STATEMENT OF PROBLEM: when using resin for class II restoration, micoleakage by instrumentation can be regarded as the primary negative characteristic. A review of the available literature suggests that using flowable resin as liner to decreased microleakage. PURPOSE: The aim of this study was to determine the influence of the nanofilled flowable resin lining on marginal microleakage after load cycling in class II composite restoration fillings using nanofiller resin. MATERIAL AND METHODS: 24 extracted premolars were prepared with class II cavity. F group was restored the nanofilled resin with the nanofilled flowable resin as liner. NF group was restored the nanofilled resin only. After restoration, an experiment was performed on 2 groups using a 300N load at 104, 105 and 106 cycles. Prior to and before each load cycling, it was gauged length on total marginal microleakage, axial marginal microleakage and buccal, gingival, lingual marginal microleakage. Data were analyzed with the Mann-Whitney test & Kruskal-Wallis test. RESULTS: There were statistically significant differences between 2 groups and between individual groups. (P < .05) The result showed less microleakage in teeth restored by the nanofilled resin, which was lined by the nanofilled flowable resin. CONCLUSION: There was significant reduction in microleakage when the nanofilled flowable resin lining was placed underneath the nanofilled resin in class II composite restoration fillings.
Bicuspid ; Tooth

Benign tumors of the esophagus occur rarely as compared with the incidence of carcinomas. Among the benign tumors of the esophagus such as leiomyoma, lipoma, hemangioma, papilioma. polyp, cystetc. leiomyoma is the most common, although less than 10 percents of leiomyomas of the gastrointestinal tract are found in the esophagus. Most of leiomyomas of the esophagus present as solitary lesions but multiple tumors occur in about 4 percents of cases. Leiomyomas of the esophagus are diagnosed by thorough clinical evaluation, esophagogram and upper gastrofiberscopic examination but histological confirmation requires surgical or necropsy specimens. Occasionally gastrofiberscopic polypectomized specimens are used. We report one case of multiple leiomyomas of the esophagus located in between 25 cm and 40 cm distance from the incisor in a 38-year-old man who complained of vague substernal discomfort for about 10 years. Gastrofiberscopic polypectomized specimen was used for preoperative histological confirmation. The pathologic examination of the specimen showed leiomyoma of the esophagus.
Adult ; Esophagus* ; Gastrointestinal Tract ; Hemangioma ; Humans ; Incidence ; Incisor ; Leiomyoma* ; Lipoma ; Polyps

BACKGROUND: Recently introduced plateletpheresis systems (AmicusTM software version 2.41 and MCS + LDP Rev. C) were evaluated for their performance. METHOD: Single-needle procedure was used for all donors, 127 with the AmicusTM and 85 with the MCS +. The targeted platelet yield was 3.2x1011. Components were evaluated for component yields, collection time, collection efficiency and incidence of donor reactions due to citrate. RESULTS: The collection time was significantly shorter with the AmicusTM (mean 57 min vs. 71 min, p< 0.05), and in 9 donors with a mean preapheresis platelet count of 325x103 /microliter the whole procedure could be completed within 40 minutes. However, the total processing time, including preprocessing and postprocessing time, between AmicusTM (78.0 min) and MCS + (74.3 min) was not statistically different. Mean platelet yield for AmicusTM and MCS + were 3.6x1011 and 3.4x1011, respectively. With 82.4% of SDPs collected with the MCS + having a platelet count of 3.0~3.9x1011, compared to 65.4% with the AmicusTM, the MCS + was more accurate in predicting the platelet yield of the final products. All components showed a residual WBC count of 5.0x106, and in 99.2% and 97.6% of components collected with the AmicusTM and MCS +, respectively, had a residual WBC count of less than 1.0x106. Mild donor reactions due to citrate tended to be more common on the MCS + (14.1%), which also used significantly more ACD (mean 342.5 mL vs. 268.0 mL, p< 0.05), than on the AmicusTM (5.5%). CONCLUSION: The plateletpheresis systems evaluated in this study allow the collection of leukoreduced SDPs of high quality within a reasonable time.
Blood Platelets ; Citric Acid ; Humans ; Incidence ; Platelet Count ; Plateletpheresis* ; Tissue Donors

Objective: To evaluate the radiographic characteristics of the ampulla of Vater cancer. Subjects and Methods:The authors analyzed retrospectively the US(n=25) and CT(n=15) findings in 25 cases of ampulla of Vater cancer, with emphasis on the potential of CT & US in regand to the detectibility of the mass. ERCP(n=15) and hypotonic duodenography(n=5) were also evaluated for the configuration of obstructed duct. RESULTS: The tumor was detected on sonography in only 12 cases(48%) as a small, relatively well delinated mass with slighty low echogenicity to the pancreas. The tumor was shown by CT in 8 cases(53% ) as a well delinated mass protruding into the second portion of duodenal lumen with slightly low attenuation to the pancreas. CBD was dilated in 25 cases(100%), but pancreatic duct was dilated in 15 cases(60%). Obstructed end of CBD was nipple shaped in 7 cases(47%), clubbed in 3, flat in 3, and indistict in 2 by ERCP. Hypotonic duodenogram showed irregular filling defect in the medial wall of second portion of the duodenum in 5 cases (100%). CONCLUSION: Mas detection rate crsing US or CT were not high in ampulla of Vater cancer. Except for a CT finding of a small mass protruding into the regional duodenal lumen, other finclings were nonspecific. Therefore, additional studies or more afgressive approach should be attempted for a correct diagnosis.
Ampulla of Vater* ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Duodenum ; Nipples ; Pancreas ; Pancreatic Ducts ; Retrospective Studies

Tumoral calcinosis is a periarticular calcific lesion and rare complication in patients with maintenance hemodialysis. The pathogenesis of tumoral calcinosis is poorly understood but may be due to elevated serum phosphorus, a high calcium phosphorus (Ca x P) product or secondary hyperparathyroidism in hemodialysis patients. A 30-year-old man presented with pain and palpable mass of left shoulder. He had been on maintenance hemodialysis with high flux dialyzer for 10 years. Laboratory finding showed hyperphosphatemia and elevated intact PTH concentration. A shoulder X-ray and CT scan demonstrated a massive calcification. Following partial resection, pain was relieved. Here we report a case of tumoral calcinosis of shoulder in a hemodialysis patient with untreated hyperphosphatemia and secondary hyperparathyroidism.
Adult ; Calcinosis ; Calcium ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Hyperphosphatemia ; Phosphorus ; Renal Dialysis ; Shoulder

BACKGROUND: Thiopental sodium and propofol are commonly used to induce anesthesia. This study was conducted to compare the hemodynamic effects of propofol and thiopental sodium during the induction of general anesthesia in elderly patients. METHODS: Forty patients undergoing general anesthesia were randomly divided into two groups. In group T, thiopental sodium was used to induce anesthesia, whereas propofol was used in group P. Hemodynamic changes in the mean blood pressure, heart rate, cardiac index (as determined using a NICCOMO monitor) and bispectral index (BIS) during induction were then compared between the two groups. In addition, the dosage of induction agent, time required until loss of response to verbal order (LOV) and eyelid reflex were compared between groups. RESULTS: The mean blood pressure was significantly lower in group P than in group T during the 1-5 min following LOV and during the 2, 3 min following intubation (P < 0.05). However, the heart rate did not differ significantly between the two groups. The cardiac index also did not differ significantly between groups, except during the first 3 min following LOV. Finally, the BIS value were significantly lower than the baseline values in both groups during induction. CONCLUSIONS: In elderly patients, the heart rate, cardiac index and BIS value did not differ significantly between the two groups. But the mean blood pressure was significantly lower in propofol than in thiopental sodium.
Aged ; Anesthesia ; Anesthesia, General ; Blood Pressure ; Cardiography, Impedance ; Eyelids ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Propofol ; Reflex ; Thiopental

Histiocytic sarcoma is a rare malignant neoplasm that originates from a histiocytic hematopoietic lineage characterized by histiocytic differentiation and its corresponding immunophenotypic features. Patients with histiocytic sarcoma usually have a poor prognosis due to its aggressive clinical behavior. Here we report a rare case of extranodal histiocytic sarcoma of the stomach which was confirmed through immunohistochemical staining. A 71-yearold man was presented with epigastric pain. Gastroscopy, abdominal CT, and EUS revealed a mass located on the posterior wall of upper body and fundus of the stomach. Grossly, grayish white solid masses were seen extending down to the submucosal layer. Microscopically, the tumor cells had eosinophilic cytoplasm, abundant vacuole, and mitosis. Immunohistochemical staining revealed that the tumor cells were positive for LCA, CD68, and lysozyme. Early detection and accurate diagnosis of this rare neoplasm is important because it can make a great difference in prognostic outcomes. To make an accurate and definitive diagnosis, immunohistochemical staining is essential in the confimation of histiocytic orign.
Adenocarcinoma/diagnosis/pathology/ultrasonography ; Aged ; Antigens, CD/metabolism ; Antigens, CD45/metabolism ; Antigens, Differentiation, Myelomonocytic/metabolism ; Diagnosis, Differential ; Gastroscopy ; Histiocytic Sarcoma/*diagnosis/pathology/ultrasonography ; Humans ; Male ; Muramidase/metabolism ; Stomach Neoplasms/*diagnosis/pathology/ultrasonography ; Tomography, X-Ray Computed

BACKGROUND: Neck flexion has been shown to increase cranial spread of contrast agent when a small fixed volume was injected into the high thoracic epidural space. The purpose of this study was to evaluate the effect of volume of contrast medium on its distribution through the high thoracic epidural space during neck extension and flexion using the rabbit model. METHODS: An epidural catheter was introduced into the epidural space of New Zealand white rabbits with the tip located at the T3-4 intervertebral level. The neck was extended or flexed (n = 8 for each group), and the contrast medium was injected with the volume increasing by increments of 0.1 ml/kg, up to 0.3 ml/kg. The spread of contrast medium was determined by counting the number of vertebral body units using lateral epidurographic images. RESULTS: In both groups, the total spread of contrast medium was similar, increasing continuously with injected volume. The cranial spread was greater in the flexion group than the extension group. However, the caudal spread was greater in the extension than in the flexion group. In the extension group, the contrast medium spread caudally about twice as far as it spread cranially, but there was no statistically significant difference between cranial and caudal spread in the flexion group. CONCLUSIONS: In the high thoracic epidural space of rabbit, the contrast medium of varying doses showed limited cranial spread. The flexion of the neck increased cranial spread and extension of the neck increased caudal spread.
Catheters ; Epidural Space ; Neck ; Rabbits

PURPOSE: As Gwangju Wide Regional Emergency Medical Center was newly opened during February 2001, a comparative analysis was performed of patients who had visited the emergency department before and after the opening in order to measure the difference and to provide basic data for its management. METHODS: The 9,995 patients who had visited between February 1, 1999, and July 31, 1999, before the opening and the 12,457 patients who visited between February 1, 2001, and July 31, 2001, after its opening were compared according to sex, age, non-trauma or trauma, means and form of visit, attending department, length of stay in the emergency department, form of discharge, and time of death verification (dead-on-arrival (D.O.A) versus deadafter-arrival (D.A.A)). RESULTS: The total number of patients increased by 24%. The admission rate was 31.8% before the opening and 40.6% after the opening; the mean length of stay in the emergency department was 15.7 hours before the opening and 12.2 hours after the opening. The mean length of stay of admitted patients decreased from 26.6 hours before the opening to 18.3 hours after the opening. CONCLUSION: The decrease in the mean length of stay in the emergency department from 15.7 hours before the opening to 12.2 hours after the opening is viewed as a positive result, but is still not satisfactory. Accordingly, it is considered urgent that every clinical department take an active part in improving circulation of patients both in the Emergency Intensive Care Unit (EICU) on the second floor and in the emergency ward on the fifth floor, as well as in providing rapid medical care and decisions on treatment strategies in the emergency department on the first floor.
Emergencies* ; Emergency Service, Hospital ; Gwangju* ; Humans ; Intensive Care Units ; Length of Stay

PURPOSE: The efficacy of stenting for the right-side colonic malignant obstruction is unknown. The purpose of this study was to evaluate the safety and feasibility of self-expandable metallic stent insertion for the right-side colonic malignant obstruction and its clinical benefits. METHODS: We retrospectively reviewed clinical data from 460 patients who underwent right hemicolectomy for right-side colon cancer from January 2006 to January 2014 at Korea University Anam Hospital. Twenty four patients who developed malignant obstruction in the right -side colon were identified and analyzed. RESULTS: Self-expandable metallic stent insertion was attempted in 14 patients, and initial technical success was achieved in 13 patients (92.9%). No immediate stent-related complications were reported. Complete relief of obstruction was achieved in all of the 13 patients. Eleven patients who failed stenting underwent emergency operation. All of the 13 patients with stent underwent laparoscopic surgery and only one case was converted to open. Only three patients in the emergency group underwent laparoscopic surgery but one was converted. Operative time and number of retrieved lymph nodes did not differ between the two groups. Postoperative hospital stay (9.8+/-3.2 in stent group vs. 16.3+/-10.9 days in emergency group, p=0.082) tended to be shorter in the stent group. Estimated blood loss (38.5+/-138.7 in stent group vs. 381.8+/-411.9 in emergency group, p=0.010) and duration for resuming diet (3.2+/-2.2 in stent group vs. 6.6+/-7.0 days in emergency group, p=0.017) were significantly better in the stent group. CONCLUSION: Self-expandable metallic stent appears to be safe and feasible in the right-side colonic malignant obstruction. It facilitates minimally invasive surgery and may result in better short-term surgical outcome.
Colon* ; Colonic Neoplasms ; Diet ; Emergencies ; Humans ; Korea ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Operative Time ; Retrospective Studies ; Stents* ; Surgical Procedures, Minimally Invasive