Bonding of brackets is one of the essential factors for successful orthodontic treatment, so bond strength of orthodontic adhesives are very important. The purposes of this research were to compare shear bond strength of various orthodontic adhesives and to evaluate failure sites. One-hundred twenty extracted human first premolars were prepared for bonding and premolar brackets were bonded to prepared enamel surfaces with Super C Ortho, Mono- Lok2, Transbond, and Super C Ortho after applying Fluorobond. After bonding of brackets, teeth specimens were divided into 3 groups. In group 1 specimens were stored at humidor 37degrees C in 1 hour, in group 2 specimens were stored at humidor 37degrees C in 24 hours, thermocycled 10 times and in group 3 specimens were stored at humidor 37degrees C in 24 hours, thermocycled 1800 times. Then the universal testing machine Instron 6022, Instron Co., U.S.A. was used to test the shear bond strength of brackets to enamel. After debonding, brackets and enamel surfaces were examined under stereoscopic microscope to determine the failure sites. The results were as follows: 1. Shear bond strength was significantly highest of using Super C Ortho after applying Fluorobond and Super C Ortho In group 1, was highest of using Super C Ortho in group 2, and was highest of using Mono- Lok2 in group 3. 2. According to time and temperature change, in using Super C Ortho the group 2 had significantly highest strength and group 3 had lowest strength, in using Mono-Lok2 the group 2 and had higher strength than group 1 and in using Super C Ortho after applying Fluorobond shear bond strength decreased constantly. 3. The failure sites were tooth-resin interface in Super C Ortho after applying Fluorobond, Mono Lok2 and Transbond and were at almost same ratio bracket base-resin interface and tooth-resin interface in Super C Orth.
Adhesives ; Bicuspid ; Dental Cements* ; Dental Enamel ; Humans ; Tooth

Broncholithiasis is uncommon in patients with silicosis. Bronchoesophageal fistula complicated by broncholithiasis is especially rare and only one case has been reported in Korea. Surgical treatment of broncholithiasis should be as conservative as possible to preserve the adequate pulmonary function. Meticulous dissection and division of the fistula with the interposition of viable tissues will prevent recurrence. We report a rare case of bronchoesophageal fistula complicated by broncholithiasis in a patient with silicosis.

PURPOSE: Assess the appropriate level of electrocardiography (EKG) education that should be incorporated into the curriculum of emergency medical technician (EMT) students. METHODS: Consensus by EMT professors and emergency medicine specialists was obtained using two rounds of the Delphi survey. The questionnaire consisted of 70 items; 12 related to demographic information, 8 related to general interpretation of EKG, 26 related to interpretation of arrhythmia, 20 related interpretations of structural anomaly, infarction and systemic disease, and 4 related to interpretation of EKG findings used for advanced cardiac life support. We considered consensus to be agreement of greater than 7 of 9 (66.7%). RESULTS: 59 and 24 subjects were included in the first and second rounds of the Delphi survey, respectively. The response rate was 59% for the first round and 40.7% for the second round. Of 70 items, 40 items came to a consensus by the panel. All items related to interpretation of EKG and advanced cardiac life support and most (10 of 12) items related to basic content were felt to be important by both EMT professors and emergency medicine specialists. However, for items related to arrhythmia and related to structural anomaly, infarction and systemic disease, less than half of the items examined were felt to be necessary in the curriculum of EMT students (12 of 26 and 6 of 20). CONCLUSION: We identified 40 items that should be included into the EKG curriculum of EMT students. These findings should be used to create more effective educational programs for EMT students.
Advanced Cardiac Life Support ; Arrhythmias, Cardiac ; Consensus ; Curriculum ; Delphi Technique ; Electrocardiography ; Emergencies ; Emergency Medical Technicians ; Emergency Medicine ; Humans ; Infarction ; Porphyrins ; Surveys and Questionnaires ; Specialization

Background: Anesthesia is needed to ensure both maternal and fetal safety during cesarean sections. This retrospective cohort study compared maternal and fetal outcomes between general and spinal anesthesia for cesarean section based on perioperative hemodynamic parameters (pre- and postoperative systolic blood pressure, heart rate), mean difference of hematocrit and estimated blood loss, and neonatal Apgar scores at 1 and 5 min. Methods: Data from electronic medical records of 331 singleton pregnancies between January 2016 and December 2018 were analyzed retrospectively; 44 cases were excluded, and 287 cases were assigned to the general group (n = 141) or spinal group (n = 146). Results: Postoperative hemodynamic parameters were significantly higher in the general group than the spinal group (systolic blood pressure: 136.8 ± 16.7 vs. 119.3 ± 12.7 mmHg, heart rate: 93.2 ± 16.8 vs. 71.0 ± 12.7 beats/min, respectively, P < 0.001). The mean difference between the pre- and postoperative hematocrit was also significantly greater in the general than spinal group (4.8 ± 3.4% vs. 2.3 ± 3.9%, respectively, P < 0.001). The estimated blood loss was significantly lower in the spinal than general group (819.9 ± 81.9 vs. 856.7 ± 117.9 ml, P < 0.001). There was a significantly larger proportion of newborns with 5-min Apgar scores < 7 in the general than spinal group (6/141 [4.3%] vs. 0/146 [0%], respectively, P = 0.012). Conclusions General group is associated with more maternal blood loss and a larger proportion of newborns with 5-min Apgar scores < 7 than spinal group during cesarean sections.

We report a case of a 58 year-old male with polysplenia and left inferior vena cava draining into the right atrium via hemiazygous vein; the left superior vena cava and the coronary sinus in order. He presented dyspnea on exertion and atrial fibrillation. Originally, through findings of mediastinal widening in chest X-ray and the double lumen of the descending aorta in transesophageal echocardiography, he was erroneously diagnosed with aortic dissection. The anomalous venous connection was discovered via spiral CT and venography. We also found three to five small spleens via CT. We emphasize that normal left superior vena cava mimic aortic dissection on chest X-rays and transesophageal echocardiographys.
Aorta, Thoracic ; Atrial Fibrillation ; Coronary Sinus ; Dyspnea ; Echocardiography, Transesophageal ; Heart Atria* ; Heterotaxy Syndrome* ; Humans ; Male ; Middle Aged ; Phlebography ; Spleen ; Thorax ; Tomography, Spiral Computed ; Veins ; Vena Cava, Inferior* ; Vena Cava, Superior*

About 50 cases of Listeria monocytogenes endocarditis were reported in worldwide literature in 1950-1995. Though clinical and laboratory data suggest a similarity with other types of bacterial endocarditis, the prognosis is more unfavorable and the mortality rate is higher. However, there has not been a report in Korean literature. We report a case of 55 year-old male with rapidly progressive native aortic endocarditis caused by L. monocytogenes. He had neither history of underlying cardiac disease nor definitive predisposing factor. He presented mild dyspnes, chest pain and febrile sensation for a week. Echocardiography showed large vegetation in aortic valve and severe aortic regurgitation. L. monocytogenes grew on blood culture. We underwent artificial aortic valve replacement due to rapidly progessive heart failure. A thromboembolism occured at right femoral artery on postoperative 2nd day was removed successfully. He discharged without any sequellae.
Adult* ; Aortic Valve ; Aortic Valve Insufficiency ; Causality ; Chest Pain ; Echocardiography ; Endocarditis* ; Endocarditis, Bacterial ; Femoral Artery ; Heart Diseases ; Heart Failure ; Humans ; Listeria monocytogenes* ; Listeria* ; Male ; Middle Aged ; Mortality ; Prognosis ; Sensation ; Thromboembolism

OBJECTIVE: Rheumatoid arthritis (RA) is characterized by the interaction of multiple mediators, especially cytokines. Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine and has been shown to be involved in RA. This study explored the association of the MIF gene polymorphism with RA in Korean. METHODS: 114 patients with RA, and 114 age and gender matched healthy controls were studied. Patients and controls were genotyped for a single nucleotide polymorphism (SNP) in the 5'-flanking region at position -173 of the MIF gene. RESULTS: No significant differences in MIF gene polymorphism were observed in RA compared to healthy controls. No association with disease severity was detected for the MIF gene polymorphism. CONCLUSION: MIF -173 G/C polymorphism did not appear to be associated with genetic susceptibility and disease severity in Korean RA patients.
Arthritis, Rheumatoid* ; Cytokines ; Genetic Predisposition to Disease ; Humans ; Macrophages* ; Polymorphism, Single Nucleotide

Wilms' tumor, aniridia, genitourinary anomalies, and mental retardation (WAGR) syndrome is caused by deletion of chromosome 11p13, including the Wilms' tumor (WT1) and aniridia gene (PAX6) loci. Here, we report the first case of WAGR syndrome in Korea; the patient was a 2-year-old girl with bilateral aniridia from birth who presented with abdominal distention and mental retardation. Cytogenetically, she had deletion of chromosome 11p11.2-13. Bilateral Wilms' tumors were successfully treated by chemotherapy and surgery. She has been tumor-free for 19 months off chemotherapy with preserved renal function.
Aniridia ; Humans ; Intellectual Disability ; Korea ; Parturition ; Preschool Child ; WAGR Syndrome ; Wilms Tumor

A 52 day-old male infant who had Taussig-Bing anomaly with coarctation of the aorta underwent initial palliative Damus-Kaye-Stansel (DKS) procedure including arch reconstruction because of suspected intramural coronary artery, size discrepancy of great arteries, potential subaortic stenosis, refractory pneumonia, and severe congestive heart failure. Total repair was done 44 months later, which was composed of VSD patch closure, DKS take-down, and arterial switch procedure. We report a successful case of DKS take-down and arterial switch operation for the reuse of native aortic and pulmonary valves rather than Rastelli-type procedure in a patient with Taussig-Bing anomaly having palliative DKS procedure.
Aortic Coarctation ; Arteries ; Constriction, Pathologic ; Coronary Vessels ; Double Outlet Right Ventricle* ; Heart Defects, Congenital ; Heart Failure ; Humans ; Infant ; Male ; Pneumonia ; Pulmonary Valve

It has recently been reported that interleukin-4 (IL-4) is required for the production of IgE, and anti-IL-4 monoclonal antibody (mAb) inhibits in vivo IgE responses. These suggest that blocking of IL-4 activity may be useful for the prevention or treatment of immediate hypersensitivity disorders. In this study we investigated whether anti-IL-4 has a regulatory role in chicken-gamma globulin (CGG)-induced active systemic anaphylaxis. Multiple injections of anti-IL-4 (up to 40 mg/mouse) failed to protect the mice from fatal anaphylaxis. Anti-IL-4 strongly suppressed CGG-specific IgE response (>90%) without any suppressive effect on CGG-specific IgG (IgG1, IgG2a, IgG2b, and IgG3) responses. Because these data suggest the possibility that fatal anaphylaxis could be induced by IgG antibodies, we examined the possibility using anti-CGG polyclonal and the subclasses of IgG monoclonal antibodies. Passive sensitization of mice with polyclonal antibodies elicited severe and fatal anaphylactic shock; about 50% of the mice died. The activity of antibodies was not diminished by heat treatment (56 degrees C, 2h), suggesting that the anaphylaxis was not mediated by IgE. Shock was also elicited by each subclass of IgG mAb; of these, IgG1 was the most effective. Combination of the IgG subclasses elicited more exaggerated shock; about 30% of mice died. These data indicate that IgG antibodies are themselves sufficient to induce systemic anaphylaxis. Therefore, the failure of anti-IL-4 to prevent active anaphylaxis is probably due to the inability of anti-IL-4 to suppress the production of IgG antibodies.
Anaphylaxis/*immunology/prevention & control ; Animal ; Antibodies, Anti-Idiotypic/immunology ; Antibodies, Monoclonal/*immunology/therapeutic use ; Chickens ; Female ; Gamma-Globulins ; Immunoglobulin E/*immunology ; Immunoglobulin G/*immunology ; Interleukin-4/*immunology/therapeutic use ; Mice ; Mice, Inbred BALB C ; Support, Non-U.S. Gov't