No abstract available.
Decompression, Surgical* ; Exophthalmos*

Background: Desflurane, a fluorinated methyl-ethyl ether, has some advantageous properties including low blood solubility, stability in soda lime, and resistance to biodegradation. Desflurane in vivo has demonstrated myocardial depressant property. The purpose of this study was to test the direct effects of desflurane on myocardial contractile function and coronary flow in the isolated heart. Methods: Twelve isolated rat hearts were continuously perfused with modified Krebs solution containing 6, 9 and 12 vol% of desflurane for 10 min at each concentration. Systolic left ventricular pressure and rate of change of ventricular pressure (dp/dt) were measured. Heart rate and coronary flow were also measured. To differentiate direct vasodilatory effect of desflurane from an indirect metabolic effect due to autoregulation of coronary flow, oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated. Results: Heart rate (control 266+/-22 beats/min) decreased to 250+/-23 beats/min at 6 vol%, 236+/-26 beats/min at 9 vol% and 223+/-22 beats/min at 12 vol% of desflurane. Systolic left ventricular pressure and dp/dt decreased in a concentration-dependent manner. In spite of decrement of myocardial oxygen consumption, coronary flow (control 12.0+/-1.2 ml/min) increased to 12.8+/-1.6 ml/min at 6 vol%, 12.9+/-1.6 ml/min at 9 vol% and 13.7+/-1.4 ml/min at 12 vol% of desflurane. Oxygen delivery increased proportionally with coronary flow. Percent oxygen extraction decreased in a concentration-dependent manner. Conclusion: These results suggest that desflurane has a direct myocardial depressing and coronary vasodilating effect in a concentration-dependent manner.
Animals ; Ether ; Heart Rate ; Heart* ; Homeostasis ; Oxygen ; Oxygen Consumption ; Rats* ; Solubility ; Ventricular Pressure

The aim of this study was to determine whether formalin reliably provokes a paw edema and pain behavior. The paw of male Sprague-Dawley rats were injected with 100 microliter of formalin with 2.5% (F2.5), 5% (F5), and 10% (F10) concentrations. Following the formalin (n=8) or saline (control, n=6) injection, the flinching or licking of the paw was recorded for the phase 1 response (0-5 min after injection) and phase 2 response (20-60 min). The formalin-induced paw edema was assessed by measuring the diameters of the injected paws at 4 hr after injection. As for flinching, phase 1 and 2 of all three groups showed higher frequency than those of the control group (p<0.05). As for licking, phase 1 cumulative time of the F2.5 and F10 groups, and phase 2 cumulative time of the F2.5 and F5 groups showed a longer duration than those in the control group (p<0.05). The diameters of the paw in the F10 group were significantly larger than those in the control group (p<0.05). Flinching behavior was more reliably expressed the biphasic response than licking response at all formalin concentrations. Peak of the licking was reached at 2.5% and that of flinching was reached at 5%, whereas the paw edema peaked at 10% concentration. This suggests that there may be some dissociation of nociception from the edema formation.
Animals ; *Behavior, Animal ; Edema/*chemically induced ; Extremities ; Formaldehyde/*adverse effects ; Male ; Pain/*chemically induced ; Rats ; Rats, Sprague-Dawley

PURPOSE: Few epidemiologic studies have investigated aggressive periodontitis in Koreans, but such studies of disease prevalence and other clinical characteristics would be invaluable in providing proper treatment. The aim of this study was to assess the prevalence of aggressive periodontitis and to measure the extent of associated periodontal breakdown. METHODS: The study population consisted of 1,692 patients who visited the Department of Periodontology, Wonkwang Daejeon Dental Hospital from January to December, 2010. Clinical parameters (probing depth, gingival recession, periodontal attachment loss) were measured by a single examiner, and radiographic examination was performed at the baseline. RESULTS: Twenty-eight (1.65%) patients showed clinical features of aggressive periodontitis, of which 27 patients exhibited the generalized form, and 1 exhibited the localized form. There was no significant difference between the percentage of male and female patients. The probing pocket depth of the maxillary first molar was deeper than that of the other teeth and gingival recession was also the most serious at the maxillary first molar. The periodontal attachment loss was the highest at the maxillary first molar. The average number of missing teeth was 1.29 per subject. Loss of the second molar was prominent. CONCLUSIONS: Within the limitations of this study, the periodontal breakdown evaluated by attachment loss was found to be most severe at the first molars of aggressive periodontitis patients. However, further large scale multicenter studies are necessary to access more precise data, including prevalence.
Aggressive Periodontitis ; Epidemiologic Studies ; Female ; Gingival Recession ; Humans ; Male ; Molar ; Periodontal Attachment Loss ; Prevalence ; Tooth

Nearly 80% of patients with Crohn's disease (CD) require surgical treatment for complications or failure of medical management. We managed a 31-year-old man with CD who presented with a post-operative fistula. The patient had undergone surgery due to multiple strictures and a fistula. However, a new fistula developed that connected to the intraperitoneal abscess. Intravenous antibiotics were started and multiple percutaneous drainage tubes were inserted to treat the abdominal abscess. However, the amount of drainage was consistently high, even one month after the operation. To treat the postoperative fistula, 5 mg/kg of infliximab was started, and the amount of drainage decreased dramatically to less than 10 cc a day. Some studies have reported that infliximab decreases the recurrence of CD after surgery. The effect of infliximab on post-operative fistulas in patients with CD has not been sufficiently studied. Our results indicated that the use of infliximab to treat post-operative fistula should be explored further in future clinical studies.
Abdominal Abscess ; Abscess ; Adult ; Anti-Bacterial Agents ; Constriction, Pathologic ; Crohn Disease* ; Drainage ; Fistula* ; Humans ; Infliximab ; Recurrence

Ulcerative colitis (UC) is one of the chronic inflammatory bowel diseases (IBD), characterized by a diffuse mucosal inflammation limited to the colon. Complications of UC include stricture, colorectal cancer, and toxic colitis. UC patients rarely present with a stenosis or fistula, and strictures develop in less than 5% of patients with UC. We present a patient with UC, accompanied by unusual complications that involved not only a stricture but also a fistula and abscess. A 49-year-old female was presented with a left flank pain and fever that had begun two weeks before admission. She had received a diagnosis of UC 20 years ago and had it treated for 2 years in a local hospital. However, she arbitrarily stopped visiting the hospital and relied on home remedies. An abdominopelvic CT scan revealed luminal narrowing and extra-peritoneal fistula formation in the descending colon. Fistula was connected with a subcutaneous abscess in the left flank. She had undergone total colectomy and ileo-anal anastomosis. On the pathologic exam, the long standing UC with severe stenosis was observed without malignant change. It cannot be emphasized enough that a correct therapeutic approach and an appropriate follow-up schedule are very important for patients with UC.
Abscess ; Appointments and Schedules ; Colectomy ; Colitis ; Colitis, Ulcerative ; Colon ; Colon, Descending ; Colorectal Neoplasms ; Constriction, Pathologic ; Female ; Fever ; Fistula ; Flank Pain ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Intestinal Fistula ; Medicine, Traditional ; Middle Aged ; Phenobarbital ; Ulcer

OBJECTIVE: Prescription rate of dabigatran and rivaroxaban, which are the direct oral anticoagulants (DOAC), has increased. We have analyzed the prescription trend and medication use of dabigatran and rivaroxaban in patients with non-valvular atrial fibrillation (NVAF). METHODS: It was retrospectively studied from September 2012 to April 2014 using the electronic medical records and the progress notes. Patients with NVAF (n=424) were evaluated on the medication use, prescribing preferences, adverse drug reactions (ADRs) and the availability of prescription reimbursement of dabigatran (n=210) and rivaroxaban (n=214). RESULTS: Dabigatran was prescribed higher than rivaroxaban (23.3% versus 7.5%, p<0.001) in the neurology department, but rivaroxaban was prescribed higher compared to dabigatran in the cardiology department (87.4% versus 74.3%, p<0.001). Dabigatran was prescribed more than rivaroxaban in high risk patients with CHADS2 score ≥ 3 (44.3% versus 31.3%, p=0.006). Dabigatran patients seemed to have more ADRs than patients with rivaroxaban (25.2% versus 11.2%, p<0.001), but no serious thrombotic events and bleeding were found. Only 35.6% (n=151) were eligible for prescription reimbursement by the National Health Insurance (NHI). Bridging therapy (86, 31.5%) and direct-current cardioversion (57, 20.2%) were main reasons of ineligibility for reimbursement. CONCLUSION: Prescription preferences were present in choosing either dabigatran or rivaroxaban for patients with NVAF. Inpatient protocols and procedures considering patient-factors in NVAF need to be developed.
Anticoagulants ; Atrial Fibrillation* ; Cardiology ; Dabigatran* ; Drug-Related Side Effects and Adverse Reactions ; Electric Countershock ; Electronic Health Records ; Hemorrhage ; Humans ; Inpatients ; National Health Programs ; Neurology ; Prescriptions ; Retrospective Studies ; Rivaroxaban* ; Stroke*

OBJECTIVE: This study was to investigate the factors that influence the propensity of Koreans in choosing care settings of dementia patients. METHODS: This study analyzed the data from the '2014 Nationwide Survey on Dementia Awareness of Koreans' that was conducted by the National Institute of Dementia. Korean's perception of care burden for dementia was measured with grading on its types. Also its influences on preference for care between facilities and homes were evaluated using multivariate analysis with socio-demographic characteristics. RESULTS: In terms of preferred care settings, respondents preferred facilities over homes in case of themselves and their family, respectively 77.5% and 68.2%. The preference for facilities was significantly influenced by the respondents' age for both themselves and their family. Additionally, the perception of relatively higher emotional and physical burden compared to economic burden significantly influenced preference for facilities for their family. CONCLUSION: Improving public awareness and setting-up a practical social supporting system are needed to reduce emotional and physical burden as well as economic burden of dementia. Furthermore, building up an appropriate and safer communities for dementia patients and their caregivers is much demanded for reducing their burdens.
Caregivers ; Surveys and Questionnaires ; Dementia* ; Humans ; Multivariate Analysis

PURPOSE: The concept of gingival biotype has been used as a predictor of periodontal therapy outcomes since the 1980s. In the present study, prospective and controlled experiments were performed to compare periodontal pocket depth (PPD) reduction and gingival shrinkage (GSH) after scaling and root planing (SRP) according to gingival biotype. METHODS: Twenty-five patients diagnosed with chronic periodontitis participated in the present study. The PPD and GSH of the labial side of the maxillary anterior teeth (from the right canine to the left canine) were evaluated at baseline and 3 months after SRP. Changes in the PPD following SRP were classified into 4 groups according to the gingival thickness and initial PPD. Two more groups representing normal gingival crevices were added in evaluation of the GSH. The results were statistically analyzed using the independent t-test. RESULTS: In the end, 16 patients participated in the present study. With regard to PPD reduction, there were no significant differences according to gingival biotype (P>0.05). Likewise, sites with a PPD of over 3 mm failed to show any significant differences in the GSH (P>0.05). However, among the sites with a PPD of under 3 mm, those with the thin gingival biotype showed more GSH (P<0.05). CONCLUSIONS: PPD changes after SRP were not affected by gingival biotype with either shallow or deep periodontal pockets. GSH also showed equal outcomes in all the groups without normal gingival crevices. The results of SRP seem not to differ according to gingival biotype.
Chronic Periodontitis ; Dental Scaling ; Humans ; Periodontal Pocket ; Prospective Studies ; Root Planing* ; Tooth

PURPOSE: To investigate the healing pattern of the mucous membrane after tooth extraction necessitated by periodontal disease in the maxillary sinus. METHODS: One hundred and three patients with 119 maxillary sinuses were investigated. Before implant placement, cone-beam computed tomography (CT) scanning was performed. The causes of extraction, the time elapsed since extraction, smoking, periodontal disease in adjacent teeth, and gender were recorded. In addition, the thickness of the mucous membrane of the maxillary sinus and the height of residual alveolar bone at the extracted area were calculated from CT images. RESULTS: The thickness of the mucous membrane in the periodontal disease group (3.05+/-2.71 mm) was greater than that of the pulp disease group (1.92+/-1.78 mm) and the tooth fracture group (1.35+/-0.55 mm; P<0.05). The causes of extraction, the time elapsed since extraction, and gender had relationships with a thickening of the mucous membrane of the maxillary sinus (P<0.05). In contrast, the height of the residual alveolar bone at the extracted area, periodontal disease in adjacent teeth, and smoking did not show any relation to the thickening of the mucous membrane of the maxillary sinus. CONCLUSIONS: The present study revealed distinct differences in healing patterns according to the causes of extraction in the maxillary sinus, especially periodontal disease, which resulted in more severe thickening of the mucous membrane.
Cone-Beam Computed Tomography ; Humans ; Maxillary Sinus ; Mucous Membrane ; Periodontal Diseases ; Smoke ; Smoking ; Tooth ; Tooth Extraction ; Tooth Fractures