This study was conducted to evaluate the tensile bond strength of three commercially available glass ionomer cements as orthodontic bracket adhesives. 120 premolars extracted for orthodontic treatment were prepared for bonding and standard edgewise brackets were bonded with Shofu GlasIonomer Cement (Shofu Co., U.S.A.), GC Fuji I(GC Co., Japan), KETAC-CEM(ESPE Co., West Germany) with different P/L ratio. The tensile bond strength was tested by Instron testing device after 24hours and 3months from bonding. After debracketing, bracket bases were examined to determine the failure sites. The results of this study were as follows: 1. KETAC-CEM showed the highest bond strength other than measurement after 24 hours and at its original P/L ratio, and seemed to have clinically a proper bond strength. It seemed, however, that both Shofu GlasIonomer Cement and GC Fuji I had an inappropriate bond strength. 2. The incorporation of additional powder into the mixture improved the tensile bond strength. 3. Prolonged storage time improved the tensile bond strength. 4. Of the failure, failure occured at the tooth-adhesive interface(54.2%) was the most common type. The second type of failure(36.7%) was combination type, where part of the adhesive remained on the tooth and part on the bracket. And the last type of failure(9.1%) occured at the adhesive-bracket interface.
Adhesives ; Bicuspid ; Glass Ionomer Cements* ; Glass* ; Orthodontic Brackets ; Tooth

PURPOSE: We evaluated one patient with multiple evanescent white dot syndrome (MEWDS), using fundus fluorescein angiography (FAG), indocyanine green angiography (ICGA), optical coherence tomography (OCT) on acute phase of the disease, at 2 weeks after onset and at 10weeks. METHODS: Each diagnostic images were compared with patient's clinical course .OCT measurements of serial retinal thickness were done to assess the change in retinal thickness over the disease process. RESULTS: White dots on fundoscopic examination showed hypofluorescent on ICGA and imaged hyperreflective on OCT without presence of neither subretinal fluid nor neuroretinal increase in thickness. These ICGA and OCT findings suggest that lesions of perfusion defect on ICGA may be caused by interstitial precipitations of inflammatory cells in choriocapillaries and the underlying mechanism is not due to vasculitis with edema or serous exudation. CONCLUSIONS: ICGA and OCT allowed more precise anatomic evaluation than FAG in diagnosis and correlated well with clinical symptoms.
Angiography ; Diagnosis ; Edema ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Perfusion ; Retinaldehyde ; Subretinal Fluid ; Tomography, Optical Coherence ; Vasculitis

Lipoid proteinosis is a rare autosomal recessively inherited disorder that is characterized by the deposition of hyaline-like material in the skin, oral cavity, and other organs. Microscopically, there is extensive deposition of amorphous eosinophilic material surrounding capillaries, sweat glands and in papillary dermis. Although the pathogenesis of this disease is not well understood, it is believed that it may result from the defect of collagen metabolism leading to abnormal accumulation of noncollagenous glycoprotein. We report a case of lipoid proteinosis in a 20-year-old female that demonstrates the characteristic clinical, histopathological, and ultramicroscopic features of this disease.
Capillaries ; Collagen ; Dermis ; Eosinophils ; Female ; Glycoproteins ; Humans ; Metabolism ; Mouth ; Skin ; Sweat Glands ; Young Adult

OBJECTIVE: To assess the intra-rater and inter-rater reliability for measuring femoral anteversion angle (FAA) by a radiographic method using three-dimensional computed tomography reconstruction (3D-CT). METHODS: The study included 82 children who presented with intoeing gait. 3D-CT data taken between 2006 and 2014 were retrospectively reviewed. FAA was measured by 3D-CT. FAA is defined as the angle between the long axis of the femur neck and condylar axis of the distal femur. FAA measurement was performed twice at both lower extremities by each rater. The intra-rater and inter-rater reliability were calculated by intraclass correlation coefficient (ICC). RESULTS: One hundred and sixty-four lower limbs of 82 children (31 boys and 51 girls, 6.3±3.2 years old) were included. The ICCs of intra-rater measurement for the angle of femoral neck axis (NA) were 0.89 for rater A and 0.96 for rater B, and those of condylar axis (CA) were 0.99 for rater A and 0.99 for rater B, respectively. The ICC of inter-rater measurement for the angle of NA was 0.89 and that of CA was 0.92. By each rater, the ICCs of the intrarater measurement for FAA were 0.97 for rater A and 0.95 for rater B, respectively and the ICC of the inter-rater measurement for FAA was 0.89. CONCLUSION: The 3D-CT measures for FAA are reliable within individual raters and between different raters. The 3D-CT measures of FAA can be a useful method for accurate diagnosis and follow-up of femoral anteversion.
Axis, Cervical Vertebra ; Bone Anteversion ; Child ; Diagnosis ; Female ; Femur ; Femur Neck ; Follow-Up Studies ; Gait ; Humans ; Imaging, Three-Dimensional ; Lower Extremity ; Retrospective Studies

BACKGROUND: Paradoxical embolism through the patent foramen ovale (PFO) is a well-recognized mechanism for otherwise unexplained ischemic stroke. Although transthoracic contrast echocardiography (TCE) has been used frequently for noninvasive diagnosis of right to left shunt through PFO, its diagnostic accuracy appears limited, especially in patients with poor acoustic window. Since harmonic imaging (HI) can enhance the definition of contrast microbubbles, theoretical advantages of HI in the detection of right to left shunt through PFO using microbubbles can be considered. However, there are few data regarding the diagnostic efficacy of HI in the detection of right to left shunt through PFO. The purpose of this study was to compare the diagnostic value of transthoracic HI in the detection of right to left shunt through PFO in patients with stroke with that of fundamental imaging (FI). Methods: One hundred thirty-six consecutive patients with stroke (82 male, mean age:9) underwent TCE in both HI and FI and transesophageal echocardiography (TEE) during rest and Valsalva maneuver with intravenous administration of agitated saline. PFO was judged to be present if microbubbles appeared in the left atrium within 3 cardiac cycles of their appearance in the right atrium. TEE was regarded as the gold standard for assessing the diagnostic accuracy of TCE. Results: Right to left shunt through PFO was detected in 40 of 136 patients by TEE (29.4%). FI of TCE detected shunt through PFO in only 9 of 136 patients (6.6%). In contrast, HI detected shunt through PFO in 25 of 136 patients (18.4%). The overall sensitivity and specificity of FI and HI for detection of right to left shunt through PFO were 22.5%, 62.5% (p<0.05) and 100%, 100%, respectively. Valsalva maneuver during HI significantly increased the detection rate of shunt through PFO (during rest in 9 and during Valsalva maneuver in 25, p<0.05). CONCLUSION: HI with contrast microbubble injection significantly enhanced the detection of right to left shunt through PFO in patients with ischemic stroke compared with FI by transthoracic approach.
Acoustics ; Administration, Intravenous ; Diagnosis ; Dihydroergotamine ; Echocardiography* ; Echocardiography, Transesophageal ; Embolism, Paradoxical ; Foramen Ovale, Patent* ; Heart Atria ; Humans ; Male ; Microbubbles ; Sensitivity and Specificity ; Stroke ; Valsalva Maneuver

PURPOSE: The purpose of this study was to evaluate whether we have to stop the antiplatelet agents prior to hemiarthroplasty surgery in patients with displaced femur neck fractures to reduce postoperative complications. MATERIALS AND METHODS: We enrolled forty-three patients with displaced femur neck fractures who were treated by bipolar hemiarthroplasty and were taking antiplatelet agents. Group I included 21 patients who discontinued antiplatelet agents and had delayed operations at an average 5.7 days and group II included 22 patients who had had early operations within 24 hours without stopping the antiplatelet agents. We compared the pre- and postoperative levels of hemoglobin, the volume of postoperative transfusion requirement and complications. Student's t-test and chi-square test were used for statistical analysis. RESULTS: The average differences between preoperative and postoperative hemoglobin was 1.4+/-0.4 g/dL decrease in group I and 2.1+/-0.5 g/dL decrease in group II (P<0.001). Patients who received a blood transfusion were 11 in group I and 13 in group II (P=0.66). Total number of blood transfusion was 13 pints in group I and 18 pints in group II (P=0.23). Pneumonia occurred in one patient in each group. Four pressure sores and three diaper rashes were developed in group I. But there were no patients requiring massive transfusion, reoperation due to hematoma and infection in each group. CONCLUSION: Although continuous taking of antiplatelet agents in displaced femur neck fracture is associated with an increased risk of postoperative bleeding, taking an antiplatelet agent itself is not a contraindication of early surgery.
Blood Transfusion ; Diaper Rash ; Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Hematoma ; Hemiarthroplasty ; Hemorrhage ; Humans ; Platelet Aggregation Inhibitors ; Pneumonia ; Postoperative Complications ; Pressure Ulcer ; Reoperation

Epileptic seizures of nystagmoid character with the fast -beat to the opposite side of the epileptogenic focus have been described as oculoclonic seizures and epileptic nystagmus. Epileptic nystagmus, especially horizontal, most commonly results from seizure activity involving the occipital cortex, although participation of adjoining portions of the parietal and temporal cortex is possible. The frequency of ictal nystagmus was less than 10% of patients with occipital lobe epilepsy. Although forty-six cases were already reported at the litherature, there was no report in korea. We reported a 20-year old patient who had history of recurrent paroxysmal attacks of epileptic nystagniu, associated with oscillopsia and followed by episodic bilateral blindness and eyelid flutter. Standard and extra occipital electrodes visualized more exact left occipital foci at the videomonitored EEG examination when the patient showed epileptic nystagmus. The ictal Brain SPECT, with the use of 99mTc-HMPAO also localized the seizures to left occipital lobe.
Blindness ; Brain ; Electrodes ; Electroencephalography ; Epilepsies, Partial* ; Epilepsy ; Eyelids ; Humans ; Korea ; Occipital Lobe* ; Rabeprazole ; Seizures ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon ; Young Adult

OBJECTIVE: We investigated the association of platelet distribution width (PDW) and mean platelet volume (MPV) with disease activity indices of ankylosing spondylitis (AS) in patients whose laboratory results or medical conditions would not affect PDW and MPV levels. METHODS: We analysed demographic and laboratory data of 88 patients with AS. On the same day as the laboratory tests were done, we assessed AS disease activity using the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Patients Global Score and Ankylosing Spondylitis Disease Activity Score (ASDAS), including erythrocyte sedimentation rate (ESR) (ASDAS-ESR) and C-reactive protein (CRP) (ASDAS-CRP). The association was analyzed by linear regression. RESULTS: The median age of 88 patients was 38.0 years and the median length of observation was 5.5 years. The median platelet count was 266,500.0/µL, the median PDW was 10.7 fL and the median MPV 9.6 fL. The median ESR was 19.0 mm/hr and CRP was 2.5 mg/L. Among acute reactants, only CRP was negatively correlated with MPV, but not PDW (r=−0.218, p<0.041). However, both PDW and MPV were not significantly correlated with any disease activity index of AS. On multivariate linear regression analysis, only the length of observation was significantly correlated with MPV (β=0.224, p<0.044). CONCLUSION: PDW and MPV were not potent surrogate markers to reflect AS activity, with potential confounding strictly controlled, to affect MPV and PDW levels.
Baths ; Biomarkers ; Blood Platelets* ; Blood Sedimentation ; C-Reactive Protein ; Humans ; Linear Models ; Mean Platelet Volume* ; Platelet Count ; Spondylitis, Ankylosing*

Livedo vasculitis is a chronic dermatosis characterized by recurrent painful ulceration of the lower limbs, which heals to leave atrophie blanche. The precise pathophysiology is not known. Antiplatelet, anticoagulant, fibrinolytic therapies and anabolic steroids have been reported to be helpful in this syndrome. However, no consistent benefit has been demonstrated with any treatment modality. Recently, pulsed intravenous immunoglobulin therapy has been reported to be effective in some refractory cases. We herein report two cases of recalcitrant livedo vasculitis which were effectively treated with pulsed intravenous immunoglobulin therapy. These were the first trials carried out in Korea.
Immunization, Passive* ; Immunoglobulins* ; Korea ; Lower Extremity ; Skin Diseases ; Steroids ; Thrombolytic Therapy ; Ulcer ; Vasculitis*

Medial antebrachial cutaneous (MABC) nerve injury associated with iatrogenic causes has been rarely reported. Local anesthesia may be implicated in the etiology of such injury, but has not been reported. Two patients with numbness and painful paresthesia over the medial aspect of the unilateral forearm were referred for electrodiagnostic study, which revealed MABC nerve lesion in each case. The highly selective nature of the MABC nerve injuries strongly suggested that they were the result of direct nerve injury by an injection needle during previous brachial plexus block procedures. Electrodiagnostic studies can be helpful in evaluating cases of sensory disturbance after local anesthesia. To our knowledge, these are the first documented cases of isolated MABC nerve injury following ultrasound-guided axillary brachial plexus block.
Anesthesia, Local ; Brachial Plexus* ; Electrodiagnosis ; Forearm ; Humans ; Hypesthesia ; Needles ; Paresthesia ; Peripheral Nerve Injuries