PURPOSE: The purpose of this study was to analyze the opinions of students and tutors about the use of reflective journals in Problem Based Learning performed in Seoul National University College of Medicine over a period of 4 weeks, and to determine the possible applications of such journals as an evaluation tool. METHODS & RESULTS: The writing of a reflective journal helps students to achieve some of the important PBL goals, for example, keeping such a journal encourages students to reflect on their learning experiences, and fosters problem solving skills. All students were asked to complete the same questionnaire every weeks for the four week period. Most students thought of a reflective journal as a tool for personal reflection, rather than as a tool for fostering problem solving skills. The questionnaire was rated on 5 point scale: from 'very important' to 'not important at all'. Fifty eight percent of tutors and 20% of students replied that the journal writing was 'very important'. CONCLUSION: We suggest the following items for the future application of the reflective journal as an evaluation tool. First, intimate trust should be developed between students and tutors, as a reflective journal can include private matters. Second, tutors should give feedback for the student's reflective journal. Finally, comprehensive direction should be given to students and tutors to allow them to use their reflective journals effectively.
Foster Home Care ; Humans ; Learning ; Problem Solving ; Problem-Based Learning* ; Seoul ; Writing ; Surveys and Questionnaires

The inflammasome is a multi-protein complex that induces maturation of inflammatory cytokines interleukin (IL)-1beta and IL-18 through activation of caspase-1. Several nucleotide binding oligomerization domain-like receptor family members, including NLRP3, recognize unique microbial and danger components and play a central role in inflammasome activation. The NLRP3 inflammasome is critical for maintenance of homeostasis against pathogenic infections. However, inflammasome activation acts as a double-edged sword for various bacterial infections. When the IL-1 family of cytokines is secreted excessively, they cause tissue damage and extensive inflammatory responses that are potentially hazardous for the host. Emerging evidence has shown that diverse bacterial pathogens or their components negatively regulate inflammasome activation to escape the immune response. In this review, we discuss the current knowledge of the roles and regulation of the NLRP3 inflammasome during bacterial infections. Activation and regulation of the NLRP3 inflammasome should be tightly controlled to prevent virulence and pathology during infections. Understanding the roles and regulatory mechanisms of the NLRP3 inflammasome is essential for developing potential treatment approaches against pathogenic infections.
Bacterial Infections/immunology/metabolism/pathology/prevention & control ; Carrier Proteins/*metabolism ; Caspase 1/metabolism ; Humans ; Inflammasomes/immunology/*metabolism ; Interleukin-1beta/metabolism ; Signal Transduction

PURPOSE: Silk fibroin (SF) is a new degradable barrier membrane for guided bone regeneration (GBR) that can reduce the risk of pathogen transmission and the high costs associated with the use of collagen membranes. This study compared the efficacy of SF membranes on GBR with collagen membranes (Bio-Gide(R)) using a rat calvarial defect model. MATERIALS AND METHODS: Thirty-six male Sprague Dawley rats with two 5 mm-sized circular defects in the calvarial bone were prepared (n=72). The study groups were divided into a control group (no membrane) and two experimental groups (SF membrane and Bio-Gide(R)). Each group of 24 samples was subdivided at 2, 4, and 8 weeks after implantation. New bone formation was evaluated using microcomputerized tomography and histological examination. RESULTS: Bone regeneration was observed in the SF and Bio-Gide(R)-treated groups to a greater extent than in the control group (mean volume of new bone was 5.49 +/- 1.48 mm3 at 8 weeks). There were different patterns of bone regeneration between the SF membrane and the Bio-Gide(R) samples. However, the absolute volume of new bone in the SF membrane-treated group was not significantly different from that in the collagen membrane-treated group at 8 weeks (8.75 +/- 0.80 vs. 8.47 +/- 0.75 mm3, respectively, P=.592). CONCLUSION: SF membranes successfully enhanced comparable volumes of bone regeneration in calvarial bone defects compared with collagen membranes. Considering the lower cost and lesser risk of infectious transmission from animal tissue, SF membranes are a viable alternative to collagen membranes for GBR.
Animals ; Bone Regeneration* ; Collagen* ; Dental Implants ; Disease Transmission, Infectious ; Fibroins* ; Guided Tissue Regeneration ; Humans ; Male ; Membranes* ; Microcomputers ; Osteogenesis ; Rats* ; Rats, Sprague-Dawley ; Silk*

PURPOSE: The aim of this study was to examine the incidence, location and morphology of antral septa using radiographic exam.(Panorama, CT) in the dentate/non-atrophic and edentulous/atrophic maxillary segments. MATERIAL AND METHODS: 232 sinuses were subdivided into two groups(group1 : 175 sinuses were classified as complete & partial dentate maxillary segments, group2 : 57 sinuses were classified as complete edentulous maxillary segments) and were investigated for the incidence, location and morphology of maxillary sinus septa. RESULTS: A total of 80 septa were observed in 232 maxillary sinuses, which corresponded to 30.65% of the sinuses(71 of 232). 67.5% of the total septa was observed in the complete & partial dentate groups, but 32.5% of the total septa was observed in the complete edentulous group. Upon analysis of the anatomical location of the septa, it was seen that 14 septa(17.5%) were located in the P1 area, 15 septa(18.7%) were located in the P2 area, 19 septa(23.8%) were located in the M1 area and 32 septa(40%) were located in the M2 area and dista area of M2. we found 45 septa in the apical lesion of teeth, Group 1. However the remaining 9 septa were found in the edentulous area. CONCLUSION: CT is a better method than panoramic radiography for detecting the presence of the maxillary sinus septa. Maxillary sinus septa are more commonly detected in complete edentulous maxillary segments than in complete and partial dentate maxillary segments. Also maxillary sinus septa are more commonly detected posteriorly than anteriorly.
Carbamates ; Dental Implants ; Incidence ; Maxillary Sinus ; Organometallic Compounds ; Radiography, Panoramic ; Tooth

Because sublingual region is well-vascularized and sublingual artery is passed throughout this region, it should be careful not to perforate lingual cortex when placing dental implant on mandible. A 83-years-old male complained severe sublingual hematoma, hemorrhage and dyspnea came our outpatient department. He had received dental implant placement in the same day. He needed hemostasis and airway control. If soft tissue of sublingual region and the artery are injured, it may result in life-threatening excessive hemorrhage. In dental implant surgery, especially mandible, we should recognize the accurate shape of mandible and anatomy of sublingual region. It is important to stop anticoagulant agent before surgery. When a patient has airway obstruction, the operator should manage airway quickly.
Airway Management ; Airway Obstruction ; Arteries ; Dental Implants ; Dyspnea ; Hematoma ; Hemorrhage ; Hemostasis ; Humans ; Male ; Mandible ; Mouth Floor ; Outpatients ; Porphyrins ; Tracheotomy

Cystic lesions on the jaws with expansion can invade the adjacent anatomical structure, infiltrate and expand the jaws, cause facial deformity, etc. There is great potential for pathologic fractures after cyst enucleation, and damage to the major structures like the nerve, artery. For these reasons, marsupialization and decompression are commonly used to reduce the cystic size. In 1947, Thomas first mentioned decompression that reduces the osmotic pressure in a cyst by making a hole in the cyst and insert a drain. In our cases, a large sized cystic lesion was treated with a specific device made from an orthodontic band and spinal needle. This device is easy and effective for applications and self irrigation.
Arteries ; Congenital Abnormalities ; Decompression ; Decompression, Surgical ; Fractures, Spontaneous ; Jaw ; Mandibular Diseases ; Needles ; Osmotic Pressure ; Radicular Cyst ; Treatment Outcome

The incidence of aspergillosis infections in the maxillary sinus has increased recently, because of overuse of antibiotics, steroids, anticancer agents, immunosuppressant, antimetabollites, and uncontrolled diabetes mellitus. The clinical features of maxillary sinus aspergillosis include pain, swelling and foul odor nasal excretion. This needs to be differentiated from bacterial maxillary sinusitis, and surgical treatment with antifungal agents are suggested. Recently, we treated two patients with maxillary sinus aspergillosis surgically (Caldwell Luc operation) and with antifungal agents(itraconazole). The results were satisfactory so we report these cases with literature review.
Anti-Bacterial Agents ; Antifungal Agents ; Antineoplastic Agents ; Aspergillosis ; Diabetes Mellitus ; Humans ; Incidence ; Itraconazole ; Maxillary Sinus ; Maxillary Sinusitis ; Odors ; Steroids

A squamous odontogenic tumor (SOT) is an epithelial originated benign tumor. It has been rarely reported and most was intramural type. We observed a case of SOT in the mandible. It was associated with the odontogenic cyst. It was shown positive to pancytokeratin and p53. Considering that the case was free from recurrence for 5 years after surgery, p53 positive did not seem to be related to the prognosis of the disease.
Mandible ; Odontogenic Cysts ; Odontogenic Tumor, Squamous* ; Prognosis ; Recurrence

OBJECTIVE: The objective of this international comparative study was to investigate the clinical features and outcome of the treatment of infratemporal fossa abscess (IFA). STUDY DESIGN: This retrospective study was conducted at the Deptartment of Oral and Maxillofacial Surgery of Hallym University and "Iuliu Hatieganu" University of Medicine and Pharmacy. Ten-year records of patients were reviewed in Romania and six-year records were reviewed in Korea. The collected data was then analyzed. RESULTS: A total of 36 cases were found to be IFA (12 males and 24 females: average age; 36.3+/-15.5 yrs: 34 cases from Romania and 2 cases from Korea). The annual frequency of IFA in Romanian and Korean hospitals was 3.40 and 0.33 respectively (P<0.001). The etiology was septic anesthesia (33.3%), infection occurring after extraction (30.6%), periapical lesion (13.9%), impacted third molar (8.3%), post-extraction alveolitis (5.6%), and unknown (8.3%). A successful outcome was seen in 27 patients (75.0%) after initial treatment. The main complication after initial treatment was restricted movement of the mouth (9 cases). CONCLUSION: The etiology of IFA was various and minimal swelling hampered early diagnosis. To prevent IFA, preoperative painting with antiseptic agent must be stressed and proper drainage proved important to relieve pain and to prevent further complications.
Abscess* ; Anesthesia ; Drainage ; Early Diagnosis ; Female ; Humans ; Korea ; Male ; Molar, Third ; Mouth ; Paint ; Paintings ; Pharmacy ; Retrospective Studies ; Romania ; Surgery, Oral

BACKGROUND/AIMS: Spontaneous HBeAg seroconversion occurs frequently in the immune reactive phase in HBeAg-positive chronic hepatitis B (CHB). Therefore, observation for 3-6 months before commencing antiviral therapy is recommended in patients with alanine aminotransferase (ALT) levels that exceed twice the upper limit of normal (ULN). However, HBeAg seroconversion occurs infrequently in patients infected with hepatitis B virus (HBV) genotype C. The aim of the present study was to determine whether the waiting policy is necessary in endemic areas of HBV genotype C infection. METHODS: Ninety patients with HBeAg-positive CHB were followed prospectively without administering antiviral therapy for 6 months. Antiviral therapy was initiated promptly at any time if there was any evidence of biochemical (i.e., acute exacerbation of HBV infection or aggravation of jaundice) or symptomatic deterioration. After 6 months of observation, antiviral therapy was initiated according to the patient's ALT and HBV DNA levels. RESULTS: Only one patient (1.1%) achieved spontaneous HBeAg seroconversion. Biochemical and symptomatic deterioration occurred before 6 months in 17 patients (18.9%) and 5 patients, respectively. High ALT and HBV DNA levels were both independent risk factors for biochemical deterioration. Of 15 patients with HBV DNA > or =5.1x107 IU/mL and ALT > or =5xULN, biochemical deterioration occurred in 7 (46.7%), including 1 patient receiving liver transplantation due to liver failure. CONCLUSIONS: Spontaneous HBeAg seroconversion in patients with HBeAg-positive CHB is rare within 6 months. Biochemical deterioration was common and may lead to liver failure. Immediate antiviral therapy should be considered, especially in patients with high ALT and HBV DNA levels in endemic areas of genotype C infection.
Adult ; Alanine Transaminase/blood ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; Female ; Follow-Up Studies ; Genotype ; Guanine/analogs & derivatives/therapeutic use ; Hepatitis B e Antigens/*blood ; Hepatitis B virus/*genetics ; Hepatitis B, Chronic/*drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Factors