No abstract available.
Hip* ; Natural History* ; Technetium Tc 99m Medronate*

PURPOSE: This study was performed to analyze the position, pattern of impacted mesiodens, and their relationship to the adjacent teeth using Dental cone-beam CT. MATERIALS AND METHODS: Sixty-two dental cone-beam CT images with 81 impacted mesiodenses were selected from about 2,298 cone-beam CT images at Chonnam National University Dental Hospital from June 2006 to March 2009. The position, pattern, shape of impacted mesiodenses and their complications were analyzed in cone-beam CT including 3D images. RESULTS: The sex ratio (M : F) was 2.9 : 1. Most of the mesiodenses (87.7%) were located at palatal side to the incisors. 79% of the mesiodenses were conical in shape. 60.5% of the mesiodenses were inverted, 21% normal erupting direction, and 18.5% transverse direction. The complications due to the presence of mesiodenses were none in 43.5%, diastema in 19.4%, tooth displacement in 17.7%, delayed eruption or impaction in 12.9%, tooth rotation in 4.8%, and dentigerous cyst in 1.7%. CONCLUSION: Dental cone-beam CT images with 3D provided 3-dimensional perception of mesiodens to the neighboring teeth. This results would be helpful for management of the impacted mesiodens.
Cone-Beam Computed Tomography ; Dentigerous Cyst ; Diastema ; Displacement (Psychology) ; Incisor ; Sex Ratio ; Tooth ; Tooth, Supernumerary

No abstract available.
Dexmedetomidine* ; Tachycardia, Supraventricular*

No abstract available.
Dexmedetomidine* ; Tachycardia, Supraventricular*

PURPOSE: Chest compression is the corner stone of resuscitation. As a result, many studies insist on the importance of retention of skill performance. But there are weak points. First, a unique characteristic of skill is ignored, "the more practice, the better outcome". Second, no one knows when they have a proficiency in a skill. Learning curve-CUSUM analysis is a good tool to evaluate each trainee's performance. Hence, we designed this study to evaluate each trainee's proficiency in performing chest compression using LC-CUSUM analysis. METHODS: Four medical students were enrolled. We asked them to perform chest compression for two minutes per day without any intervention over six weeks. Data included the depth and rate of chest compression. Eventually, all trainees performed chest compression at least 30 times. We plotted the LC-CUSUM curve according to the results of attempts, successes or failures. RESULTS: According to median values of the depth and rate of chest compression through the 30th attempt, trainees had performances within the acceptable range, 40~49 mm (for depth) and 100~105 beats per minutes (for rate) of chest compression. Nonetheless, LC-CUSUM analysis indicated that two trainees no longer were proficient throughout, and even though the rest of them were once proficient, they appear to have lost that proficiency regarding depth of chest compression. LC-CUSUM analysis of rate of compression showed that all trainees had proficiency during the early phase. CONCLUSION: We propose that instructors can evaluate their trainees' proficiency easily, based on LC-CUSUM analysis.
Cardiopulmonary Resuscitation ; Clinical Competence ; Humans ; Learning ; Resuscitation ; Retention (Psychology) ; Students, Medical ; Thorax ; Training Support

In order to evaluate the effect of cardiac rhythm on hemodynamic changes and pulmonary arterial atrial natriuretic peptide(ANP) levels after percutaneous mitral valvuloplasty(PMV), we measured and analyzed the correlations between hemodynamic parameters and pulmonary arterial ANP levels in 65 patients with mitral stenosis before, 20 minutes, and 24 hours after PMV. The results are as follows: 1) Normal sinus rhythm was present in 49 patients(group1), whereas the other sixteen (group 2) had chronic atrial fibrillation. 2)PMV decreased mean left atrial pressure(LAP) in both groups(p<0.001). Left atrial volume was also reduced after PMV in group 1(p<0.0001), whereas it was not decreased significantly in group 2. 3) Pulmonary arterial ANP levels at 24 hours after PMV decreased significantly in group 1(p<0.001), compared to those prior to PMV. However there was no significantl changes in group 2. 4) In group 1, there was a significant linear relationship between extents of drop in pulmonary arterial ANP levels and LAP, measured 24hours after PMV. These results suggest that ANP secretion might be influenced not only by hemodynamic changes of the left atrium, but also by possible structural changes of left atrial wall induced by chronic atrial fibrillation.
Atrial Fibrillation ; Atrial Natriuretic Factor ; Heart Atria ; Hemodynamics* ; Humans ; Mitral Valve Stenosis

Inguinal endometriosis is a rare gynecologic disease. A 43-year-old woman had felt small nodular mass, which causing cyclic groin pain and fluctuation with menstrual cycle. CT scan revealed the extraperitoneal inguinal mass connected to the left round ligament. During the operation, infiltrative fibrotic mass around the inguinal mass could only be excised with wide groin dissection. After dissection of the abdominal muscles, the intraperitoneal mass could be pulled out and excised at the level of the intact round ligament. Histological diagnosis at the excised mass was endometriosis. After the surgery, the pain disappeared completely. We have reviewed published articles concerning inguinal endometriosis. The mechanism of development of inguinal endometriosis seems to be to that of indirect hernia with a difference of disappearing hernia sac resulting from inflammation of endometriosis. About half of the patients revealed periodicity such as cyclic pain or fluctuation of pain with menstral cycle. We describe the complete surgical excision of extraperitoneal inguinal endometriosis connected to round ligament endometriosis. Successful treatment can be achieved with understanding of the pathophysiology and anatomy related to the inguinal endometriosis.
Abdominal Muscles ; Adult ; Endometriosis ; Female ; Genital Diseases, Female ; Groin ; Hernia ; Humans ; Inflammation ; Menstrual Cycle ; Periodicity ; Round Ligament of Uterus

BACKGROUND: Dizziness due to brain lesions manifests mainly in infratentorial lesions, with few cases related to supratentorial lesions having been reported. This study aimed to elucidate the clinical characteristics and demographic factors of patients with dizziness caused by cerebral infarction and to determine the site of the brain where supratentorial lesions are most prevalent. METHODS: Patients with prominent dizziness who visited the emergency room of Gachon University Gil Hospital between July 2006 and July 2007 were included. Among them, 101 patients with acute cerebral infarction were categorized into supratentorial (n=51) and infratentorial (n=50) groups based on brain MRI. Demographics and clinical characteristics of dizziness in each group were compared, and common brain sites of the supratentorial group were assessed. RESULTS: The nature of the dizziness differed between the supratentorial group (vertigo, 27.4%; presyncope, 5.9%; disequilibrium, 29.4%; ocular, 11.8%; and nonspecific, 25.5%) and the infratentorial group (vertigo, 50.0%; presyncope, 6.0%; disequilibrium, 32.0%; ocular, 0%; and nonspecific, 12.0%; p=0.02). The duration of dizziness was shorter in the supratentorial than the infratentorial group (p<0.01). In the supratentorial group, common sites of the lesion were the thalamus (19.6%) and frontoparietal lobe (15.7%). The lesion usually appeared in the left hemisphere (60.8%). CONCLUSIONS: Dizziness from supratentorial lesions manifests in different ways, and its duration is shorter than that from infratentorial lesions. The central vestibular pathway may be located in the thalamus and frontoparietal lobe.
Brain ; Cerebral Infarction ; Demography ; Dizziness ; Emergencies ; Humans ; Infarction ; Syncope ; Thalamus

Cerebral Venous Sinus Thrombosis (CVST) in children is rare and its cause is multifactorial. The clinical manifestations of CVST vary and may cause long-term neurological sequelae and even death on rare occasion. In this case, a 15 year old boy presented with severe headache and vomiting for 1 day. Brain MRI with venography revealed multiple lesions of CVST in superior sagittal sinus and the left transverse sinus. Anticoagulation therapy was performed for 3 months, which led to the complete resolution in superior sagittal sinus and partial resolution in left transverse sinus.
Adolescent ; Brain ; Child ; Headache ; Humans ; Phlebography ; Sinus Thrombosis, Intracranial ; Superior Sagittal Sinus ; Vomiting

PURPOSE: We compared pathogen recovery rates by obtaining two blood cultures instead of one blood culture containing 1ml and collecting a larger volume, 1 to 3ml. METHODS: Total of 750 blood specimens from 250 patients with fever, a temperature higher than 39degrees C and suspected bacteremia were obtained. Each patient had two samples of blood, A (1ml) and B (4ml), obtained at 30-minute interval from separate sites of extremities and B was divided into B1 (1ml) and B2 (3ml). Each sample was inoculated into aerobic culture media. Patients were excluded if two samples of blood were not obtained or if the isolate represented a contaminant. RESULTS: A pathogen was isolated in 19 (7.6%) of 250 patients and 37 (4.9%) of 750 specimens. In 7 patients, the pathogen was isolated with all the culture methods and in 12 patients, one or more of the cultures yielded no growth. The pathogen recovery rates were 53% (10/19) in A and B1, 89% (17/19) in B2 and 68% (13/19) in A+B1. No difference was detected between A or B1 and A+B1 (P>0.05) and the pathogen recovery rate for B2 was significantly greater than that for A or B1 (P<0.05), but no significant differences were found in pathogen recovery when B2 was compared with A+B1. CONCLUSION: Increasing volume of blood from 1 to 3ml inoculated into blood culture bottles improves detection of bacteremia in pediatric patients and spares patients the cost and pain of an additional venipuncture.
Bacteremia* ; Child* ; Culture Media ; Extremities ; Fever ; Humans ; Phlebotomy