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: 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*

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

BACKGROUND: Indications and applications of percutaneous transluminal coronary angioplasty(PTCA) has been broaden in reccent years. However,we considered many aspects in performing angioplasty in patient with multivessel disease. There were procedural success rate, complication, risk, restenosis and long-term effect. So we evaluated the initial success rate, safety and follow-up results. METHODS: To assess the likelihood of initial success in patients with multivessel coronary artery disease, single or multiple site angioplasy were performed at 449 lesions from 273 patients(Male 202,Female 71, Mean age 60.0+/-9.4 years). To evaluate the restenosis rate of angioplasty in multivessel disease, follow-up coronary angiogram were performed at 164 lesions from 95 patients at average 6months after angioplasty. RESULTS: The extent of coronary artery disease revealed that two vessel disease were 200(73.3%) and triple vessel disease were 73(26.7%). Single vessel angioplasty(SVA) was performed in 180(40.1%) lesions and multivessel angioplasty(MVA) was performed in 269(59.9%) lesions. Procedural success was achieved 377(84.0%) out of total 449 lesions. The proccdural success rate was 81.1% in SVA and 85.9% in MVA. According to major epicardial coronary artery, procedural success rate of left anterior descending artery was 82.0%, left circumflex artery 92.4% and right coronary artery 79.4%. According to angiographic morphology of lesions, procedural success rate of type A was 95.7%, type B 88.9% and type C 56.4%. Complete revascularization was done in 87 patients(31.9%) out of 273 patients. Major cause of failure of angioplasty in multivessel disease was inability to pass the guide wire cross the lesion due to total occlusion. Complications included dissection in 101, acute closure in 7(9.7%), coronary artery perforation in 2, cardiogenic shock in 1 and ventricular fibrillation in 1. Follow-up coronary angiography revealed the restenosis rate was 42.2%. CONCLUSION: Coronary angioplasty in selected patients with multivessel coronary artery disease might be useful and have relatively good immediate and long-term results.
Angioplasty* ; Arteries ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Follow-Up Studies ; Humans ; Shock, Cardiogenic ; Ventricular Fibrillation

There have been few reports of manifestations such as vasculitis, nephrosis, neuritis, encephalitis, and serum sickness occuring in a temporal relation to insect stings. Symptoms usually start several days to several weeks after the sting and may last for a long time. Angioedema with eosinophilia induced by bee sting has not reported in medical literature. We report a case of eosinophilia with angioedema induced by bee venom in a 30-year-old woman whom presented with edema of extremities and peripheral blood eosinophilia. The patient had high titer of specific IgE to yellow jacket venom.
Adult ; Angioedema* ; Bee Venoms ; Bees* ; Bites and Stings* ; Edema ; Encephalitis ; Eosinophilia* ; Extremities ; Female ; Humans ; Immunoglobulin E ; Insect Bites and Stings ; Nephrosis ; Neuritis ; Serum Sickness ; Vasculitis ; Venoms ; Wasps

BACKGROUND: Restenosis is a major limitation of balloon angioplasty. Recently, new angioplasty devices have been used in an attempt to reduce the restenosis compared with coronary balloon angioplasty. Directional coronary atherectomy effectively dilated the lesion by removal of the atherosclerotic plaque. Therefore, we tried to evaluate immediate and late clinical outcomes after directional coronary atherectomy in the 57 patients with coronary artery disease. METHODS: From October 1991 to March 1997, fifty seven consecutive patients with 69 lesions were treated with directional coronary atherectomy. The patients underwent coronary angiography at pre-intervention, immediately after intervention and at 6 months post-intervention. Restenosis was assessed clinically and by computer-assissted quantitative measurements of luminal dimensions. Patients were requested to undergo coronary angiography at 6 months after directional coronary atherectomy. Angiographic restenosis was defined as more than 50% diameter stenosis by quantitative coronary angiographic analysis. RESULTS: Successful results were achieved in 61 of the 69 lesions(88%) and mean stenosis was reduced from 78.0+/-13.0% to 10.0+/-5.0%. Atherectomy resulted in an increase in minimal lumen diameter from 0.8+/-0.3mm to 3.0+/-0.6mm. Six months follow-up angiogram was obtained in 68% of 50 eligible lesions. The overall angiographic restenosis rate was 32%. Six month clinical follow-up was obtained in 94% of the eligible lesions. The clinical recurrence occured in 38% of the patients. The target lesion revascularization rate was 17%. CONCLUSIONS: Removal of coronary artery plaque with directional atherectomy led to large luminal diameter and six months follow-up angiography shows an overall restenosis rate of 32% However, further clinical study is warranted to evaluate the efficacy of atherectomy with larger numbers of patients.
Angiography ; Angioplasty ; Angioplasty, Balloon ; Angioplasty, Balloon, Coronary ; Atherectomy ; Atherectomy, Coronary* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Follow-Up Studies ; Humans ; Phenobarbital ; Plaque, Atherosclerotic ; Recurrence

PURPOSE: The aim of present investigation was to find out the influence of several times iatrogenic mobilization in the initial stage of implant installation on bone-implant osteointegration. MATERIALS AND METHODS: The experimental implants (3.75 mm in diameter, 8.0 mm in length) were made of commercially pure (Grade IV) titanium, and were treated with RBM (MegaGen(R): Ca-P) on lower 4.0 mm part. Only lower part of implant was inserted to bone and the implants were nonsubmerged. The 130 implants (two in each tibia) were inserted into the monocortical tibias of 33 rabbits which each weighed more than 3.5 kg (Female, New Zealand White). According to the removal torque interval, the groups were divided into 13 groups, group I (1 day), group II (1 day + 2 days), group III (1 day + 2 days + 3 days), group IV (1 day + 2 days + 3 days + 4 days), group V (2 days), group VI (2 days + 4 days), group VII (2 days + 4 days + 6 days), group VIII (2 days + 4 days + 6 days + 8 days), group IX (4 days), group X (4 days + 7 days), group XI (4 days + 7 days + 10 days), group XII (4 days + 7 days + 10 days + 14 days) and control group. In the control group, the removal torque was measured at 8 weeks with a digital torque gauge (Mark-10, USA). In the experimental groups, the removal torque was given once, twice, three times or four times by experiment design before the final removal torque and the value was measured each time. The implants were then screwed back to their original positions. All the experimental groups were given a final healing time of 8 weeks after placement, in which values were compared with the control groups and the 1st, 2nd, 3rd or 4th removal torque values in each experimental group. RESULTS: In comparison of the final removal torque tests among experimental groups, the removal torque value of experimental groups except group XII were not statistically different that of control group. And the values of group I and II were significantly higher than the values of group VI, VIII, X, XI, and XII. In addition, the values of group III, IV, and V were significantly higher than group XI and XII. In comparison of the removal torque in the each experimental group, the final removal torque were significantly higher in all groups except group VIII, X, XI, and XII. CONCLUSION: If sufficient healing time was allowed, a few mobilization of fixture at the very early stage after the implant placement in the rabbits didn't interrupt the final bone to implant osseointegration.
Dental Implants ; Implants, Experimental ; New Zealand ; Osseointegration ; Rabbits ; Tibia ; Titanium ; Torque

BACKGROUND: Detection of left ventricular regional wall motion abnormality(RWMA) by 2 dimensional echocardiography during ergonovine provocation(Erg Echo) can be used for noninvasive diagnosis of coronary vasospasm(CVS). The aim of this study was to test the safety and diagnostic validity of Erg Echo as a screening test in patients with chest pain syndromes before coronary angiography was undertaken. METHODS: From Mar 1993 to Jun 1994, Erg Echo was performed in 80 consecutive patients (56 males) with chest pain syndromes suggestive of variant angina, after the confirmation of negative treadmill or normal stress myocardial perfusion scan using thallium 201. A bolus of ergonovine maleate was injectedd at 5min intervals up to total cumulative dosage of 0.35mg with echocardiographic montioring of the left ventricular wall motion. Twelve leads ECG was also recorded every 3min after each ergonovine injection. The positive criteria of the test was transient ST segment clevation or depression greater than 0.1mV in 12-leads ECG or development of RWMA. Coronary angiography was undertaken 2(+/-4) days after Erg Echo, and spasm provocation test with acetylcholine, or ergonovine was done in case of normal angiogram or luminal narrowing of less than 70%. The appearance of total or subtotal occlusion of a major coroary artery associated with ST segment elevation or depression on the ECG or chest pain, or both, was considered to be a manifestation of spasm. RESULTS: According to the invasive angiographic criteria, 56 patients revealed CVS ; CVS was ruled oup in 19 patients showing near normal angiogram with negative spasm provocation test and in 5 patients with restion high degree fixed stenosis(luminal narrowing of 97+/-4%). Erg Echo could diagnose CVS before the angiography with the sensitivity of 91%(51/56,95% confidence interval [CI] ; 84-98%) and the specificity of 88%(21/24,95% CI ; 75-100%). Of 53 patients showing RWMA in Erg Echo, 42%(22/53) revealed no significant changes in the simultaneously recorded ECG and characteristic ST elevation was recorded in only 38%(20/53). There was no case of myocardial infarction or fatal arrhythmia during Erg Echo. CONCLUSION: Erg Echo befor the coronary angiography is safe and can e utilized as a reliable diagnostic screening test of CVS in patients with negative tradmill or normal stess myocardial perfusion scan, This finding suggests that invasive coronary angiography can be avioded in selected patients for the diagnosis of vasospastic angina.
Acetylcholine ; Angiography ; Arrhythmias, Cardiac ; Arteries ; Chest Pain ; Coronary Angiography* ; Coronary Vasospasm* ; Depression ; Diagnosis* ; Echocardiography* ; Electrocardiography ; Ergonovine* ; Humans ; Mass Screening ; Myocardial Infarction ; Perfusion ; Phenobarbital ; Sensitivity and Specificity ; Spasm ; Thallium