OBJECTIVE: Speedy surgical orthodontics (SSO), an innovative orthodontic treatment, involves the application of orthopedic forces against temporary skeletal anchorage devices following perisegmental corticotomy to induce movement of specific dental segments. Herein, we report the biological effects of SSO on the teeth and periodontal structures. METHODS: Five beagle dogs were divided into 2 groups and their 6 maxillary incisors were retracted en masse by applying 500 g orthopedic force against a single palatal mini-plate. Retraction was performed without and with perisegmental corticotomy in groups I and II, respectively. All animals were killed on the 70th day, and their periodontal structures were processed for histologic analyses and scanning electronic microscopy (SEM). The linear distance between the third maxillary incisor and canine was used as a benchmark to quantify the retraction amount. RESULTS: Retraction was markedly faster and retraction amount greater in group II than in Group I. Surprisingly, Group II did not show any root resorption despite extensive retraction, while Group I showed prominent root surface irregularities. Similarly, SEM showed multiple resorption lacunae in Group I, but not in Group II. CONCLUSIONS: SSO is an effective and favorable orthodontic approach for major en masse retraction of the maxillary anterior teeth.
Animals ; Dogs ; Electronics ; Electrons ; Incisor ; Microscopy ; Orthodontics ; Orthopedics ; Root Resorption ; Tooth

PURPOSE: We undertook this study to evaluate the usefullness of radiologic placement of subcutaneous infusion ports (SIP). MATERIALS AND METHODS: Between August 1999 and May 2000 we performed 45 implantations of SIP in radiologic suite. Both sonography and fluoroscopy were used for venipuncture and to guide port insertion. We prospectively evaluated 45 systems in 45 patients with solid tumors. RESULTS: Median follow-up time was 189 days (61~352 days). Technical success rate is 100% without any venipuncture-related complications. Early complication rate within 30 days of procedure was 4.4%, including wound dehiscence (n=1) and pocket hematoma and local infection (n=1). Catheter-related infection rate was 6.7% and catheter-related venous thrombosis rate was 4.4%. Mean duration of catheter use was 208 96 days (total, 9,381 days). Overall port survival rate was 38.5%, and four systems (8.9%) were prematurely removed because of catheter tunnel infection (n=1), pocket infection (n=1), and central venous thrombosis (n=2). CONCLUSION: Radiologic placement of SIP had higher success rate and equal or lower complication rate compared with reported conventional surgical technique using anatomical landmarks. Moreover, clinical convenience, resulting from ease of scheduling could make it replace surgical method.
Catheter-Related Infections ; Catheters ; Fluoroscopy ; Follow-Up Studies ; Hematoma ; Humans ; Infusions, Subcutaneous* ; Phlebotomy ; Prospective Studies ; Survival Rate ; Venous Thrombosis ; Wounds and Injuries

PURPOSE: To introduce novel findings of polypoidal choroidal vasculopathy (PCV) via optical coherence tomography angiography (OCTA) METHODS: This study is a retrospective chart review of 16 patients (16 eyes) with PCV. OCTA (Avanti RTVue XR) findings were evaluated and selected for analysis after agreement by two retina specialists . RESULTS: Twenty one polyps in 16 eyes (16 patients) with PCV were included in this study. The mean patient age was 67 years (13 men and three women). The shape of polypoidal lesions on OCTA at initial were halo (five polyps), rosette (seven polyps), and vascular network (nine polyps). Eight months after anti-vascular endothelial growth factor treatment, in a total of four eyes, seven polyps could be followed up completely, the two halo type polypoidal lesions changed to rosette and vascular network type. The lesions of three rosette and two vascular network type lesions did not change in shape. In addition, the size of the polypoidal lesions (one among two halo types, two among three rosette types, and two among two vascular network types) decreased, but one halo type did not change and one rosette type increased in size on OCTA. CONCLUSIONS: En-face OCTA enabled us to categorize novel types of PCV with polypoidal lesions.
Angiography ; Choroid ; Endothelial Growth Factors ; Humans ; Male ; Polyps ; Retina ; Retrospective Studies ; Specialization ; Tomography, Optical Coherence

The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) first was published in 2002, and has been revised four times, in 2006, 2012, 2017, and 2021. In this review, we compared recommendations from the recently revised KMAP-DD 2021 to four global clinical practice guidelines (CPGs) for depression published after 2010. The recommendations from the KMAP-DD 2021 were similar to those from other CPGs, although there were some differences. The KMAP-DD 2021 reflected social culture and the healthcare system in Korea and recent evidence about pharmacotherapy for depression, as did other recently published evidence-based guidelines. Despite some intrinsic limitations as an expert consensus-based guideline, the KMAP-DD 2021 can be helpful for Korean psychiatrists making decisions in clinical settings by complementing previously published evidence-based guidelines, especially for some clinical situations lacking evidence from rigorously designed clinical trials.

Radioactive iodine (131I) has been used in the treatment of thyroid cancer to eliminate residual thyroid tissue after thyroidectomy and to treat metastatic disease. Leukemia has rarely been reported as a late complication of 131I therapy, occurring most frequently after receiving a cumulative activity of 800 mCi of the radioisotope. Although FAB M3 type (acute promyelocytic leukemia, APL) as the secondary acute leukemia had been rarely reported, recently there have been a few cases of therapy-related APL leukemia seen. We hereby report a case of secondary acute promyelocytic leukemia occurring in a patient who received radioactive iodine therapy for papillary thyroid carcinoma. An assessment of causality using the Naranjo probability scale showed that a possible relationship existed between APL seen in the patient and the use of the radioactive iodine. Although this is a very rare event, strict hematologic follow-up of patients treated with radioactive iodine may be warranted, along with a high index of suspicion in those with coagulopathy.
Follow-Up Studies ; Humans ; Iodine ; Leukemia ; Leukemia, Promyelocytic, Acute* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

Objectives: The Korean Medication Algorithm Project for Depressive Disorder 2021 (KMAP-DD 2021) was a revision of previous works. The main purpose of the current study was to amend guidelines for the treatment of a major depressive disorder (MDD) for children and adolescents. Methods: The survey consisted of 21 questionnaires for children and adolescents. A total of 33 of the 46 experts in child and adolescent psychiatry answered the survey. Results: Antidepressant (AD) monotherapy was selected as the 1st line option for MDD with mild to moderate severity. As the 1st line of treatment for MDD severe without psychotic features in children and adolescents, AD monotherapy and AD augmented with atypical antipsychotics (AAP) were recommended. For MDD with psychotic features, AD augmented with AAP was preferred as the 1st line of treatment. Conclusion We developed an algorithm for child and adolescent populations with depressive disorders, more specifically than the KMAP-DD 2017. We expect this algorithm will provide clinicians useful information and help in the treatment of children and adolescents with depressive disorders.

Objectives: The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) was developed in 2002 and revised in 2006, 2012, 2017. In 2021, the fifth edition was published.This edition reflected new findings and the latest trends in the areas of pharmacological treatment. The aim of this study is to present strategies and treatment options according to the subtype of depression using data from the KMAP-DD-2021. Methods: Ninety-seven psychiatrists with clinical experience in depressive disorder were selected. The questionnaires for KMAP-DD 2021 were sent to participants via mail. KMAP-DD 2021 consists of overall treatment strategies and treatment options under specific circumstances.Each treatment strategy or treatment option was evaluated with an overall score of nine and was divided into the three phases of recommendation that include primary, secondary, and tertiary. Results: For persisting depressive disorder, antidepressant monotherapy including selective serotonin reuptake inhibitor (SSRI) (escitalopram, fluoxetine, sertraline, paroxetine), serotoninnorepinephrine reuptake inhibitor (SNRI) (desvenlafaxine, venlafaxine, duloxetine, milnacipran), vortioxetine, and mirtazapine, was recommended as first-line medications. For melancholia of major depressive disorder, SSRI, SNRI, vortioxetine, and mirtazapine also were recommended as first-line medications. For mixed features, SSRI, bupropion, mirtazapine, SNRI, except for duloxetine, and milnacipran were recommended as first-line medications. For anxious distress, SSRI, mirtazapine, and SNRI, except milnacipran, were recommended as first-line medications. Conclusion The preferences of antidepressants by experts differed according to the subtype of depression. These findings suggest that experts treat patients with a major depressive disorder after considering the subtype of depression involved.

Objectives: The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) is a consensus-based medication guideline. To reflect advances in pharmacotherapy for depressive disorders, we have undertaken a fourth revision of the KMAP-DD. Methods: The review committee for the new version of the KMAP-DD (KMAP-DD 2021) included 143 Korean psychiatrists with clinical experience in the field of depressive disorders. Each treatment strategy or treatment option was evaluated with an overall score of nine, and the treatment option was categorized into the three levels of recommendation of primary, secondary, and tertiary. Results: The first-line pharmacotherapeutic strategy for mild to moderate major depressive episodes (MDE) was antidepressant (AD) monotherapy. For severe MDE without psychotic features, AD monotherapy or the combination of AD and atypical antipsychotics (AAP) was the first-line strategy. The combination of AD and AAP was recommended as the first-line for the MDE with psychotic features as well. When treatment response to initial AD monotherapy was insufficient, a combination of AAP or another AD was recommended. In the case of unsatisfactory response to initial treatment with an AD and AAP combination, switching to another AAP or adding another AD was recommended. Conclusion Generally, there were no significant changes in the recommendations for MDE management in the KMAP-DD 2021 compared to previous versions. However, it was notable that the preference for the use of AAP and AD with the novel mechanism of action including vortioxetine and agomelatine increased.

Objectives: The Korean Medication Algorithm Project for Depressive Disorder 2021 (KMAP-DD 2021) was made to update new researches and data. This study focused on non-pharmacological biological treatments. Methods: Ninety-seven psychiatrists with extensive clinical experience in the non-pharmacological biological treatment of depressive disorder were primary selected and a questionnaire was sent to each of them by mail, 65 of the 97 replied. Results: Electroconvulsive therapy (ECT) was recommended as an initial strategy for major depressive disorder, severe depressive disorder with/without psychotic features with urgent suicidal risk, or a severe depressive episode with psychotic features in pregnant patients, for non-responders on pharmacotherapy for a moderate depressive episode, and as a second strategy for non-responders on antidepressant monotherapy or combination therapy combined with physical illness. For pregnant women with a severe episode of major depressive disorder, repetitive transcranial magnetic stimulation (rTMS) was preferred as a first-line strategy, and as a second strategy for non-responders on combined antipsychotic and antidepressant therapy and non-responders with comorbidity and physical illness. Complementary or novel treatment was not recommended as the first-line treatment strategy for depressive disorder, but transcranial direct current stimulation (tDCS), vagus nerve stimulation (VNS), deep brain stimulation (DBS), light therapy, and omega-3 fatty acid nutritional therapy were second-line treatment strategies. Conclusion ECT and rTMS are initial strategies in specific clinical situations. Preferences for complementary or novel treatments such as tDCS, light therapy, and omega-3 fatty acid nutritional therapy have increased gradually, but in practice, their usages are still limited.

Objectives: An expert consensus guideline for the treatment of depressive disorder, the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD), was first established in 2002 and updated in 2017. To provide an up-to-date treatment guideline, KMAP-DD 2021 was recently completed. This study was undertaken to provide a guideline for the treatment of depressive disorder in a selected population that included females and elderly. Methods: The survey conducted consisted of 7 questionnaires for each population, females and elderly, with depressive disorder. A total of 65 of 97 experienced psychiatrists answered the survey. Results: For the treatment of premenstrual dysphoric disorder, the selective serotonin reuptake inhibitors, venlafaxine, and desvenlafaxine were recommended as first-line therapies. For major depressive disorder (MDD) during pregnancy, antidepressant (AD) monotherapy was recommended as a first-line therapy for mild to moderate and severe depression, and combined electroconvulsive therapy and AD with atypical antipsychotics (AAP) were recommended as a first-line therapy for severe depression with psychotic features. AD plus AAP was generally recommended for post-partum depression. In elderly with depression, AD monotherapy was recommended as the treatment of choice for mild to moderate episodes, and AD monotherapy and AD plus AAP were recommended as a first-line therapy for severe depression without psychotic features. Lastly, AD plus AAP was chosen as the treatment of choice for psychotic depression. Conclusion Present study provides an updated algorithm for the treatment of females and elderly with depressive disorders. This algorithm provides a practical aid to clinicians for the treatment of females and elderly with MDD.