In periodontal regeneration treatment, access to the frucation area is very difficult. Thus complete removal of plaque, calculus and endotoxin is somewhat impossible. In this study, teeth that were extracted due to periodontal disease were used. The furcation area was treated with periodontal curette, ultrasonic scaler, roto bur and they observed using SEM. The result was follows 1. The group treatment with curette showed remaining plaque, the cementum existed in most of the surface and partial dentinal tubule orifice could be seen. 2. The group treatment with ultrasonic scaler showed less removalof plaque compared to curette and irregular surface could be seen. 3. The group treatment with roto bur showed cleaner surface and many dentinal tubule orifice could be seen compared to the curette and ultrasonic scaler groups. Thus when suing treatments such as bone grafting or guided tissue regeneration, it is considered that the furcation area should be treatment with Roto bur.
Bone Transplantation ; Calculi ; Dental Cementum ; Dentin ; Guided Tissue Regeneration ; Periodontal Diseases ; Regeneration ; Tooth ; Ultrasonics

The purpose of this study was to evaluate clinical changes in graft size after treatment with strip gingival autograft in human. 57 premolar teeth in 27 patients having the following mucogingival problems were selected. The width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth were measured at the initial examination, 2, 12 and 24 weeks following the strip gingival autograft and free gingival autograft. The change of width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth according to healing process in both graft procedures was statistically analyzed by repeated measure ANOVA test and independent t-test using SPSS program. The results were as follows : 1. The change of keratinized gingiva in both graft procedures was increased significantly at 24 weeks post-op. 2. The clinical sulcus depth exhibited no marked changes throughout the entire investigation in both graft procedures. 3. No dimensional variation was seen in graft size in both graft procedures. 4. Shrinkage did not differ significantly in both graft procedures. From the day of grafting to 24 weeks after surgery the percentages of shrinkage were : strip gingival autograft 28% and free gingival autograft 29%.
Autografts* ; Bicuspid ; Gingiva ; Humans ; Tooth ; Transplants*

BACKGROUND: The aim of this study was to assess the relationship between acute physiologic and chronic health examination (APACHE) II and sequential organ failure assessment (SOFA) scores and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia (TH). METHODS: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between January 2010 and December 2012 were retrospectively evaluated. We captured all components of the APACHE II and SOFA scores over the first 48 hours after intensive care unit (ICU) admission (0 h). The primary outcome measure was in-hospital mortality and the secondary outcome measure was neurologic outcomes at the time of hospital discharge. Receiver-operating characteristic and logistic regression analysis were used to determine the predictability of outcomes with serial APACHE II and SOFA scores. RESULTS: A total of 138 patients were enrolled in this study. The area under the curve (AUC) for APACHE II scores at 0 h for predicting in-hospital mortality and poor neurologic outcomes (cerebral performance category: 3-5) was more than 0.7, and for SOFA scores from 0 h to 48 h the AUC was less than 0.7. Odds ratios used to determine associations between APACHE II scores from 0 h to 48 h and in-hospital mortality were 1.12 (95% confidence interval [CI], 1.03-1.23), 1.13 (95% CI, 1.04-1.23), and 1.18 (95% CI, 1.07-1.30). CONCLUSIONS: APACHE II, but not SOFA score, at the time of ICU admission is a modest predictor of in-hospital mortality and poor neurologic outcomes at the time of hospital discharge for patients who have undergone TH after return of spontaneous circulation following OHCA.
APACHE ; Area Under Curve ; Cardiopulmonary Resuscitation ; Hospital Mortality ; Humans ; Hypothermia* ; Hypothermia, Induced ; Intensive Care Units ; Logistic Models ; Odds Ratio ; Organ Dysfunction Scores* ; Out-of-Hospital Cardiac Arrest* ; Outcome Assessment (Health Care) ; Retrospective Studies ; Survivors

Bone graft using growth factors and guided tissue regeneration have been used for the regeneration of infrabony defects which caused by periodontal disease. Calcium sulfate which is one of the resorbable barrier materials used for guided tissue regeneration. Platelet rich plasma which is a easy method to obtain the growth factors had many common points but, platelet rich plasma was still studying. This study was the comparative study between bone graft using platelet rich plasma and guided tissue regeneration using calcium sulfate barrier material in clinical view. For the study, 28 sites(2 or 3 wall infrabony defects) were treated. 14 infrabony defects were received surgical implantation of BBP-calcium sulfate composite with a calcium sulfate barrier and the others received BBP mixed with platelet rich plasma. Clinical outcome was accessed 3 and 6 months of postsurgery. 1. There was no statistical difference between CS group and PRP group in pocket depth, gingival recession, clinical attachment level, and probing bone level at baseline. 2. was statistically significant reduction in probing depth, clinical attachment level, and probing bone level at 3 and 6 months postsurgery(p<0.05). 3. In the probing depth and clincial attachment level PPR group had less improvement than CS group, but there was no statistically difference at 3 and 6 months postsurgery. 4. In the recession PPR group had less recession than CS group, but there was no statistically difference at 3 and 6 months postsurgery. 5. In the probing bone level PPR group had less improvement than CS group, but there was no statistically difference at 6 months postsurgery. In conclusion bone graft using platelet rich plasma and guided tissue regeneration using calcium sulfate barrier showed similar clinical improvement for the treatment of 2 or 3 wall infrabony defects.
Blood Platelets* ; Calcium Sulfate* ; Calcium* ; Gingival Recession ; Guided Tissue Regeneration ; Intercellular Signaling Peptides and Proteins ; Periodontal Diseases ; Platelet-Rich Plasma* ; Regeneration* ; Transplants*

Torsade de pointes (TdP) is a form of polymorphic ventricular tachycardia that is associated with prolongation of the QT interval. Although it occurs in many clinical settings, torsade de pointes is most commonly caused by drugs. The second generation antihistamines, including terfenadine and astemizole, have little sedation or other adverse effects on the CNS. They have been used widely to treat various allergic diseases, but it has been reported that overdoses or combinations with antifungal agents or macrolide antibiotics may lead to TdP. We report a case of TdP that occured during com-bination therapy of terfenadine and ketoconazole.
Anti-Bacterial Agents ; Antifungal Agents ; Astemizole ; Histamine H1 Antagonists, Non-Sedating ; Ketoconazole* ; Tachycardia, Ventricular ; Terfenadine* ; Torsades de Pointes*

PURPOSE: To evaluate functional MR imaging of the motor speech area with and without motor stimulation duringthe rest period. MATERIALS AND METHODS: Nine healthy, right-handed volunteers(M:F=7:2, age:21-40years) wereincluded in this study. Brain activity was mapped using a multislice, gradient echo single shot EPI on a 1.5T MRscanner. The paradigm consisted on a series of alternating rest and activation tasks, performed six times. Each volunteer in the first study(group A) was given examples of motor stimulation during the rest period, while eachin the second study(group B) was not given examples of a rest period. Motor stimulation in group A was achieved bycontinuously flexing five fingers of the right hand. In both groups, maximum internal word generation was achievedduring the activation period. Using fMRI analysis software(Stimulate 5.0) and a cross-correlationmethod(background threshold, 200; correlation threshold, 0.3; ceiling, 1.0; floor, 0.3; minimal count, 3),functional images were analysed. After correlating the activated foci and a time-signal intensity curve, theactivated brain cortex and number of pixels were analysed and compared between the two tasks. The t-test was usedfor statistical analysis. RESULT: In all nine subjects in group A and B, activation was observed in and adjacentto the left Broca's area. The mean number of activated pixels was 31.6 in group A and 27.8 in group B, adifference which was not statistically significant(P>0.1). Activities in and adjacent to the right Broca 's areawere seen in seven of group A and four of group B. The mean number of activated pixels was 14.9 in group A and 18in group B. Eight of nine volunteers in group A showed activity in the left primary motor area with negativecorrelation to the time-signal intensity curve. The mean number of activated pixels for this group was 17.5. Inthree volonteers, activation in the right primary motor area was also observed, the mean number of activatedpixels in these cases was 10.0. CONCLUSION: During the rest period, functional MR imaging of the motor speechcenter combined with motor stimulation was more effective than that without stimulation, and simultaneouslyprovided mapping of the primary motor area.
Brain ; Fingers ; Hand ; Magnetic Resonance Imaging* ; Volunteers

PURPOSE: To analyze the effects of the aspheric rigid gas permeable (RGP) lens on the corneal topography and endothelial cells in eyes with keratoconus. METHODS: Sixty five eyes of 35 keratoconic patients who had follow-up of more than 6 months were included in the study. Thirty eyes of 16 patients wore aspheric RGP lens, and the remaining control eyes did not wear any lens. After aspheric RGP lens fitting, visual acuity and manifest refractive error were evaluated, Slit lamp examination and corneal topography were also done. Mean cell area and density of corneal endothelial cell were measured by specular microscopy at first visit and 6 months after lens fitting. RESULTS: After lens fitting, the percentage of best corrected visual acuity of better than 20/25 was 93.3% (28 eyes). The change of astigmatism, the Steepest Simulated keratometry reading, Surface asymmetry index, Surface regularity index, and apical corneal power were significantly increased in the keratoconic cornea in aspheric lens fitting group compared to the control group (p<0.05) There was no significant difference in corneal endothelial cell counts and mean cell areas between the two groups (p>0.05). CONCLUSIONS: Short-term wearing of aspheric RGP lens in keratoconic patients showed no effect on corneal endothelial cells. However, it increased the irregularity and steepening of the keratoconic cornea. It may indicate that mid-peripheral corneal-to-lens relationship may be inappropriate when keratoconus is fitted with aspheric lens.
Astigmatism ; Cornea ; Corneal Topography* ; Endothelial Cells* ; Endothelium, Corneal ; Follow-Up Studies ; Humans ; Keratoconus* ; Microscopy ; Refractive Errors ; Visual Acuity

Digoxin is commonly used in treatment of various heart conditions, such as atrial fibrillation, atrial flutter, and sometimes heart failure. The therapeutic range of digoxin is narrow. Therefore, Digoxin toxicity is common. However, severe digoxin intoxication is uncommon. Many cases involving application of Digoxin immune Fab for digoxin intoxication in other countries have been reported. However, no cases have been reported in Korea. We reported on one case, a 34-year-old male with acute and severe digoxin intoxication who was treated with digibind(R). His chief complaint was gastrointestinal symptoms, including nausea and vomiting. Electrocardiography (ECG) showed third degree atrioventricular (AV) block. After an infusion of digibind(R), third degree AV block rhythm was changed to first degree AV block. Nowadays, we can obtain a digoxin antidote from the national poisoning information center. Therefore, we should actively consider application of Digoxin immune Fab in patients with severe digoxin intoxication.
Adult ; Atrial Fibrillation ; Atrial Flutter ; Atrioventricular Block ; Digoxin* ; Electrocardiography ; Heart ; Heart Failure ; Humans ; Information Centers ; Korea ; Male ; Nausea ; Poisoning ; Vomiting

The relationship between infective endocarditis and mycotic aneurysm formation appers clear : In about two to ten percent of patients with infective endocarditis harbor septic intracranial aneurysms. But the pathogenesis, natural course and management of these lesions remains controversial. Aggressive medical treatment of the underlying infected cardiac valve or surgical replacement therapy have significantly reduced the morbidity and mortality rates associated with infective endocarditis. Clinical predictors of mycotic aneurysm, especially neurologic prodromes prior to rupture have been ill-defined since most series contain few patients or include patients with infective aneurysms who have no infective endoarditis. Similarly there has been no consensus regarding the indications and timing of cerebral angiography in patients with infective endocarditis. We have experienced a case of cerebral mycotic aneurysm complicated with subarachnoid hemorrhage due to infective endocarditis in a 29 year-old female patient, who admitted to our hospital because of the pain and paralysis of sudden onset in right forearm, which was diagnosed by echocardiography, brain computed tomography and 4-vessel cerebral angiography. The patient died of sudden rupture of mycotic aneurysm in the 7th hospital day despite intensive medical treatment. We report one case of cerebral mycotic aneurysm with a brief of literature.
Adult ; Aneurysm ; Aneurysm, Infected* ; Brain ; Cerebral Angiography ; Consensus ; Echocardiography ; Endocarditis* ; Female ; Forearm ; Heart Valves ; Humans ; Intracranial Aneurysm ; Mortality ; Paralysis ; Rupture ; Subarachnoid Hemorrhage*