Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder and is the most common enzyme deficiency worldwide. Although this disease is rare in Korea, its prevalence may increase due to an increase of multicultural families. Patients with this deficiency are prone to hemolytic anemia provoked by specific drugs commonly used or prescribed in pediatric dentistry. It is necessary for pediatric dentists to have accurate knowledge of a patient's medical history and to consult with a pediatric hematologist to avoid oxidative stress that can lead to hemolysis. The most effective treatment is prevention of exposure to factors that may trigger anemia. Appropriate education regarding risk factors is essential for patients diagnosed with this disease. This case report aimed to discuss the drugs and dental management methods that should be cautious in children with G6PD deficiency.

Color stability of pulp-capping material is considered vital to the final aesthetic result since the material is placed in the coronal area. The purpose of this study was to compare the color stability of various pulp-capping materials by analyzing color change of tooth over time.
A cavity was formed in the crown of the extracted premolar, and 4 types of pulp-capping materials were filled. Color assessment was performed with a spectrophotometer at different intervals: before placement; immediately after material placement; 1 day, 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after placement.
Proroot white MTA® and TheraCal LC® showed a significant decrease in the L* value and an increase in the ΔE* value over time. In contrast, Biodentine® and Well-Root™ PT showed no significant change in the L* value and maintained a steady ΔE* value. The application of pulp-capping materials containing bismuth oxide as a radiopacifier may result in a color change of teeth. Long-term color stability of pulp-capping materials should be considered when treating teeth with thin enamel thickness or in aesthetically important area.

PURPOSE: The tortuosity of the iliac artery and length of the common iliac artery are considered to be limiting factors when performing endovascular aneurysm repair (EVAR). The aim of this study was to determine the anatomical features of the common iliac artery in patients who underwent EVAR. METHODS: Common iliac artery tortuosity was retrospectively assessed in 144 abdominal aortic aneurysm (AAA) patients (127 men; mean age, 70 years) treated from April 2007 to March 2011. Median luminal centerline measurements of 288 iliac arteries were made on preoperative computed tomography images using a three-dimensional workstation. RESULTS: The mean aneurysm diameter (+/-standard deviation) was 56.83+/-11.31 mm. The mean tortuosity index was 1.4287+/-0.1808. Five variables were significantly associated with the tortuosity ratio: age (r=0.216, P=0.009), diabetes mellitus (r=-0.215, P=0.010), smoking (r=-0.212, P=0.011), height (r=-0.169, P=0.043), and body mass index (r=-0.215, P=0.010). Procedure time and tortuosity were weakly correlated (r=0.166, P<0.05). Of the 70 cases with EVAR-related complications, there were 19 graft-related complications. There was no correlation found between iliac tortuosity and graft-related complications. CONCLUSION: A high degree of iliac artery tortuosity can be a limiting factor that increases the procedure time required for endovascular treatment of AAA. Measurement of iliac tortuosity is feasible and clinically meaningful, and its role in relation to human assessment must be further defined.
Aneurysm ; Aortic Aneurysm, Abdominal* ; Body Mass Index ; Diabetes Mellitus ; Endovascular Procedures* ; Humans ; Iliac Artery* ; Male ; Phenobarbital ; Retrospective Studies ; Smoke ; Smoking

Pleomorphic adenoma is the most common benign tumor of major salivary gland, but it rarely originates from the nasal cavities. Meanwhile, the lobular capillary hemangioma, known as pyogenic granuloma, is also a benign tumor of unclear etiology unusually found in the sinonasal area. Little is known about cases where pleomorphic adenoma and lobular capillary hemangioma originate simultaneously in the nasal cavity. Here, we report a case of 63-year-old female with pleomorphic adenoma and lobular capillary hemangioma simultaneously arising from the nasal septum. After endoscopic tumor resection, there was no recurrence or complication during the follow-up.

OBJECTIVE: The study was designed to ascertain a proper method of early diagnosis and treatment of ectopic pregnancy by analyzing its clinical and epidemiological characteristics. METHODS: The medical records of patients who were diagnosed to ectopic pregnancy at Hallym medical center during the period from January 1, 2000 to December 31, 2007 have been reviewed. RESULTS: The incidence of ectopic pregnancy was 7.3% (1,067) out of 14,519 deliveries. The most frequent age group was 26~30 (29.5%). Risk factors they had were previous histories of abdominal or pelvic surgery (37.0%), artificial abortion (30.8%), pelvic inflammatory disease (12%), and tubal sterilization (9.6%). Most frequent clinical symptoms were amenorrhea (88.7%), lower abdominal pain (81.2%), and vaginal spotting (60.0%). Percentage of patients with hemoglobin level over 10.0 gm/dL was 79% and below 8.0 gm/dL 3.9%. The clinical symptoms of ectopic pregnancy most commonly occurred after 6~8 weeks from last menstrual period (47%). Ectopic gestation was implanted on the fallopian tube in 89%, cornus in 7.2%, ovary in 1.1% and the cervix in 2.7%. Laparosopic surgeries were performed in 755 cases (71.6%) and laparotomies in 273 cases (25.9%) and dilatation and curettages in 26 cases (2.5%). Salpingectomy was performed most frequently (82.4%). Methotrexate (MTX) treatment was successful in 13 cases (1.21%). CONCLUSION: The early diagnosis of ectopic pregnancy is most useful when serum beta-hCG and vaginal sonography are used together. Laparoscopy would be a preferred method because of its short hospitalization period and low complication rate compared with laparotomy in ectopic pregnancy treatment.
Abdominal Pain ; Amenorrhea ; Cervix Uteri ; Cornus ; Curettage ; Dilatation ; Early Diagnosis ; Fallopian Tubes ; Female ; Hemoglobins ; Hospitalization ; Humans ; Incidence ; Laparoscopy ; Laparotomy ; Medical Records ; Methotrexate ; Metrorrhagia ; Ovary ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic ; Risk Factors ; Salpingectomy ; Sterilization, Tubal

One of characteristic features of AIDS-related encephalitis and dementia is the infiltration of monocytes into the CNS. HIV-1 Tat was demonstrated to facilitate monocyte entry into the CNS. In this study, we examined the effect of HIV-1 Tat on the expression of adhesion molecules, generation of reactive oxygen species (ROS) and NF-kappaB activation in CRT-MG human astroglioma cells. Treatment of CRT-MG cells with HIV-1 Tat protein significantly increased protein and mRNA levels of ICAM-1 and VCAM-1, as measured by Western blot analysis and RT-PCR, indicating that Tat increases these protein levels at an mRNA level. In addition, Tat induced the activation of NF-kappaB in astrocytes. Treatment of CRT-MG with NF-kappaB inhibitors led to decrease in Tat-induced protein and mRNA expression of ICAM-1 and VCAM-1. Furthermore, HIV-1 Tat protein increased ROS generation. Inhibition of Tat-induced ROS generation by N-acetyl cysteine, vitamin C and diphenyl iodonium suppressed Tat-induced NF-kappaB activation, ICAM-1 and VCAM-1 expression, and monocyte adhesion in CRT-MG. These data indicate that HIV-1 Tat can modulate monocyte adhesiveness by increasing expression of adhesion molecules such as ICAM-1 and VCAM-1 via ROS- and NF-kappaB-dependent mechanisms in astrocytes.
Vascular Cell Adhesion Molecule-1/genetics/*metabolism ; Up-Regulation/*drug effects ; Transcription, Genetic/genetics ; Reactive Oxygen Species/*metabolism ; NF-kappa B/*metabolism ; Monocytes/cytology/*drug effects/metabolism ; Intercellular Adhesion Molecule-1/genetics/*metabolism ; Humans ; *HIV-1 ; Gene Products, tat/*pharmacology ; Cell Line ; Cell Adhesion/drug effects ; Astrocytes/cytology/metabolism

Enzyme/prodrug approach is one of the actively developing areas for cancer therapy. In an effort to develop more effective enzyme/prodrug systems, cell-permeable cytosine deaminase was produced by fusing yeast cytosine deaminase (yCD) in frame with RKKRRQRRR domain of HIV-1 Tat which is an efficient delivery peptide of the foreign proteins into cells. The purified Tat-yCD fusion protein expressed in Escherichia coli was readily transduced into mammalian cells in a time- and dose-dependent manner. A significant level of the transduced Tat-yCD protein was recovered in the cell and was stable for 24 h as indicated by both results of the enzymatic assay of 5-fluorocytosine (5-FC) conversion to 5-fluorouracil (5-FU) and Western blot analysis. The cells transduced with Tat-yCD become highly sensitive to the cytotoxicity of 5-FC, while cells treated with yCD are unaffected by 5-FC. In addition, a strong bystander effect was observed with conditioned media from cells transduced with Tat-yCD added to non-transduced cells. Tat-yCD fusion protein demonstrated here for its ability to transduce into cells and convert nontoxic prodrug 5-FC to the toxic antimetabolite 5-FU, may be a useful approach for cancer therapy.
Animals ; Antimetabolites/*metabolism/pharmacology ; Bystander Effect ; Cytosine Deaminase/genetics/*metabolism ; Flucytosine/*metabolism/pharmacology ; Gene Products, tat/chemistry/genetics/*metabolism ; Genetic Vectors/genetics/metabolism ; HIV-1/metabolism ; Hela Cells/drug effects/physiology ; Humans ; Prodrugs/metabolism/therapeutic use ; Recombinant Fusion Proteins/genetics/*metabolism ; Research Support, Non-U.S. Gov't ; Saccharomyces cerevisiae Proteins/genetics/*metabolism ; *Transduction, Genetic

Accurate measurement of the volume status in hemodialysis patients is important as it can affect mortality. However, no studies have been conducted regarding volume management in cases where a sudden change of body fluid occurs, such as during puerperium in hemodialysis patients. This report presents a case in which the patient was monitored for her body composition and her volume status was controlled using a body composition monitor (BCM) during the puerperal period. This case suggests that using a BCM for volume management may help maintain hemodynamic stability in patients with a rapidly changing volume status for a short term period, such as during puerperium.
Body Composition ; Body Fluids ; Hemodynamics ; Humans ; Organothiophosphorus Compounds ; Postpartum Period ; Renal Dialysis

BACKGROUND: Static parameters such as central venous pressure and pulmonary artery occlusion pressure, have limitation in evaluation of patients' volume status. Dynamic parameters such as stroke volume variation (SVV), have been used to evaluate intraoperative hemodynamic volume status, in various operations. We examined if SVV is also effective for patients undergoing operation with prone position for fluid management. METHODS: Eighteen patients that received spinal surgery under prone position November 2015 to May 2016, were enrolled. Patients were kept at an SVV value less than 14% during surgery. Changes of pre-, post-operative volume status were evaluated, using transthoracic echocardiography. RESULTS: Mean fluid administered was 1,731.97 ± 792.38 ml. Left ventricular end-diastolic volume was 72.85 ± 13.50 ml before surgery, and 70.84 ± 15.00 ml after surgery (P value = 0.594). Right ventricular end-diastolic area was 15.56 ± 1.71 cm² before surgery, and 13.52 ± 2.65 cm² after surgery (P value = 0.110). Inferior vena cava diameter was 14.99 ± 1.74 mm before surgery, and 13.57 ± 2.83 mm after surgery (P value = 0.080). CONCLUSIONS: We can confirm that fluid management based on SVV is effective, even in prone position surgery. So, SVV, that can be measured by continuous arterial pressure, can be considered a guideline for effective fluid management in spinal surgery.
Arterial Pressure ; Central Venous Pressure ; Echocardiography ; Fluid Therapy ; Hemodynamics ; Humans ; Prone Position ; Pulmonary Artery ; Stroke Volume ; Stroke ; Vena Cava, Inferior

Purpose: The aim of this study was to estimate the effect of targeting risk factors for the control of central line-associated bloodstream infection (CLABSI) among high-risk infants in a tertiary neonatal intensive care unit (NICU). Methods: Infants admitted to the NICU and diagnosed with CLABSI from January to December 2013 were eligible for inclusion to the study. The CLABSI group (n=47) was matched in a 1:2 ratio to the control group (n=94) based on gestational age, birth weight, and Score for Neonatal Acute Physiology-II. Risk factors for CLABSI were identified using the Cox proportional hazard model, and analysis of the effect of these risk factors targeting infection control was performed. Results: The risk factors associated with CLABSI were prolonged central line dwell days (adjusted hazard ratio [HR], 1.028; 95% confidence interval [CI], 1.011 to 1.045; P=0.001), use of a silicone catheter (adjusted HR, 5.895; 95% CI, 1.893 to 18.355; P=0.002), surgical treatment (adjusted HR, 3.793; 95% CI, 1.467 to 9.805; P=0.006), and less probiotic supplementation (adjusted HR, 0.254; 95% CI, 0.068 to 0.949; P=0.042). By targeting these risk factors with a quality improvement initiative, the mean CLABSI incidence rate per 1,000 catheter-days decreased from 6.6 to 3.1 (P=0.004). Conclusion Targeting risk factors for infection control significantly reduced the rate of CLABSI among high-risk infants in the NICU.