No abstract available.

STATEMENT OF PROBLEM: Surface texture of the implant is one of the important factors of the implant success, especially in the immediate implant loading. Many methods of the surface treatment of implant have developed and introduced. PURPOSE: This study was to evaluate the effects of the Ca-P coating implant crystallized the hydroxyapatite on the surface by the removal torque test and the histomorphometric analysis in vivo. Material and methods: 135 screw type implants, 4.0mm in length and 3.75mm in diameter were used in this study. Implants were divided into 3 groups and treated in the different methods. Group I was not treated, Group II was treated in the SLA method, and Group III was treated in the Ca-P coating with the anodizing method and the hydroxyapatite was crystallized on the surface with the hydrothermal treatment. Firstly, the surface roughness of each group was measured. 45 rabbits were used in this experiment. Two implants were inserted on right tibial metaphysis and one implant was inserted on left side with the alternating order. After the healing periods of 3, 5, and 12 weeks, the rabbits were sacrificed to evaluate the osseointergration by the removal torque test and the histomorphometric analysis. RESULTS: 1. In the analysis for the surface roughness, Group II showed the highest roughness. And Group III showed higher secondly. There was a significant difference one another statistically. 2. In the removal torque test, Group III and II were significantly higher than Group I. There was no statistical difference between Group III and Group II. 3. For all Groups, the removal torque values at 12th week were significantly higher than at 3rd and 5th week. 4. In histomorphometric analysis, the bone implant contact rates of Group III and II were higher than that of Group I at 3rd and 5th week. There was a significant difference at 5th week. 5. In histomorphometric analysis, the bone implant contact rate of Group III and II increased from 3rd week to 5th week, but decreased at 12th week. In Group I, the contact rate at 12th week was significantly higher than at 3rd week and 5th week.
Durapatite ; Rabbits ; Tibia* ; Torque*

Interest in the prevalence of patent foramen ovale(PFO) and its relation to embolic stroke has increased with the sophistication of methods for noninvasive cardiac assessment. The effect of foramen ovale closure on the risk for subsequent strokes is promised. A 22-year old woman was presented with sudden onset of cerebral infarct. She had a patent formen ovale, and right to left shunt during the Valsalva maneuver, which was diagnosed by transesophageal contrast echocardiography. Transcatheter closure of PFO was performed with Rashkind PDA umbrella under the guidance of transesophageal echocardiography. Transcatheter closure of PFO can be accomplised with little morbidity and may reduce the risk of embolic episode.
Echocardiography ; Echocardiography, Transesophageal* ; Female ; Foramen Ovale ; Foramen Ovale, Patent* ; Humans ; Prevalence ; Stroke* ; Valsalva Maneuver ; Young Adult

PURPOSE: To identify the recognition of patients, families, nurses, and physicians about clinical decision-making and biomedical ethics. METHODS: Data were collected from October 23 to 30, 2012 using the structured questionnaires. A total of 200 data were analyzed using SPSS 20.0 version. RESULTS: Response about 'who should receive the first notice of a cancer diagnosis?' was significant difference statistically. Cancer patients had preferences to be notified their diagnosis first. Patients responded the person who made decision of treatment options would be physician first and then themselves. Families, nurses, and physicians answered that decision-maker would be both of patient and family. All four groups answered that the person who made decision about care-giver after discharge was patient and their family. Nurses and physicians who didn't aware of the advanced directive were over 30.0%, and patients and family who didn't aware of that were over 60.0%. Lastly, the rate of positive answer about making attempt of advanced directive after legalization was over 80.0%. CONCLUSION: Patient's attitude about making decisions is different from family's attitude. Nurses and physicians have to put emphasis on the patient's autonomy & self-determination and family members' needs.
Bioethics* ; Diagnosis ; Humans ; Surveys and Questionnaires

PURPOSE: The aim of this study was to evaluate the stress concentration and distribution whether restoring the cavity or not while restoring with metal ceramic crown on tooth with abfraction lesion using finite element analysis. MATERIALS AND METHODS: Maxillary first premolar was selected and made a total of 10 finite element model. Model 1 was natural tooth; Model 2 was tooth with metal ceramic crown restoration which margin was positioned above 2 mm from CEJ; Model 3 was tooth with metal ceramic crown restoration which margin was positioned on CEJ; Model 4 was natural tooth which has abfraction lesion; Model 5 and 6 had abfraction lesion and the other condition was same as model 2 and 3, respectively; Model 7 was natural tooth which had abfraction lesion restored with composite resin; Model 8 and 9 was tooth with metal ceramic crown after restoring on abfraction lesion with composite resin; Model 10 was restored tooth on abfraction lesion with composite resin and metal ceramic crown restoration which margin is positioned on lower border of abfraction lesion. Load A and Load B was also designed. Von Mises value was evaluated on each point. RESULTS: Under load A or load B, on tooth with abfraction lesion, stress was concentrated on the apex of lesion. Under load A or load B, on tooth that abfraction lesion was restored with composite resin, the stress value was reduced on the apex. CONCLUSION: In case of abfraction lesion was restored with composite resin, the stress was concentrated on the apical border of restored cavity regardless of marginal position. It was favorable to place crown margin on the enamel for restoring with metal ceramic crown.
Bicuspid ; Ceramics ; Crowns ; Dental Enamel ; Dental Stress Analysis ; Finite Element Analysis* ; Prostheses and Implants* ; Tooth Cervix ; Tooth*

Metastatic thyroid papillaty carcinoma was diagnosed in a 54-year-old woman. The cancer had present in many lymph nodes. After her surgical procedure, she was advised to have radioiodine treatment. However, the patient had chronic renal failure and was on hemodialysis. We tried radioiodine therapy of usual dose for remove of residual tumor burden. Hemodialysis treatments of 4hours and 2 hours performed each 24 and 48 hours after the administration of 131I resulted in a 66% and 80% reduction in total body radiation levels. All contaminated wastes were disposed of by the hospital's department of radiation safety. Postdialysis monitoring revealed no residual radiation contamination of dialysis machines or radiation exposure to the dialysis staff. It is needed more experiences about dose of radioiodine and timing, blood flow rate and duration of hemodialysis.
Carcinoma, Papillary* ; Dialysis ; Female ; Humans ; Kidney Failure, Chronic* ; Lymph Nodes ; Middle Aged ; Neoplasm, Residual ; Renal Dialysis* ; Thyroid Gland*

PURPOSE: We evaluated the long-term results of endoscopic Deflux(R) injection for treating vesicoureteral reflux (VUR) in children. METHODS: Between September 2004 and September 2014, 243 children (137 boys and 106 girls) with a mean age of 53 months underwent Deflux(R) injection. Our clinical protocol included radionuclide voiding cystography (RNC) at postoperative 3 months, 1 year and 3 years to assess the VUR resolution. RESULTS: The cure rates at 3 months, 1 year, and 3 years by patients were 70.8%, 64.3%, and 65.6% for the total patients and 79.2%, 75.2%, and 76.4%, for the ureters, respectively. The recurrence rate of postoperative febrile urinary tract infection (UTI) was 20% in patients without VUR at postoperative 1 year. Twenty patients undergoing ureteroneocystostomy (UNC) significantly had younger age (P=0.003), higher VUR grade (P<0.001), and lower success rates of Deflux(R) injection (P<0.05). On univariate analysis, older age (P=0.014) and lower grade of VUR (P=0.031) were the significant predictors of a successful outcome. But there was none on multivariate analysis. Younger age, especially age of 0-12 month-old, was the only significant predictor of postoperative febrile UTI recurrence on both univariate and multivariate analysis. CONCLUSION: Deflux(R) injection is efficacious with a low complication rate for the anti-reflux procedure in children. There is low recurrence rate of UTI though VUR persists, and high probability of no VUR at 3 years if no VUR at 1 year. It is recommendable not to perform follow-up RNC at 3 years routinely if no VUR at 1 year.
Child* ; Clinical Protocols ; Humans ; Multivariate Analysis ; Recurrence ; Ureter ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

PURPOSE: We evaluated the long-term results of endoscopic Deflux(R) injection for treating vesicoureteral reflux (VUR) in children. METHODS: Between September 2004 and September 2014, 243 children (137 boys and 106 girls) with a mean age of 53 months underwent Deflux(R) injection. Our clinical protocol included radionuclide voiding cystography (RNC) at postoperative 3 months, 1 year and 3 years to assess the VUR resolution. RESULTS: The cure rates at 3 months, 1 year, and 3 years by patients were 70.8%, 64.3%, and 65.6% for the total patients and 79.2%, 75.2%, and 76.4%, for the ureters, respectively. The recurrence rate of postoperative febrile urinary tract infection (UTI) was 20% in patients without VUR at postoperative 1 year. Twenty patients undergoing ureteroneocystostomy (UNC) significantly had younger age (P=0.003), higher VUR grade (P<0.001), and lower success rates of Deflux(R) injection (P<0.05). On univariate analysis, older age (P=0.014) and lower grade of VUR (P=0.031) were the significant predictors of a successful outcome. But there was none on multivariate analysis. Younger age, especially age of 0-12 month-old, was the only significant predictor of postoperative febrile UTI recurrence on both univariate and multivariate analysis. CONCLUSION: Deflux(R) injection is efficacious with a low complication rate for the anti-reflux procedure in children. There is low recurrence rate of UTI though VUR persists, and high probability of no VUR at 3 years if no VUR at 1 year. It is recommendable not to perform follow-up RNC at 3 years routinely if no VUR at 1 year.
Child* ; Clinical Protocols ; Humans ; Multivariate Analysis ; Recurrence ; Ureter ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

BACKGROUND AND PURPOSE: If early middle cerebral artery signs (EMCAS) are present, prognoses are known to be poor, even if interventional therapy is performed. The aim of this study is to evaluate the clinical effect of a superselective intra-arterial urokinase infusion in cerebral infarction patients presenting EMCAS. METHODS: We conducted prospective longitudinal clinical trial and observed patients (n-22) with middle cerebral artery infarctions who manifested EMCAS in precontrast brain CT scans between January 1996 and April 1997. The patients were divided into two groups, one group (n-11) underwent superselective intra-arterial urokinase infusion; and the other (n-11) was treated with classic osmotherapy and heparinization. We evaluated the clinical outcome for each patient using the Canadian Neurological Scale (CNS) and the National Institutes of Health Stroke Scale (NIHSS) on admission (pre-treatment state) and on, the 3rd, 7th, and 30th days. RESULTS: The two patients groups had an even distribution of risk factors, EMCAS, age and the interval from the ictus to the initiation of treatment. The outcome at the 30th day after stroke therapy improved for all patients compared to their status on admission (p<0.01), and there was a significant interaction between the group and the time (p<0.01). This means that the group which underwent superselective intra-arterial urokinase infusion had better clinical outcomes. Hemorrhagic transformation occurred in 5 cases (22.7%), 2 from the superselective intra-arterial urokinase infusion group and 3 from the heparinization group. However, this did not influence the clinical outcome. CONCLUSIONS: Compared to previous reports suggesting the poor prognostic value of EMCAS, even when all patients having these signs, this study showed that the clinical outcomes in the thrombolyic therapy group were better than in the conservatively treated one. Therefore, more aggressive interventional therapies such as superselective intra-arterial urokinase infusion may be considered option.
Brain ; Cerebral Infarction ; Heparin ; Humans ; Infarction ; Infarction, Middle Cerebral Artery* ; Middle Cerebral Artery* ; National Institutes of Health (U.S.) ; Prognosis ; Prospective Studies ; Risk Factors ; Stroke ; Thrombolytic Therapy* ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator

BACKGROUND: The clinical use of intracoronary stents is impeded by the risk of subacute stent thrombosis and complications associated with the anticoagulant regimen. The use of high pressure balloon dilatations and confirmation of adequate stent expansion by intravascular ultrasound provide assurance that anticoagulation therapy can be safely omitted. Therefore, we evaluated the effect of anticoagulation of subacute thrombosis sfter stenting retrospectively on a consecutive series of patients who received palmaz-Schatz coronary stents with high pressure balloon dilatation. METHOD: From March 1995 to August 1995, 62 patients underwent Palmaz-Schatz coronary stent implantation. After deploying stents successfully, high pressure overdilatation of the stents was performed in all patients. According to post-stent anticoagulation, 32 patients received aspirin 200 mg/day, ticlopidine 500 mg/day and warfarin for two months, 30 patients received aspirin and ticlopidine. RESULTS: The clinical or angiographic variables were not significantly different between the two groups. There was no acute or subacute thrombosis in the two groups. The hospital stay after stenting was significantly shorter in the patients without antcoagulation than in patients with anticoagulation. CONCLUSION: The Palmaz-Schatz stent can be safely implanted without anticoagulation provided that stent expansion is daequate by the use high pressure balloon dilatation This technique significantly reduces hospital time and vascular complications and has a low stent thrombosis rate.
Aspirin ; Dilatation* ; Humans ; Length of Stay ; Retrospective Studies ; Stents* ; Thrombosis ; Ticlopidine ; Ultrasonography ; Warfarin