PURPOSE: The object of the present study was to evaluate the shear bonding strength of composite to PEKK by applying several methods of surface treatment associated with various bonding materials. MATERIALS AND METHODS: One hundred and fifty PEKK specimens were assigned randomly to fifteen groups (n = 10) with the combination of three different surface treatments (95% sulfuric acid etching, airborne abrasion with 50 µm alumina, and airborne abrasion with 110 µm silica-coating alumina) and five different bonding materials (Luxatemp Glaze & Bond, Visio.link, All-Bond Universal, Single Bond Universal, and Monobond Plus with Heliobond). After surface treatment, surface roughness and contact angles were examined. Topography modifications after surface treatment were assessed with scanning electron microscopy. Resin composite was mounted on each specimen and then subjected to shear bond strength (SBS) test. SBS data were analyzed statistically using two-way ANOVA, and post-hoc Tukey's test (P<.05). RESULTS: Regardless of bonding materials, mechanical surface treatment groups yielded significantly higher shear bonding strength values than chemical surface treatment groups. Unlike other adhesives, MDP and silane containing self-etching universal adhesive (Single Bond Universal) showed an effective shear bonding strength regardless of surface treatment method. CONCLUSION: Mechanical surface treatment behaves better in terms of PEKK bonding. In addition, self-etching universal adhesive (Single Bond Universal) can be an alternative bonding material to PEKK irrespective of surface treatment method.
Adhesives ; Aluminum Oxide ; Dental Bonding ; Methods ; Microscopy, Electron, Scanning ; Polymers* ; Sulfur

PURPOSE: The purpose of this study is to evaluate the effect of applying Silano-pen to feldspathic porcelain and zirconia on shear bond strength with composite resin. MATERIALS AND METHODS: Feldspathic porcelain and zirconia specimens were produced into 30 per each 2 mm thick and 12 mm in diameter and their surface was made smooth and even and then embedded in acrylic resin. The specimens were divided into each Group F (Feldspathic porcelain) and Group Z (Zirconia), (1) Hydrofluoric acid etching and silane (F1 & Z1), (2) Silano-pen and silane (F2 & Z2), (3) Hydrofluoric acid etching and Silano-pen, silane (F3 & Z3). After surface conditioning, substrate surfaces of the specimen were examined by SEM. Composite resin cylinders (2 mm high, 3 mm in diameter)were bonded to specimen and shear bond strength between ceramic and composite resin was measured by using universal testing machine. The measured values were statistically analyzed by using two way ANOVA and Tukey's multiple comparison test (alpha=.05). RESULTS: In the scanning electron micrograph of the treated ceramic surface, Group F2 and F3 appeared the high roughness and Group Z3 appeared the highest density of silica particle. In Feldspathic porcelain, the result of measuring shear bond strength showed that Group F3 was measured to be highest and Group F1 was measured to be lowest but there was no statistical significance among Groups. In zirconia, Group Z3 was measured to be highest and Group Z1 was measured to be lowest and there was statistical significance among Groups (P<.05). CONCLUSION: In zirconia, applying hydrofluoric acid etching and then Silano-pen and silane is effective for composite resin adhesion.
Ceramics ; Dental Porcelain* ; Hydrofluoric Acid ; Silicon Dioxide

OBJECTIVE: The present study was performed to investigate whether apoptosis occur in human embryos by annexin staining and detect the expression of Fas, Fas-ligand (FasL), Bax, and Bcl-2 in human fragmented embryos derived from IVF-ET by immunofluorescence and Western blot analysis. MATERIALS AND METHODS: Using annexin staining, immunofluorescence and Western blot analysis on normal and fragmented embryos, we were able to detect apoptotsis and apoptotic gene products in fragmented embryos. RESULTS: Phosphatidylserine (PS) translocation, the marker for apoptosis, were detected frequently in fragmented embryos. Bcl-2 and Bax protein were detected in both fragmented and non-fragmented embryos. When fragmented embryos compared to normal embryos, immunofluorescent intensity of Bcl-2 tended to be lower in fragmented embryos. Bax gene expression increased in the fragmented embryos compared to the normal embryos. This result supports a model in which the molar ratio of Bcl-2 to Bax determines whether apoptosis induced or inhibited in human embryo. Fas was highly expressed in human preimplantation embryos but not FasL. It suggests that embryo may undergo apoptosis by binding with FasL produced by follicular or immune cells. CONCLUSION: The over expression of Bax and Fas will trigger apoptosis to lead embryo fragmentation and change embryo to be nonviable.
Apoptosis* ; bcl-2-Associated X Protein ; Blastocyst ; Blotting, Western ; Embryonic Structures* ; Fluorescent Antibody Technique ; Gene Expression ; Humans* ; Molar

BACKGROUND: Various methods or regimens treating pain after a pediatric tonsillectomy were postulated. Ibuprofen, an NSAIDs, is Known to be useful due to its analgesic effects and safety in a pediatric tonsillectomy. Even though with rapid induction, emergence and nonirritating airway properties, sevoflurane may be associated with a agitation or delirium in a higher incidence compared with halothane in children. We performed this study to determine whether oral ibuprofen could have an influence on characteristics during emergence in addition to analgesic effects after use of sevoflurane/fentanyl in a pediatric tonsillectomy. METHODS: Twenty nine pediatric patients scheduled for a tonsillectomy were assigned into two groups; an oral placebo (Group 1, n = 13) or ibuprofen 5 mg/Kg (Group 2, n = 16) was given 60 min before the operation. Rapid masK induction with sevoflurane and maintenance with sevoflurane, nitrous oxide and fentanyl were performed. After the tonsillectomy, patients were transferred to the PACU with prompt recovery. Postoperative pain and emergence were accessed by using VAS (1-5) and Aldrete scores at 5 min after the discharge from operating room. The incidences of agitation, vomiting and postoperative bleeding in addition to VAS scores and Aldrete scores were compared in both groups. RESULTS: The VAS score in Group 2 (1.69 +/- 0.79) was lower than that of Group 1 (2.85 +/- 1.25) (P < 0.05). Aldrete score in Group 2 (8.69 +/- 0.86) is higher than that of Group 1 (9.88 +/- 0.34) (P < 0.05). There was no significant difference in incidence of agitation (38.5% in Group 1 and 18.8% in Group 2). There was no vomiting and bleeding in either groups. CONCLUSIONS: Preoperative oral ibuprofen potentiates analgesic effects and hastens emergence time without any increase in the incidences of vomiting and bleeding. However ibuprofen does not decrease the incidence of agitation.
Anti-Inflammatory Agents, Non-Steroidal ; Child* ; Delirium ; Dihydroergotamine ; Fentanyl ; Halothane ; Hemorrhage ; Humans ; Ibuprofen* ; Incidence ; Masks ; Nitrous Oxide ; Operating Rooms ; Pain, Postoperative ; Tonsillectomy* ; Vomiting

OBJECTIVE: This study is to determine the cross-cultural adaptation and validation of the Korean version of the EQ-5D (KEQ-5D) in various rheumatic patients. METHODS: We performed translation, backward translation and cognitive debriefing by the guidelines of the EuroQol group. The validity was evaluated by using the KEQ-5D, Korean Short- Form 36 (KSF-36) and disease-specific measures on 508 out-patients with ankylosing spondylitis, fibromyalgia syndrome, rheumatoid arthritis, osteoarthritis or systemic lupus erythematosus. Construct validity were evaluated by testing a-priori hypotheses of the association between the KEQ-5D and other measures. For the verification of reliability, we gave the same questionnaires twice to another 57 patients 1-week apart, and intra-class correlations and Kappa statistics were estimated. To test responsiveness, 60 patients with RA repeated the KEQ-5D at 12-week intervals within the context of 12-week clinical trials of a TNF blocker, and we calculated the t-test, effect size and standardized response mean RESULTS: There were no major modifications on the cross-cultural adaptation. The relationships between the KEQ-5D and the generic or disease-specific measures were observed to be as we expected previously in a-priori hypotheses:higher KEQ-5Dindex and KEQ-5DVAS scores were correlated with generic or disease-specific measures on the better health status, and groups with a better functional class showed higher KEQ-5D scores. The intra-class correlations of the KEQ-5Dindex and KEQ-5DVAS were 0.751 and 0.767, respectively, and Kappa statistics for agreement ranged from 0.455 to 0.772 across five dimensions. The standardized response means of KEQ-5Dindex and KEQ-5DVAS were 0.649 and 0.410. CONCLUSION: The KEQ-5D had good validity and sensitivity in several rheumatic conditions. Also, its reliability and responsiveness were moderate to good.
Arthritis, Rheumatoid ; Fibromyalgia ; Humans ; Korea ; Lupus Erythematosus, Systemic ; Osteoarthritis ; Outpatients ; Quality of Life ; Surveys and Questionnaires ; Rheumatic Diseases* ; Spondylitis, Ankylosing

The effect of fentanyl and nalbuphine used as analgesics in balanced anesthesia were evaluated in 60 full term parturients, ASA physical status class I or II, sheduled for elective cesarean section. They were injected intramusculary with 0.2 mg of glycopyrrolate 30 minutes to one hour prior to the induction of anesthesia. Four mg/kg of thiopental sodium and one mg/kg of succinylcholine were administered intravenously for the induction and endotracheal intubation. Anesthesia was maintained with 66% of nitrous oxide in oxygen until delivery. Following the intravenous injection of 4 mg-vecuronium, controlled ventilation was applied to maintain at PCO1 30 to 40 mmHg. Immediately after clamping of the umbilical cord, 3 ug/kg of fentanyl(F group) or 0.3 mg/kg of nalbuphine(N group) with 5 mg of droperidol were administered. In the F group, the systolic and diastolic blood pressures at three minutes after fentanyl were significantly lower than those during the preinduction period and during recovery room stay. The systolic BP in the preinduction period was significantly higher than those of three minutes after nalbuphine, and the diastolic BP at the preinduction period was also higher than those of three minutes after nalbuphine and during recovery room stay. Heart rates were significantly increased three minutes after nalbuphine than at recovery room. The blood presures and heart rates were not significantly different between the two groups. The time intervals from the end of the operation to the first analgesics were significantly longer in the N group(mean 11.3 hours) in contrast to the F group(mean 6.9 hours). There were a few complications such as nausea, headache, dizziness, somnolence and euphoria. The incidences of awareness was 13.3 and 6.7% in the F and N group, respectively. We concluded that the balanced anesthetic technique using nalbuphine with droperidol nuder the inhalation of 66%-nitrous oxide resulted in a satisfactory anesthesia for cesarean seetion with good postoperative analgesia.
Analgesia ; Analgesics ; Anesthesia ; Anesthetics ; Balanced Anesthesia* ; Cesarean Section* ; Constriction ; Dizziness ; Droperidol ; Euphoria ; Female ; Fentanyl* ; Glycopyrrolate ; Headache ; Heart Rate ; Incidence ; Inhalation ; Injections, Intravenous ; Intubation, Intratracheal ; Nalbuphine* ; Nausea ; Nitrous Oxide ; Oxygen ; Pregnancy ; Recovery Room ; Succinylcholine ; Thiopental ; Umbilical Cord ; Ventilation

BACKGROUND AND OBJECTIVES: We investigated in patients with coronary vasospastic angina whether the exercise ECG test results are influenced by the different modes of exercise load and compared the clinical characteristics including coronary risk factors between patients with positive and negative exercise tests. MATERIALS AND METHODS: This study comprised 34 patients with documented coronary artery spasm without significant stenosis (coronary artery luminal diameter narrowing <70%) and treadmill exercise test. Treadmill exercise ECG test was performed based on Bruce's protocol (graded exercise test, GET) and sudden rapid exercise protocol (non-graded exercise test, NGET) in the morning of the same day. RESULTS: 1) Of 29 patients who underwent both GET and NGET, 19 patients manifested positive result by NGET, whereas only 11 patients did by GET (66 vs. 38%, P=0.04). All patients with positive GET had positive NGET and 8 of 18 patients with negative GET had positive NGET. 2) Of 34 patients who underwent GET, there was no significant difference in frequency of hypertension, diabetes, current smoking, presence of effort chest pain by history, mixed disease (fixed stenosis >50%, <70% of luminal diameter) or total cholesterol level between patients with positive and negative results. In 18 typical variant angina patients by clinical history, 8 of 10 patients with high disease activity (5 times or more attack per week) manifested positive result by GET or NGET, whereas 4 of 8 patients with low disease activity (80 vs. 50%, P=NS). CONCLUSION: In patients with coronary vasospastic angina, sudden rapid exercise could induce more frequently coronary artery spasm than multistage exercise. The result of an exercise test may not be correlated with coronary risk factors, coronary anatomy, effort chest pain, and the disease activity.
Arteries ; Chest Pain ; Cholesterol ; Constriction, Pathologic ; Coronary Vessels ; Electrocardiography ; Exercise Test* ; Humans ; Hypertension ; Phenobarbital ; Risk Factors ; Smoke ; Smoking ; Spasm

BACKGROUND: Cutaneous vasculitis associated with viral hepatitis seems to occur as a hypersensitivity reaction against the circulating viral antigens. Hepatitis B virus(HBV)-encoded X antigen(HBxAg) is known to participate in the carcinogenesis of hepatocellular carcinoma(HCC) by the inactivation of p53. However, HBxAg has been found in chronic infiammatory lesions without the overexpression of p53. Accordingly, not only EBsAg and HBcAg but also HBxAg may be involved in HCC-associated cutaneous vasculitis, regardless of the alteration of p53. OBJECTIVE: This study was conducted to investigate the expression of HBV-encoded antigens in cutaneous vasculitis accompanied by HBV hepatopathy. Additionally, we have compared the expression of 3 HBV antigens and p53 between vasculitic patients with HCC and in others showing HCC-non-associated vasculitis. METHODS: Immunohistochemically, we examined the expression of HBsAg, HBcAg, and HBxAg in the tissue specimens taken from the vasculitic lesions of the 33 HBsAg-positive enrolled patients with cutaneous vasculitis proven by skin biopsy. RESULTS: 1. The immunohistochemical positivity rate to HBsAg in vasculitic patients with HBV hepatopathy was 66.7% overall. It was 90% in HCC-associated vasculitic subjects and 56.5% in the vasculitic subjects without HCC, respectively. 2. We found the expression of HBxAg in 80% of the vasculitic subjects showing HCC. The vasculitic patients without HCC showed 17,3% of the positivity rate to HBxAg. 3. We could not find the overexpression of p53 in the vasculitic tissue specimens of the HCC patients without the cutaneous metastasis from primary HCC. CONCLUSION: HBsAg, HBcAg and HBxAg may participate in the pathogenesis of cutaneous vasculitis with HBV hepatopathy, regardless of tumorigenesis.
Antigens, Viral ; Biopsy ; Carcinogenesis ; Hepatitis B Core Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Hypersensitivity ; Neoplasm Metastasis ; Skin ; Vasculitis*

OBJECTIVE: We have developed an instant messenger system that supports transmitting 3D medical image objects for telediagnostic use. METHODS: We used thresholding and down-scaling technique to build down-scaled 3D object with 80 sliced Digital Imaging and Communication in Medicine(DICOM) images. And, we also construct instant messenger for medical data transfer and general communication. We measured total image size and transmission time which were decreased when applied peer to peer connection using instant messenger for medicine. RESULTS: Our study showed that total DICOM image size was decreased around 1% and transmission time was also decreased by 1.59% when we use proposed system. CONCLUSION: Proposed methods have a potential to be a useful tool in ubiquitous health network system. Also, we expect the synergy effect is increased by developing 3D object technique and security solutions.

Isolated ACTH deficiency is a rare cause of secondary adrenocortical insufficiency. Adrenal crisis in isolated ACTH deficiency is less common compared to primary adrenal insufficiency, but isolated ACTH deficiency is an important cause of hypoglycemia. Recently we experienced a 41-year-old man admitted because of mental confusion. On admission, plasma glucose and sodium concentration were 1.7, 132 mmol/L, respectively. Basal plasma ACTH and cortisol levels were low and other pituitary hormone showed normal response to combined pituitary stimulation test except growth hormone. Plasma ACTH concentration remained low even after intravenous injection of ovine corticotropin releasing factor. It suggest that the defect of ACTH secretion was apparently due to intrinsic pituitary rather than hypothalamic disease. The sellar CT showed the fossa to be filled by cerebrospinal fluid. After treatment with glucocorticoid, he had no further evidence of hypoglycemia and hyponatremia. In conclusion, we report a case of isolated ACTH deficiency with empty sella.
Addison Disease ; Adrenocorticotropic Hormone ; Adult ; Blood Glucose ; Cerebrospinal Fluid ; Corticotropin-Releasing Hormone ; Growth Hormone ; Humans ; Hydrocortisone ; Hypoglycemia ; Hyponatremia ; Hypothalamic Diseases ; Injections, Intravenous ; Plasma ; Sodium