PURPOSE: Birth rate of preterm twins has gradually increased recently, and preterm twins have higher morbidity and higher mortality compared with term twins. Hence, we carried out the study to find out whether there were differences in mortality and morbidity according to birth order. METHODS: We examined the medical records of premature babies, who were born under 37 weeks of gestational age from January, 2004 to December, 2009. Among 226 twins (113 pairs),we compared the following parameters between the first-born twins and the second-born twins: birth weight, Apgar score at 1 & 5 minutes, days of ventilator use, days of total oxygenation use, hemoglobin after birth, maximum total bilirubin within 4 weeks, mortality, and morbidities including transient tachypnea of newborn (TTN), respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), retinopathy of prematurity (ROP), brain white matter disease (WMD), necrotizing enterocolitis (NEC), and sepsis. RESULTS: There were no difference between birth weight, Apgar score at 1 & 5 minute, duration of ventilator use, duration of total oxygenation use, hemoglobin after the birth, maximum total bilirubin and morbidities. Moreover, there were no statistical differences in mortality between the first twin and the second (3.5% vs. 4.4%, P=0.734). Subdivided into preterm twins less than 32 weeks of gestational age, mortalities were 13.3% vs. 16.7% (P=0.718). There were no differences in morbidity and other factors between two groups. CONCLUSION: According to our study, there were no notable statistical differences in mortality and morbidity based on birth order of preterm twins. However, larger studies are necessary.
Apgar Score ; Bilirubin ; Birth Order ; Birth Rate ; Birth Weight ; Brain ; Bronchopulmonary Dysplasia ; Cesarean Section ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Female ; Gestational Age ; Hemoglobins ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Leukoencephalopathies ; Medical Records ; Oxygen ; Parturition ; Pregnancy ; Retinopathy of Prematurity ; Transient Tachypnea of the Newborn ; Twins ; Ventilators, Mechanical

No abstract available.
Meningitis, Bacterial ; Posterior Cerebral Artery ; Stroke

PURPOSE: The purpose of this study was to identify the link between health-related physical fitness level and cardiovascular disease-related risk factors in adult male workers. METHODS: We tested cardiovascular disease- related risk factors (waist circumference, SBP, DPB, fasting glucose, TC, HDL-C, TG, LDL-C) and health-related physical fitness (VO2max, grip, Sit-up, Flexibility, Body fat) and divided health-related physical fitness level of the subjects into 3 groups - A (very good, n=56), B (good, n=59), and C (below-average, n=57) according to the criterion of the Health and Fitness counseling guidelines of KOSHA. The statistical techniques such as standard deviation, one-way ANOVA and multiple regression (p<.05) were used. RESULTS: There were significant differences between group C and group B & A (p<.001) in waist circumference, DBP, Fasting glucose, HDL-C, TG, LDL-C. In TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, Group C was higher than group B and A. CONCLUSION: On the basis of these results, we identified that improvement of health-related physical fitness level positively effects on the decrease of cardiovascular disease-related risk factors.
Adult ; Cardiovascular Diseases ; Counseling ; Fasting ; Glucose ; Hand Strength ; Humans ; Male ; Physical Fitness* ; Pliability ; Risk Factors* ; Waist Circumference

PURPOSE: Resonance frequency analysis, Periotest, and removal torque (RT) test were known as the methods to assess implant stability. The results of these methods are affected by the bone condition, implant diameter and shape. The purpose of this study is to access the meaning and the correlationship of the resonance frequency analysis, Periotest and RT test in osseointegration simulated acrylic resin when the engaged bone thickness and peri-implant bone defect are changed. MATERIALS AND METHODS: To simulate osseointegration, the fixture was fixed to an aluminum mold with a screw. Acrylic resin powder and liquid were poured into the mold for polymerization. The engaged resin thickness with implant was controlled. Simulated cortical bone thicknesses were 1, 3, 5 and 10 mm. Additional 1, 3 and 5 mm peri-implant bone defects were simulated. Three types of implants were used; 4 mm diameter implants of straight shape, 4 mm diameter implants of tapered shape and 5 mm diameter implants of tapered shape. Five fixtures per each type were tested in respective bone condition. Resonance frequency analysis and Periotest were evaluated in all bone conditions. Peak removal torque was measured at simulated cortical bone thicknesses of 1 and 3 mm. The statistical analysis was performed with the Kruskal-Wallis test, Mann-Whitney U test, and Spearman test using a 95% level of confidence. RESULTS: With increasing engaged bone depth, the Implant Stability Quotient (ISQ) values increased and the Periotest values (PTVs) decreased (P<.001, P<.001). With increasing peri-implant bone defect, ISQ values decreased and PTVs increased (P<.001). When the diameter of implant increased, ISQ values increased and Periotest values (PTV) decreased (P<.001). There was a strong correlation between ISQ values and PTVs (r = -0.99, P<.001). Furthermore, the peak removal torque values had weak correlations with both ISQ values and PTVs (r = 0.52, P<.001 ; r = -0.52, P<.001). CONCLUSION: This study confirmed favorable implant stability with increasing engaged bone depth and implant diameter and decreasing peri-implant bone defect. ISQ values and PTVs showed strong correlation with each other and not with the peak removal torque values.
Aluminum ; Fungi ; Osseointegration ; Polymerization ; Polymers ; Torque

PURPOSE: Few studies have investigated the marginal accuracy of 3-unit zirconia fixed partial dentures (FPDs) fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM) system. The purpose of this study was to compare the marginal fit of zirconia FPDs made using two CAD/CAM systems with that of metal-ceramic FPDs. MATERIALS AND METHODS: Artificial resin maxillary central and lateral incisors were prepared for 3-unit FPDs and fixed in yellow stone. This model was duplicated to epoxy resin die. On the resin die, 15 three-unit FPDs were fabricated per group (45 in total): Group A, zirconia 3-unit FPDs made with the Everest system; Group B, zirconia 3-unit FPDs made with the Lava system; and Group C, metal-ceramic 3-unit FPDs. They were cemented to resin dies with resin cement. After removal of pontic, each retainer was separated and observed under a microscope (Presize 440C). Marginal gaps of experimental groups were analyzed using one-way ANOVA and Duncan test. RESULTS: Mean marginal gaps of 3-unit FPDs were 60.46 microm for the Everest group, 78.71 microm for the Lava group, and 81.32 microm for the metal-ceramic group. The Everest group demonstrated significantly smaller marginal gap than the Lava and the metal-ceramic groups (P<.05). The marginal gap did not significantly differ between the Lava and the metal-ceramic groups (P>.05). CONCLUSION: The marginal gaps of anterior 3-unit zirconia FPD differed according to CAD/CAM systems, but still fell within clinically acceptable ranges compared with conventional metal-ceramic restoration.
Denture, Partial, Fixed ; Incisor ; Resin Cements ; Zirconium

BACKGROUND: Interest in pharmacist participation in the multidisciplinary intensive care team is increasing. However, studies examining pharmacist interventions in the medical intensive care unit (MICU) are limited in Korea. The aim of this study was to describe the current status of pharmacist interventions and to identify common pharmacologic problems requiring pharmacist intervention in the MICU. METHODS: Between September 2013 and August 2014, a retrospective, observational study was conducted in the 22-bed MICU at a university hospital. Data were obtained from two trained pharmacists who participated in MICU rounds three times a week. In addition to patient characteristics, data on the cause, type, related drug, and acceptance rate of interventions were collected. RESULTS: In 340 patients, a total of 1211 pharmacologic interventions were performed. The majority of pharmacologic interventions were suggested by pharmacists at multidisciplinary rounds in the MICU. The most common pharmacologic interventions were adjustment of dosage and administration (n = 328, 26.0%), followed by parenteral/enteral nutritional support (n = 228, 18.1%), the provision of drug information (n = 228, 18.1%), and advice regarding pharmacokinetics (n = 118, 9.3%). Antimicrobial agents (n = 516, 42.6%) were the most frequent type of drug associated with pharmacist interventions. The acceptance rate of interventions was 84.1% with most accepted by physicians within 24 hours (n = 602, 92.8%). CONCLUSIONS: Medication and nutritional problems are frequently encountered pharmacotherapeutic problems in the MICU. Pharmacist interventions play an important role in the management of these problems.
Anti-Infective Agents ; Humans ; Critical Care ; Intensive Care Units* ; Korea ; Nutritional Support ; Observational Study ; Pharmacists* ; Pharmacokinetics ; Retrospective Studies

Nitric oxide(NO) is thought to play an important role in development and plasticity of brain. In this study, we aimed to examine the expression of neuronal NOS and NADPH-diaphorase (NADPH-d) activity in the developing rat brain. The results show that there is a great variation in the time of appearance of the earliest NOS containing cells depending on their location: At the 15th embryonic day weakly stained cells were present in caudate-putamen, and neurons in the sensory trigeminal nucleus and the solitary nucleus displayed an intense staining. The NOS neurons in orbital neocortex, bed nucleus of stria terminalis, paraventricular hypothalamic nucleus, lateral hypothalamic area and mammillary body appeared first at the 18th embryonic day. The supraoptic nucleus and superior and inferior colliculi also weakly labeled at the 18th embryonic day, At the loth embryonic day, positive cells appeared in horizontal limb of diagonal band, anterior olfactory nucleus and parafascicular thalamic nucleus. In the cerebellum, weak NOS staining was present in fibers and cells situated below Purkinje cert layer. The Purkinje cell layer displayed a weak, rather diffuse activity throughout the cerebellum at postnatal day 0. At the 4th postnatal day. the reaction product in the Purkinje cell layer became more distinct. At the 10th postnatal day, the inner part of molecular layer became populated by NOS positive basket cells, and the reaction products on the Purkinje cells began to disappear. The present results showed that NOS in the rat brain is expressed in different populations of neurons at different stages of development. This expression pattern of NOS suggests that NO may play a role in the developmental remodelling of the mammalian brain.
Animals ; Brain* ; Cerebellum ; Extremities ; Hypothalamic Area, Lateral ; Inferior Colliculi ; Intralaminar Thalamic Nuclei ; Mamillary Bodies ; Neocortex ; Neurons ; Nitric Oxide Synthase* ; Nitric Oxide* ; Orbit ; Paraventricular Hypothalamic Nucleus ; Plastics ; Purkinje Cells ; Rats* ; Septal Nuclei ; Solitary Nucleus ; Supraoptic Nucleus ; Trigeminal Nuclei

BACKGROUND: There have been a lot of methods that prevent catatrophic airway fires during laser surgery, but none of them can protect endotracheal tube cuff exposed directly to laser beam. This study was performed to know the preventive effect of viscous lidocaine-filled cuffs on laser-induced combustion, and to know how long we can maintain positive pressure ventilation if laser beam broke out cuff perforation. METHODS: Transparent acrylic trachea attached to artificaial lung was intubated with 8.0 ID polyvinylchloride endotracheal tube. Cuff was filled with 8ml of saline or saline and viscous lidocaine mixture with 2:1 or 4:1 ratio. Positive pressure ventilation with air in tidal volume of 500 ml was begun. The laser output was set to 10 watt/sec in the continuous mode with beam diameter of 1 mm. Laser beam was directed perpendicularly at the part of the cuff protruding between endotracheal tube shaft and acrylic trachea, and laser emission was continued until the cuff was perforated or combusted. RESULTS: There was no case of laser-induced fires. After the perforation of cuff, the tidal volume was slowly decreased in 2:1 mixture of saline and viscous lidocaine filled cuff compared to others (P<0.05). CONCLUSION: 2:1 mixture of saline and viscous lidocaine may be used as an efficient inflating material of endotracheal tube cuffs on laser airway surgery.
Fires* ; Laser Therapy ; Lidocaine ; Lung ; Polyvinyl Chloride* ; Polyvinyls* ; Positive-Pressure Respiration ; Tidal Volume* ; Trachea

PURPOSE: The aim of this study was to investigate the combined effects of physical and chemical surface factors on in vivo bone responses by comparing chemically modified hydrophilic sandblasted, large-grit, acid-etched (modSLA) and anodically oxidized hydrophobic implant surfaces. METHODS: Five modSLA implants and five anodized implants were inserted into the tibiae of five New Zealand white rabbits (one implant for each tibia). The characteristics of each surface were determined using field emission scanning electron microscopy, energy dispersive spectroscopy, and confocal laser scanning microscopy before the installation. The experimental animals were sacrificed after 1 week of healing and histologic slides were prepared from the implant-tibial bone blocks removed from the animals. Histomorphometric analyses were performed on the light microscopic images, and bone-to-implant contact (BIC) and bone area (BA) ratios were measured. Nonparametric comparison tests were applied to find any significant differences (P<0.05) between the modSLA and anodized surfaces. RESULTS: The roughness of the anodized surface was 1.22 +/- 0.17 microm in Sa, which was within the optimal range of 1.0-2.0 microm for a bone response. The modSLA surface was significantly rougher at 2.53 +/- 0.07 microm in Sa. However, the modSLA implant had significantly higher BIC than the anodized implant (P=0.02). Furthermore, BA ratios did not significantly differ between the two implants, although the anodized implant had a higher mean value of BA (P>0.05). CONCLUSIONS: Within the limitations of this study, the hydrophilicity of the modSLA surface may have a stronger effect on in vivo bone healing than optimal surface roughness and surface chemistry of the anodized surface.
Animal Experimentation ; Animals ; Chemistry ; Dental Implants ; Hydrophobic and Hydrophilic Interactions ; Microscopy, Confocal ; Microscopy, Electron, Scanning ; Osseointegration ; Rabbits ; Spectrum Analysis ; Tibia ; Titanium*

BACKGROUND: Bupivacaine induces cardiac depression, which is resistant to treatment. Therefore early recognition of its development is important so that the injection of bupivacaine can be discontinued promptly. We compared the efficacy of continuous mixed venous oxygen saturation (cSvO2) monitoring with that of the mean arterial blood pressure (MBP) monitoring in terms of the prediction of cardiac output (CO) changes in anesthetized dogs with bupivacaine-induced cardiovascular depression. METHODS: Bupivacaine was infused to pentobarbital-anesthetized mongrel dogs (n = 8) at a rate of 0.5 mg/kg/min until the MBP decreased to 40 mmHg or less (end of bupivacaine infusion; BIE). We defined the early period as the interval from baseline till 30 minutes after the bupivacaine infusion and the late period as that after the 30 minutes till BIE. We monitored cSvO2 with a fiberoptic pulmonary artery catheter. The MBP and CO were measured every ten minutes after the initiation of the bupivacaine infusion. Arterial blood gas analysis, mixed venous gas analysis, measurement of serum electrolyte concentrations and serum bupivacaine concentrations were performed simultaneously. The relationship between CO versus cSvO2 or versus MBP was compared retrospectively by regression analysis. RESULTS: The Pearson's correlation coefficients between CO and cSvO2 were 0.782 (r2 = 0.6111, P < 0.01) in the early period and 0.824 (r2 = 0.6790, P < 0.01) in the late period. The correlation coefficients between CO and MBP were 0.019 (r2 = 0.0003, P > 0.05) in the early period and 0.799 (r2 = 0.6381, P < 0.01) in the late period. CONCLUSIONS: cSvO2 is superior to MBP for the prediction of CO changes in bupivacaine-induced cardiac depression in dogs, especially in the early period. We might expect a profound reduction of CO when MBP begins to decrease in the late period.
Anesthesia ; Animals ; Arterial Pressure* ; Blood Gas Analysis ; Blood Pressure ; Bupivacaine ; Cardiac Output ; Catheters ; Depression* ; Dogs* ; Oxygen* ; Pulmonary Artery ; Retrospective Studies