The purpose of this study was to compare the success rates of two pulp capping materials, BiodentineTM and RetroMTA®, used for partial pulpotomy in permanent molars after carious exposures and to compare the final restorative outcome of using composite resin to that of using a stainless steel crown. We studied children who were diagnosed with dental caries of permanent molars and underwent partial pulpotomy. The patients were followed up for more than 1 year. Clinical and radiographic evaluation were used to evaluate the success of each treatment. Fisher's exact test was used to compare the outcomes of two groups. For pulp capping agents, the success rate of using RetroMTA® was lower than that of using BiodentineTM(p < 0.05). Final restoration with composite resin was less successful than restoration with an stainless steel crown(p < 0.05). In combination of pulp capping agents and final restoration material, RetroMTA®- composite resin shows the lowest success rate(p < 0.05).

BACKGROUND: It is well known that patients with neurological disorders are vulnerable to depression. However, in Korea, National Health Insurance services had banned non-psychiatrists from prescribing antidepressants for more than 2 months until January 2017. Now, neurologists are able to prescribe antidepressants to patients with only four neurological disorders. Due to this recent change in national health insurance policy, there will be a large change in the prescription pattern of antidepressants. In this study, we performed an analysis of antidepressant prescription patterns in Korea prior to this recent policy change. METHODS: The source population of this retrospective cohort study is the Health Insurance Review & Assessment Service database. We analyzed the claim database for patients who have one of four major neurologic disorders and had healthcare documentation submitted by healthcare providers between January 1, 2011 and December 31, 2016. RESULTS: During 2012–2016, antidepressant prescription rates of 6.21% (127,192 of a total 2,048,165 patients), 9.93% (81,861 out of 824,290), 10.12% (173,582 of 1,714,776), and 13.36% (48,530 of 363,347) were found for cerebrovascular disease, epilepsy, dementia, and Parkinson's disease respectively. The most frequently prescribed antidepressant in cerebrovascular disease and epilepsy was tricyclic antidepressants (TCAs). In Parkinson's disease and dementia, the most frequently used antidepressant was selective serotonin reuptake inhibitors. CONCLUSIONS: The overall prescription rate of antidepressants was much lower than the estimated rates reported in other countries. TCAs were the primarily prescribed antidepressant. It is now expected that TCAs will be replaced by newer antidepressants.
Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Cerebrovascular Disorders ; Cohort Studies ; Delivery of Health Care ; Dementia ; Depression ; Epilepsy ; Health Personnel ; Humans ; Insurance, Health ; Korea ; National Health Programs ; Nervous System Diseases ; Parkinson Disease ; Prescriptions ; Retrospective Studies ; Serotonin Uptake Inhibitors

Meta-analysis of diagnostic test accuracy studies differs from the usual meta-analysis of therapeutic/interventional studies in that, it is required to simultaneously analyze a pair of two outcome measures such as sensitivity and specificity, instead of a single outcome. Since sensitivity and specificity are generally inversely correlated and could be affected by a threshold effect, more sophisticated statistical methods are required for the meta-analysis of diagnostic test accuracy. Hierarchical models including the bivariate model and the hierarchical summary receiver operating characteristic model are increasingly being accepted as standard methods for meta-analysis of diagnostic test accuracy studies. We provide a conceptual review of statistical methods currently used and recommended for meta-analysis of diagnostic test accuracy studies. This article could serve as a methodological reference for those who perform systematic review and meta-analysis of diagnostic test accuracy studies.
Area Under Curve ; Databases, Factual ; Diagnostic Tests, Routine/*statistics & numerical data ; Humans ; ROC Curve ; *Research ; Software

Background: We investigated how 100-g oral glucose tolerance test (OGTT) results can be used to predict adverse pregnancy outcomes in gestational diabetes mellitus (GDM) patients. Methods: We analyzed 1,059 pregnant women who completed the 100-g OGTT between 24 and 28 weeks of gestation. We compared the risk of adverse pregnancy outcomes according to OGTT patterns by latent profile analysis (LPA), numbers to meet the OGTT criteria, and area under the curve (AUC) of the OGTT graph. Adverse pregnancy outcomes were defined as a composite of preterm birth, macrosomia, large for gestational age, low APGAR score at 1 minute, and pregnancy-induced hypertension. Results: Overall, 257 participants were diagnosed with GDM, with a median age of 34 years. An LPA led to three different clusters of OGTT patterns; however, there were no significant associations between the clusters and adverse pregnancy outcomes after adjusting for confounders. Notwithstanding, the risk of adverse pregnancy outcome increased with an increase in number to meet the OGTT criteria (P for trend=0.011); odds ratios in a full adjustment model were 1.27 (95% confidence interval [CI], 0.72 to 2.23), 2.16 (95% CI, 1.21 to 3.85), and 2.32 (95% CI, 0.66 to 8.15) in those meeting the 2, 3, and 4 criteria, respectively. The AUCs of the OGTT curves also distinguished the patients at risk of adverse pregnancy outcomes; the larger the AUC, the higher the risk (P for trend=0.007). Conclusion The total number of abnormal values and calculated AUCs for the 100-g OGTT may facilitate tailored management of patients with GDM by predicting adverse pregnancy outcomes.

Masseter muscle rigidity (MMR), known as the ‘jaw of steel’, sometimes makes laryngoscope unusable due to the stiffness of the jaw. MMR during general anesthesia was previously considered as an early episode of malignant hyperthermia (MH). Generally, MMR occurs in the pediatric patients after induction with succinylcholine and volatile agents. However, MMR following the administration of non-depolarizing muscle relaxants is uncommon, although described in some reports. We report a case of 62-year-old male patient which developed MMR following intravenous administration of rocuronium during induction of anesthesia. Our patient was not found to be vulnerable to MH. Although fiberoptic nasotracheal intubation had been successfully performed in our case, an unanticipated difficult airway due to MMR can be experienced at any time. Therefore, we should be aware that, although rare, MMR can occur after using non-depolarizing muscle relaxant. Additionally, in case of any incident of MMR, anesthesiologists need to recognize the management of a difficult airway and to maintain adequate oxygenation in a variety of methods according to a difficult airway algorithm.

Masseter muscle rigidity (MMR), known as the ‘jaw of steel’, sometimes makes laryngoscope unusable due to the stiffness of the jaw. MMR during general anesthesia was previously considered as an early episode of malignant hyperthermia (MH). Generally, MMR occurs in the pediatric patients after induction with succinylcholine and volatile agents. However, MMR following the administration of non-depolarizing muscle relaxants is uncommon, although described in some reports. We report a case of 62-year-old male patient which developed MMR following intravenous administration of rocuronium during induction of anesthesia. Our patient was not found to be vulnerable to MH. Although fiberoptic nasotracheal intubation had been successfully performed in our case, an unanticipated difficult airway due to MMR can be experienced at any time. Therefore, we should be aware that, although rare, MMR can occur after using non-depolarizing muscle relaxant. Additionally, in case of any incident of MMR, anesthesiologists need to recognize the management of a difficult airway and to maintain adequate oxygenation in a variety of methods according to a difficult airway algorithm.

Gastric cancer remains a significant global health concern, coercing the need for advancements in imaging techniques for ensuring accurate diagnosis and effective treatment planning. Artificial intelligence (AI) has emerged as a potent tool for gastric-cancer imaging, particularly for diagnostic imaging and body morphometry. This review article offers a comprehensive overview of the recent developments and applications of AI in gastric cancer imaging. We investigated the role of AI imaging in gastric cancer diagnosis and staging, showcasing its potential to enhance the accuracy and efficiency of these crucial aspects of patient management. Additionally, we explored the application of AI body morphometry specifically for assessing the clinical impact of gastrectomy. This aspect of AI utilization holds significant promise for understanding postoperative changes and optimizing patient outcomes. Furthermore, we examine the current state of AI techniques for the prognosis of patients with gastric cancer. These prognostic models leverage AI algorithms to predict long-term survival outcomes and assist clinicians in making informed treatment decisions.However, the implementation of AI techniques for gastric cancer imaging has several limitations. As AI continues to evolve, we hope to witness the translation of cutting-edge technologies into routine clinical practice, ultimately improving patient care and outcomes in the fight against gastric cancer.

BACKGROUND AND PURPOSE: Temporal changes in the quality of life (QOL) and the underlying factors after epilepsy surgery might be specific to Korea, where social stigma toward patients with epilepsy is still pronounced. METHODS: The seizure characteristics, number of antiepileptic drugs (AEDs), and the presence of stigma, anxiety, and depression were assessed before and after surgery (at 6 months and around 2 years) in 32 surgery patients and 32 nonsurgery patients. The QOL was compared between these groups using the Epilepsy Surgery Inventory-55 questionnaire. The factors affecting QOL were also evaluated. RESULTS: The scores in the mental, physical, and role-functioning domains were significantly higher at 6 months (all p<0.01) and around 2 years (all p<0.01) than at baseline in the surgery group but not in the nonsurgery group. The factors related to QOL differed at the two follow-up times, with seizure freedom being important at 6 months, and AEDs and depression being important at around 2 years. CONCLUSIONS: A marked increase in QOL in our population was observed after epilepsy surgery. Although the small sample limits the interpretation of the results, the QOL change in our surgery patients shows similar trends to those reported in Western countries. A full understanding of underlying factors related to QOL might aid the development of optimal strategies for improving the long-term postsurgery QOL in this population.
Anticonvulsants ; Anxiety ; Depression ; Epilepsy ; Follow-Up Studies ; Freedom ; Humans ; Korea ; Quality of Life ; Seizures ; Social Stigma ; Surveys and Questionnaires

OBJECTIVE: To compare the breathing effects on dynamic contrast-enhanced (DCE)-MRI between controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA)-volumetric interpolated breath-hold examination (VIBE), radial VIBE with k-space-weighted image contrast view-sharing (radial-VIBE), and conventional VIBE (c-VIBE) sequences using a dedicated phantom experiment. MATERIALS AND METHODS: We developed a moving platform to simulate breathing motion. We conducted dynamic scanning on a 3T machine (MAGNETOM Skyra, Siemens Healthcare) using CAIPIRINHA-VIBE, radial-VIBE, and c-VIBE for six minutes per sequence. We acquired MRI images of the phantom in both static and moving modes, and we also obtained motion-corrected images for the motion mode. We compared the signal stability and signal-to-noise ratio (SNR) of each sequence according to motion state and used the coefficients of variation (CoV) to determine the degree of signal stability. RESULTS: With motion, CAIPIRINHA-VIBE showed the best image quality, and the motion correction aligned the images very well. The CoV (%) of CAIPIRINHA-VIBE in the moving mode (18.65) decreased significantly after the motion correction (2.56) (p < 0.001). In contrast, c-VIBE showed severe breathing motion artifacts that did not improve after motion correction. For radial-VIBE, the position of the phantom in the images did not change during motion, but streak artifacts significantly degraded image quality, also after motion correction. In addition, SNR increased in both CAIPIRINHA-VIBE (from 3.37 to 9.41, p < 0.001) and radial-VIBE (from 4.3 to 4.96, p < 0.001) after motion correction. CONCLUSION: CAIPIRINHA-VIBE performed best for free-breathing DCE-MRI after motion correction, with excellent image quality.
Acceleration ; Artifacts ; Magnetic Resonance Imaging ; Respiration* ; Signal-To-Noise Ratio

Recently, sarcopenia has garnered renewed interest. Sarcopenia is a disease characterized by decreased skeletal muscle mass and strength/function, which can impair the quality of life and increase physical disability, adverse metabolic effects, and mortality. Imaging tools for evaluating and diagnosing sarcopenia have developed rapidly. Radiologists should be aware of sarcopenia and its clinical implications. We review current knowledge about sarcopenia, its pathophysiological impact, and advantages and disadvantages of methods for evaluation of sarcopenia focusing on body composition imaging modalities such as whole-body dual-energy X-ray absorptiometry, CT, and MRI. Controversial issues are discussed, including the lack of consensus and standardization of the disease definition, imaging modality, measurement methods, and diagnostic cutoff points.
Absorptiometry, Photon ; Body Composition ; Consensus ; Magnetic Resonance Imaging ; Mortality ; Muscle, Skeletal ; Quality of Life ; Sarcopenia