The retraction of anterior teeth is one of the fundamental methods in orthodontic treatment and a proper position and angulation of anterior teeth after the retraction are very important for esthetics, stability, and function of teeth. In this research we analyzed, by Finite Element Method, the stress distribution on the periodontal ligament according to the variation of force and moment applied on the crown and predict the pattern of movement of maxillary central incisor. At the same time, the amount of force and moment caused by activation of the loop which was used for retraction of maxillary central incisor was analyzed by Finite Element Method. We observed the following results: 1) We could control the stress distribution on the periodontal ligament by proper moment/force ratio on maxillary right central incisor and predict the pattern of movement of maxillary right central incisor. 2) The amount of stress on the periodontal ligament as well as the moment/force ratio demanded by each pattern of movement increased as the destruction of alveolar bone was worse. 3) The moment/force ratio demanded by each pattern of movement decreased as the angle between the maxillary central incisor and occlusal plane decreased. 4) The force with the open loop was shown to be large compared to that with the closed loop. Also, the force with the helix decreased by 30% compared to that without the helix. 5) Under the same conditions we observed a larger moment/force ratio when the open loop and/or the helix were used.
Crowns ; Dental Occlusion ; Esthetics ; Incisor* ; Periodontal Ligament ; Tooth

The purpose of this research was to analyze the tasks on foodservice, clinical nutrition service in hospital dietetic departments. A survey of 30 hospital food and nutrition service departments was undertaken and detailed informations were collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows: Regarding distitian's training period, 38.6% dietitians answered that they spent 1~2 years in mastering food service management. 28.4% dietitians replied that they needed 2~3 years in learning clinical nutrition management. It was shown that 48.9% dietitians were engaged in food service management, while 26.7% were engaged in clinical nutrition and 26.7% were engaged in both. The 13 elements of food service management showed low performance level. These elements were food temperature, food intake, menu selection, contaminated substances and serving mistake and reliance on hospital food. These should be controlled with caution. The average score of dietitian's life satisfaction within the work place was 3.42 out of 5. The most dissatisfactory element was physical environment of the workplace. 5 elements for improving nutrition service activities showed low performance level with high importance score. Problem analysis showed low difference score between importance and performance level. Hospitals under contract foodservice management received higher points on clinical nutrition performance(P<.05) than hospitals under self-operated foodservice management.
Data Interpretation, Statistical ; Eating ; Food Services ; Learning ; Nutritionists ; Workplace

The aim of this research was to examine the management practices related to foodservice, clinical nutrition service provided by hospital foodservice operations. A survey of 30 hospital food nutrition service departments was undertaken and detailed information was collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Out of 30 hospitals, 73.3%(22) were directly operated and 26.7%(8) were under contract foodservice management. Licensed number of beds were 768.7, with an average length of 11.4 days. The general characteristics of the dietitians were that 49.4% were aged between 25~29, and 60.8% were ordinary dietitians. 76.7% had bachelor's degree, 15.9% with master's degree and 7.4% were college graduates. Most hospital dietitians had internship training and 35.2% took a training course of 6 to 12 months. The average space of kitchen was 452.52m2, with 133.63m2 for modified diet space and 18.13m2 for nutrition counselling room space. The total number of normal meals was 1,255.47, with 502.93 of modified meals.The average calorie of normal meals was 2,145.04kcal, with 91.9g of protein contained in normal meal. The total food waste was 351.40kg. An average monthly cost for disposing food waste was 745,171.67 won. 83.3?% of the kitchens were on the 1st basement and only 66.7%(20) of 30 hospitals had its own nutrition counselling room. 80% used dishwashers and 66.7% had an exclusive elevator for delivering meals. 80.0% of hospitals used centralized delivery service. 90% had established an area for hygiene division, 70% used dry zone within the dishwashers for sterilization, 66.7% provided spoon and chopstick, and 100% used dish cover. As means of food waste treatment, most hospitals(56.7%) used animal feed by contracters, followed by means of collection by contracters(30%) and in-house high speed fermentation machines(13.3%). It was found that only 33.3% hospitals regularly checked temperatures of the meals given to patients. Total productivity index was 3.72(meals/hour) in average, with an average productivity index for normal diet of 5.41. Average productivity index for modified diet was 4.62. Productivity indices for patient meals and clinical nutrition were 5.01(meals/hour) and 1.12(cases/hour) respectively and hospitals under self-operated foodservice management received higher points on clinical nutrition productivity index(P<0.01) than hospitals under contract foodservice management.
Animal Feed ; Data Interpretation, Statistical ; Diet ; Efficiency ; Elevators and Escalators ; Fermentation ; Humans ; Hygiene ; Internship and Residency ; Meals ; Nutritionists ; Sterilization

Neurologic complications of Epstein-Barr virus (EBV) infection are diverse including a number of neurologic diseases such as encephalitis, encephalomyelitis, Guillain-Barre syndrome, optic neuritis, acute disseminated encephalomyelitis, cerebellitis, and Alice-In-Wonderland syndrome. In general encephalitis caused by EBV in children has been considered a self-limited disease with few or no sequelae. Occasionally it leaves a severe neurologic sequela and complications. Therefore administration of high dose acyclovir and steroid in early stages of EBV encephalitis is recommended currently. In this case, the patient of a 8-year-old boy was admitted because of generalized tonic seizure of 2 times. He showed 16% of atypical lymphocytosis in peripheral blood smear and positive findings in VCA-IgM and EA-IgM tests. EBV DNA Antibody, and virus PCR in CSF was not evaluated. He also showed hepatosplenomegaly in abdominal sonography. Brain MRI revealed a bilateral increased signal intensity at lenticular nucleus and caudate nucleus, multiple high signal intensity at cortical layer of both gyrus reti, both frontal, inferior parietal, and dorsal aspect of the right paracentral lobue. As mentioned in serologic and imaging study, he was diagnosed as the EBV- associated encephalitis. Although we administered high dose acyclovir and corticosteroids, he showed clinical deterioration with confusion, delirium, and ataxia. Therefore, we administered additional high dose intravenous immunoglobulin, and finally he was recovered. We report the case of improvement of EBV-associated encephalitis after high-dose Intravenous immunoglobulin therapy.
Acyclovir ; Adrenal Cortex Hormones ; Ataxia ; Brain ; Caudate Nucleus ; Child ; Corpus Striatum ; Delirium ; DNA ; Encephalitis* ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated ; Guillain-Barre Syndrome ; Herpesvirus 4, Human* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Lymphocytosis ; Magnetic Resonance Imaging ; Male ; Optic Neuritis ; Polymerase Chain Reaction ; Rabeprazole ; Seizures

Neurologic complications of Epstein-Barr virus (EBV) infection are diverse including a number of neurologic diseases such as encephalitis, encephalomyelitis, Guillain-Barre syndrome, optic neuritis, acute disseminated encephalomyelitis, cerebellitis, and Alice-In-Wonderland syndrome. In general encephalitis caused by EBV in children has been considered a self-limited disease with few or no sequelae. Occasionally it leaves a severe neurologic sequela and complications. Therefore administration of high dose acyclovir and steroid in early stages of EBV encephalitis is recommended currently. In this case, the patient of a 8-year-old boy was admitted because of generalized tonic seizure of 2 times. He showed 16% of atypical lymphocytosis in peripheral blood smear and positive findings in VCA-IgM and EA-IgM tests. EBV DNA Antibody, and virus PCR in CSF was not evaluated. He also showed hepatosplenomegaly in abdominal sonography. Brain MRI revealed a bilateral increased signal intensity at lenticular nucleus and caudate nucleus, multiple high signal intensity at cortical layer of both gyrus reti, both frontal, inferior parietal, and dorsal aspect of the right paracentral lobue. As mentioned in serologic and imaging study, he was diagnosed as the EBV- associated encephalitis. Although we administered high dose acyclovir and corticosteroids, he showed clinical deterioration with confusion, delirium, and ataxia. Therefore, we administered additional high dose intravenous immunoglobulin, and finally he was recovered. We report the case of improvement of EBV-associated encephalitis after high-dose Intravenous immunoglobulin therapy.
Acyclovir ; Adrenal Cortex Hormones ; Ataxia ; Brain ; Caudate Nucleus ; Child ; Corpus Striatum ; Delirium ; DNA ; Encephalitis* ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated ; Guillain-Barre Syndrome ; Herpesvirus 4, Human* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Lymphocytosis ; Magnetic Resonance Imaging ; Male ; Optic Neuritis ; Polymerase Chain Reaction ; Rabeprazole ; Seizures

No abstract available.
Knee Joint* ; Knee*

Krukenberg tumor of the primary breast carcinoma is rare and this is almost invasive lobular carcinoma. They are usually bilateral and frequent in premenopausal women. Diagnosis of symptomatic Krukenberg tumor is reported to be 1 or 2 year after the diagnosis of primary neoplasm. But sometimes it is discovered prior to the detection of the primary breast carcinoma. Unexpected ovarian micrometastasis was recognized after oophorectomy of normally appearing ovaries in breast cancer patients. Existence of Krukenberg tumor means advanced primary disease and possible metastasis to other organs, and have a poorer prognosis. We report a case of Krukenberg tumors occurred 3 years after the diagnosis of primary ductal type breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Lobular ; Diagnosis ; Female ; Humans ; Krukenberg Tumor* ; Neoplasm Metastasis* ; Neoplasm Micrometastasis ; Ovariectomy ; Ovary* ; Prognosis

STUDY DESIGN: Retrospective study. OBJECTIVES: We analyzed to verify clinical result and recurrence of long term follow-up after open lumbar discectomy. SUMMARY OF LITERATURE REVIEW: There are many reports concerning the clinical result of open discectomy. However, long-term result is not frequently reported. MATERIALS AND METHODS: From 1989 to 2000, 289 patients underwent open discectomies. 142 patients who was followed more than 5 years were enrolled in this study. Follow-up rate, clinical outcome were analyzed as gender, age at the operation and operated level. Re-operation rate was analyzed as gender, age at the operation, operated level divided into same level-same side, same level-contralateral side and other level and the time at reoperation. Clinical outcomes were evaluated by Kim and Kim criteria. RESULTS: More than 5 years follow-up rate was 49.1%. Average follow-up period were 99.2 months. Clinically successful result was obtained in 75.4%, and it was not related with gender, age at the operation and operated level. Reoperations were needed in 21 patients(14.8%). Reoperation rate was not related with gender, age at the operation. Same level-same side reherniation were frequent before 6 months after first surgery, but other side and different level were similar more than 2 years after first surgery. CONCLUSIONS: Our clinical result was acceptable(75.4%). Main cause of reoperations before 6 months after first surgery was recurrence at the same level and same side, but cause of reoperation more than 2 years after first surgery were herniation at the other side and different level increased with time.
Diskectomy ; Follow-Up Studies ; Humans ; Recurrence ; Reoperation ; Retrospective Studies

Objective: This study aimed to compare the outcomes of adult out-of-hospital cardiac arrest (OHCA) before and after the coronavirus disease 2019 (COVID-19) outbreak in a large metropolitan city. Methods: This before-and-after observational study used a prospective citywide OHCA registry. Adult patients with emergency medical service-treated OHCA, with presumed cardiac etiology, pre- and post-COVID-19 outbreak were enrolled. The study period spanned 2 months, starting from February 18, 2020. The control period was 2 months from February 18, 2019. The primary and secondary outcomes were good neurologic outcome and survival to hospital discharge, respectively. The association between the COVID-19 outbreak and OHCA outcomes was assessed using multivariable logistic regression analysis. Results: This study analyzed 297 OHCA patients (control period, 145; study period, 152). The bystander cardiopulmonary resuscitation rates were 64.8% and 60.5% during the control and study periods, respectively. Response and on-scene times increased by 2 minutes, supraglottic airway use increased by 35.6%, and mechanical chest compression device use increased by 13% post-COVID-19 outbreak. Good neurologic outcome was significantly lower during the study period in overall OHCAs (adjusted odds ratio, 0.23; 95% confidence interval, 0.05–0.98) and in witnessed OHCAs (adjusted odds ratio, 0.14; 95% confidence interval, 0.02–0.90). No significant difference was found in the survival to hospital discharge of OHCA patients between the two periods. Conclusion During the COVID-19 pandemic, the response and on-scene times were longer, and good neurologic outcome was significantly lower than that in the control period.

Objective: This study aimed to compare the outcomes of adult out-of-hospital cardiac arrest (OHCA) before and after the coronavirus disease 2019 (COVID-19) outbreak in a large metropolitan city. Methods: This before-and-after observational study used a prospective citywide OHCA registry. Adult patients with emergency medical service-treated OHCA, with presumed cardiac etiology, pre- and post-COVID-19 outbreak were enrolled. The study period spanned 2 months, starting from February 18, 2020. The control period was 2 months from February 18, 2019. The primary and secondary outcomes were good neurologic outcome and survival to hospital discharge, respectively. The association between the COVID-19 outbreak and OHCA outcomes was assessed using multivariable logistic regression analysis. Results: This study analyzed 297 OHCA patients (control period, 145; study period, 152). The bystander cardiopulmonary resuscitation rates were 64.8% and 60.5% during the control and study periods, respectively. Response and on-scene times increased by 2 minutes, supraglottic airway use increased by 35.6%, and mechanical chest compression device use increased by 13% post-COVID-19 outbreak. Good neurologic outcome was significantly lower during the study period in overall OHCAs (adjusted odds ratio, 0.23; 95% confidence interval, 0.05–0.98) and in witnessed OHCAs (adjusted odds ratio, 0.14; 95% confidence interval, 0.02–0.90). No significant difference was found in the survival to hospital discharge of OHCA patients between the two periods. Conclusion During the COVID-19 pandemic, the response and on-scene times were longer, and good neurologic outcome was significantly lower than that in the control period.