Background: β-blockers (BBs) are considered primary therapy in stable heart failure (HF) with reduced ejection fraction (HFrEF) without atrial fibrillation (AF); evidence-based benefits of BB on outcome have been documented. However, BBs have not been shown to improve mortality or reduce hospital admissions in HF patients with AF. This study assessed the relationship between BBs at discharge and relevant clinical outcomes in acute heart failure (AHF) patients with AF. Methods: From the Korean Acute Heart Failure Registry, 936 HFrEF and 639 HF patients with preserved ejection fraction (HFpEF) and AF were selected. Propensity score (PS) matching accounted for BB selection bias when assessing associations. Results: BB-untreated patients in the overall cohort of HFrEF and HFpEF had greater deteriorated clinical and laboratory characteristics. In the 670 PS-matched cohort of HFrEF patients, incidences of all clinical events at 60 days and 1 year were not different according to use of BBs. In the 470 PS-matched cohort of HFpEF, rehospitalization and composite outcome at 6 months and 1 year more frequently occurred in non-users of BBs. After adjusting for covariates in the multivariable Cox model of matched cohorts, BB was not associated with clinical outcomes at 60 days and 1 year in HFrEF with AF patients. In HFpEF patients with AF, BB use was associated with reduced 6-month (hazard ratio [HR], 0.38; 95% confidence interval [CI], 0.20–0.74) and 1-year rehospitalization (HR, 0.53; 95% CI, 0.34–0.82). Conclusion In the HFrEF with AF PS-matched cohort, the use of BBs at discharge was not associated with clinical outcome. However, in HFpEF with AF, the use of BB was associated with reduced rehospitalization during the 6-month and 1-year follow up.

BACKGROUND/AIMS: Fabry disease is an X-linked recessive and progressive disease caused by alpha-galactosidase A (alpha-GaL A) deficiency. We sought to assess the prevalence of unrecognized Fabry disease in dialysis-dependent patients and the efficacy of serum globotriaosylceramide (GL3) screening. METHODS: A total of 480 patients of 1,230 patients among 17 clinics were enrolled. Serum GL3 levels were measured by tandem mass spectrometry. Additionally, we studied the association between increased GL3 levels and cardiovascular disease, cerebrovascular disease, or left ventricular hypertrophy. RESULTS: Twenty-nine patients had elevated serum GL3 levels. The alpha-GaL A activity was determined for the 26 patients with high GL3 levels. The mean alpha-GaL A activity was 64.6 nmol/hr/mg (reference range, 45 to 85), and no patient was identified with decreased alpha-GaL A activity. Among the group with high GL3 levels, 15 women had a alpha-GaL A genetics analysis. No point mutations were discovered among the women with high GL3 levels. No correlation was observed between serum GL3 levels and alpha-GaL A activity; the Pearson correlation coefficient was 0.01352 (p = 0.9478). No significant correlation was observed between increased GL3 levels and the frequency of cardiovascular disease or cerebrovascular disease. CONCLUSIONS: Fabry disease is very rare disease in patients with end-stage renal disease. Serum GL3 measurements as a screening method for Fabry disease showed a high false-positive rate. Thus, serum GL3 levels determined by tandem mass spectrometry may not be useful as a screening method for Fabry disease in patients with end stage renal disease.
Adult ; Aged ; Fabry Disease/blood/*diagnosis ; Female ; Humans ; Kidney Failure, Chronic/blood/*therapy ; Male ; Middle Aged ; *Renal Dialysis ; Trihexosylceramides/*blood ; alpha-Galactosidase/genetics/metabolism

All contours of the restoration not directly related to occlusion are related to the gingival tissues only. And proper contour of restoration is essential for the health of the periodontal tissues. But there are so many controversies about the contour of the restoration, and there is no uniform agreement in the literature as to which contour of restoration is best for periodontium. In general, the contour of restoration means the supragingival contour only but in the case of the intracrevicular restorative procedure the subgingival contour of restoration must be considered. Because a portion of the restoration is placed in a gingival sulcus which is extremely vulnerable to periodontal disease. In this article the concepts or theories of the supragingival contour, the subgingival contour, and the emergence profile were discussed. The contour of the restoration and the biotype of the periodontium must be considered in intracrevicular restorative procedure. And sufficient tooth preparation is important factor to develop the proper contour of restoration which is kind to periodontium.
Periodontal Diseases ; Periodontium ; Tooth Preparation

There are so many considerations for successful restorative dentistry and the periodontal consideration is one of the most important facors to consider. In modern dentistry intracrevicular margin is popular due to esthetic reason. But the marginal tissue recession after intracrevicular restoration is one of the most troublesome phenomena. The marginal tissue recession may be controlled with understanding the mechamsms. In conclusion (1) the inflammation of periodontium must be controlled before intracrevicular restorative percedure (2) the width and thicknes of keratinized gingiva must be evaluated before intracrevicular restorative procedure (3) tooth preparation must follow the natural scallop of CEJ.
Dentistry ; Esthetics ; Gingiva ; Inflammation ; Pectinidae ; Periodontium ; Tooth Cervix ; Tooth Preparation

Chitosan has been known as a wound healing agent. The purpose of this study was to evaluate the biocompatibility and guided bone regenerative effect of chitosan and chitosan-cellulose membranes. The effects of chitosan and chitosan-cellulose membranes on the growth and survival of human periodontal ligament cells were examined by rapid colorimetric MTT(tetrazolium) assay, and the tissue response and resorption pattern were observed by implanting the membranes into the subcutaneous tissue of the back of rats for 6 weeks. To evaluate the guided bone regenerative potential of membranes, the amount of newly formed bone in the rat calvarial defects(8mm in diameter) was measured by histomorphometry and radiomorphometry 1,2 and 4 weeks after implantation of membranes. Chitosan and chitosan-cellulose membranes showed no adverse effect on the growth and survival of human periodontal ligament cells. When membranes were subcutaneously implanted, inflammatory reaction was observed at 1 week and which gradually subsided 2 weeks after implantation. Membranes remained intact throughout the experimental period of 6 weeks. Radiomorphometric analysis of the craniotomy sites revealed that chitosan and chitosan-cellulose membrane implanted sites showed increased radiopacity over control. Statistically significant differences with control were found in chitosan-cellulose membrane implanted group at 2 and 4 weeks, and chitosan membrane implanted group at 4 weeks(P<0.05). Histomorphometric data indicated a pattern of osseous healing similar to radiomorphometric analysis. There was a statistically significant difference between control and chitosan-cellulose membrane implanted group at 4 weeks(P<0.05). These results implicate that chitosan and chitosan-cellulose membrane might be useful for guided bone regeneration.
Humans ; Rats ; Animals

The objective of the present study was to investigate the vertical and horizontal location of the molar furcations in korean. The samples used in this study included 132 maxillary molars and 120 mandibular molars. Of them, 47 maxillary molars and 34 mandibular molars had the fused roots. So, 85 maxillary molars(54 1st and 31 2nd molars) and 86 mandibular molars(46 1st and 40 2nd molars) were measured. The vertical and horizontal location of molars were measured with divider and digimatic micrometer and their means and standard deviation calculated. The results were summarized as follows: 1. The ratio of fused roots found in this study was the highest in the maxillary second molars with 59%, followed by mandibular second molars(46%) and maxillary first molars(7%) and none were discovered in the mandibular first molars. 2. In the study of the vertical location of molar furcation, the results were as follows : In the maxillary first molars, the length in descending order were distal(5.06mm), mesial(4.52mm) and buccal(4.01mm) and in the maxillary second molar, distal(4.04mm), mesial(4.02mm) and buccal(3.87mm). In the mandibular first molar, the length was 3.69mm on the lingual side and 2.81mm on the buccal side, and in the mandibular second molar, 3.87mm on the lingual and 3.61mm on the buccal side. 3. The location of the mesial and distal furcations in horizontal dimension measured showed following results : buccal and mesial furcations of the maxillary molars and buccal and lingual furcations of the mandibular molars generally found at the center, but the mesial furcation of the maxillary molars were found approximately two thirds toward the palatal aspect.

BACKGROUND: A clinical trial was performed to evaluate the antihypertensive efficacy and side effects of amlodipine, a new long-action calcium antagonist, in patients with mild to moderate essential hypertension as measured by 24-h ambulatory blood pressure monitoring. METHODS AND RESULTS: 1) The study patients consisted of 4 men and 6 women, and the mean age was 51 years. Amlodipine monotherapy(5~10mg) was continued for 4 weeks, and blood pressure was measured by 24-h ambulatory blood pressure monitoring. 2) A smooth and sustained lowering of blood pressure was clearly achieved without affecting the circadian rhythm throughout dosing interval. The mean-pressure drop was 21.2/13.7mmHg after 4 weeks of amlodipine monotherapy. 3) The ambulatory pulse rate revealed virtually identical average hourly pulses during the recording period before and after amlodipine treatment. 4) All of the laboratory parameters including blood chemistry, glucose, lipid and electrolytes did not change significantly after 4 weeks of amlodipine monotherapy. 5) Amlodipine therapy resulted in minimal side effects that were well tolerated. CONCLUSIONS: Once-daily amlodipine monotherapy with 5 to 10mg in controlling blood pressure throughout each 24-h cycle is effective and well tolerated in the patients with mild to moderate essential hypertension.
Amlodipine* ; Blood Pressure Monitoring, Ambulatory ; Blood Pressure* ; Calcium ; Chemistry ; Circadian Rhythm ; Electrolytes ; Female ; Glucose ; Heart Rate ; Humans ; Hypertension ; Male

No abstract available.
Gingival Crevicular Fluid* ; Periodontal Diseases*

No abstract available.
Porphyromonas gingivalis* ; Porphyromonas* ; Virulence*

No abstract available.
Porphyromonas gingivalis* ; Porphyromonas* ; Virulence*