Coronal microleakage of four temporary restorative materials in Class II-type endodontic access preparations

OBJECTIVES: The purpose of this study was to evaluate the microleakage of 4 temporary materials in teeth with Class II-type endodontic access preparations by using a glucose penetration model. MATERIALS AND METHODS: Glucose reaction test was performed to rule out the presence of any reaction between glucose and temporary material. Class II-type endodontic access preparations were made in extracted human premolars with a single root (n = 10). Each experimental group was restored with Caviton (GC), Spacer (Vericom), IRM (Dentsply-Caulk), or Fuji II(GC). Microleakage of four materials used as temporary restorative materials was evaluated by using a glucose penetration model. Data were analyzed by the one-way analysis of variance followed by a multiple-comparison Tukey test. The interface between materials and tooth were examined under a scanning electron microscope (SEM). RESULTS: There was no significant reaction between glucose and temporary materials used in this study. Microleakage was significantly lower for Caviton and Spacer than for Fuji II and IRM. SEM observation showed more intimate adaptation of tooth-restoration interfaces in Caviton and Spacer than in IRM and Fuji II. CONCLUSIONS: Compared to IRM and Fuji II, Caviton and Spacer can be considered better temporary sealing materials in Class II-type endodontic access cavities.

The Relationship of Homocysteine, Vitamin B12, Vitamin B6 and Folate with Ischemic Heart Disease

BACKGROUND AND OBJECTIVES: An elevated serum homocysteine level is a risk factor of atherosclerosis. The relationship between homocysteine and antioxidant vitamins, and other cardiovascular risk factors, and between cardiovascular patients and controls, were evaluated. SUBJECTS AND METHODS: The study population consisted of 146 patients, with objectively first diagnosed ischemic heart disease, and 146 healthy sex and age matched controls. The serum levels of homocysteine, folate, vitamin B12 and vitamin B6 were measured. The correlation between the serum levels of homocysteine and those of folate, vitamin B6 and vitamin B12 were also evaluated. RESULTS: The serum homocysteine concentrations were significantly higher in the cardiovascular patients than in the matched controls (13.35+/-0.51 mmol/l vs. 11.43+/-0.37 mmol/l, p=0.003). However, there was no significant difference between the stable angina, unstable angina and myocardial infarction subgroups. From a multivariate analysis, the elevated homocysteine level was still associated with a low folate level (patient group;r=-0.380, p=0.000, control group;r=-0.229, p=0.000). The measured vitamin B12 level showed no correlation with the homocysteine level in the cardiovascular patients, but did in the controls (R2=0.066, p<0.05). The measured levels of vitamin B6 showed no correlation with the homocysteine level in either group. CONCLUSION: The serum homocysteine level was inversely correlated with the serum folate level; therefore, folic acid supplementation would be expected to improve the endothelial function, and may also reduce cardiovascular events in patients with ischemic heart disease.

Sick Sinus Syndrome Associated with Head Trauma

Numerous central nervous system disorders can produce various electrocardiographic abnormalities due to vagal stimulation. These common abnormalities may include: QT prolongation, a large and inverted T wave and a prominent U wave etc. Sinus bradycardia and atrioventricular block have rarely been reported. We experienced a case of sick sinus syndrome, which was associated with a subarachnoid hemorrhage and subdural hematoma following a head trauma.

Primary Myxoid Liposarcoma Arising from Pericardium

Primary myxoid liposarcoma of the heart is very rare. Following is a report on a 35 year old male presented with a huge, 8x8 cm sized mass along the inferior wall of right ventricle. The histologic diagnosis of the mass was primary myxoid liposarcoma of the pericardium. The patient died 5 months after diagnosis due to progressive dyspnea.

A Case of Sinus of Valsalva Aneurysm Combined with Aortic Valve Aneurysm

Sinus of Valsalva aneurysm is postulated to arise from a developmental weakness in the distal bulbar septum by Abbott in 1919. Additionally, properly shaped sinuses will allow stress sharing with the leaflets. The sinus of Valsalva aneurysm is combined with valvular aneurysm is very rare. This anomaly is a very rare and can be confirmed by echocardiography, angiography and operative finding. Clinically, patients complain with the symptom, but surgical approach including aneurysmectomy with patch repain for the tissue defect is recommend to abolish fatal outcome due to intracardiac or extracardiac rupture of aneurysm and fatal deterioration of valvular heart disease. A 48-year-old man presented mild dyspnea and was diagnosed of having a noncoronary cusp and sinus of Valsalva aneurysm by echocardiography. He underwent prosthetic aortic valve replacement and vessel repair with patch of pericardial membrane.

Primary Gastrointestinal Lymphoma: A Comparison of Survival Rates between Gastric and Intestinal Non-Hodgkin's Lymphoma / 대한암학회지

PURPOSE: The purpose of this study was to evaluate the differences in survival rates between primary gastric and intestinal gastrointestinal non-Hodgkin's lymphoma (NHL) and to investigate risk factors for survival. MATERIALS AND METHODS: We reviewed survival rates and risk factors in 60 cases with stage I and II primary gastrointestinal lymphomas treated at Keimyung University Hospital between January 1972 and August 1999. RESULTS: No differences in sex, age, histology, stage, or percentage of curative resection were observed between primary gastric and intestinal lymphoma. The overall 10-year survival rates of gastric and intestinal NHL were 68.1% and 39.6%, respectively (p<0.05). The overall 10-year survival rates in stage I gastric and intestinal NHL were 66.7% and 70.0%, respectively, while those in stageII were 65.1% and 23.7%, respectively (p<0.001). A multivariate analysis of risk factors for survival revealed that the site of origin (5.68, CI=1.8-17.5) and stage (4.22, CI= 1.19-14.85) were significantly correlated with prognosis (p<0.05). There was no significant difference in the expression of bcl-2 and p53 between gastric and intestinal NHL. Furthermore bcl-2 and p53 expressions were not correlated with the prognosis. CONCLUSION: This study indicates that stage II primary intestinal lymphoma has lower survival rate than gastric lymphoma.

A case of bypass arthritis-dermatitis syndrome after bypass gastrojejunostomy / 대한내과학회지

Bypass surgery, as therapy for morbid obesity, was introduced in 1952. Multiple complications such as arthritis and dermatitis as well as liver dysfunction, renal injury, diarrhea, malnutrition and electrolyte imbalance were reported after bypass surgery. Recently, we have experienced a case of bypass arthritis-dermatitis syndrome in a patient after pyloric exclusion and bypass gastrojejunostomy due to traumatic duodenal perforation. He complained arthralgia of left knee, both wrist and both ankle and developed erythematous maculopapular rash over lower extremities. He was successfully treated with NSAIDs and clindamycin.

A Case of Multiple Myeloma with Multiple Plasmacytomas pesented as Upper Airway and Esophageal Obstruction / 대한혈액학회지

Herein, we report a case of multiple myeloma with multiple plasmacytomas of thyroid, lung, lymph nodes and adrenal gland, who presented as upper airway and esophageal obstruction with vocal cord palsy. An 80-year-old women complained of dysphagia, hoarseness and anterior neck mass. Ultrasonography of the neck showed huge inhomogeneous solid mass involving left thyroid lobe and isthmus with several lymphadenopathy along the both upper deep cervical chain. Chest CT scanning revealed 4x3 cm sized, low density mass in posterobasal segment of the right lower lobe with both lower paratracheal lymphadenopathy, and abdominal CT scanning revealed 4.5x4.5 cm sized round low density mass in left adrenal gland. Serum and urine electrophoresis was normal and immunofixation of serum and urine was negative. Bone marrow smear and a bone scintigram revealed no abnormality, but iliac bone marrow biopsy revealed infiltration of abnormal plasma cells. Histologic and immunohistochemical examinations of the thyroid and lung mass revealed monoclonal proliferation of plasma cells of kappa light chain. After local irradiation of the neck with parenteral dexamethasone injection, anterior neck mass was much diminished in size, but 2 weeks later she had a pneumonia with fatal outcome.

A Case of Pernicious Anemia and Myasthenia Gravis after Thymectomy and Irradiation of an Invasive Thymoma / 대한내과학회지

Herein we wish to report a case of pernicious anemia and myasthenia gravis occurred after treatment with removal of an invasive thymoma and irradiation. Nine years ago, the male patient was visited due to chest pain, and was found a mediastinal mass at his age of 55. He received open thoracotomy and was found stage III invasive thymoma which infiltrated phrenic nerve and pericardium. After removal of thymoma, he received 4,500cGy of radiation. Two years later, he complained of left eyelid drooping and diagnosed as myasthenia gravis with tensilon test. His myasthenic eye symptom was controled with Mestinon. After 9 years from thymectomy, he complained of dizziness and dyspnea on exertion. Bone marrow smear revealed megaloblastic anemia and serum vitamin B12 level was 42.24pg/ml. Gastric juice analysis revealed achlorhydria with positive anti-intrinsic factor antibody. 6 weeks after treatment with parenteral vitamin B12, hematologic findings were normalized.

Solitary Plasmacytoma of Iliac Bone Rapidly Progressed to Multiple Myeloma / 대한내과학회지

Solitary osseous plasmacytoma accounts for 3-5% of plasma cell tumor and are assumed to have a fairly good prognosis, with long duration of relapse free survival after local irradiation. A 64 year old woman with a lytic lesion involving left iliac bone was diagnosed as a solitary plasmacytoma, with a negative work-up for coexisting plasma cell disorders. Three months after irradiation of 5,400 cGy, the patient was readmitted with hypercalcemia and mass in left forehead and left gingiva. New multiple osteolytic lesions were developed. A aspiration cytology of forehead mass and curetted specimen of right femur due to pathologic fracture revealed plasmacytoma. MRI of thoracolumbar spine revealed abnormal high signal intensity in the L2 body, T8 and T9 vertebrae. Serum protein electropheresis revealed monoclonal gammopathy of IgG-kappa type. This aggressive case of solitary plasmacytoma, evolving into multiple myeloma after brief duration of remission, is in sharp contrast with the natural course of a solitary plasmacytoma.