OBJECTIVE: The aim of this study was to compare the success rates of the manual and motor-driven mini-screw insertion methods according to age, gender, length of mini-screws, and insertion sites. METHODS: We retrospectively reviewed 429 orthodontic mini-screw placements in 286 patients (102 in men and 327 in women) between 2005 and 2010 at private practice. Age, gender, mini-screw length, and insertion site were cross-tabulated against the insertion methods. The Cochran-Mantel-Haenszel test was performed to compare the success rates of the 2 insertion methods. RESULTS: The motor-driven method was used for 228 mini-screws and the manual method for the remaining 201 mini-screws. The success rates were similar in both men and women irrespective of the insertion method used. With respect to mini-screw length, no difference in success rates was found between motor and hand drivers for the 6-mm-long mini-screws (68.1% and 69.5% with the engine driver and hand driver, respectively). However, the 8-mm-long mini-screws exhibited significantly higher success rates (90.4%, p < 0.01) than did the 6-mm-long mini-screws when placed with the engine driver. The overall success rate was also significantly higher in the maxilla (p < 0.05) when the engine driver was used. Success rates were similar among all age groups regardless of the insertion method used. CONCLUSIONS: Taken together, the motor-driven insertion method can be helpful to get a higher success rate of orthodontic mini-screw placement.
Female ; Hand ; Humans ; Male ; Maxilla ; Private Practice ; Retrospective Studies

Spontaneous intracranial hypotension is a syndrome characterized by postural headache without trauma, spinal anesthesia or other medical history. The headache is usually resolved in a few days or weeks if the patient remains in bed with good hydration. Relief can usually be obtained by the application of a blood patch, by injecting 10-20 ml of the patient's own blood into the epidural space close to the leakage site. In the overwhelming majority of patients, the leak is at the level of the spine, particularly the thoracic spine and cervicothoracic junction. Spontaneous intracranial hypotension presenting with mental change has rarely been reported. We report a 39 years old male patient who was diagnosed with spontaneous intracranial hypotension. The patient experienced continuous headache followed by slight mental change. The patient was successfully managed by 3 episodes of epidural blood patch.
Adult ; Anesthesia, Spinal ; Blood Patch, Epidural* ; Epidural Space ; Headache ; Hematoma, Subdural ; Humans ; Intracranial Hypotension* ; Male ; Spine

Spontaneous intracranial hypotension is a syndrome characterized by postural headache without trauma, spinal anesthesia or other medical history. The headache is usually resolved in a few days or weeks if the patient remains in bed with good hydration. Relief can usually be obtained by the application of a blood patch, by injecting 10-20 ml of the patient's own blood into the epidural space close to the leakage site. In the overwhelming majority of patients, the leak is at the level of the spine, particularly the thoracic spine and cervicothoracic junction. Spontaneous intracranial hypotension presenting with mental change has rarely been reported. We report a 39 years old male patient who was diagnosed with spontaneous intracranial hypotension. The patient experienced continuous headache followed by slight mental change. The patient was successfully managed by 3 episodes of epidural blood patch.
Adult ; Anesthesia, Spinal ; Blood Patch, Epidural* ; Epidural Space ; Headache ; Hematoma, Subdural ; Humans ; Intracranial Hypotension* ; Male ; Spine

A mature teratoma is a tumor composed of normal derivatives of all three germ layers, and usually occurs in ovaries, testes, or mediastinum. Mature teratoma of the gastrointestinal tract occurs less frequently, and case reports of primary mature teratoma of the rectum have not been published much. Here, we report a 65-year-old woman patient presented with lower abdominal discomfort. Colonoscopy revealed a pedunculated polypoid tumor arising from the rectum with hairs on its surface, and endoscopic ultrasound revealed an exophytic pattern bulging from the serosa. The tumor was removed surgically and confirmed histologically as a benign, primary mature teratoma of the rectum.
Aged ; Colonoscopy ; Female ; Gastrointestinal Tract ; Germ Layers ; Hair ; Humans ; Mediastinum ; Ovary ; Rectum* ; Serous Membrane ; Teratoma* ; Testis ; Ultrasonography

PURPOSE: This study aimed to investigate the incidence and risk factors of early postoperative small bowel obstruction (EPSBO) after laparotomy for trauma patients. METHODS: From 2009 to 2016, consecutive patients who had undergone laparotomy for trauma were retrospectively evaluated. EPSBO was defined as the presence of signs and symptoms of obstruction between postoperative days 7 and 30, or obstruction occurring anytime within 30 days and lasting more 7 days. RESULTS: Among 297 patients who met the inclusion criteria, 72 (24.2%) developed EPSBO. The length of hospital stay was significantly longer in patients with EPSBO than in those without EPSBO (median [interquartile range], 34 [21–48] days 24 [14–38] days, P < 0.001). Multivariate logistic analysis identified male sex (adjusted odds ratio [AOR], 3.026; P = 0.008), intraoperative crystalloid (AOR, 1.130; P = 0.031), and Abbreviated Injury Scale (AIS) score for mesenteric injury (AOR, 1.397; P < 0.001) as independent risk factors for EPSBO. The incidence of adhesive small bowel adhesion after 30 days postoperatively did not significantly differ between the 2 groups (with EPSBO, 5.6% without EPSBO, 5.3%; P = 0.571). Most of the patients with EPSBO were recovered by conservative treatment (95.8%). CONCLUSION: After laparotomy for trauma patients, the incidence of EPSBO was 24.2% in our study. EPSBO was associated with a longer hospital stay. Male sex, use of intraoperative crystalloid, and AIS score for mesenteric injury were significant independent risk factors for EPSBO. Patients with these risk factors should be followed-up more carefully.
Abbreviated Injury Scale ; Abdominal Injuries ; Adhesives ; Humans ; Ileus ; Incidence ; Laparotomy ; Length of Stay ; Male ; Odds Ratio ; Retrospective Studies ; Risk Factors

Purpose: The occurrence of trauma-related delirium following postoperative abdominal surgery is associated with a poor prognosis. The purpose of this study was to identify predictive risk factors for trauma-related delirium. Methods: Trauma patient data from a regional trauma center were retrospectively collected from August 2015 to December 2016. The primary inclusion criteria were patients diagnosed with traumarelated delirium following abdominal trauma surgery. Head trauma patients and those under 18 years of age were excluded from this study. A multivariate logistic regression analysis was performed to identify the risk factors associated with trauma-related delirium. Results: Of the 255 trauma patients who met the inclusion criteria, 32 (12.5%) were diagnosed with delirium. The mean values for the age of the patients, Injury Severity Score, Glasgow Coma Scale score, and length of intensive care unit stay were 52.1 ± 17.8 years, 16.9, 14, and 7.1 days, respectively. Among the measured parameters, age [odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01-1.06; p = 0.022)], sex (OR, 0.125; 0.03-0.55; p = 0.006), hemoglobin level (OR, 0.875; CI, 0.68-0.98; p = 0.03), length of stay in the intensive care unit (OR, 1.12; CI, 1.03-1.22; p = 0.01), and having an abdominal operation (OR, 2.92; CI, 1.10-7.23; p = 0.011) showed strong correlations with trauma-related delirium. Conclusion This study showed that abdominal surgery was strongly associated with delirium in patients with traumatic abdominal injury. Thus, changes in consciousness should be carefully monitored following surgery.

Missed lung cancers on chest radiograph (CXR) may delay the diagnosis and affect the prognosis. CXR is the primary imaging modality to evaluate the lungs and mediastinum in daily practice. The purpose of this article is to review chest radiographs for common blind spots and highlight the importance of various radiologic presentations in primary lung cancer to avoid significant diagnostic errors on CXR.

Purpose: The occurrence of trauma-related delirium following postoperative abdominal surgery is associated with a poor prognosis. The purpose of this study was to identify predictive risk factors for trauma-related delirium. Methods: Trauma patient data from a regional trauma center were retrospectively collected from August 2015 to December 2016. The primary inclusion criteria were patients diagnosed with traumarelated delirium following abdominal trauma surgery. Head trauma patients and those under 18 years of age were excluded from this study. A multivariate logistic regression analysis was performed to identify the risk factors associated with trauma-related delirium. Results: Of the 255 trauma patients who met the inclusion criteria, 32 (12.5%) were diagnosed with delirium. The mean values for the age of the patients, Injury Severity Score, Glasgow Coma Scale score, and length of intensive care unit stay were 52.1 ± 17.8 years, 16.9, 14, and 7.1 days, respectively. Among the measured parameters, age [odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01-1.06; p = 0.022)], sex (OR, 0.125; 0.03-0.55; p = 0.006), hemoglobin level (OR, 0.875; CI, 0.68-0.98; p = 0.03), length of stay in the intensive care unit (OR, 1.12; CI, 1.03-1.22; p = 0.01), and having an abdominal operation (OR, 2.92; CI, 1.10-7.23; p = 0.011) showed strong correlations with trauma-related delirium. Conclusion This study showed that abdominal surgery was strongly associated with delirium in patients with traumatic abdominal injury. Thus, changes in consciousness should be carefully monitored following surgery.

Missed lung cancers on chest radiograph (CXR) may delay the diagnosis and affect the prognosis. CXR is the primary imaging modality to evaluate the lungs and mediastinum in daily practice. The purpose of this article is to review chest radiographs for common blind spots and highlight the importance of various radiologic presentations in primary lung cancer to avoid significant diagnostic errors on CXR.

Mucosal-associated invariant T (MAIT) cells and natural killer T (NKT) cells are known to play important roles in autoimmunity, infectious diseases and cancers. However, little is known about the roles of these invariant T cells in multiple trauma. The purposes of this study were to examine MAIT and NKT cell levels in patients with multiple trauma and to investigate potential relationships between these cell levels and clinical parameters. The study cohort was composed of 14 patients with multiple trauma and 22 non-injured healthy controls (HCs). Circulating MAIT and NKT cell levels in the peripheral blood were measured by flow cytometry. The severity of injury was categorised according to the scoring systems, such as Acute Physiology and Chronic Health Evaluation (APACHE) II score, Simplified Acute Physiology Score (SAPS) II, and Injury Severity Score (ISS). Circulating MAIT and NKT cell numbers were significantly lower in multiple trauma patients than in HCs. Linear regression analysis showed that circulating MAIT cell numbers were significantly correlated with age, APACHE II, SAPS II, ISS category, hemoglobin, and platelet count. NKT cell numbers in the peripheral blood were found to be significantly correlated with APACHE II, SAPS II, and ISS category. This study shows numerical deficiencies of circulating MAIT cells and NKT cells in multiple trauma. In addition, these invariant T cell deficiencies were found to be associated with disease severity. These findings provide important information for predicting the prognosis of multiple trauma.
APACHE ; Autoimmunity ; Cell Count ; Cohort Studies ; Communicable Diseases ; Flow Cytometry ; Humans ; Injury Severity Score ; Linear Models ; Multiple Trauma* ; Natural Killer T-Cells* ; Physiology ; Platelet Count ; Prognosis ; T-Lymphocytes*