The purpose of this study was to evaluate the long term tooth-brushing effect on the color change of specially treated IPS Empress porcelain surface. Staining technique with blue stain and liquid was used. The surfaces of the specimen were treated with 5% and 10% Hydrofluoric acid, 50mm and 250mm alumina sandblast, and then blue stain and liquid were used for external stain. After 29,200, 58,400, 87,600, 116,200 brushing strokes (equivalent to 2, 4, 6, 8 years each), color changes of the stained layer were measured with spectrophotometer(CM-3500d, MINOLTA, Thkyo, Japan). The result of this study was obtained as follows : 1. The color changes were great after 29,200 tooth brushing strokes in every group, but from 29,200 strokes to 116,800 strokes, there were no significant color changes in each group.(p>0.05) 2. The greatest color changes were observed in 5% HF treated group and the least color changes were observed in 50 micrometer aluminar sandblast treated group in every stroke(p<0.05), but no ststistical difference between groups compared with control group(p>0.05). According to these results, pretreatment of I.P.S. Empress porcelain with alumina sandblast improved the color of IPS Empress porcelain significantly on this condition, but long term follow-up will be needed.
Aluminum Oxide ; Dental Porcelain* ; Hydrofluoric Acid ; Stroke ; Tooth ; Toothbrushing*

BACKGROUND: Activated charcoal has been widely used as an adsorbent for the management of drug intoxicated patients in the emergency department(ED). Although there are several commercial ready-mixed charcoal suspension preparations in the market, we are using custom-made suspension from hospital grade bulk charcoal powder. We designed this study to compare the adsorptive capacity of the Actidose Aqua(R), which is a commercial charcoal product, Fuller's earth, and custom-made activated charcoal used in our ED. METHODS: First, we performed modified USP methylene blue adsorption test which is a standard adsorption test for activated charcoal. Then, the drug adsorption test for phenobarbital, acetaminophen, salicylate, and aminophylline was done. Graded amount of three adsorptives were added to the stock solutions of each drugs. The adsorption test were performed as follows: The vials containing drugs and adsorptives were shaken for 30 minutes to ensure adsorption equilibrium, then the suspension was filtered through in-line filter. The filtrates were analyzed by ultraviolet spectroscopy to determine the residual drug concentrations. Finally we examined and compared the surface area and the structure of activated charcoal and Fuller's earth using scanning electron microscopy. RESULTS: In methylene blue adsorption test, the adsorption rate was 60.1% in Actidose Aqua(R) and 59.0% in custom-made charcoal, and 70.2% in Fuller's earth. For the phenobarbital, acetaminophen, and sallcylate, the adsorption rate of Actidose Aqua(R) and custom-made charcoal was greater than 90% with the ratio o adsorptives to drugs over 10:1. For aminophylline, two charcoal products showed excellent adsorption in 5:1 ratio. But Fuller's earth showed poor adsorption in all rages. CONCLUSION: Custom-made activated charcoal showed a comparable adsorption capacity to Actidose Aqua(R). Fuller's earth showed a poor performance to be used as a substitute for activated charcoal in acute drug poisoning otherwise paraquat.
Acetaminophen ; Adsorption ; Aminophylline ; Charcoal* ; Emergencies ; Humans ; Methylene Blue ; Microscopy, Electron, Scanning ; Paraquat ; Phenobarbital ; Poisoning ; Rage ; Spectrum Analysis

OBJECTIVES: Balloon cells and dysplastic neurons are histopathological hallmarks of the cortical tubers of tuberous sclerosis complex (TSC) and focal cortical dysplasia (FCD) of the Taylor type. They are believed to be the epileptogenic substrate and cause therapeutic drug resistant epilepsy in man. P-glycoprotein (P-gp) is the product of multidrug resistance gene (MDR1), and it maintains intracellular drug concentration at a relatively low level. The authors investigated expression of P-gp in balloon cells and dysplastic neurons of cortical tubers in patients with TSC. METHODS: An immunohistochemical study using the primary antibody for P-gp, as an indicative of drug resistance, was performed in the cortical tuber tissues in two patients of surgical resection for epilepsy and six autopsy cases. RESULTS: Balloon cells of each lesion showed different intensity and number in P-gp immunopositivity. P-gp immunopositivity in balloon cells were 28.2%, and dysplastic neurons were 22.7%. These immunoreactivities were more prominent in balloon cells distributed in the subpial region than deeper region of the cortical tubers. Capillary endothelial cells within the cortical tubers also showed P-gp immunopositivity. CONCLUSION: In this study, the drug resistance protein P-glycoprotein in balloon cells and dysplastic neurons might explain medically refractory epilepsy in TSC.
Autopsy ; Drug Resistance* ; Drug Resistance, Multiple ; Endothelial Cells ; Epilepsy ; Genes, MDR ; Humans ; Malformations of Cortical Development ; Neurons ; P-Glycoprotein ; Tuberous Sclerosis* ; Up-Regulation*

Hiccup can be regarded as a failure of the usual alternating excitation-inhibition between glottis closure and inspiration. The coordinating center is located in the brain-stem reticular formation. A wide variety of pathological conditions can cause intractable hiccup: myocardial infarction, brain tumor, renal failure, prostate cancer, abdominal surgery, etc. Stroke is an unusual cause of intractable hiccup. Intractable hiccup is rare but disabling condition which can induce depression, weight loss, sleep deprivation, and even death. Etiological treatment is not always available and intractable hiccup treatment has classically relied on metoclopramide and chlorpromazine. We experienced a case of intractable hiccup induced by multiple cerebral infarct, and we present this rare case with the review of literature.
Brain Neoplasms ; Chlorpromazine ; Depression ; Glottis ; Hiccup* ; Metoclopramide ; Myocardial Infarction ; Prostatic Neoplasms ; Renal Insufficiency ; Reticular Formation ; Sleep Deprivation ; Stroke ; Weight Loss

BACKGROUND: Posttransplant osteoporosis in renal transplant recipient is frequently observed complications, but therapeutic modalities are not clearly elucidated. Recent studies indicate that vitamin K2 also play a role in bone metabolism. Therefore, we performed prospective study to evaluate the effect of vitamin K2 (Menatetrenone(R)) on posttransplant osteroporosis. METHODS: Our study included total 83 patients (40 male, 43 female; age 36.9+/-5.5 years) who received a renal transplant more than 6 months ago. They underwent dual-energy X-ray absorptiometry (DEXA) at lumbar spine and femoral neck. The patients with osteoporosis were treated with vitamin K2 (glakay 15 mg) (group 1) or vitamin D3 with calcium carbonate (group 2). The patients without osteoporosis was observed without any treatment (group 3). After one year, follow-up BMD was performed in all patients. RESULTS: Of 83 patients, 44 patients (53.0%) had osteoporosis and 39 patients (47.0%) had not. In group 1 (N=28), vitamin K2 treatment significantly increased BMD at femoral neck (-3.2+/-0.4 vs 2.6+/-0.6, p<0.05), but there was no increase of BMD at lumbar spine (-2.2+/-1.0 vs 2.2+/-0.9, p>0.05). In group 2 (N=16), there was significant increase in BMD at femoral neck (-3.0+/-0.6 vs -2.5+/-0.8, p< 0.05), but there was no increase of BMD at lumbar spine (-1.8+/-0.7 vs -1.8+/-0.8, p>0.05). Between group 1 and 2, there was no significant difference in BMD change. In group 3, BMD decreased at femoral neck (-1.3+/-0.2 vs -1.5+/-0.2) and lumbar spine (-0.8+/-0.2 vs -1.0+/-0.2) during follow-up period. CONCLUSION: Vitamin K2 (Menatetrenone(R)) is effective in treating osteoporosis at femoral neck and its effectiveness is s imilar with that of using vitamin D3 with calcium carbonate.
Absorptiometry, Photon ; Calcium Carbonate ; Cholecalciferol ; Female ; Femur Neck ; Follow-Up Studies ; Humans ; Male ; Metabolism ; Osteoporosis* ; Prospective Studies ; Spine ; Transplantation* ; Vitamin K 2