• Title/Summary/Keyword: Clinical Function

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Early Hemodynamic Changes and Short-term Outcomes of Mitral Valvuloplasty versus Replacement with Chordal Preservation for Patients with Mitral Regurgitation (승모판막폐쇄부전 환자에서 판막성형술과 판막대치술이 수술 후 혈역학과 단기 예후에 미치는 영향 비교)

  • Choi, Yong-Seon;Kwak, Young-Lan;Chang, Byung-Chul;Kim, Ji-Ho;Hong, Yong-Woo;Bang, Sou-Ouk
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.659-666
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    • 2007
  • Background: Preserving the subvalvular apparatus after mitral valve replacement (MVR) results in better ventricular function and a better outcome. In conjunction, mitral valve repair (MVr) is associated with a better outcome, yet little is known about the hemodynamics and outcomes between patients undergoing MVr and MVR with chordal preservation. We prospectively evaluated the hemodynamic changes and outcomes of patients undergoing MVr and MVR with chordal preservation. Material and Method: Fifty-four patients with mitral regurgitation (MR) who under-went MVR with chordal preservation (n=21) or MVr (n=33) were studied. The patients' characteristics, the intra-and postoperative hemodynamics and the use of cardiac medications, the postoperative outcome and the complications were recorded during the hospital stay. All the patients were followed up for at least 6 months post-operatively for determining their morbidity and mortality. Result: The patients' characteristics were similar between the groups, except for the presence of atrial fibrillation and congestive heart failure which was more frequent in the MVR group. Also, the preoperative left ventricular ejection fraction was lower in the MVR group than in the MVr group ($64{\pm}9%$ versus $69{\pm}5%$, respectively, p=0.043). There were no significant differences of the hemodynamics between the groups. The use of inotropic drugs and pacemakers during the 12hrs postoperatively was more common in the MVR group than in the MVr group (48% versus 24%, p=0.025 and 52% versus 24%, p=0.035, respectively). The other postoperative outcomes were similar in both groups for at least the 6 months follow-up period. Conclusion: MVR with chordal preservation was comparable with regard to the hemodynamics and clinical outcomes, supporting the beneficial effect of preserving the subvalvular apparatus after MVR.

A Study of the Comparison of Microleakage according to the Types of Cement on the Cast Post and Core (주조 포스트코아에서 시멘트 종류가 미세누출에 미치는 영향)

  • Nam, Ki-Young;Lee, Cheong-Hee;Cho, Kwang-Hyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.1
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    • pp.51-60
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    • 2000
  • The purpose of this study was to compare the microleakage at the interface of cast post and tooth according to the type of cement. Forty anterior teeth with single root were used. The teeth were cut 2 mm coronal from the cementoeamel junction and chamfer finish line was made on 1 mm coronal from the cementoeamel junction. After the routine endodontic treatment, post space was prepared using #5.5 Parapost drill to a depth of 7 mm. After the pick up impression, core building was made to 3 mm of clinical crown with burnout wax, then post and core was cast with nonprecious metal. The teeth were divided into four groups of ten each. In Group I, post and core were cemented with Fleck's(Zinc phosphate cement) In Group II, post and core were cemented with Fuji I(Glass ionomer cement) In Group III, post and core were cemented with Superbond C & B(Composite resin cement) In Group IV, post and core were cemented with Panavia 21(Composite resin cement) All cemented teeth were stored in normal saline at $37^{\circ}C$ for 7 days and thermocycled from $5^{\circ}C$ to $55^{\circ}C$ for 500 cycles with a dwell time of 30 seconds. After thermocycling, teeth were immersed in 1% Basic fuchsin dye for 48 hours. All 40 teeth were then embedded in the epoxy resin and cut buccolingually with a cutting instrument. The degree of penetration of dye at interface was graded on a scale of 0 to 4 using a stereomicroscope at 25 to 40 times magnification. Through the findings of this study, the following conclusion were obtained. 1. All the groups showed the microleakage at the interface of cast post core and tooth. 2. Group I showed the highest microleakage score among the groups with a significant difference(p<0.05). 3. Group II showed higher microleakage score than Group III and Group IV with a significant difference(p<0.05). 4. Group IV showed the lowest microleakage score but there were no significant difference with Group III(p>0.05).

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Comparison of relative fitness between zirconia single coping and 3-unit fixed partial dentures (FPDs) manufactured by dental CAD/CAM system (치과 캐드/캠 시스템으로 제작된 지르코니아 single 코핑과 3-unit 구조물의 상대적 적합도 비교)

  • Lee, Wan-Sun;Park, Jong-Kyoung;Kim, Wook-Tae
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.1
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    • pp.16-22
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    • 2014
  • Purpose: The purpose of this study was to assess the marginal and mesial fitness of zirconia single copings and 3-unit fixed partial dentures (FPDs) manufactured with an identical model. Materials and Methods: An epoxy model in which the maxillary right 2nd premolar is lost and maxillary 1st premolar and 2nd molar are formed as abutments was manufactured and scanned by using a laser scanner. A ten units of zirconia single copings were manufactured for maxillary 1st premolar and 2nd molar, respectively and the same number of 3-unit FPDs were manufactured. For the measurements of fitness, the manufactured silicone replicas were divided into four parts and the fitness were measured by digital microscope at measurement points (P1, P2, P3, P4 and P5) of each plane. The measured gaps were classified into three categories: marginal gap (MG, P1), axial gap (AG, average of P2 and P3), occlusal gap (OG, average of P4 and P5). Results: The ranges of MG, AG and OG for single copings were 18.47 - 40.54 ${\mu}m$, 39.73 - 73.61 ${\mu}m$ and 116.90 - 134.69 ${\mu}m$, respectively. The ranges of MG, AG and OG for 3-unit FPDs were 45.95 - 87.44 ${\mu}m$, 23.78 - 57.00 ${\mu}m$ and 99.89 - 131.06 ${\mu}m$, respectively. Conclusion: The result of the study shows that the MGs for 3-unit FPDs were higher than those of single copings, though they are within the range of clinical acceptance, indicating that the use of more homogeneous zirconia block and modification of sintering processes are needed to ensure the prevention of increase of gap in 3-unit FPDs.

Retention of CAD/CAM Metal Copings Cemented on Short Titanium Abutments with Different Cements (짧은 티타늄 지대주에 합착된 CAD/CAM 금속 코핑의 시멘트 종류에 따른 유지력 비교)

  • Kim, Hyo-Jung;Song, Eun-Young;Yoon, Ji-Young;Lee, Si-Ho;Lee, Yong-Keun;Oh, Nam-Sik
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.2
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    • pp.119-126
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    • 2012
  • State of problem: Cement-retained implant-supported prostheses are routinely used in dentistry. The use of high strength cements has become more popular with the increasing confidence in the stability of the implant-abutment screw connection and the high survival rates of osseointegrated implants. No clinical data on retention of metal copings using CAD/CAM. To evaluate retention of metal copings using CAD/CAM system bonded to short titanium abutment with four different cements and compare retentive strength of metal copings with sandblasting or without sandblasting before cementation. Forty titanium abutment blocks were fabricated and divided into 4 groups of 10 samples each. Forty metal copings with occlusal hole to allow for retention testing were fabricated using CAD/CAM technology. The four cements were Fujicem(Fuji, Japan), Maxcem Elite(Kerr, USA), Panavia F2.0(Kurarary, Japan) and Superbond C&B(Sunmedical, Japan). The copings were cemented on the titanium abutment according to manufacture's recommendation. All samples were stored for 24h at 37oC in 100% humidity and tested for retention using universal testing machine(Instron) at a crosshead speed of 1.0mm/min. Force at retentive failure was recorded in Newton. The mode of failure was also recorded. Means and standard deviations of loads at failure were analyzed using ANOVA and Paired t-test. Statistical significance was set at P<0.05. Panavia F2.0 provided significantly higher retentive strength than Fujicem, Maxcem Elite(P<0.05). Sandblasting significantly increased bond strength(P<0.05). The mode of failure was cement remaining principally on metal copings. Within the limitation of this study, Panavia F2.0 showed significantly stronger retentive strength than Fujicem, Maxcem Elite(p<0.05). The Ranking order of the cements to retain the copings was Panavia F2.0, Fujicem = Maxcem Elite. Sandblasting significantly increased bond strength(P<0.05). The retentive strength of metal copings on implant abutment were influenced by surface roughness and type of cements.

A Spectrophotometric Study on Color Differences between Various Light-Cured Composite Resins and Shade Guides (광중합형 복합레진과 shade guide의 색차에 관한 연구)

  • Lim, Kyung-Min;Lee, Min-Ho;Song, Kwang-Yeob
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.1
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    • pp.13-22
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    • 2009
  • The composite resin, due to its esthetic quality, is considered the material of choice for restoration of anterior teeth. To get a satisfactory result in the composite resin restorations, it is necessary to choose right shade. At present, most of the commercial composite resins are based on the Vita Lumin shade guides or shade guides that are provided by their company, but color differences among them might be expected even using the same shade in various materials. This study is to measure color differences between various light-cured composite resins and shade guides and to provide the clinicians with information which may aid in improved color match of esthetic restoration. Four kinds of light-cured composite resins (Gradia Direct (GD), Z250 (Z250), Clearfil AP-X (AP-X), Esthet X (E X)) and shade guides with A2 and A3 shade were used. Three specimens of each material and one specimen of each shade guide were made. Each composite resin was filled into the Teflon mold (1.35 mm depth, 8 mm diameter), followed by compression, polymerization and polishing with wet sandpaper. Shade guides were grinded with polishing stones and rubber points to a thickness of approximately 1.35 mm. Color characteristics were performed with a spectrophotometer(color i5, GretagMacbeth, USA). A computer-controlled spectrophotometer was used to determine CIELAB coordinates ($L^*$, $a^*$, $b^*$) of each specimen and shade guide. The CIELAB measurements made it possible to evaluate the amount of the color difference values (${\Delta}E^*ab$) between composite resins and shade guides. CIE standard D65 was used as the light source. The results were as follows : 1. Among the $L^*$, $a^*$, $b^*$ values of most of 4 kinds of composite resin specimens which are produced by same shade, there were significant differences(p<0.05). 2. Among all 4 kinds of composite resin specimens which are produced by same shade, there were color differences that is perceptible to human eye(${\Delta}E^*>3.3$). 3. Between most of composite resin specimens investigated and their corresponding shade guides, there were color differences that is perceptible to human eye(${\Delta}E^*>3.3$). 4. In the clinical environment, it is recommended that custom shade guides be made from resin material itself for better color matching. Shade guides supplied by manufacturers or Vita Lumin shade guide may not provide clinicians a accurate standard in matching color of composite resins, and there are perceptible color differences in most of products. Therefore, it is recommended that custom shade guides be made from resin material itself and used for better color matching.

The Effect of Temperature and Concentration of Setting Solution on the Rheological Properties of Injectable Calcium Phosphate (경화액의 농도와 온도가 인산칼슘시멘트의 유변학적 성질에 미치는 영향에 관한 연구)

  • Yoo, Hyun-Mi;Chang, Seok-Woo;Park, Dong-Sung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.1
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    • pp.73-82
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    • 2009
  • Injectable calcium phosphate cement (CPC) has been used as bone substitute successfully due to good biocompatibility and osteoconductivity. One of the important mechanical characteristics of CPC is flowablility, which can be evaluated by measuring rheological parameters. However, there have been few studies that measured rheological properties of CPC. The purpose of this study was to evaluate the effects of temperature and concentrations of 2 kinds of setting solutions, hydroxyprophyl methylcellulose (HPMC) and polyacrylic acid (PAA), on rheological properties of CPC. The CPC used was dicalcium phosphate dihydrate (DCPD). Rheological properties of CPC paste were measured using rheometer. The effect of concentrations of each solution (2% and 1% HPMC and 35% and 17.5% PAA) was evaluated. The effect of temperature ($25^{\circ}C$ and $37^{\circ}C$) on the rheological properties of CPC was also investigated. The statistical analysis was carried out with Mann-whitney test with Bonferronis collection. CPC with both setting solutions showed shear thinning behavior. Higher concentrations of setting solution (2% HPMC and 35% PAA) produced significantly higher viscosity than lower concentrations of setting solution (1% HPMC and 17.5% PAA). CPC with HPMC showed significantly higher viscosity at $37^{\circ}C$ that at $25^{\circ}C$. CPC with PAA showed lower viscosity at $37^{\circ}C$ than at $25^{\circ}C$, although the difference was not statistically significant. The results showed that CPC with HPMC or PAA solutions are pseudoplastic and the concentrations of setting solutions and temperature may have an effect on the rheological properties of CPC paste. These results showed that the flowability of injectable CPC could be improved by use of increasing frequency of oscillation. In clinical practice, the use of ultrasonic vibration would be helpful in application of injectable CPC. CPC with HPMC could be more easily applicated at $25^{\circ}C$ than $37^{\circ}C$. The use of lower concentrations of HPMC and PAA solution would be beneficial in terms of flowability.

Retrospective study on survival rate of 2158 osseointegrated implants placed in 770 patients in Sanbon dental hospital of Wonkwang University (원광대학교 산본치과병원에서 770명의 환자에 식립한 2158개의 골유착성 임플란트의 보철 전 초기 생존율에 관한 후향적 연구)

  • Seon, Hwa-Gyeong;Chee, Young-Deok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.4
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    • pp.278-288
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    • 2014
  • Purpose: The aim of the study was to evaluate preprosthetic initial survival rate and factors associated with survival of osseointegrated implants placed in edentulous area of maxilla and mandible and to suspect the possible causes leading to failure. Materials and Methods: A total of 2158 endosseous implants that had been inserted between 2004 through 2013 were placed in 770 patients. The clinical comparisons were performed to evaluate implant loss in relation to age and gender of patients, position, system, length and diameter of implant, and bone graft technique. Results: According to position, the survival rates were 98.23% in maxillary anterior site, 96.98% in maxillary posterior site, 97.85% in mandibular anterior site and 98.76% in mandibular posterior site (P < 0.05). According to diameter of implant, the survival rates were 100% under 3.0 mm, 97.09% between 3.0 to 3.5 mm, 98.19% between 3.5 to 4.0 mm and 98.29% between 4.0 to 4.5 mm but relatively lower survival rate was 75% in 5.0 mm-over (P < 0.05). The survival rates of implants were 89.51%, 98.28%, 98.34% and 99.27% in the group with isolated sinus graft, with isolated GBR, with sinus graft and GBR simultaneously and without bone graft, especially (P < 0.05). Conclusion: This study establishes a relationship between survival rate of implant and position, diameter of implant system and bone graft technique. In conclusion, there were low survival rates in maxillary posterior site, in dental implants with wide diameter of 5 mm-over, and in the group with isolated sinus graft.

Effects of Intracavitary Urokinase Instillation in Complicated Pleural Effusion (합병성 흉막 삼출에 대한 국소적 Urokinase 주입치료 효과에 관한 연구)

  • Sohn, Dong-Hyun;Yoon, Su-Mi;Kim, Chung-Mi;Park, Ik-Soo;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.3
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    • pp.357-364
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    • 2000
  • Background : Complicated exudative pleural fluid collections have traditionally been treated by either closed tube thoracostomy drainage or by open surgical drainage. Complete drainage is important in order to control pleural sepsis, restore pulmonary function, and entrapment. Recently intracavitary fibrinolytic therapy has been advocated as a method to facillitate drainage of complicated exudative pleural effusion and to allow enzymatic debridemant of the restrictive fibrinous sheets covering the pleural surface. The purpose of this study is to prospectively evaluate the effects of image-guided catheter drainage with high dose urokinase(UK) instillation in the treatment of complicated pleural effusions. Patients : Twenty complicated pleural effusion patients that poorly respond to image-guided drainage were allocated to receive UK. There were 8 pneumonia and 12 tuberculosis. Methods : Drugs were diluted in 250 mL normal saline and were infused intrapleurally through the chest tube or pig-tail catheter in a daily dose of 250,000 IU of UK. Response was assessed by clinical outcome, fluid drainage, chest radiography, pleural ultrasound and/or computed tomography. Results : The mean UK instillation time was $1.63{\pm}0.10$. The mean volume drained UK instillation was $381.3{\pm}314.4\;mL$, and post-UK was $321.6{\pm}489.5\;mL$. The follow up duration after UK therapy was mean $212.9{\pm}194.5$ days. We had successful results in 19 cases (95.0%). There were 12 pleural thickenings (60.0%), 2 markedly decreased effusions (10.0%) and 5 cases of no thickening or effusion. There was recurrence after treatment in only one patient(5%) with complicated pleural effusiondue to tuberculosis. Conclusions : Image-guided drainage with high dose UK instillation (250,000 U/day) in complicated pleural effusion is a safe and more effective method than closed thoracostomy drainage. And this management, in turn, can obviate surgery in most cases.

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The Role of Open Lung Biopsy in Diagnosis and Treatment of Diffuse Interstitial Lung Disease in High-resolution Computed Tomography Era (고해상도 전산화단층촬영 시대에 있어서 미만성 간질성 폐질환의 진단 및 치료에서의 개흉폐생검의 역할)

  • Kim, Gye Su;Lee, Jae Chul;Lee, Seung Joon;Yoo, Chul-Gyu;Kim, Young Whan;Han, Sung Koo;Min, Kyung Up;Im, Jung-Gi;Kim, You Young;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.746-754
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    • 1996
  • Objective: Diffuse interstitial lung disease (DILD) is a group of diverse diseases that share conUTIon clinical, radiologic, and pulomonary function features. Open lung biopsy (OLB) has been regarded as gold standard in differential diagnosis of DILD. However open lung biopsy is a invasive diagnostic tool not free of its own risk or complications. These days, high-resolution computed tomography (HRCf) has become an important diagnostic tool in DILD through its precise image analysis. In many instances, HRCT could provide specific diagnosis or, at least, provide infonnation on the disease activity of DILD. The authors re-evaluate the role of open lung biopsy in this "HRCT era" by investigating the additional diagnostic gain and impacts on the treannent plan in patients who have undergone high-resolution CT. Method : Diagnoses obtained by high-resolution CT and open lung biopsy were compared and changes of treatment plans were evaluated retrospectively in 30 patients who had undergone open lung biopsy for the purpose of diagnosis of diffuse interstitial lung disease from March 1988 to June 1994. Results : High-resolution cr suggeted specific diagnoses in 22 out of 28 patients (78.6%) and the diagnoses were confinned (0 be correct by open lung biopy in 20 of those 22 cases (91%). Open lung biopsy could not give specific diagnosis in 5 out of 30 cases (16.7%). In 5 out of 6 cases (83.3%) in whom high reolution cr was not able to suggest specific diagnosis, open lung biopsy gave specific diagnoses. Treatment plan was altered by the result of open lWlg biopsy in only 2 cases. Conclusion: The aoove fmdings suggest that in "HRCT era", when HRCT could suggest specific diagnosis, the need for open lung biopsy should be re-evaluated.

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Importance of Carbon Monoxide Transfer Coefficient (KCO) Interpretation in Patients with Airflow Limitation (기류제한 환자의 일산화탄소확산능 해석에서 폐용적 보정의 의의)

  • Seo, Yong Woo;Choi, Won-Il;Lee, Jeong Eun;Park, Hun Pyo;Ko, Sung Min;Won, Kyoung Sook;Keum, Dong Yoon;Lee, Mi-Young;Jeon, Young June
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.374-379
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    • 2005
  • Background : The single-breath carbon monoxide diffusion capacity (DLCO) and the per unit alveolar volume (KCO; $D_LCO/VA$) gave discordant values when there was an abnormal alveolar volume (VA). However, the clinical significance of the discordant values in patients with airflow limitation has not been examined. This study investigated the $D_LCO$ and KCO changes after improving the airflow limitation. Methods : The baseline $D_LCO$ and KCO with lung volume were measured in patients with an airflow obstruction. The effective alveolar volume was measured using the single-breath $CH_4$ dilution method. The patients divided into two groups according to the baseline values: (1) increased KCO in comparison with the $D_LCO$ (high discordance) (2) decreased or not increased KCO in comparison with the $D_LCO$ (low discordance). The diffusion capacity and lung volume were measured after treatment. Results : There was no significant difference in the baseline lung volumes including the $FEV_1$ and FVC between the two groups. The $FEV_1$ and FVC were significantly increased in the high discordance group compared with the low discordance group after treating the airflow limitation. The $D_LCO$ and alveolar volume were significant higher in the high discordance group compared with the low discordance group while the TLC was not. Conclusion : The discordance between the $D_LCO$ and KCO could be translated into an airflow reversibility in patients with an airflow limitation.