Angina, Stable ; Angioplasty ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Incidence ; Multivariate Analysis ; Myocardial Infarction* ; Percutaneous Coronary Intervention* ; Perfusion ; Stents ; Technetium ; Tomography, Emission-Computed, Single-Photon ; Rosuvastatin Calcium