OBJECTIVE: To report our initial experience on the technical feasibility and safety for hemostasis of a new pneumatic compression device in patients undergoing femoral arteriotomy. MATERIALS AND METHODS: This study included 40 consecutive patients in whom hemostasis after transfemoral catheterization was readered by using a pneumatic compression device consisting of an inflatable bulb-containing main body and four pieces of supplementary tape. Medical records were retrospectively reviewed for outcomes and complications of hemostasis. Technical success was defined as achieving immediate hemostasis 10 minutes after applying the device over the arteriotomy sites, and clinical success was defined as the ability to ambulate after 4 hours of bed rest without any complications. RESULTS: Technical and clinical success was achieved in 38 (95%) and 37 (93%) patients, respectively. In two patients, hemostasis was achieved after conversion to manual compression. One patient required sand bag placement after removal of the device to control minimal oozing of blood. No patients had late complications. CONCLUSION: The new pneumatic compression device provides effective and safe hemostasis after transfemoral catheterization in selected patient populations.
Carcinoma, Hepatocellular/therapy ; Chemoembolization, Therapeutic/methods ; Feasibility Studies ; Female ; Femoral Artery/*surgery ; Hemostatic Techniques/*instrumentation ; Humans ; Liver Neoplasms/therapy ; Male ; Middle Aged ; *Punctures ; Retrospective Studies ; Treatment Outcome

Purpose: The safety and efficacy of laparoscopic cholecystectomy (LC) in elderly patients is a matter of concern because morbidity and clinical risk are higher in elderly patients; and some clinicians recommend non-surgical supportive treatments. There is limited data reported in the literature for LC in super-elderly individuals (aged ≥ 80 years). This study compared the clinical outcome for the elderly and super-elderly patients undergoing LC. Methods: Patients who had a cholecystectomy for acute or chronic cholecystitis, and empyema of the gall bladder between January 2011 and June 2018 were analyzed retrospectively. The clinical outcomes of the super-elderly patients (≥ 80 years, Group 2) were compared with elderly patients (65-79 years, Group 1). Complications, conversion rate, postoperative hospital stays were assessed. Results: The conversion rate was 5.5% and 8.4% in Groups 1 and 2, respectively (p = 0.749). The surgical or medical complication rates were similar in both groups. A significant difference in operation time was observed between groups (p < 0.001). Although the super-elderly patients had longer postoperative hospital stays (7.10 ± 6.98) than the elderly patients (4.60 ± 6.06), there was no significant difference with between the 2 groups (p = 1.000). Conclusion The clinical outcomes of the conversion rate, complications, and mortality were similar in patients aged 65 to 79 years and ≥ 80 years. Therefore, LC is deemed to be a safe and simple procedure for the super-elderly.

Purpose: The safety and efficacy of laparoscopic cholecystectomy (LC) in elderly patients is a matter of concern because morbidity and clinical risk are higher in elderly patients; and some clinicians recommend non-surgical supportive treatments. There is limited data reported in the literature for LC in super-elderly individuals (aged ≥ 80 years). This study compared the clinical outcome for the elderly and super-elderly patients undergoing LC. Methods: Patients who had a cholecystectomy for acute or chronic cholecystitis, and empyema of the gall bladder between January 2011 and June 2018 were analyzed retrospectively. The clinical outcomes of the super-elderly patients (≥ 80 years, Group 2) were compared with elderly patients (65-79 years, Group 1). Complications, conversion rate, postoperative hospital stays were assessed. Results: The conversion rate was 5.5% and 8.4% in Groups 1 and 2, respectively (p = 0.749). The surgical or medical complication rates were similar in both groups. A significant difference in operation time was observed between groups (p < 0.001). Although the super-elderly patients had longer postoperative hospital stays (7.10 ± 6.98) than the elderly patients (4.60 ± 6.06), there was no significant difference with between the 2 groups (p = 1.000). Conclusion The clinical outcomes of the conversion rate, complications, and mortality were similar in patients aged 65 to 79 years and ≥ 80 years. Therefore, LC is deemed to be a safe and simple procedure for the super-elderly.

PURPOSE: Laparoscopic subtotal cholecystectomy (LSC) can be an alternative surgical technique for difficult cholecystectomies. Surgeons performing LSC sometimes leave the posterior wall of the gallbladder (GB) to shorten the operation time and avoid liver injury. However, leaving the inflamed posterior GB wall is a major concern. In this study, we evaluated the clinical outcomes of standard laparoscopic cholecystectomy (SLC), LSC, and LSC removing only anterior wall of the GB (LSCA). METHODS: We retrospectively reviewed the medical records of laparoscopic cholecystectomies performed between January 2006 to December 2015 and analyzed the outcomes of SLC, LSC, and LSCA. RESULTS: A total of 1,037 patients underwent SLC. 22 patients underwent LSC; and 27 patients underwent LSCA. The mean operating times of SLC, LSC, and LSCA were 41, 74, and 68 minutes, respectively (P < 0.01). Blood loss was 5, 45, and 33 mL (P < 0.05). The mean lengths of postoperative hospitalization were 3.4, 5.4, and 5.8 days. Complications occurred in 24 SLC patients (2.3%), 2 LSC patients (9%), and 1 LSCA patient (3.7%). There was no mortality among the LSC and LSCA patients. CONCLUSION: LSC and LSCA are safe and feasible alternatives for difficult cholecystectomies. These procedures help surgeons avoid bile duct injury and conversion to laparotomy. LSCA has the benefits of shorter operation time and less bleeding compared to LSC.
Bile Ducts ; Cholecystectomy* ; Cholecystectomy, Laparoscopic ; Gallbladder ; Hemorrhage ; Hospitalization ; Humans ; Laparotomy ; Liver ; Medical Records ; Mortality ; Retrospective Studies ; Surgeons

Depth of prostate volume from the skin can vary due to intra-fractional and inter-fractional movements, which may result in dose reduction to the target volume. Therefore we evaluated the feasibility of automated depth determination-based adaptive proton therapy to minimize the effect of inter-fractional movements of the prostate. Based on the center of mass method, using three fiducial gold markers in the prostate target volume, we determined the differences between the planning and treatment stages in prostate target location. Thirty-eight images from 10 patients were used to assess the automated depth determination method, which was also compared with manually determined depth values. The mean differences in prostate target location for the left to right (LR) and superior to inferior (SI) directions were 0.9 mm and 2.3 mm, respectively, while the maximum discrepancies in location in individual patients were 3.3 mm and 7.2 mm, respectively. In the bilateral beam configuration, the difference in the LR direction represents the target depth changes from 0.7 mm to 3.3 mm in this study. We found that 42.1%, 26.3% and 2.6% of thirty-eight inspections showed greater than 1 mm, 2 mm and 3 mm depth differences, respectively, between the planning and treatment stages. Adaptive planning based on automated depth determination may be a solution for inter-fractional movements of the prostate in proton therapy since small depth changes of the target can significantly reduce target dose during proton treatment of prostate cancer patients.
Humans ; Prostate ; Prostatic Neoplasms ; Proton Therapy ; Protons ; Skin

Depth of prostate volume from the skin can vary due to intra-fractional and inter-fractional movements, which may result in dose reduction to the target volume. Therefore we evaluated the feasibility of automated depth determination-based adaptive proton therapy to minimize the effect of inter-fractional movements of the prostate. Based on the center of mass method, using three fiducial gold markers in the prostate target volume, we determined the differences between the planning and treatment stages in prostate target location. Thirty-eight images from 10 patients were used to assess the automated depth determination method, which was also compared with manually determined depth values. The mean differences in prostate target location for the left to right (LR) and superior to inferior (SI) directions were 0.9 mm and 2.3 mm, respectively, while the maximum discrepancies in location in individual patients were 3.3 mm and 7.2 mm, respectively. In the bilateral beam configuration, the difference in the LR direction represents the target depth changes from 0.7 mm to 3.3 mm in this study. We found that 42.1%, 26.3% and 2.6% of thirty-eight inspections showed greater than 1 mm, 2 mm and 3 mm depth differences, respectively, between the planning and treatment stages. Adaptive planning based on automated depth determination may be a solution for inter-fractional movements of the prostate in proton therapy since small depth changes of the target can significantly reduce target dose during proton treatment of prostate cancer patients.
Humans ; Prostate ; Prostatic Neoplasms ; Proton Therapy ; Protons ; Skin

This study aims to evaluate the color stability and surface roughness of the single-shade composite resin after finishing and polishing for primary molars. A single-shade composite resin (OM, OMNICHROMA) and two multi-shade composite resins (FT, FiltekTM Z350XT; ES, ESTELITE® SIGMA QUICK) were included. The specimens were divided into three subgroups using different polishing methods: control, Sof-Lex XT, and Sof-Lex Diamond. For color stability tests, cavities were prepared on extracted primary second molars and restored with experimental composite resins. Each specimen was immersed in the coffee solution for 48 hours. The color difference of each specimen was calculated. For surface roughness tests, cylindrical specimens were crafted with experimental composite resins. Surface roughness was analyzed using an atomic force microscope and a scanning electron microscope. In the color stability tests, FT demonstrated a significantly lower ΔEab than ES among the control groups, but no significant differences were observed between the ΔEab values of OM and FT or OM and ES. Additionally, no significant differences were found between the Sof-Lex XT and Sof-Lex Diamond subgroups in the three composite groups. Moreover, no significant differences in the surface roughness were found between the three composite groups, regardless of the polishing methods. The single-shade composite resin demonstrated comparable color stability and surface roughness to that of the multi-shade composite resins regardless of the polishing methods used in restoring primary molars. The single-shade composite resin is expected to be applicable in clinical pediatric dentistry reducing chair time due to the easy shade matching procedures.

This study aims to evaluate the color stability and surface roughness of the single-shade composite resin after finishing and polishing for primary molars. A single-shade composite resin (OM, OMNICHROMA) and two multi-shade composite resins (FT, FiltekTM Z350XT; ES, ESTELITE® SIGMA QUICK) were included. The specimens were divided into three subgroups using different polishing methods: control, Sof-Lex XT, and Sof-Lex Diamond. For color stability tests, cavities were prepared on extracted primary second molars and restored with experimental composite resins. Each specimen was immersed in the coffee solution for 48 hours. The color difference of each specimen was calculated. For surface roughness tests, cylindrical specimens were crafted with experimental composite resins. Surface roughness was analyzed using an atomic force microscope and a scanning electron microscope. In the color stability tests, FT demonstrated a significantly lower ΔEab than ES among the control groups, but no significant differences were observed between the ΔEab values of OM and FT or OM and ES. Additionally, no significant differences were found between the Sof-Lex XT and Sof-Lex Diamond subgroups in the three composite groups. Moreover, no significant differences in the surface roughness were found between the three composite groups, regardless of the polishing methods. The single-shade composite resin demonstrated comparable color stability and surface roughness to that of the multi-shade composite resins regardless of the polishing methods used in restoring primary molars. The single-shade composite resin is expected to be applicable in clinical pediatric dentistry reducing chair time due to the easy shade matching procedures.

This study aims to evaluate the color stability and surface roughness of the single-shade composite resin after finishing and polishing for primary molars. A single-shade composite resin (OM, OMNICHROMA) and two multi-shade composite resins (FT, FiltekTM Z350XT; ES, ESTELITE® SIGMA QUICK) were included. The specimens were divided into three subgroups using different polishing methods: control, Sof-Lex XT, and Sof-Lex Diamond. For color stability tests, cavities were prepared on extracted primary second molars and restored with experimental composite resins. Each specimen was immersed in the coffee solution for 48 hours. The color difference of each specimen was calculated. For surface roughness tests, cylindrical specimens were crafted with experimental composite resins. Surface roughness was analyzed using an atomic force microscope and a scanning electron microscope. In the color stability tests, FT demonstrated a significantly lower ΔEab than ES among the control groups, but no significant differences were observed between the ΔEab values of OM and FT or OM and ES. Additionally, no significant differences were found between the Sof-Lex XT and Sof-Lex Diamond subgroups in the three composite groups. Moreover, no significant differences in the surface roughness were found between the three composite groups, regardless of the polishing methods. The single-shade composite resin demonstrated comparable color stability and surface roughness to that of the multi-shade composite resins regardless of the polishing methods used in restoring primary molars. The single-shade composite resin is expected to be applicable in clinical pediatric dentistry reducing chair time due to the easy shade matching procedures.

Since the first description of this disease in 1887, there are rare reports on osteochondrosis dissecans (OCD) found in the glenoid cavity by way of anthropological studies. During an excavation project for recovery of the remains of Korean War casualties, a skeletonized soldier was found inside a cave fort at the Arrowhead Ridge of the demilitarized zone (DMZ), South Korea. In our recovery and examination of a Korean War casualty in DMZ, we identified a possible OCD in the individual’s glenoid cavity of a right-sided scapula by radiological analysis and computed tomography reconstruction. This is a rare case of scapular OCD discovered in an archaeologically investigated skeleton.