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

STATEMENT OF PROBLEM: The performance and maintenance of implant-supported prostheses are primarily dependent upon load transmission both at the bone-to-implant interface and within the implant-abutment-prosthesis complex. The design of the interface between components has been shown to have a profound influence on the stability of screw joints. PURPOSE. The Purpose of this study was to compare the strength and the fatigue resistance of 1-piece and 2-piece abutment connected to oral implant, utilizing an internal conical interface. MATERIAL AND METHODS: Twenty Implatium(R) tapered implants were embedded to the top of the fixture in acrylic resin blocks. Ten Combi(R)(1-piece) and Dual(R)(2-piece) abutments of the same dimension were assembled to the implants, respectively. The assembled units were mounted in a testing machine. A load was applied perpendicular to the long axis of the assemblies and the loading points was at the distance of 7mm from the block surface. Half of 1-piece and 2-piece abutment-implant units were tested for the evaluation of the bending strength, and the others were cyclically loaded for the evaluation of the fatigue resistance until plastic deformation occurred. Nonparametric statistical analysis was performed for the results. RESULTS: Mean plastic and maximum bending moment were 1,900+/-18Nmm, 3,609+/-106Nmm for the 1-piece abutment, and 1,250+/-31Nmm, 2,688+/-166Nmm for the 2-piece abutment, respectively. Mean cycles and standard deviation when implant-abutment joint showed a first plastic deformation were 238,610+/-44,891. cycles for the 1-piece abutment and 9,476+/-3,541 cycles for the 2-piece abutment. A 1-piece abutment showed significantly higher value than a 2-piece abutment in the first plastic bending moment (P<.05), maximum bending moment (P<.05) and fatigue strength (P<.05). CONCLUSION: Both 1-piece and 2-piece conical abutment had high strength and fatigue resistance and this suggests long-term durability without mechanical complication. However, the 1-piece conical abutment was more stable than the 2-piece conical abutment in the strength and the fatique resistance.
Axis, Cervical Vertebra ; Fatigue* ; Joints* ; Plastics ; Prostheses and Implants

BACKGROUND: Much time and cost have been consumed for just a treatment of a simple disease and inappropriate management has taken place because of misjudgement by laymen. To establish a desirable health care system, need for the usual-medical-provider system (U.MP. system) has been suggested. This study was performed to find some data that would be helpful to establish the U.MP. system by surveying some factors influencing on choosing care providers of children. METHODS: 440 questionnaires were gathered from surveys administered to the parents of the students in a primary school. The period for study was 1 week of September in 1999 and the response rate was 88.0%. The questionnaire was composed of sociodemographic variables, a question for having U.MP. and some factors related with choosing U.MP. RESULTS: The fourth and fifth decade of age showed higher proportion for having U.MP. than sixth decade. The proportion of having U.MP. was also higher in respondents with higher educational attainment and higher income. The proportion of visiting local clinics or hospitals was about 65.7% in groups having U.MP., whereas the proportion was about 41.5% in group not having U.MP., The frequency of visiting local clinics or hospitals for a year was higher for groups having U.MP., compared with groups not having U.MP.. The factors related with choosing U.MP. were `doctors who explain the disease in detail and easily', `doctors who provide care meticulously', and `effective treatment'. CONCLUSION: To establish the U.MP. system, a kinder attitude and care would be necessary for doctors who will provide care to the patients and their family.
Child ; Surveys and Questionnaires ; Delivery of Health Care ; Humans ; Parents

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