PURPOSE: This study compared the accuracy of an abutment-framework (A-F) taken with open tray impression technique combining cementon crown abutments, a metal framework and resin cement to closed tray and resin-splinted open tray impression techniques for the 3-implant definitive casts. The effect of angulation on the accuracy of these 3 techniques was also evaluated. MATERIAL AND METHODS: Three definitive casts, each with 3 linearly positioned implant analogs at relative angulations 0, 30, and 40 degrees, were fabricated with passively fitted corresponding reference frameworks. Ten impressions were made and poured, using each of the 3 techniques on each of the 3 definitive casts. To record the vertical gap between reference frameworks and analogs in duplicate casts, a light microscope with image processing was used. Data were analyzed by two-way analysis of variance and the Tukey test. RESULTS: The open tray techniques showed significantly smaller vertical gaps compare to closed tray technique (P < .05). The closed tray and the resin-splinted open tray technique showed significantly different vertical gaps according to the angulation of implant (P < .05), but the A-F impression technique did not (P > .05). CONCLUSION: The accuracy of the A-F impression technique was superior to that of conventional techniques, and was not affected by the angulation of the implants.
Crowns ; Light ; Resin Cements

PURPOSE: To report the case of a silastic sheet that was found during an endoscopic transnasal dacryocystorhinostomy for treatment of acute dacryocystitis with necrosis of the lacrimal sac. METHODS: A thirty-two year old male presented with painful swelling on the nasal side of his left lower lid two weeks prior to visiting this clinic. Fourteen years ago, the patient was involved in a traffic accident and underwent surgery to reconstruct the ethmoidal sinus. Lacrimal sac massage showed a regurgitation of a purulent discharge from the left lower punctum. Therefore, the patient was diagnosed with acute dacryocystitis and an endoscopic transnasal dacryocystostomy was performed the next day. RESULTS: The surgical finding showed severe necrosis around the lacrimal sac and a 20 x 15-mm sized silastic sheet was found crumpled within the purulent discharge. The sheet was removed, the lacrimal sac was irrigated with an antibiotic solution, and a silicone tube was intubated into the lacrimal pathway. After surgery, the painful swelling on the nasal side of left lower lid resolved gradually, and there were no symptomatic complications three months later. CONCLUSIONS: We report the first case where a silastic sheet applied during a facial reconstruction had migrated adjacent to the lacrimal sac resulting in severe inflammation.
Silicones/*adverse effects ; Reoperation ; Prosthesis Implantation ; Prosthesis Failure ; Male ; Intraoperative Period ; Humans ; Foreign-Body Migration/*complications/surgery ; Facial Injuries/surgery ; Ethmoid Sinus/injuries/surgery ; *Endoscopy ; Dimethylpolysiloxanes/*adverse effects ; Dacryocystorhinostomy/*methods ; Dacryocystitis/*etiology/surgery ; Adult

Fractures, Comminuted ; Humans ; Immobilization ; Incidence ; Mandibular Fractures ; Wounds and Injuries

We report a rare case of the idiopathic membranous glomerulonephritis (IMGN) in association with the thin glomerular basement membrane nephropathy (TGBMN) in a 63-year-old female with hematuria. This is the first case reported in Korea. In renal biopsy of this case, direct immunofluorescence demonstrated anti-IgG Ab along the glomerular capillary wall with granular pattern. The basement membrane was thin, about 170-220 nm and small epimembranous electron dense deposits were observed by electron microscopy. As this case, the combination of TGBMN and IMGN is very uncommon because the IMGN is characterized morphologically by diffuse global thickening of the glomerular capillary wall, while the TGBMN is defined as an extreme thinning of the glomerular basement membrane, less than 200 nm. Our case showed no renal function deterioration and benign prognosis as other reports showed.
Basement Membrane ; Biopsy ; Capillaries ; Female ; Fluorescent Antibody Technique, Direct ; Glomerular Basement Membrane* ; Glomerulonephritis, Membranous* ; Hematuria ; Humans ; Korea ; Microscopy, Electron ; Middle Aged ; Prognosis

Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the “referral and return of patients to clinics” program and reduce the rate of returning patients. Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as “failure to transport,” among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the “failure to transport” patients. Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes. Conclusion The success rate of the “referral and return of patient to clinics” program differed based on each patient’s characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.

BACKGROUND: Currently, the incidence of hepatitis A is on the increase in Korea. Although there is emphasis on contact precautions, the nosocomial outbreak of hepatitis A virus (HAV) in healthcare personnel has increased within endemic areas because these workers inevitably come in close contact with patients and work under suboptimal hygiene conditions. In this study, we evaluated the necessity of immunization against HAV for healthcare personnel. METHODS: We investigated the seropositivity of serum immunoglobulin G (IgG) anti-HAV antibody (Ab) in 672 healthcare personnel on the basis of their age-group, sex, and occupation in Soon Chun Hyang University Hospital and Soon Chun Hyang University Bucheon Hospital. RESULTS: The subjects were divided into 6 groups on the basis of their ages to identify differences among the various age groups in the number of cases with HAV Ab seropositivity. Significant intergroup differences were noted in this respect: 21-25 years, 2/152 (1.3%); 26-30 years, 33/245 (13.5%); 31-35 years, 70/148 (47.3%); 36-40 years, 52/79 (65.8%); >40 years, 44/48 (91.7%). CONCLUSION: The number of seropositive cases was low among young healthy personnel: low seropositivity is an emerging risk for vulnerable population. With the increase in the incidence of hepatitis A, healthcare personnel have become a risk population for hepatitis A, as are community residents. Therefore, for healthcare personnel working in hospitals, immunization against HAV should be recommended for personnel younger than 30 years, and serological testing for older personnel.
Delivery of Health Care ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A Vaccines ; Hepatitis A virus ; Humans ; Hygiene ; Immunization ; Immunoglobulin G ; Incidence ; Korea ; Occupations ; Serologic Tests ; Vulnerable Populations

BACKGROUND: The patient-controlled sedation (PCS) allows for rapid individualized titration of sedative drugs. Propofol has been the most widely used IV adjuvant, during the monitored anesthesia care (MAC). This study was designed to compare the sedation quality, side effect and recovery of the propofol alone, and propofol-remifentanil combination, using PCS for breast biopsy. METHODS: Seventy five outpatients, undergoing breast biopsy procedures with local anesthesia, were randomly assigned to receive propofol alone (group P), propofol-25 ug/ml of remifentanil (group PR25), and propofol-50 ug/ml of remifentanil (group PR50), using PCS. Pain visual analogue scores (VAS) and digit symbol substitution test (DSST), Vital signs, bi-spectral index (BIS) and observer assessment of alertness and sedation (OAA/S) score were recorded. RESULTS: Apply/Demand ratio in the group PR50 had a significant increase over the other groups (P < 0.05). The incidence of excessive sedation and dizziness were significantly more frequent in the group PR50 (P < 0.05). BIS and OAA/S score significantly decreased in the group PR25, PR50 at 15 min after the operation, the end of surgery (P < 0.05). At 5 min after the start of PCS, patients in the group PR25 and PR50 gave significantly less correct responses on the DSST than that of the group P (P < 0.05). CONCLUSIONS: Compared with the propofol alone, intermittent bolus injection of propofol-remifentanil mixture could be used, appropriately, for the sedation and analgesia during MAC. The group PR25 in a low dose of remifentanil has more advantages in terms of sedation and satisfaction because of the group PR50's side effects.
Analgesia ; Anesthesia ; Anesthesia, Local ; Biopsy ; Breast ; Dizziness ; Humans ; Incidence ; Outpatients ; Piperidines ; Propofol ; Vital Signs

OBJECTIVES: To investigate the spinal bone mineral density (BMD) in patients with invasive cervical cancer without bone metastases. METHODS: We measured spinal bone mineral densities by dual-photon absorptiometry in 119 patients with invasive uterine cervical cancer and compared them with measurements from 135 control women. RESULTS: When adjusted for age, mean bone mineral density in patients with uterine cervical cancer was 13.9% lower (P=0.0003) and age-matched percentiles were 9.2% lower (P=0.0003) than in control women. The deficits in bone mineral density and age-matched percentiles were confined to the uterine cervical cancer patients in their fifties. CONCLUSIONS: Our study results suggest that patients with invasive cervical cancer have a lower spinal BMD, resulting in an increased risk of osteoporosis.
Absorptiometry, Photon ; Bone Density ; Female ; Humans ; Osteoporosis ; Spine ; Uterine Cervical Neoplasms

OBJECTIVES: The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. METHODS: 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. RESULTS: Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. CONCLUSIONS: This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.
Anxiety ; Comorbidity ; Compliance ; Depression ; Education ; Humans ; Logistic Models ; Mass Screening* ; National Health Programs ; Quality of Life ; Sleep Initiation and Maintenance Disorders

Wound healing of the skin and soft tissue defect is accomplished by generation of granulation tissue, collagen synthesis, contraction and re-epithelization. In the full-thickness skin wound, contraction plays an important role and fundamental principles in the treatment of infected wounds include the elimination of infection, the evacuation of pus, and the debridement of all necrotic material. The natural healing process of infected wounds can be expedited by the application of agents which will effectively eliminate infection with facilitating the healing process. Yunkyo is one of the most commonly used oriental herb medicine which is known to be effective in wound healing. In order to evaluate the effects of Yunkyo over wound healing and inhibition of bacterial growth, the author counted the bacterial colony in vitro and made skin defect on the back of rats for the comparison of reduced wound size and changes of tissue bacterial colony count after treatmnet with Solcoseryl, TCDO (Tetra-chloro-deca-oxide) and povidone. The results were obtained as follows: Calculating colony count in vitro, Yunkyo treated group was the most effective(p<0.001). There were significant differences between Yunkyo treated and control group in wound healing(p<0.001): Yunkyo healed the wound more rapidly. Calculating tissue bacterial colony count in open infected wound, Yunkyo treated group was showed the lowest colony count. In microscopic findings, the author observed marked growth of the granulation tissue, infiltration of the inflammatory cells, development of capillaries and even arrangement of collagen in Yunkyo treated groups than in the control group. In electron microscopy, abundant protein synthesis and myofilament in the myofibroblast were observed, and the authors found active wound contraction and the growth of granulation tissue. In conclusion, the Yunkyo has remarkable antibiotic effect and promotes wound contraction and the growth of granulation tissue in the process of wound healing.
Actihaemyl ; Animals ; Capillaries ; Collagen ; Debridement ; Granulation Tissue ; Microscopy, Electron ; Myofibrils ; Myofibroblasts ; Povidone ; Rats* ; Skin ; Suppuration ; Wound Healing* ; Wounds and Injuries*