The behavior and mechanism for erosion of glass-ionomer cements in organic-acid buffer solutions were studied as a function of time, pH, and citric-acid concentration. In acidic solutions, the dissolution of the cement was controlled by the diffusion of the eluted species in the cement matrix, which depended on H+ ion concentration. In citric-acid solutions, the dissolution of the cement was controlled by both the diffusion and the surface reaction between the acid anion and the eluted species. Contribution of the latter reaction was larger with the increase in the acid concentration.
In order to clarify the mechanism for erosion of glass-ionomer cements, we immersed two commercial luting cements in an acidic buffer solution under various conditions. The amounts of F, Al, Si, and Ca eluted from the cement were (1) in proportion to the square root of immersion time, (2) unrelated to shape or volume of the sample, (3) dependent on its surface area, and (4) not affected by shaking of the solution. It was concluded that the dissolution was controlled by the diffusion of those species in the cement matrix, which was influenced by the structure of the matrix and the concentration of H+ ion at the cement surface. The unreacted glass particles near the cement surface were dissolved by the long immersion, and many pores were left in the surface region.
To assess the usefulness of radionuclide tests in detecting coronary occlusive lesions in children with Kawasaki disease, we compared the results of stress thallium-201 myocardial single photon emission computed tomography with dipyridamole infusion and coronary angiography in 34 patients (19 males and 15 females). Perfusion defects on the stress image only were categorized as transient and were attributed to coronary vascular disease in the presence of redistribution on the delayed image. Others were classified as persistent, due to myocardial damage. Five of the seven children (71%) with severe stenosis on coronary angiography showed persistent and/or transient perfusion defects. However, six of the 11 children (55%) with aneurysms but no obvious stenosis, and four of the 16 children (25%) with normal angiography, showed persistent and/or transient defects. After analyzing 20 individual segments of perfusion defects in the 15 children, six segments (30%) were attributed to the stenosis of supplying coronary arteries, six segments (30%) were related to the coronary aneurysms, and eight segments (40%) were unrelated to any abnormalities on angiography. Thus, significant discordance between the radionuclide and angiographic studies was demonstrated. These results suggest that coronary lesions, as conventionally defined by angiography and supplemented by echocardiography, may not completely identify all Kawasaki patients who may develop myocardial ischemia in the future or who had ischemia in the past.
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