Journal of Dental Rehabilitation and Applied Science
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v.18
no.3
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pp.145-155
/
2002
The results of the present feasibility study are summarized as follows, 1. The three unit bridge of knitted material and UD fibre reinforcement has both the rigidity and the strength against a vertical occlusal load of 75N. 2. Stress concentration at the junctional area between the bridge and the abutments, i.e. between the pontic and the knitted caps was observed. In the case of the bridge with reinforcement straps, it was partly shown that the concentration problem could be improved by simply increasing the fillet size at the area. Further refining in the surface of the junctional area will be needed to ensure a further improvement in the stress distribution. This will require some trade off in the level of the stress and the available space. A parametric study will help to decide the appropriate size of the fillet. 3. Design refinement is a must to improve the stress distribution and realize the most favourable shape in terms of fabrication. The current straight bar with a constant cross section area can be redesigned to a tapered shape. The curve from the dental arch should also be placed on the pontic design. In accordance with design refinement, the resistance of the bridge frame to other load cases should be evaluated. 4. Although not included in the present feasibility study, it is estimated that bridges of the anterior teeth can be made strong enough with the knitted material without further reinforcement using unidirectional materials. In this regard, a feasibility study on design concepts and stress analysis for 3, 4, 5 unit bridge is suggested. 5. Two types of bridge were analysed in terms of fatigue. The safe life design concept, i.e. fatigue design concept, looks reasonable for the bridge where if cracks should form and propagate there is virtually nothing a dentist to do. The bridge must be designed so that no crack will be initiated during the life span. In the case of crowns, however, if constructed with composite resin with knitted materials, it might be possible to repair them, which in general is impossible for crowns of PFM or of metal. Therefore for composite resin crowns, a damage tolerance design concept can be applied and reasonably higher operational stresses can be allowed. In this case, of course, a periodic inspection program should be established in parallel. 6. Parts of future works in terms of structural viewpoint which need to be addressed are summarized as the following: 1) To develop processing technology to accommodate design concepts; 2) More realistic modelling of the bridge and analysis-geometry and loading condition. Thickness variation in the knitted material, taper in the pontic, design for anterior tooth bridge, the effect of combined loads, etc, will need to be included; 3) To develop appropriate design concepts and design goals for the fibre composite FPD aiming at taking the best advantage of knitted materials, including the damage tolerance design concept; 4) To develop testing method and perform test such as static ultimate load test, fatigue test, repair test, etc, as necessary.
A 10-year-old, castrated poodle dog presented with a cough for 2 weeks, and the cough initially developed since very young age. On radiographs, pneumothorax was noticed by characteristics of radiolucent area without pulmonary markings along the thoracic wall and diaphragm, retracted lung lobes from the thoracic wall and severely decreased volume of the left cranial lung lobe with disconnected bronchus. Computed tomography (CT) findings identified several pulmonary air-filled cysts and collapsed lung with abnormal shape and non-tapered end of bronchus, bronchioles at the accessory lobe and left cranial lobe. Also, pneumothorax, pneumomediastinum and subcutaneous emphysema were found. Imaging diagnosis was the spontaneous pneumothorax caused by ruptured emphysematous bullae associated with congenital bronchial cartilage abnormality or bronchial tree malformation. On surgery, hypoplasia of the left cranial lobe, right middle lobe, and accessory lobe with a bulla where air was leaking was identified. The accessory lobe was partially resected and bronchial cartilage hypoplasia was confirmed by histopathologic examination.
Kim, Kyung-Hwan;Moon, In-Sung;Park, Jang-Sang;Koh, Yong-Bok;Ahn, Hyuk
Journal of Chest Surgery
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v.35
no.4
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pp.267-273
/
2002
Background: We performed a phase IV clinical trial to examine the usefulness of a continuous infusion of nicardipine hydrochloride to control hypertension in patients with acute aortic dissection. material and Method: Systolic/diastolic blood pressure, and heart rate were monitored before and after the intravenous administration of nicardipine in 31 patients with aortic diseases. The period of nicardipine administration in each patient was from 3 to 14 days. Efficacy was evaluated by determining the average amount of blood pressure reduction on the 3rd day of drug administration. The dosage of another antihypertensive agent was slowly tapered down, and ultimately replaced by the test drug. Result: 28 patients were diagnosed as acute aortic dissection, 2 patients as rupture of the aortic arch aneurysm, and 1 patient as traumatic aortic rupture. Mean age was 53.9 $\pm$ 14.9(29~89) years, and 21 patients(67.7%) were male. 14 patients(32.3%) had complications associated with underlying aortic disease: aortic insufficiency in 7, hemopericardium in 6, acute renal failure in 1, paraplegia in 1, lower extremity ischemia in 1, and hemothorax in 1. The time needed to reach the target blood pressure was within 15 minutes in 16, from 15 to 30 minutes in 10, from 30 to 45 minutes in 3 and from 45 to 60 minutes in 2, and their baseline average systolic, diastolic, and mean arterial blood pressures(mmHg) were 147$\pm$23, 82.3$\pm$ 18.6, and 104 $\pm$ 18, respectively. Average systolic, diastolic, and mean arterial blood pressures(mmHg) on the third day of nicardipine infusion were 119$\pm$ 12, 69$\pm$9, and 86$\pm$8, and they all showed statistically significant decrease(p<0.05). The average systolic, diastolic, and mean arterial blood pressure(mmHg) after the discontinuation of the nicardipine infusion were 119 $\pm$ 15, 71 $\pm$ 14, and 86$\pm$ 13, respectively. No significant difference was observed between the average pressures measured on the third day and those measured after the discontinuation of the nicardipine infusion, and no definite side effects were observed during the study period. Conclusion: Nicardipine hydrochloride was both effective and safe at controlling blood pressure in patients with acute aortic dissection.
Purpose: The purpose of this study was to compare the stress distribution characteristics of four different abutment connections on SS-$III^{(R)}$ fixture under occlusal loading, using 3-dimensional finite element method. Materials and methods: The fixture of SS-$III^{(R)}$ (Osstem, Korea) with 4 mm diameter and 11.5 mm length and 4 types of abutments were analyzed; Solid, Com-Octa, ComOcta Gold, and Octa abutment. The models were placed in the area of first molar in the mandible. The 4 loading conditions were; (1) the vertical loading of 100 N on the central fossa, (2) the vertical loading of 100 N on the buccal cusp, (3) the $30^{\circ}$ inclined loading of 100 N to lingual side on the central fossa, and (4) the $30^{\circ}$ inclined loading of 100 N to the lingual side on the buccal cusp. The 3G.Author program was used, the von-Mises stress was calculated and the stress contours were plotted on each part of the implant systems and the surrounding bone structures. Results: Regardless of abutment types and loading conditions, higher stress concentration was observed at the cortical bone. In cancellous bone, the highest stress was observed at apical portion and the maximum stress occurred at the implant neck. The higher internal stress was observed in the fixtures than in the bone. The lowest stress was observed at loading condition 1 and the stress concentration was also lower than any other loading conditions. Conclusion: Within the limitation of the result of this study, it seems that the abutment connection type does not affect much on the stress distribution of bone structure.
Hong Ihn Hee;Ko Cheol Woo;Koo Ja Hoon;Kim Ji-Hong;Kim Pyung-Kil;Cho Byoung Soo
Childhood Kidney Diseases
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v.3
no.1
/
pp.48-56
/
1999
Purpose : This multicenter collaboratory study was conducted to see the therapeutic efficacy and side effect of cyclosporine A (Cipol-$N^{(R)}$, Chong Kun Dang) on children with idiopathic nephrotic syndrome who experienced frequently relapsing (FR), steroid dependent (SD), or steroid resistant (SR) pattern. Patients and methods : Thirty-nine children with SD/FR NS and 3 children with SR NS were enrolled in the study. After induction of remission (SD/FR NS) with steroid or after 4 weeks of steroid therapy (SR NS), cyclosporine A was started in a dose of 4-5 mg/Kg/day in two divided dose and steroid (prednisolone or equivalent dose of deflazacort) was tapered slowly. During 16 weeks of study period, monthly check up of physical examination and various laboratory tests including BUN, creatinine, Ccr and cyclosporine blood level were done. Results : Out of 39 children with SD/FR NS, 35($89.7\%$) maintained sustained remission and at 4 weeks after therapy, values of serum protein, albumin, cholesterol, and 24 hours urinary protein excretion showed normal values. Two out of 3 children with SR NS showed and sustained remission with cyclosporine A therapy. Side reaction to cyclosporine A therapy showed hypertrichosis in 8 cases and hyperuricemia in 5 cases. However, other laboratory tests including CBC, liver profile, BUN, creatinine and GFR (creatinine clearance utilizing 24 hour urine) did not show any abnormalities during the 16 weeks of study period. Conclusion : Cyclosporine A (Cipoi-$N^{(R)}$ Chong Kun Dang) can be utilized quite effectively on children with SD/FR or SR NS and further trial of cyclosporine A on long-term basis (1-2 year period) is needed to determine it's efficacy and side effect (especially nephrotoxicity) of long-term administration of cyclosporine A.
Purpose : The aim of this study was to evaluate whether the incidence of relapse or nephritis might be influenced by the duration of corticosteroid therapy in children with Henoch-Schonlein purpura(HSP). Methods : We retrospectively analyzed 186 children with a diagnosis of HSP in two major hospitals in Ilsan, Korea from the years 2000 to 2003. To evaluate whether renal involvement or relapse might be influenced by the duration of corticosteroid therapy in children with HSP, one pediatric nephrologist from hospital A, maintained corticosteroid therapy for at least 2 weeks(Group A, n=94). The other from hospital B used only during the symptomatic period(Group B, n=92). Results : There were no significant differences in age, sex, body weight, white blood cell count, hemoglobin, hematocrit, platelet count, serum protein and albumin levels between the two groups. The incidence of abdominal pain or arthralgia also did not differ between two groups. However, the duration of steroid therapy was significantly longer in Group A than in Group B and the cumulative dose of prednisolone was also higher in Group A than in Group B. The development of nephritis was more frequent in Group A. Conclusion : The longer duration of steroid use was not associated with the decreased rate of nephritis. Therefore, corticosteroids should be used carefully in a selected group of HSP children, and be tapered rapidly after control of the acute symptoms.
Journal of Dental Rehabilitation and Applied Science
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v.26
no.2
/
pp.121-143
/
2010
To investigate the effect of implant types and bone resorption on the fracture characteristics. 4 types of Osstem$^{(R)}$Implant were chosen and classified into external parallel, internal parallel, external taper, internal taper groups. Finite elements analysis was conducted with ANSYS Multi Physics software. Fatigue fracture test was performed by connecting the mold to the dynamic load fatigue testing machine with maximum load of 600N and minimum load of 60N. The entire fatigue test was performed with frequency of 14Hz and fractured specimens were observed with Hitachi S-3000 H scanning electron microscope. The results were as follows: 1. In the fatigue test of 2 mm exposed implants group, Tapered type and external connected type had higher fatigue life. 2. In the fatigue test of 4 mm exposed implants group, Parallel type and external connected types had higher fatigue life. 3. The fracture patterns of all 4 mm exposed implant system appeared transversely near the dead space of the fixture. With a exposing level of 2 mm, all internally connected implant systems were fractured transversely at the platform of fixture facing the abutment. but externally connected ones were fractured at the fillet of abutment body and hexa of fixture or near the dead space of the fixture. 4. Many fatigue striations were observed near the crack initiation and propagation sites. The cleavage with facet or dimple fractures appeared at the final fracture sites. 5. Effective stress of buccal site with compressive stress is higher than that of lingual site with tensile stress, and effective stress acting on the fixture is higher than that of the abutment screw. Also, maximum effective stress acting on the parallel type fixtures is higher. It is careful to use the internal type implant system in posterior area.
Background: The routine application of the combined regimen of corticosteroid-antituberculosis therapy to the tuberculous pleurisy remains controversial. Steroid therapy to tuberculous pleurisy could be effective on the acceleration of absorption of pleural effusion and symptom improvement, but there has been debate about the effect of prednisolone on the prevention of pleural adhesion. So we studied the efficacy of combined regimen of prednisolone-antituberculosis therapy on the absorption of pleural effusion and prevention of pleural adhesion. Method: A prospective, randomized study was performed in 82 patients, 50 patients(non-steroid group) were treated with only antituberculosis regimen for 6 months and in 32 patients(steroid group) prednisolone(30mg/day) were administered in addition to antituberculosis regimen for one months and tapered for another month. The amount of pleural effusion was compared at the beginning of treatment, 2nd month, 6th month and final visit with chest X-ray findings which were graded from grade 0(complete absorption) to grade 6(near total haziness). Results: The amount of pleural effusion of steroid group at 2nd month, 6th month and final visit was lesser than that of non-steroid group(P<0.05). The incidence of the complete absorption of the pleural effusion was 3/32(9.4%) in steroid group, 1/50(2%) in non-steroid group at 2nd month after treatment; and 12/32(37.5%) in steroid group, 6/50(12%) in non-steroid group at 6th month after treatment(P<0.05). At final observation, the incidence of residual pleural thickening was 15/32(47%) in steroid group and 37/50(74%) in non-steroid group(P<0.05). No serious side effects were noted during the treatment with prednisolone. Conclusion: The administration of prednisolone in conjunction with antituberculosis chemotherapy improved the absorption of pleural effusion and decreased the residual pleural thickening.
Kim, Jung-Won;Park, Jeong-Kil;Hur, Bock;Kim, Hyeon-Cheol
Restorative Dentistry and Endodontics
/
v.32
no.6
/
pp.530-541
/
2007
Currently, various Nickel-Titanium rotary files are used in endodontic treatment, but there is no one perfect system that can be applied to any clinical situation. Therefore, the combined uses of various file systems which can emphasize the advantages of each system are introduced as hybrid instrumentation. The ProTaper system is efficient in body shaping and apical pre-enlargement but is reported to have more possibility of transportation and produce more aberrations and deformation in more or less severe curved canals. Recently, new ProTaper system(ProTaper Universal) with different configuration and cross-sectional design to overcome the week points of ProTaper have been marketed. The purpose of this study was to compare and evaluate the shaping abilities of ProTaper, ProTaper Universal system, and two hybrid methods using S-series of ProTaper Universal and Hero Shaper or ProFile. The time lapses for instrumentation were measured and the used files were inspected for distortion. The pre- and post-instrumented root canals were scanned and superimposed to evaluate the aberrations and reduction of root canal curvature and change of radius of canal curvature. The increased canal width and apical centering ratio were calculated at 1, 2, 3, 4 and 5 mm levels from apical foramen. Under the conditions of this study, the ProTaper Universal seems to have better shaping ability than ProTaper in terms of instrumented width and instrumentation time. It may be suggested that the ProTaper Universal system is efficient as much as hybrid instrumentation using ProTaper and other constant-tapered NiTi file systems in highly experienced operators.
The purpose of this study was to compare the apical leakage of the root canal filled with the System B and the EndoTwinn(the combined application of heat and ultrasonic vibration). Sixty extracted premolars with straight root were cleaned and shaped to size 35. Group SB was obturated using System B and Group ET was filled with EndoTwinn. A size 35 of 0.06 tapered gutta-percha and Adseal were used and the plugger which could be introduced to 4 mm short of working length was selected in the obturation procedure. As the positive control, Group PC was not filled. In Group SB, ET and PC, all external surfaces of each tooth were coated with nail varnish leaving only 1 mm area around the apical foramen. In the negative control of Group NSB and Group NET, all of external tooth surface including apical foramen was coated with the nail varnish. The specimens were immersed in methylene blue dye solution for 2 days. Then the specimens were sectioned at each 1 mm from apex to 5 mm level. The final score of one specimen was given by summing up of the points at all levels. The dye leakage of Group ET was significantly less than that observed in Group SB (p < 0.05). And the frequency of gutta-percha pulling out from root canal when the plugger was removed was more often with the System B than with EndoTwinn but there was no significant difference.
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