ABSTRACT
STATEMENT OF PROBLEM: It is difficult to obtain a good titanium casting body using the traditional sprue design because of high melting point of Ti, and the low fluidity and high reactivity of molten Ti. PURPOSE: A new sprue design for titanium casting bodies needs more trial and error. In order to decrease the number of trial and error, computer simulation(MAGMASOFT, Magmasoft Giessereitechnologie GmbH, Achen, Germany) was used to optimize sprue design in U-shaped implant superstructures. MATERIAL AND METHOD: Five kinds of sprue were examined for the design of the sprue former for titanium casting: Sprue design A(sprue length 4 mm, rectangular shape, 4 sprues), Sprue design B(sprue length 4 mm, round shape, radius 2 mm, 7 sprues), Sprue design C (sprue length 2 mm, round shape, radius 2 mm, 7 sprues), Sprue design D (sprue length 2 mm, cone shape, large radius 3mm, small radius 2mm, 7 sprues), and Sprue design E( sprue length 2 mm, one unit channel shape). Sprue design F(sprue length 2mm, one unit channel hape) was also examined for the design of the customized sprue former in the Biotan system(Schutz Dental Gmbh, Germany). The casting bodies were taken in Sprue design A, Sprue design D, Sprue design E, and Sprue design F in the Biotan casting system. The numerically predicted defects were compared with the experimental dental castings by the radiographic and sectional view observations. RESULTS: 1. According to the result of computer simulation, turbulence during mold filling was decreased in the sequence of Sprue design F, Sprue design E, Sprue design D, Sprue design C, Sprue design B, and Sprue design A. 2. The calculated solidification time contours indicate that hot spot was moved from the casting body to the sprue button in the sequence of Sprue design A, Sprue design B, Sprue design C, Sprue design D, and Sprue design E. The filling pattern of Sprue design F was similar to that of Sprue design E. 3. The predicted filling pattern shows that less turbulence was found in the customized sprue former than in the standard sprue former. 4. According to the results of the radiographic and cross sectional observations, casting defects less than 1mm were found at the center of a casting body with Sprue design E and Sprue design F. However, larger casting defects of 4mm were found in a casting with Sprue design A. 5. The predicted casting porosity was similar to that of the real casting. CONCLUSION: One unit channel-type and customized sprue former can be recommended. Further research and development of various sprue designs using computer simulation is necessary to optimize casting design, in order to reduce the formation of casting defects in implant titanium superstructures.
ABSTRACT
BACKGROUND: Symptoms of musculoskeletal system is a common problem, followed by those of respiratory system. Most patients with problems of musculoskeletal system are examined and treated by a primary doctor. This research was performed to inquire into a method which can increase the effectiveness and the precision of history taking in patients with problems of musculoskeletal system in primary care and also to assess a self-marking method where patients can mark their pain site on a normalized picture. METHODS: In the department of family medicine and rehabilitation of an university hospital in Seoul, 44 patients with musculoskeletal pain on their first visit in an outpatient clinic were asked to put marks on a normalized picture and also mark the degree of pain with a visual analog scale from 0 to 10, before history taking. After history taking, the doctor also marked the spot of the patient's pain on the normalized picture and then compared the spots together. After comparing the two pictures of the doctor's and the patients', they then drew another picture with only one spot to avoid overlapping spots. We compared the differences among the patients in every decade from ages 20 to 60 and divided the value of visual analog scale into 3 groups concerning the spots drawn by patients, and compared the relations between them. RESULTS: The pain spots drawn by doctor only were on the lumbar spine and the shoulder whereas most of pain spots drawn by patients only were on the upper back, the cervical spine, and the lumbar spine. The older the patient and the lower the degree of pain was, the more humerous it had spots. CONCLUSIONS: It is considered that with a general history taking method and a self-marking method, clinical effectiveness will be great to the patients having pain on the abdomen, the cervical spine, and the lumbar spine and to those who are elderly and with lower pain spots.
Subject(s)
Aged , Humans , Abdomen , Ambulatory Care Facilities , Musculoskeletal Pain , Musculoskeletal System , Outpatients , Primary Health Care , Rehabilitation , Respiratory System , Seoul , Shoulder , Spine , Visual Analog ScaleABSTRACT
The interstitial lung diseases(ILD) comprises a large, heterogeneous group of disorders characterized by derangement of alveolar walls and alveolar capillary unit causing restrictive pulmonary dysfunction and disordered gas exchange. It is rare, especially in children, and the opinions on investigation and treatments are controversial. The classification of adult ILD is applied to that of children. But considering occurrence during the developing state of lung and immune systems, we should be more cautious because the clinical manifestations and prognosis will be different from those of adults. In 1995, Katzenstein named a unique type of ILD, chronic pneumonitis of infancy (CPI) for the first time. CPI is characterized by marked alveolar septal thickening, striking type II pneumocyte hyperplasia, and eosinophilic alveolar exudate containing numerous macrophages. We report a 14 month-old girl, who had continuing respiratory difficulty and cyanosis after upper respiratory infection, could not sustain oxygen saturation and was finally diagnosed as CPI by histologic examination.
Subject(s)
Adult , Child , Female , Humans , Infant , Capillaries , Classification , Cyanosis , Eosinophils , Exudates and Transudates , Hyperplasia , Immune System , Lung , Lung Diseases, Interstitial , Macrophages , Oxygen , Alveolar Epithelial Cells , Pneumonia , Prognosis , Strikes, EmployeeABSTRACT
This disease predominantly affects infants and young children living in Japan and Taiwan, and manifests itself as acute encephalopathy following viral infections. The hallmark of this encephalopathy is multifocal, symmetric brain lesions affecting bilateral thalamus, brainstem tegmentum, cerebral periventricular white matter and cerebellar medulla, which can be visualized by computed tomography and magnetic resonance imaging. Both the gray and white matter are involved, with neuropathological evidence of local breakdown of the blood-brain barrier. The prognosis was poor in the 1980s, but has improved recently. A characteristic combination of focal neurologic signs is often recognized as the sequelae. We experienced a case of a 7-month-old male infant who had been transferred to our hospital for comatous mentality and clonic seizure of both arms and legs. We report this case with a review of the related literatures.
Subject(s)
Child , Humans , Infant , Male , Arm , Blood-Brain Barrier , Brain , Brain Stem , Japan , Leg , Magnetic Resonance Imaging , Neurologic Manifestations , Prognosis , Seizures , Taiwan , ThalamusABSTRACT
Branchio-oto-renal(BOR) syndrome is an autosomal dominant disorder. The pathophysiology of this syndrome is unknown. BOR syndrome has a wide range of clinical manifestations affecting the branchial, auditory and renal systerns. Associated abnormalities of the face, lacrimal duct, palate and ureters have also been described. However, the major clinical findings associated and/ or ear pits, and renal anormaly. We experienced a case of a 15-day-old rnale newborn who had visited our hospital for deformed auricle and atresia of external auditory canal found at birth. We report this case with a review of the related literatures.
Subject(s)
Humans , Infant, Newborn , Branchial Region , Branchio-Oto-Renal Syndrome , Ear , Ear Canal , Palate , Parturition , UreterABSTRACT
Pelizaeus-Merzbacher disease (PMD) is a rare sudanophilic leukodystrophy with a reduced number of mature oligodendrocytes as well as diffuse central nervous system hypomyelination (dysmyelination) due to abnormal synthesis of proteolipid protein. PMD is characterized with pendular nystagmus, stridor, delay in psychomotor development, hypotonia, ataxia, athetosis and extrapyramidal signs. Abnormal high signal intensity is shown in the entire white matter of cerebrum and cerebellum at early stage by T2-weighted magnetic resonance imaging (MRI). We report two cases of PMD diagnosed with characteristic clinical manifestations and brain MRI findings.
Subject(s)
Ataxia , Athetosis , Brain , Central Nervous System , Cerebellum , Cerebrum , Magnetic Resonance Imaging , Muscle Hypotonia , Nystagmus, Pathologic , Oligodendroglia , Pelizaeus-Merzbacher Disease , Respiratory SoundsABSTRACT
Ramsay Hunt Syndrome was initially described by Ramsay Hunt in 1907 as herpes zoster of the geniculate ganglion. The frequency of RHS in patients with herpes zoster has been calculated to be about 1%. RHS affects mostly adults; however a small number of children with herpes zoster oticus have been reported. We describe a case of RHS in a healthy 39/12-year-old boy. A complete peripheral facial palsy on the left side was noted as well as vesicles of herpes zoster type on the pinna of the same side. The analysis of sera confirmed the clinical diagnosis of RHS with a positive IgG-ELISA antibody titier. Treatment of acyclovir was tried for 7 days, starting 2 days after facial palsy was objerved. In addition, oral prednisolon, divided into two doses per day, was administered for 5 days and then tapered to zero over the following 10 days. Complete recovery observed after 1 month.
Subject(s)
Adult , Child , Humans , Male , Acyclovir , Diagnosis , Facial Paralysis , Geniculate Ganglion , Herpes Zoster , Herpes Zoster OticusABSTRACT
Enterobacter sakazakii previously known as a 'yellow-pigmented Enterobacter cloacae', was designated as a unique species in 1980. This reclassification was based on differences from E. cloacae in DNA relatedness, pigment production and biochemical reactions. In 1961, Urmenyi and Franklin reported the first two known cases of neonatal meningitis and septicemia caused by E. sakazakii, although at that time it was still considered as an E. cloacae strain. Since 1961, a number of cases of neonatal infection caused by E. sakazakii have been reported worldwide. Usually newborn with E. sakazakii meningitis have a poor prognosis, many of them dying within days of infection. The reported case-fatality rate vary from 40-80%. We diagnosed and experienced a case of epidural abscess caused by E. sakazakii in a 1 month old male patient, who was asymptomatic with brain mass detected on brain ultrasound examination. We presented this case with a brief review of literatures.
Subject(s)
Humans , Infant, Newborn , Male , Brain , Cloaca , Cronobacter sakazakii , DNA , Enterobacter , Epidural Abscess , Meningitis , Prognosis , Sepsis , UltrasonographyABSTRACT
Neonatal vocal cord paralysis is the second most common laryngeal anomaly, which accounts for approximately 10% of all congenital laryngeal lesions. Neonate with bilateral vocal cord paralysis are charactenzed with a glottic obstruction which usually shows dyspnea and inspiratory stridor. Treatment of bilateral vocal cord paralysis in neonate have two major goals : restore proper breathing and retain the voice. Tracheostomy is the best method for restoring breating in neonate. The prognosis of bilateral paralysis looks worse. Spontaneous recovery was seen in only half of the cases which usually occur in the idiopathic group and neurologic group. We experienced a case of bilateral vocal cord paralysis in a neonate who showed dyspnea, cyanosis and inspiratory stridor soon after birth. Diagnosis was confirmed by direct laryngoscopy and he was treated with tracheostomy.
Subject(s)
Humans , Infant, Newborn , Cyanosis , Diagnosis , Dyspnea , Laryngoscopy , Paralysis , Parturition , Prognosis , Respiration , Respiratory Sounds , Tracheostomy , Vocal Cord Paralysis , Vocal Cords , VoiceABSTRACT
Spinal epidural hematoma results from various causes such as use of anticoagulants, hemorrhagic diathesis, pregnancy, labor, arteriovenous malformation and spinal anesthesia as well as idiopathic orgin. We report a 3-year-old boy who was found to have spinal epidural hematoma and presented with lower back pain and fever. He developed paraplegia of lower legs after two consecutive lumbar punctures during two days. The lesion of spinal epidural hematoma was not found with lumbar spinal MRI but with cervico-thorasic one, because the lesion was at the C7-T6 level. Laminectomy was done to evacuate the hematoma and some specimen was obtained, of which pathologic finding was arteriovenous malformation. The boy is receiving physical therapy continuously due to unsatisfactory results with hematoma aspiration procedure and laminectomy treatment.
Subject(s)
Child, Preschool , Humans , Male , Pregnancy , Anesthesia, Spinal , Anticoagulants , Arteriovenous Malformations , Fever , Hematoma , Hematoma, Epidural, Spinal , Hemorrhagic Disorders , Laminectomy , Leg , Low Back Pain , Magnetic Resonance Imaging , Paraplegia , Spinal PunctureABSTRACT
Hypothalamic hamartoma is a congenital anomaly presenting precocious puberty, gelastic seizure and mental retardation. Other possible accompanying anomalies are cleft palate, tetralogy of Fallot, skeletal malformation and anal malformation. But the patient describing here manifested gelastic seizure only with isosignal mass of 1.5cm in diameter situated just behind optic chiasm in T1WI and T2WI of MRI. His EEG showed multifocal spike and sharp waves at left frontal and central area with asymmetric sleep spindles. The seizure has been refractory to conventional antiepileptic drugs. He is now on Lamotrigine, a newly developed antiepileptic drug available.
Subject(s)
Humans , Anticonvulsants , Arteriovenous Malformations , Cleft Palate , Electroencephalography , Hamartoma , Intellectual Disability , Magnetic Resonance Imaging , Optic Chiasm , Paraplegia , Puberty, Precocious , Seizures , Spine , Tetralogy of FallotABSTRACT
PURPOSE: This study was aimed at determining whether tri-iodinated compounds with greater solubility and low osmolality, Na or meglumine ioxaglate(Hexabrix 320, Guerbet Lab., France) had deleterious effects on renal function after cardiac angiography for the evaluation of congenital heart disease(CHD) and determining whether correction of dehydration using iv hydration given before cardiac angiography were effective in prventing renal dysfunction. METHODS: For the study of radiocontrast media induced nephrotoxicity, 21 children with various CHDs admitted to the hospital for the evaluation of their CHDs. None of them had any evidence of renal dysfunction before study. They were devided into 2 groups, one was low-dose group(ioxaglate given, < 2.0 mL/kg) and the other one was high-dose group(>2.0 mL/kg). Renal function studies including serum creatinine(Scr), fractional excretion of sodium(FENa) and urinary beta2-microglobulin excreton(mg of beta2- microglobulin per gm creatinine) were done before and after ioxaglate administration. For the study of hydration effect on radiocontrast media induced nephrotoxicity, 9 children with CHDs were subjected. Thery were hydated with 5% D/S 1 hr before cardiac angiography using high-dose ioxaglate(> 2.0 mL/kg) and maintained on fluid therapy during the examination. Renal function studies were done before and after ioxaglate administration. Statistical analyses were done using Wilcoxon signed rank test. RESULTS: 1) Scr level and FENa were not increased significantly after administration of ioxaglate in both of low-dose and high-dose group. 2) A significant increase of urinary beta2M per creatinine excretion(mg/gm creatinine) was observed after administration of ioxaglate n the high-dose group(0.24 vs 0.57, p0.05) 3) Hydration before ioxaglate administration made urinary B2M per creatinine excretion insignificant even in patients who received high-dose ioxaglate, more than 3.0 ml/kg(0.22 vs 0.27, p>0.55). 4) Uric acid and/or calcium oxalate crystaluria appeared after ioxaglate administration, particularly in patients with dehydration. CONCLUSIONS: Ioxaglate, a low osmolality ionic dimer contrast media, could induce renal tubular dysfunction, which depended on dose used. Correction of dehydration before ioxaglate administration significantly reduced the risk of ioxaglate induced nephrotoxicity.
Subject(s)
Child , Humans , Acute Kidney Injury , Angiography , Calcium Oxalate , Contrast Media , Creatinine , Dehydration , Fluid Therapy , Heart , Ioxaglic Acid , Meglumine , Osmolar Concentration , Solubility , Uric AcidABSTRACT
No abstract available.