OBJECTIVES: Some antioxidants are believed to restore dentin bond strength after dental bleaching. This study was done to evaluate the influence of antioxidants on the bond strength of bleached bovine dentin. MATERIALS AND METHODS: Thirty incisors were randomly assigned to 10 groups (two unbleached control and eight bleached groups: immediate bonding IB, 4 wk delayed bonding DB, 10% sodium ascorbate treated SA, 10% alpha-tocopherol treated TP groups). Teeth in half of groups were subjected to thermal stress, whereas the remaining groups were not. Resin-dentin rods with a cross-sectional area of 2.25 mm2 were obtained and microtensile bond strength was determined at a crosshead speed of 1 mm/min. Fifteen specimens were prepared for SEM to compare the surface characteristics of each group. The change in dentin bond strength from thermal stress and antioxidant treatment was evaluated using two-way analysis of variance (ANOVA) and Sheffe's post hoc test at a significance level of 95%. RESULTS: The control group exhibited the highest bond strength values, whereas IB group showed the lowest value before and after thermocycling. The DB group recovered its bond strength similar to that of the control group. The SA and TP groups exhibited similar bond strength values with those of the control and DB groups before thermocycling. However, The TP group did not maintain bond strength with thermal stress, whereas the SA group did. CONCLUSIONS: Applying a 10% sodium ascorbate solution rather than 10% alpha-tocopherol solution for 60 sec is recommended to maintain dentin bond strength when restoring non-vitally bleached teeth.
alpha-Tocopherol ; Antioxidants* ; Ascorbic Acid ; Dentin* ; Incisor ; Tooth ; Tooth Bleaching

BACKGROUND: Neurosurgical site infection may have serious sequelae, especially that occurring after craniotomy. A nationwide prospective multicenter study was performed in Korea to determine the incidence and risk factors for surgical site infections (SSI) after craniotomy. Methods: We collected demographic data, clinical and operative risk factors for SSI, and information regarding the antibiotics administered for the patients who underwent craniotomy in 17 hospitals between July and December of 2008. All the data were collected using a real-time web-based reporting system. RESULTS: Of the 1,020 patients who underwent craniotomy, 31 (3%) developed SSI, including 4 with superficial incisional SSI, 2 with deep incisional SSI, and 25 with organ/space SSI. The SSI rate was predicted on the basis of the National Nosocomial Infections Surveillance (NNIS) risk index. The SSI rate of 3.1%, 3.3%, and 1.8% were ascribed NNIS scores of 0, 1, and 2, respectively. The independent risk factors for SSI identified were postoperative cerebrospinal fluid leakage (odds ratio, 12.13; 95% confidence interval, 4.54-32.42) and preoperative Glasgow coma scales score < or =8 (odds ratio, 2.35; 95% confidence interval, 1.07-5.18). Third generation cephalosporins were the most frequently (in 65.6% of the cases) used for prophylaxis. CONCLUSION: A multicenter SSI surveillance system for craniotomy was first established in Korea. The NNIS risk index was not effective in identifying the patients at risk. We required to further analyze a large number of SSI cases to correctly identify the risk factors for SSI after craniotomy.
Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Cephalosporins ; Coma ; Craniotomy ; Cross Infection ; Humans ; Incidence ; Korea ; Prospective Studies ; Risk Factors ; Weights and Measures

BACKGROUND AND OBJECTIVES: The 5-HT2A receptor is one of the main mediators of a serotonin-evoked coronary artery contraction. This is because vasoconstriction is selectively blocked by the 5-HT2 receptor antagonist, with the 5-HT2A receptor gene mRNA being detected in spastic coronary arteries. The relationship between the T102C polymorphism of the 5-HT2A receptor gene and the response to the 5-HT2A antagonist (clozapine) has recently been established, suggestive of a functional implication. Previous studies have observed an association between low cholesterol levels and mental disorders, but the underlying cause has not been determined. It has been established that the T102C polymorphism of the 5-HT2A serotonin receptor gene and a variety of psychological problems are related, but the relationship between the serum lipid level and this genetic polymorphism has not been reported. We investigated the influence of this polymorphism on coronary artery disease, including vasospastic angina and the clinical parameters, such as the lipid profile. SUBJECTS AND METHODS: After a diagnostic angiography was performed, the genotype was identified from the genomic DNA extracted from the peripheral blood of 646 patients without specific psychiatric diseases. RESULTS: There were no differences in the genotype frequencies between coronary artery disease, coronary artery disease with vasospasm, and the normal control groups, even from a subgroup analysis of the clinical parameters. Contrary to previous reports, the genotype distribution was not related to a myocardial infarction or hypertension. The lipid profile analysis showed significantly lower total cholesterol (193.5 vs. 202.1mg/dL, p=0.016) and HDL-cholesterol (42.7 vs. 46.2mg/dL, p=0.003) levels in the CC genotype than the other genotypes, and the frequencies of CC genotype showed a significantly decreasing trend between the HDL-cholesterol (p=0.003) and total cholesterol (p=0.003) quartiles. From a multivariate analysis, only the HDL-cholesterol level was significantly associated with a lower frequency of the CC genotype (p=0.006). CONCLUSION: The T102C polymorphism is not related to coronary artery disease, including vasospasm of the coronary artery, but the CC genotype of this polymorphism is related to low HDL-cholesterol. We identified a novel genetic polymorphism of the serotonin receptor, which affects the HDL-cholesterol level. Because previous observational studies have shown an association between low cholesterol levels and mental disorders, our data should be considered when analyzing the serum lipid levels and serotonin receptor function in humans.
Angiography ; Cholesterol ; Coronary Artery Disease* ; Coronary Vessels* ; DNA ; Genotype ; Humans ; Hypertension ; Mental Disorders ; Multivariate Analysis ; Muscle Spasticity ; Myocardial Infarction ; Polymorphism, Genetic ; Receptor, Serotonin, 5-HT2A* ; RNA, Messenger ; Serotonin ; Serotonin 5-HT2 Receptor Antagonists ; Vasoconstriction

More than 95% of all cases of lymphangioma occur in head, neck and axilla. But, intraabdominal lymphangioma is rare. The etiology of intraabdominal lymphangioma is thought to be related with the congenital malfomation of lymphatics. It is more common in children than in adults and most of them are known to be cystic lymphangioma in pathology. The clinical symptoms of mesenteric lymphangioma seem to be related with the size and location of the tumor. We report a case of lymphangioma which was diagnosed preoperatively by lipoprotein electrophoresis in a 21-year-old woman with periumblical pain.
Adult ; Axilla ; Child ; Electrophoresis* ; Female ; Head ; Humans ; Jejunum ; Lipoproteins* ; Lymphangioma* ; Lymphangioma, Cystic ; Mesentery* ; Neck ; Pathology ; Young Adult

OBJECTIVES: To analyze the findings of rectal intussusception and to find the other accompanied functional anorectal diseases. MATERIALS AND METHODS: We analyzed defecograms in 25 patients with rectal intussusception among 77 patients taken with obstructed defecatory symptom. Females were 16 (64%), males were 9 (36%), and the mean age was 55 years old. The changes of anorectal angle (ARA) and movement of anorectal junction were measured, and the morphologic changes of rectal wall during defecation were analyzed. RESULTS: ARAs measured by central axis method (CAM), the mean angles were 114.6, 102.2, and 119.8 degree, respectively in resting, squeezing, and straining period. By posterior wall methods (PWM), those were 86.7, 72.0, 93.3 degree. The differences of ARA between resting and straining period were 5.2, 6.6 degree, respectively by CAM and PWM. The mean descent of anorectal junction during defecation was 0.83 cm. The most frequent finding associated with rectal intussusception was rectocele (12 cases;48%). The other accompanied findings were 9 spastic pelvic floor syndrome (36%) and 4 fecal incontinence (16%). Total 18 patients out of 25 patients were accompanied with other functional anorectal diseases (72%). CONCLUSIONS: Recognition of rectal intussusception with accompanied diseases would be important for the proper treatment planning.
Axis, Cervical Vertebra ; Defecation ; Fecal Incontinence ; Female ; Humans ; Intussusception* ; Male ; Middle Aged ; Muscle Spasticity ; Pelvic Floor ; Rectocele

OBJECTIVES: To analyze the findings of rectal intussusception and to find the other accompanied functional anorectal diseases. MATERIALS AND METHODS: We analyzed defecograms in 25 patients with rectal intussusception among 77 patients taken with obstructed defecatory symptom. Females were 16 (64%), males were 9 (36%), and the mean age was 55 years old. The changes of anorectal angle (ARA) and movement of anorectal junction were measured, and the morphologic changes of rectal wall during defecation were analyzed. RESULTS: ARAs measured by central axis method (CAM), the mean angles were 114.6, 102.2, and 119.8 degree, respectively in resting, squeezing, and straining period. By posterior wall methods (PWM), those were 86.7, 72.0, 93.3 degree. The differences of ARA between resting and straining period were 5.2, 6.6 degree, respectively by CAM and PWM. The mean descent of anorectal junction during defecation was 0.83 cm. The most frequent finding associated with rectal intussusception was rectocele (12 cases;48%). The other accompanied findings were 9 spastic pelvic floor syndrome (36%) and 4 fecal incontinence (16%). Total 18 patients out of 25 patients were accompanied with other functional anorectal diseases (72%). CONCLUSIONS: Recognition of rectal intussusception with accompanied diseases would be important for the proper treatment planning.
Axis, Cervical Vertebra ; Defecation ; Fecal Incontinence ; Female ; Humans ; Intussusception* ; Male ; Middle Aged ; Muscle Spasticity ; Pelvic Floor ; Rectocele

No abstract available.
Pituitary Neoplasms*

Duchenne's muscular dystrophy (DMD) is an X-linked recessive disease. Clinical descriptions of the disorder focus principally on skeletal muscle degeneration. Another manifestation, which involves the gastrointestinal tract, may be fatal. But its prevalence remains undefined. We report here a case of acute gastroparesis associated with Duchenne's muscular dystrophy. In our case, the patient's symptoms were improved by prokinetic agents and timely decompression in life-threatening acute gastric dilatation.
Acute Disease ; Adolescence ; Case Report ; Contrast Media ; Decompression ; Gastric Emptying/physiology ; Gastrointestinal Agents/therapeutic use ; Gastrointestinal Motility/drug effects ; Gastroparesis/radiography ; Gastroparesis/physiopathology ; Gastroparesis/etiology* ; Human ; Male ; Muscular Dystrophies/complications* ; Radiography, Abdominal

PURPOSE: To evaluate the usefulness of the esophagogram using marshmallow bolus in the evaluation of the causes of variable esophageal-related symptoms. MATERIALS AND METHODS: Esophagograms using marshmallow bolus were performed on 44 patients with esophageal-related symptoms and on ten normal volunteers. Video fluoroscopic studies were also made. Patients were classified into three groups according to their esophageal-related symptoms ; those with dysphagia, those with globus symptom, and those with chest pain. Abnormal findings on an esophagogram with marshmallow were graded into three categories ; mild, moderate, and severe. Provocation of the same symptom wasalso evaluated. Esophageal manometric studies were performed on 16 patients and those results were compared with the results obtained from the esophagogram using marshmallow bolus. RESULTS: The provocation rate of the same symptom was 33% in the first group, 47% in the second, and 24% in the third. The provocation rate was highest inthe second group. The provocation rate was also higher in patients with a severe degree of abnormality on anesophagogram using marshmallow bolus. Where there were abnormal findings, an esophagogram using marshmallow bolus showed a higher abnormality rate than did a conventional esophagogram. In cases showing abnormal findings on the esophageal manometric study, an esophagogram using marshmallow bolus showed a higher provocation rate and more severe abnormality than in cases showing normal findings on manometric study. CONCLUSION: An esophagogram using marshmallow bolus will a useful radiologic screening modality for the evaluation of patients with esophageal-related symptoms.
Althaea* ; Chest Pain ; Deglutition Disorders ; Healthy Volunteers ; Humans ; Mass Screening

BACKGROUND: Vasodilators including angiotensin converting enzyme inhibitor(ACEI) have been suggested to reduce left ventricular volume and to improve left ventricular performance in patients with moderate to severe regurgitant valvular heart diseases. However, long-term effects of angiotensin converting enzyme inhibitor upon left ventricular size and function in asymptomatic or minimally symptomatic patients with chronic mitral regurgitation remain to be elucidated. MATERIALS AND METHOD: Forty five patients with moderate to severe chromic mitral regurgitation on echocardiography and mild or no symptoms were studied. Serial changes of left ventricular dimension and ejection fraction were analyzed retrospectively using M-mode echocardiography in patients treated with ACEI(ACEI group, n=21) and in patients treated with other medications except ACEI or with no medication(non-ACEI group, n=24). RESULTS: The mean duration of follow-up was 30+/-15 months. ACEI group showed trends of decreasing left ventricular end-systolic dimension(LVESD) and left ventricular end-diastolic dimension(LVEDD) and a trend of increasing ejection fraction(EF), though statistically insignificant when compared to those of before-treatment or non-ACEI group. In patients with larger initial LVESD(>35mm), LVEDD was reduced(the percent changes of LVEDD 2 and 3 years after ACEI treatment were -4.2# and -4.4%) that was significantly different from those of non-ACEI group(+3.4% and +3.4% each)(p<0.05). In patients with larger initial LVEDD(>60mm), the percent changes of LVEDD 2 and 3 years after ACEI treatment were -4.9% and -5.8%, and in patients with initial EF less than 60%, the percent change of LVEDD 2 years after ACEI treatment was -0.57%. Those changes were also statistically significant compared to those of non-ACEI group(p<0.05 each). CONCLUSION: In mildly symptomatic chronic mitral regurgitation patients, especially whose left ventricular dimension is increase, long-term ACEI therapy seems to be effective in preventing left ventricular dilatation or in reducing left ventricular volume and such therapy may have a beneficial effect on the natural history of such patients.
Angiotensins* ; Dilatation ; Echocardiography ; Follow-Up Studies ; Heart Valve Diseases ; Humans ; Mitral Valve Insufficiency* ; Natural History ; Peptidyl-Dipeptidase A* ; Retrospective Studies ; Vasodilator Agents