Temperature change and performance of bur efficiency for two different drill combinations / 대한치과보철학회지

Purpose@#. The purpose of this study was to evaluate the performance efficiency of two different drill combinations according to the heat generated and drilling time. @*Materials and methods@#. In this study, cow ribs were used as research materials. To test the specimen, cow bones were rid of fascia and muscles, and a temperature sensor was mounted around the drilling area. The experimental group was divided into a group using a guide drill and a group using a Lindmann drill according to the drill used before the initial drilling. The drilling sequence of the guide drilling group is as follows; guide drill (ø 2.25), initial drill (ø 2.25), twist drill (ø 2.80), and twist drill (ø 3.20). The drilling sequence of the Lindmann drilling group is as follows; Lindmann drill (ø 2.10), initial drill (ø 2.25), twist drill (ø 2.80), and twist drill (ø 3.20). The temperature was measured after drilling. For statistical analysis, the difference between the groups was analyzed using the Mann-Whitney U test and the Friedman test was used (α = .05). @*Results@#. The average performance efficiency for each specimen of guide drilling group ranged from 0.3861 to 1.1385 mm3/s and that of Lindmann drilling group ranged from 0.1700 to 0.4199 mm3/s. The two drill combinations contained a guide drill and Lindmann drill as their first drills. The combination using the guide drill demonstrated excellent performance efficiency when calculated using the drilling time (P < .001). @*Conclusion@#. Since the guide drill group showed better performance efficiency than the Lindmann drill group, the use of the guide drill was more suitable for the primary drilling process.

Clinical Features and Risk Factors for Severe Complications among Patients with Acute Hepatitis A Virus Infection in The Jeonbuk Province of Korea / 대한소화기학회지

BACKGROUND/AIMS: The frequency of symptomatic acute HAV infections in adulthood are increasing in Korea. This study analyzes the clinical severity in patients with acute HAV infection and investigates risk factors associated with three severe complications: prolonged cholestasis, acute kidney injury, and acute liver failure. METHODS: We performed a retrospective analysis of 726 patients diagnosed from January 2006 to December 2010 at three tertiary hospitals in Jeonbuk Province, Republic of Korea with acute HAV infection. RESULTS: In the group of 726 patients, the mean age was 30.3 years, 426 (58.6%) were male, and 34 (4.7%) were HBsAg positive. Severe complications from acute HAV infection occurred as follows: prolonged cholestasis in 33 (4.6%), acute kidney injury in 17 (2.3%), and acute liver failure in 16 (2.2%). Through multivariate analysis, age > or =40 years (OR 2.63, p=0.024) and peak PT (INR) > or =1.5 (OR 5.81, p=0.035) were found to be significant risk factors for prolonged cholestasis. Age > or =40 years (OR 5.24, p=0.002) and female gender (OR 3.11, p=0.036) were significant risk factors for acute kidney injury. Age > or =40 years (OR 6.91, p=0.002), HBsAg positivity (OR 5.02, p=0.049), and peak total bilirubin (OR 1.11, p=0.001) were significant risk factors for acute liver failure. CONCLUSIONS: Age > or =40 years, female gender, HBsAg positivity, peak PT (INR) > or =1.5, and peak total bilirubin were significant risk factors for severe complications in acute HAV infections.

A Case of Colonic Adenocarcinoma in a Patient with Wilson's Disease

Wilson's disease (WD) is an autosomal recessive inherited disorder of copper metabolism that results in the accumulation of copper in the body and primarily in the liver, brain, and cornea. Copper is a toxic metal and might be associated with cancer induction. Most malignancies associated with WD are hepatocellular carcinoma and cholangiocarcinoma. Other intra-abdominal malignancies have been only rarely reported. To our knowledge, this is the first report to suggest that patients with WD may be vulnerable to a malignant change in the colonic mucosa during long-term copper chelating therapy. We report a case of colonic adenocarcinoma in a patient with WD and review the related literature.

Reconstruction of Lower Extremity Soft Tissue Defect using Cross-leg Free Flap

PURPOSE: To reconstruct soft tissue defect on lower extremity especially combined with osteomyelitis, free flap with enough blood supplies is required. There are some instance when patients have inadequate recipient vessels for microanastomosis. Anastomosis with harvested vein graft can solve the problem. It may be more problematic or even increase recipient site complication. Cross leg free flaps using contra-lateral vessel can be a solution. METHODS: From 2005 to 2008, 12 cases of cross leg free flap were done for 12 patients(9 male, 3 female). External fixators used in all cases. The free flaps used were laissmus dorsi muscle flap(n=5), anterolateral thigh flap(n=4), gracilis muscle flap(n=2) and medial plantar artery fasciotaneous flap(n=1). In all cases, contralateral posterior tibial artery and vein were used as recipient pedicle. RESULTS: All flaps survived without additional operative procedures. There happened no complications such as hematoma or Infection. Sometimes patients needed further therapeutic exercise for fast movement recovery. CONCLUSION: Although cross leg free flaps require long period of bed resting and rehabilitation after pedicle cutting, It can be a practical alternative for soft tissue defect on lower distal extremity with inadequate recipient vessels for free flap on affected leg.

Apoptotic Effect of Radiocontrast Media on Human Umbilical Vein Endothelial Cells

The damage of vascular endothelial cells leads to the progression of vascular disease. Apoptotic damage of endothelial cells is an important mechanism in vascular disease. Recently, it has been reported that radiocontrast can induce vascular endothelial cell injury. The present study used terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) and FACScan analysis to examine whether radiocontrast agenst, such as iopromide, sodium-meglumine-ioxithalamate or gadopentetate dimeglumine, induce apoptotic injury in human umbilical vein endothelial cells. In the study, iopromide, sodium-meglumine-ioxithalamate and gadopentetate dimeglumine brought about human umbilical vein endothelial cell death in phase-contrast microscopic findings. According to TUNEL and FACScan analysis, iopromide and sodium-meglumine- ioxithalamate induced apoptosis in vascular endothelial cells in a dose-dependent. The apoptotic effect of sodium-meglumine-ioxithalamate was shown to be greater than that of iopromide. Gadopentetate dimeglumine also induced apoptosis in human umbilical vein endothelial cells as observed by TUNEL and FACScan analysis. These results suggest that iopromide, which is a non-ionic radiocontrast agent, proved to be less apoptotic than sodium-meglumine-ioxithalamate. Gadopentetate dimeglumine, which is used MRI, has an apoptotic effect in vascular endothelial cells. Thus, apoptosis of endothelial cells by radiocontrast agents might induce deleterious effects on vascular endothelial integrity.