OBJECTIVE: Teeth discoloration is a rare orthodontic complication. The aim of this study was to report the clinical progression of discoloration during orthodontic treatment. METHODS: Discolored teeth, detected during orthodontic treatment between January 2003 and December 2012 by a single dentist using similar techniques and appliances, were analyzed. RESULTS: The total number of teeth that showed discoloration was 28. Progression of discoloration was evaluated in only 24 teeth that were observed without any treatment. During the observation period, the discoloration “improved” in 8 of the 24 teeth (33.3%) and was “maintained” in 16 (66.6%). The electric pulp test performed at the time of initial detection of discoloration showed 14.3% positivity, which improved to 21.4% at the final follow-up. None of the initial and final follow-up radiographic findings showed any abnormalities. CONCLUSIONS: When teeth discoloration is detected during orthodontic treatment, observation as an initial management is recommended over immediate treatments.
Dentists ; Esthetics ; Follow-Up Studies ; Humans ; Tooth*

Posterior Reversible Encephalopathy Syndrome(PRES) mainly develops in patients under immunosuppressive therapy after transplantation, or patients who suffer hemato-oncologic diseases, eclampsia, acute hypertensive encephalopathy related with nephrotic disease. Sudden headache, nausea, mental derangement, convulsion, vision problems are the main symptoms shown in PRES. It typically shows edema of occipito-parietal area of cortex or subcortex in Magnetic Resonance Imaging(MRI). A 10-year-old male was hospitalized with the chief complaint of headache, vomiting and dizziness for 3 days. He was treated for upper respiratory infection for 1 week before the hospitalization. Initial blood pressure was 145/95 mmHg, which was high for his age. Uninalysis showed microscopic hematuria(3+). The hypertension persisted even after the hospitalization, and re-checked blood pressure was 175/115 mmHg. The patient complained of headache, and after that, he suffered from alteration of mental status with dysarthria and generalized type of seizure events. The MRI showed lesions suggestive of PRES. He recovered to alertmental status after the blood pressure was controlled. Antistreptolysin-O(ASO) titer was increased and complement 3(C3) titer was decreased. The follow up MRI taken 1 month after the event became normal. We report a case of PRES related with contemporary hypertensive event in Acute Post-Streptococcal Glomerulonephritis(APSGN).
Blood Pressure ; Child ; Complement System Proteins ; Dizziness ; Dysarthria ; Eclampsia ; Edema ; Female ; Follow-Up Studies ; Glomerulonephritis ; Headache ; Hospitalization ; Humans ; Hypertension ; Hypertensive Encephalopathy ; Magnetic Resonance Spectroscopy ; Male ; Nausea ; Posterior Leukoencephalopathy Syndrome ; Pregnancy ; Seizures ; Transplants ; Vision, Ocular ; Vomiting

BACKGROUND AND OBJECTIVES: Assessment of left ventricle (LV) function by using strain and strain rate is popular in the clinical setting. However, the use of these echocardiographic tools in assessing right ventricle (RV) failure, and the manner in which they both reflect the functional capacity of the patient, remains poorly understood. This study aimed to investigate the change in exercise capacity and strain between before and (1 month) after the transcatheter closure of atrial septal defects (ASDs). SUBJECTS AND METHODS: Thirty patients who underwent transcatheter closure of ASD between May 2014 and June 2015 at the Division of Pediatric Cardiology, Severance Cardiovascular Hospital, were enrolled. We compared and analyzed the results of the following examinations, before and (1 month) after the procedure: echocardiography, cardiopulmonary exercise test (CPET), and N-terminal pro-brain natriuretic peptide level. RESULTS: There were no mortalities, and the male-to-female ratio was 1:2. The mean defect size was 22.3±4.9 mm; the mean Qp/Qs ratio, 2.1±0.5; and the mean device size, 22.3±4.9 mm. Changes in global RV longitudinal (GRVL) strain and LV torsion were measured echocardiographically. Exercise capacity improved from 7.7±1.2 to 8.7±1.8 metabolic equivalents (p=0.001). These findings correlated to the change in GRVL strain (p=0.03). CONCLUSION: The average exercise capacity increased after device closure of ASD. The change in strain was evident on echocardiography, especially for GRVL strain and LV torsion. Further studies comparing CPET and strain in various patients may show increased exercise capacity in patients with improved RV function.
Cardiology ; Echocardiography ; Exercise Test ; Heart Septal Defects, Atrial* ; Heart Ventricles ; Humans ; Metabolic Equivalent ; Mortality ; Natriuretic Peptide, Brain

PURPOSE:The purpose of this study was to determine the prevalence of asthma, allergic rhinitis, atopic dermatitis and allergic conjunctivitis among primary school pupils in Ilsan, Gyeonggi province. We also investigated change of symptoms after environmental control. METHODS:In April 2005, a cross-sectional study was performed among 2,745 1st to 6th graders of 3 primary schools in Ilsan, Gyeonggi province. International Study of Asthma and Allergies in Childhood (ISAAC) standardized questionnaires and additional questionnaires about environmental changes were distributed to their parents. RESULTS:Data were collected from 2,535 children (1,279 boys and 1,256 girls). The most common allergic symptom was rhinorrhea (43.0%), and atopic skin lesions, ocular lesions and wheezing were 24.5%, 19.7% and 18.2%, respectively. There was no significant relationship between allergic diseases and environmental status. One thousand four hundred nineteen children moved to a new place or had new interior decorations within the last 2 years. Of these children, 352 (24.8%) had allergic symptoms (OR=2.76, CI= 1.96-3.41, P=0.001). Interestingly, we found that children who had moved into apartments experienced more symptom changes than those who had not (P=0.022). CONCLUSION:The results of this study demonstrated that the prevalence of allergic conditions in primary school children in Ilsan, Gyeonggi province in 2005 was higher than those of nation-wide studies in 2000. We found the results of our study is similar to those of Seoul in 2005. We found a significant relationship between environmental status and changes of symptoms in primary school children in Ilsan, Gyeonggi province.
Asthma ; Bronchial Hyperreactivity ; Child* ; Conjunctivitis, Allergic ; Cross-Sectional Studies ; Dermatitis, Atopic ; Gyeonggi-do* ; Humans ; Hypersensitivity ; Parents ; Prevalence* ; Pupil ; Surveys and Questionnaires ; Respiratory Function Tests ; Respiratory Sounds ; Rhinitis ; Seoul ; Skin

PURPOSE:The purpose of this study was to determine the prevalence of asthma, allergic rhinitis, atopic dermatitis and allergic conjunctivitis among primary school pupils in Ilsan, Gyeonggi province. We also investigated change of symptoms after environmental control. METHODS:In April 2005, a cross-sectional study was performed among 2,745 1st to 6th graders of 3 primary schools in Ilsan, Gyeonggi province. International Study of Asthma and Allergies in Childhood (ISAAC) standardized questionnaires and additional questionnaires about environmental changes were distributed to their parents. RESULTS:Data were collected from 2,535 children (1,279 boys and 1,256 girls). The most common allergic symptom was rhinorrhea (43.0%), and atopic skin lesions, ocular lesions and wheezing were 24.5%, 19.7% and 18.2%, respectively. There was no significant relationship between allergic diseases and environmental status. One thousand four hundred nineteen children moved to a new place or had new interior decorations within the last 2 years. Of these children, 352 (24.8%) had allergic symptoms (OR=2.76, CI= 1.96-3.41, P=0.001). Interestingly, we found that children who had moved into apartments experienced more symptom changes than those who had not (P=0.022). CONCLUSION:The results of this study demonstrated that the prevalence of allergic conditions in primary school children in Ilsan, Gyeonggi province in 2005 was higher than those of nation-wide studies in 2000. We found the results of our study is similar to those of Seoul in 2005. We found a significant relationship between environmental status and changes of symptoms in primary school children in Ilsan, Gyeonggi province.
Asthma ; Bronchial Hyperreactivity ; Child* ; Conjunctivitis, Allergic ; Cross-Sectional Studies ; Dermatitis, Atopic ; Gyeonggi-do* ; Humans ; Hypersensitivity ; Parents ; Prevalence* ; Pupil ; Surveys and Questionnaires ; Respiratory Function Tests ; Respiratory Sounds ; Rhinitis ; Seoul ; Skin

PURPOSE: Transcatheter closure has become an effective therapy in most patients with patent ductus arteriosus (PDA). However, there are difficulties in transcatheter closure of PDA in small children. We reviewed clinical outcomes of transcatheter closure of PDA in children weighing less than 10 kg in a single center. METHODS: Between January 2003 and December 2009, 314 patients with PDA underwent transcatheter closure in our institute. Among them, 115 weighed less than 10 kg. All of these patients underwent transcatheter closure of PDA using either COOK Detachable Coil(R), PFM Nit-Occlud(R), or Amplatzer duct occluder(R). A retrospective review of the treatment results and complications was performed. RESULTS: The mean age of patients was 9.1+/-5.9 months (median, 8 months), and mean weight was 7.6+/-1.8 kg (median, 7.8 kg). The mean diameter of PDA was 3.2+/-1.4 mm (median, 3 mm). Complete occlusion occurred in 113 patients (98%). One patient was sent to surgery because of a failed attempt at device closure, and another patient had a small residual shunt after device placement. The average mean length of hospital stay was 3.0+/-3.3 days, and mean follow-up duration was 21.0+/-19.6 months. There were no major complications in any of the patients. CONCLUSION: Transcatheter closure of PDA is considered safe and efficacious in infants weighing less than 10 kg. With sufficient experience and further effort, transcatheter closure of PDA can be accepted as the gold standard of treatment for this group of patients.
Catheterization ; Child ; Ductus Arteriosus, Patent ; Follow-Up Studies ; Humans ; Infant ; Length of Stay ; Retrospective Studies

Procalcitonin (PCT) is a predictive marker for the occurrence of bacterial infection and the decision to terminate antibiotic treatment in critically ill patients. An unusual increase in PCT, regardless of infection, has been observed during extracorporeal membrane oxygenation (ECMO) support. We evaluated trends and the predictive value of PCT levels in adult cardiogenic shock during treatment with ECMO. We reviewed the clinical records of 38 adult cardiogenic shock patients undergoing veno-arterial ECMO support between January 2014 and December 2016. The exclusion criteria were age < 18 years, pre-ECMO infection, and less than 48 hours of support. The mean patient age was 56.7±14.7 years and 12 (31.6%) patients were female. The mean duration of ECMO support was 9.0±7.6 days. The rates of successful ECMO weaning and survival to discharge were 55.3% (n=21) and 52.6% (n=20), respectively. There were 17 nosocomial infections in 16 (42.1%) patients. Peak PCT levels (mean 25.6±9.4 ng/mL) were reached within 48 hours after initiation of ECMO support and decreased to ≤5 ng/mL within one week. The change in PCT levels was not useful in predicting the occurrence of new nosocomial infections during the ECMO run. However, a PCT level >10 ng/mL during the first week of ECMO support was significantly associated with mortality (p < 0.01). The change in PCT level was not useful in predicting new infection during ECMO support. However, higher PCT levels within the first week of the ECMO run are associated with significantly higher mortality.
Adult ; Bacterial Infections ; Calcitonin ; Critical Illness ; Cross Infection ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Mortality ; Shock ; Shock, Cardiogenic ; Weaning

In the published article, the Figure 4 was published with incorrect y-axis and legend.

Data on the frequency of nosocomial infections during extracorporeal membrane oxygenation (ECMO) in adult populations remain scarce. We investigated the risk factors for nosocomial infections in adult patients undergoing venoarterial ECMO (VA-ECMO) support. From January 2011 to December 2015, a total of 259 patients underwent ECMO. Of these, patients aged 17 years or less and patients undergoing ECMO for less than 48 hours were excluded. Of these, 61 patients diagnosed with cardiogenic shock were evaluated. Mean patient age was 60.6 ± 14.3 years and 21 (34.4%) patients were female. The mean preoperative Sequential Organ Failure Assessment (SOFA) score was 8.6 ± 2.2. The mean duration of ECMO support was 6.8 ± 7.4 days. The rates of successful ECMO weaning and survival to discharge were 44.3% and 31.1%, respectively. There were 18 nosocomial infections in 14 (23.0%) patients. These included respiratory tract infections in 9 cases and bloodstream infections in a further 9. In multivariate analysis, independent predictors of infection during ECMO were the preoperative creatinine level (hazard ratio [HR], 2.176; 95% confidence interval [CI], 1.065–4.447; P = 0.033) and the duration of ECMO support (HR, 1.400; 95% CI, 1.081–1.815; P = 0.011). A higher preoperative creatinine level and an extended duration of ECMO support are risk factors for infection. Therefore, to avoid the development of nosocomial infections, strategies to shorten the length of ECMO support should be applied whenever possible.