STATEMENT OF PROBLEM: More than 70% of patients who need the implant supported restoration are parially edentulous. The principles of design for implant supported fixed partial denture in mandibular posterior region are many and varied. Jurisdiction for their use is usually based on clinical evaluation. There are several areas of interest regarding the design of implant supported fixed partial denture in mandibular posterior region. 1) Straight and tripod configuration in implant placement, 2) Two restoration types such as individualized and splinted restorations. PURPOSE: The purpose of this study was to compare the amount and distribution of stress around the implant fixtures placed in the mandibular posterior region with two different arrangements and to evaluate the effects of splinting using the photoelastic stress analysis. MATERIALS AND METHODS: 1) Production of study model: Mandibular partially edentulous model was waxed-up and duplicated with silicone and two models were poured in stone. 2) Fixture installation and photoelastic model construction: Using surveyor(Ney, USA), 3 fixtures(two 4.0x13 mm, one 5.0x10 mm, Lifecore, USA) were installed in straight and tripod configurations. Silicone molds were made and poured in photoelastic resin (PL-2. Measurements group, USA). 3) Prostheses construction: Four 3-unit bridges (Type III gold alloy, Dongmyung co., Korea) were produced with nonhexed and hexed UCLA abutments and fitted with conventional methods. The abutments were tightened with 30 Ncm torque and the static loads were applied at 12 points of the occlusal surface. 4) Photoelastic stress analysis: The polarizer analyzer system with digital camera(S-2 Pro, Fujifilm, Japan) was used to take the photoelastic fringes and analysed using computer analysis program. RESULTS: Solitary hexed UCLA restoration developed different stress patterns between two implant arrangement configurations, but there were no stress transfer to adjacent implants from the loaded implant in both configurations. However splinted restorations showed lesser amount of stresses in the loaded implants and showed stress transfer to adjacent implants in both configurations. Solitary hexed UCLA restoration with tripod configuration developed higher stresses in anterior and middle implants under loading than implants with straight configurations. Splintied 3 unit fixed partial dentures with tripod configuration showed higher stress development in posterior implant under loading but there were no obvious differences between two configurations. CONCLUSIONS: The tripod configuration of implant arrangement didn't show any advantages over the straight configuration. Splinting of 3 unit bridges with nonhexed UCLA abutments showed less stress development around the fixtures. Solitary hexed UCLA restoration developed tilting of implant fixture under offset loads.
Alloys ; Denture, Partial, Fixed ; Fungi ; Humans ; Prostheses and Implants* ; Silicones ; Splints ; Torque

PURPOSE: The purpose of this study was to analyze research in the Korean Journal of Rehabilitation Nursing and to suggest further perspective for rehabilitation nursing research. METHOD: In this study we reviewed the contents of 134 articles published in this journal from its beginning year 1998 to 2004. RESULTS: The majority of subjects were adult patients. The type of disease were Cerebrovascular Accident, Neuromuscular disease, Cancer patients, Urogenital disease such as Chronic Renal Failure, Spinal cord injury. Domain of research almost was client, type of research were survey (34.3%), quasi experimental study (20.9%), correlation study (19.4%). Nursing intervention of experimental study was exercise (39.0%), education (17.1%). Place of data collection was hospital (58.2%), position of researcher was professor (67.2%), method of data collection was questionnaire (50.7%). CONCLUSION: There has been a lack of written consent, child rehabilitation, measurement tool development, qualitative research. More studies about rehabilitation nursing are needed to extend the role and fields for professional nursing.
Adult ; Child ; Data Collection ; Education ; Humans ; Kidney Failure, Chronic ; Neuromuscular Diseases ; Nursing ; Qualitative Research ; Surveys and Questionnaires ; Rehabilitation Nursing* ; Rehabilitation* ; Spinal Cord Injuries ; Statistics as Topic ; Stroke

BACKGROUND: Ischemic acute renal failure (ARF) is increasingly recognized as involving chronic functional and structural sequelae. Ischemia reperfusion injury (I/R) plays a major role in delayed graft function and long-term changes after kidney transplantation, also. The present study was designed to evaluate the long-term changes after acute ischemic injury and whether renoprotection by alpha-MSH in the acute ischemic stage, could reduce the long-term sequelae. METHODS: In control group, ischemia/reperfusion injury was induced in male Sprague-Dawley rats by clamping Lt. renal pedicle for 15, 45, 60 minutes after removal of Rt. Kidney and followed by reperfusion. The animals in alpha-MSH group were injected alpha-MSH prior to reperfusion and then every day for 1 week. We measured BUN, creatinine at 24 hour after I/R injury, and in each group, 6 animals were sacrified at 1 week and 4 weeks after I/R injury to evaluate apoptosis, ED1, PCNA, and histopathologic changes. RESULTS: At 4 weeks after I/R injury, the remnant structural damage such as apoptosis, ED1 stained cells, MT (+) tubulointerstitial fibrosis were observed. alpha-MSH could reduce the initial functional injury, and apoptosis, ED1 stained monocyte, MT (+) tubulointerstitial fibrosis, also. CONCLUSION: Renal function was recoverd at 4 weeks after I/R injury, but structural sequelae such as apoptosis, fibrosis were remnant. alpha-MSH could attenuate initial functional damage and remnant fibrosis.
Acute Kidney Injury ; alpha-MSH* ; Animals ; Apoptosis ; Constriction ; Creatinine ; Delayed Graft Function ; Fibrosis ; Humans ; Kidney Transplantation ; Kidney* ; Male ; Monocytes ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury

STATEMENT OF PROBLEM: Several prosthetic options are available for the restoration of multiple adjacent implants. A passively fitting prosthesis has been considered a prerequisite for the success and maintenance of osseointegration. Passivity is a particular concern with multiple implants because of documented inaccuracies in the casting and soldering process. One way to avoid this problem is to restore the implants individually, however, the restorations of individual adjacent impants requires careful adjustment of interproximal contacts. PURPOSE: The purpose of this study was to compare the stress distribution pattern and amount surrounding Bicon implants with individual crowns and splinted restorations. MATERIAL AND METHOD: A photoelastic model of a human partially edentulous left mandible with 3 Bicon implants(4*1 mm) was fabricated. For non-splinted restorations, individual crowns were fabricated on 3 abutments (4.0*6.5 mm, 0 degree, 2.0 mm post, Bicon Inc., Boston, USA) After the units were cemented, 4 levels of interproximal contact tightness were evaluated: open, ideal (8 micrometershim stock drags without tearing), medium(40 micrometer), and heavy(80 micrometer). Splinted 3-unit fixed partial dentures were fabricated and cemented to the model. Changes in stress distribution under simulated non-loaded and loaded conditions(7.5, 15, 30 lb) were analyzed with a circular polaricope. RESULTS: 1. Stresses were distributed around the entire body of fin in Bicon implants. 2. Splinted restorations were useful for distribution of stress around implants especially with higher loads. 3. By increasing the contact tightness between the individually restored three implants, the stress increased in the coronal portion of implants. CONCLUSIONS: Ideal adjustment of the contact tightness was important to reduce the stresses around individually restored Bicon implants.
Crowns ; Denture, Partial, Fixed* ; Humans ; Mandible ; Osseointegration ; Prostheses and Implants ; Splints

PURPOSE: The purpose of this study was to evaluate the pattern and the magnitude of stress distribution in the supporting tissues surrounding three different types of implants(ITI, 3i, and Bicon implant system). MATERIAL AND METHOD: Photoelastic models were made with PL-2 resin(Measurements Group, Raleigh, USA) and three implants of each kind were placed in the mandibular posterior edentulous area distal to the canine . For non-splinted restorations, individual crowns were fabricated on three titanium abutments. For splinted restorations, 3-unit fixed partial dentures were fabricated. Photoelastic stress analyses were carried out to measure the fringe order around the implant supporting structure under simulated loaded conditions(15 lb, 30 lb). CONCLUSION: The results were as follows; 1. Regardless of the implant design, stresses were increased in the apex region of loaded implant when non-splinted restorations were loaded. While relatively even stress distribution occurred with splinted restorations. Splinting was effective in the second implant. 2. Strain around Bicon implant were lower than those of other implants, which confirmed the splinting effect. The higher the load, the more the stress occurred in supporting tissue, which was most obvious in the Bicon system. 3. Stress distribution in the supporting tissue was favorable in the ITI system, while the other side of 3i system tended to concentrate the stress in some parts.
Crowns ; Denture, Partial, Fixed ; Splints ; Titanium

PURPOSE: The purpose of this study was to evaluate the pattern and the magnitude of stress distribution in the supporting tissues surrounding three different types of implants(ITI, 3i, and Bicon implant system). MATERIAL AND METHOD: Photoelastic models were made with PL-2 resin(Measurements Group, Raleigh, USA) and three implants of each kind were placed in the mandibular posterior edentulous area distal to the canine . For non-splinted restorations, individual crowns were fabricated on three titanium abutments. For splinted restorations, 3-unit fixed partial dentures were fabricated. Photoelastic stress analyses were carried out to measure the fringe order around the implant supporting structure under simulated loaded conditions(15 lb, 30 lb). CONCLUSION: The results were as follows; 1. Regardless of the implant design, stresses were increased in the apex region of loaded implant when non-splinted restorations were loaded. While relatively even stress distribution occurred with splinted restorations. Splinting was effective in the second implant. 2. Strain around Bicon implant were lower than those of other implants, which confirmed the splinting effect. The higher the load, the more the stress occurred in supporting tissue, which was most obvious in the Bicon system. 3. Stress distribution in the supporting tissue was favorable in the ITI system, while the other side of 3i system tended to concentrate the stress in some parts.
Crowns ; Denture, Partial, Fixed ; Splints ; Titanium

Sarcoidosis is a systemic granulomatous disease that primarily affects the lung and lymphatic system of the body. The involvement of thyroid gland with sarcoidosis is uncommon. Moreover, sarcoidosis with thyroid cancer are rarely reported in the world. We encountered papillary thyroid carcinoma (PTC) coexistent with pulmonary sarcoidosis. A 35-year-old female with a medical history of pulmonary sarcoidosis visited the endocrinology department for evaluation of the thyroid nodule. Thyroid ultrasonography showed multiple markedly hypoechoic nodules in the left thyroid lobe. Then ultrasonogram-guided fine needle aspiration of left thyroid nodule was positive for papillary carcinoma. She underwent total thyroidectomy with left complete cervical lymph node dissection. The histopathology was confirmed PTC combined with non-caseating granulomatous inflammation suggesting sarcoidosis on thyroid mass and lymph node. We report here a case of PTC coexistent with thyroid involvement of pulmonary sarcoidosis.
Adult ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Endocrinology ; Female ; Humans ; Inflammation ; Lung ; Lymph Node Excision ; Lymph Nodes ; Lymphatic System ; Sarcoidosis* ; Sarcoidosis, Pulmonary ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography

PURPOSE: This study aims to identify the role and function of the RNP (rehabilitational nurse practitioner) expected by nurses and doctors. METHOD: This study was a survey. The data were collected 188 nurses and 21 doctors who worked for disabled patients in the rehabilitation hospital during months of June, 2004 and August, 2005. RESULTS: 98.4% of nurse and 61.9% of doctors agreed at opening of RNP course. The major role of RNP expected by nurses were educator, counsellor and case manager. The major role of RNP expected by doctors were direct care, self care promoter & exercise and emotional care. There was a significant difference about the need for opening of RNP course and major role and function of RNP between the group of nurses and doctors. CONCLUSION: The results of this study showed that the need for opening of RNP was identified and the major role of RNP was educator, counsellor, case manager and direct care. So there is a need for further research about major role of RNP related to various setting including rehabilitation hospital, nursing home, home care etc.
Home Care Services ; Humans ; Nurse Practitioners* ; Nursing Homes ; Rehabilitation* ; Self Care

One of the indications of outpatient surgery is chemical peeling of the face. It usually requires deep sedation with analgesia of short duration. For this purpose we tried to use ketamine(1 mg/kg) and midazolam(0.1 mg/kg) but experienced frequent hypertension and tachycardia. We tried to use beta blocker, esmolol for the of control blood pressure and heart rate. The patients were divided into two groups. In control group, eighty-five patients were anesthetized with bolus intravenous injection of I mg/kg of ketamine and 0.1 mg/kg of midazolam. In esmolol group, eighty-three patients reed a continuous infusion of esmolol(500 mcg/kg/min for initial dose, followed by 200 mcg/kg/min for maintenance) in addition to midazolam(0.1 mg/kg) and ketamine(1 mg/kg). During operation, we observed systolic, diastolic blood pressure and peripheral oxygen saturation(SaO2). All patients were allowed to breathe spontaneously. There was no case of airway obstruction and SaO2 value was over 98% in most cases. So we investigated the effects of esmolol on blood pressure,heart rate,emergence sequelae and patients acceptance in the anesthesia with ketamine and midazolam in the patient of facial chemical peeling. The results were as follows: 1) No one could recall. 2) There were no differences on the status of mood, emotion and patient's positive acceptance between two groups 3) Blood pressure and heart rate were increased during anesthesia with midazolam and ketamine. But esmolol attenuated this response, significantly(P<0.05). We concluded that esmolol added benefits of control of blood pressure and heart rate in the anesthesia of facial chemical peeling. But the control of the high blood pressure is not so easy, so it is needed to find out the optimal dosage of esmolol for complete blocking of the sympathetic response without complications.
Airway Obstruction ; Ambulatory Surgical Procedures ; Analgesia ; Anesthesia* ; Blood Pressure ; Deep Sedation ; Heart Rate ; Humans ; Hypertension ; Injections, Intravenous ; Ketamine* ; Midazolam* ; Oxygen ; Tachycardia

PURPOSE: The purpose of this study was to analyze the importance, difficulty, and frequency of work (duties and tasks) done by nurses' in Outpatient Departments (OPD). METHOD: Data were collected using structured questionnaires, which included 11 duties and 92 tasks making up the OPD nurse's job. Questionnaires were completed by 286 nurses. Each duty and task was analyzed for importance, difficulty, and frequency (range 1-3). RESULTS: The mean score for importance was 2.58+/-0.29, for difficulty, 2.11+/-0.31, and for frequency, 2.18+/-0.31. OPD nurses recognized'patient education and consultation' as important and difficult. However, in practice OPD nurses reported the most frequent task as'support for medical services'. There was a significant difference in importance and difficulty of duties according to OPD nurses' university degree (F=3.693, p= .026; F=4.089, p= .018) and hospital size (F=4.274, p= .006; F=3.154, p= .025). However there were no differences in importance, difficulty, or frequency according to clinical experience in OPD. CONCLUSION: The findings indicate that OPD nurses must be able to do important and difficult duties and tasks, especially patient education and consultation. To have time for these uniquely nursing tasks, OPD nurses need to delegate'preparation for medical service', and'management of facility and environment' to nonmedical health-care workers.
Health Facility Size ; Humans ; Job Description ; Outpatients ; Patient Education as Topic ; Surveys and Questionnaires