OBJECTIVE: This in-vivo study aimed to compare landmark identification errors in anteroposterior (AP) and posteroanterior (PA) cephalograms generated from cone-beam computed tomography (CBCT) scan data in order to examine the feasibility of using AP cephalograms in clinical settings. METHODS: AP and PA cephalograms were generated from CBCT scans obtained from 25 adults. Four experienced and four inexperienced examiners were selected depending on their experience levels in analyzing frontal cephalograms. They identified six cephalometric landmarks on AP and PA cephalograms. The errors incurred in positioning the cephalometric landmarks on the AP and PA cephalograms were calculated by using the straight-line distance and the horizontal and vertical components as parameters. RESULTS: Comparison of the landmark identification errors in CBCT-generated frontal cephalograms revealed that landmark-dependent differences were greater than experience- or projection-dependent differences. Comparisons of landmark identification errors in the horizontal and vertical directions revealed larger errors in identification of the crista galli and anterior nasal spine in the vertical direction and the menton in the horizontal direction, in comparison with the other landmarks. Comparison of landmark identification errors between the AP and PA projections in CBCT-generated images revealed a slightly higher error rate in the AP projections, with no inter-examiner differences. Statistical testing of the differences in landmark identification errors between AP and PA cephalograms showed no statistically significant differences for all landmarks. CONCLUSIONS: The reproducibility of CBCT-generated AP cephalograms is comparable to that of PA cephalograms; therefore, AP cephalograms can be generated reliably from CBCT scan data in clinical settings.
Adult ; Cone-Beam Computed Tomography* ; Humans ; Spine

No abstract available.

OBJECTIVE: Lateral cephalometric radiographs have been the main form of resource for assessing two dimensional anteroposterior airway changes. The purpose of this study was to evaluate the three dimensional volumetric change in the upper airway space in Class III malocclusion patients who underwent mandibular setback surgery. METHODS: Three dimensional cone-beam computed tomographs (CBCT) and their three dimensional reconstruction images were analyzed. The samples consisted of 20 adult patients (12 males and 8 females) who were diagnosed as skeletal Class III and underwent mandibular setback surgery. CBCTs were taken at 3 stages - Baseline (1.8 weeks before surgery), T1 (2.3 months after surgery), and T2 (1 year after surgery). Pharyngeal airway was separated according to the reference planes and reconstructed into the nasopharynx, the oropharynx and the hypopharynx. Measurements at Baseline, T1, and T2 were compared between groups. RESULTS: The result showed the volume of the pharyngeal airway decreased significantly 2.3 months after surgery (p < 0.001) and the diminished airway did not recover after 1 year post-surgery. The oropharynx was the most decreased area. CONCLUSIONS: These findings suggest that mandibular setback surgery causes both short-term and long-term decrease in the upper airway space.
Adult ; Cone-Beam Computed Tomography ; Humans ; Hypopharynx ; Male ; Malocclusion ; Nasopharynx ; Oropharynx ; Orthognathic Surgery

Background: Malaria elimination strategies in the Republic of Korea (ROK) have decreased malaria incidence but face challenges due to delayed case detection and response. To improve this, machine learning models for predicting malaria, focusing on high-risk areas, have been developed. Methods: The study targeted the northern region of ROK, near the demilitarized zone, using a 1-km grid to identify areas for prediction. Grid cells without residential buildings were excluded, leaving 8,425 cells. The prediction was based on whether at least one malaria case was reported in each grid cell per month, using spatial data of patient locations. Four algorithms were used: gradient boosted (GBM), generalized linear (GLM), extreme gradient boosted (XGB), and ensemble models, incorporating environmental, sociodemographic, and meteorological data as predictors. The models were trained with data from May to October (2019–2021) and tested with data from May to October 2022. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC). Results: The AUROC of the prediction models performed excellently (GBM = 0.9243, GLM = 0.9060, XGB = 0.9180, and ensemble model = 0.9301). Previous malaria risk, population size, and meteorological factors influenced the model most in GBM and XGB. Conclusion Machine-learning models with properly preprocessed malaria case data can provide reliable predictions. Additional predictors, such as mosquito density, should be included in future studies to improve the performance of models.

Objectives: Severe fever with thrombocytopenia syndrome (SFTS) has no vaccine or treatment and an extremely high fatality rate. We aimed to analyze and evaluate the risk factors for death associated with SFTS. Methods: Among reports from 2018 to 2022, we compared and analyzed 1,034 inpatients aged 18 years or older with laboratory-confirmed SFTS who underwent complete epidemiological investigations. Results: Most of the inpatients with SFTS were aged 50 years or older (average age, 67.6 years). The median time from symptom onset to death was 9 days, and the average case fatality rate was 18.5%. Risk factors for death included age of 70 years or older (odds ratio [OR], 4.82); agriculture-related occupation (OR, 2.01); underlying disease (OR, 7.20); delayed diagnosis (OR, 1.28 per day); decreased level of consciousness (OR, 5.53); fever/chills (OR, 20.52); prolonged activated partial thromboplastin time (OR, 4.19); and elevated levels of aspartate aminotransferase (OR, 2.91), blood urea nitrogen (OR, 2.62), and creatine (OR, 3.21). Conclusion The risk factors for death in patients with SFTS were old age; agriculture-related occupation; underlying disease; delayed clinical suspicion; fever/chills; decreased level of consciousness; and elevated activated partial thromboplastin time, aspartate aminotransferase, blood urea nitrogen, and creatine levels.

Carbon dioxide (CO2) laser is one of the most widely used lasers in dermatology. CO2 laser can precisely ablate the skin with good hemostasis, which makes it an ideal surgical laser. With the development of pulsed CO2 laser, which enabled cleaner ablation with less residual thermal damage, CO2 laser resurfacing became the gold standard for skin rejuvenation. The rejuvenation effect of full-face CO2 laser resurfacing is unparalleled to other methods; however, it is associated with a relative high incidence of side effects and prolonged downtime. Fractional CO2 laser was developed to overcome this problem. With a new technology of fractionating the laser beam into hundreds of microbeams, fractional CO2 laser resurfacing can improve various skin conditions including skin laxity, photodamage, and acne scars with short downtime and significantly lesser side effects. For optimal treatment results, clinicians have to decide the treatment depth and density based on proper understanding of the laser tissue interaction and underlying skin conditions.
Acne Vulgaris ; Carbon Dioxide* ; Carbon* ; Cicatrix ; Dermatology ; Hemostasis ; Incidence ; Lasers, Gas* ; Rejuvenation ; Skin

A complete cDNA sequence encoding a pore-forming subunit (Kir6.2) of ATP-senstive potassium channel in the adult worm, Clonorchis sinensis, termed CsKir6.2, was isolated from an adult cDNA library. The cDNA contained a single open-reading frame of 333 amino acids, which has a structural motif (a GFG-motif) of the putative pore-forming loop of the Kir6.2. Peculiarly, the CsKir6.2 shows a lack-sequence structure, which deleted 57 amino acids were deleted from its N-terminus. The predicted amino acid sequence revealed a highly conserved sequence as other known other Kir6.2 subunits. The mRNA was weekly expressed in the adult worm.
Adenosine Triphosphate/metabolism ; Amino Acid Sequence ; Animals ; Base Sequence ; Cloning, Molecular ; Clonorchis sinensis/*genetics/metabolism ; Helminth Proteins/*genetics/metabolism ; Human ; Molecular Sequence Data ; Potassium Channels, Inwardly Rectifying/*genetics/metabolism ; RNA, Helminth/chemistry/genetics ; Sequence Alignment ; Support, Non-U.S. Gov't

A 20-year-old man presented with semicoma due to severe ethanol intoxication. Initially, his blood ethanol level was markedly elevated to 73 mmol/L. The patient's level of consciousness did not change for 6 hours with conservative treatment. In an attempt to expedite his recovery, hemodialysis was started using a femoral vein catheter. After an initial session of hemodialysis, his blood ethanol level was decreased to 19 mmol/L, and his mental status showed improvement. Subsequent hemodialysis further reduced his blood ethanol concentration to 3 mmol/L and improved his consciousness level. The patient was treated conservatively for additional complications caused by ethanol toxicity including liver failure, rhabdomyolysis and peripheral polyneuropathy. Most commonly, peripheral polyneuropathy is related with chronic ethanol intoxication and it is extremely rare in acute ethanol intoxication. We report a case of peripheral polyneuropathy related with acute ethanol intoxication and suggest that hemodialysis should be considered in patients with severe ethanol intoxication for life preservation and prevention of complications.
Catheters ; Consciousness ; Ethanol* ; Femoral Vein ; Humans ; Liver Failure ; Polyneuropathies ; Renal Dialysis* ; Rhabdomyolysis ; Sciatic Neuropathy* ; Young Adult

Fat embolism syndrome is a rare and potentially lethal complication most commonly seen in long bone fractures and intramedullary manipulation. The clinical triad of fat embolism syndrome consists of mental confusion, respiratory distress, and petechiae. This study reports a case of cerebral fat embolism syndrome following elective bilateral total knee replacement. After an uneventful anesthesia and initial recovery, the patient developed neurologic symptoms nine hours postoperatively.
Anesthesia ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Embolism, Fat ; Fractures, Bone ; Humans ; Neurologic Manifestations ; Purpura

BACKGROUND: Recently, the prevalence of diabetes mellitus in elderly people is increasing in Korea because of an increase in longevity. With advancing age, also a greater proportion of end-stage renal disease (ESRD) patients with complex medical co-morbidity contributes to the higher mortality seen in patients receiving dialysis. Diabetic nephropathy has become the most important cause of ESRD worldwide. More intensive therapeutic manipulation is needed to prevent the progression of diabetic nephropathy, but there are few studies about this subject in type 2 diabetes. The aim of this study is to predict renal outcomes of elderly people with type 2 diabetes and investigate risk factors related with the deterioration of renal function and the development of ESRD. METHODS: Study subjects were 67 elderly patients (over 65 years old) with type 2 diabetes. We retrospectively analyzed risk factors for the end points of doubling of serum creatinine or the development of ESRD (dialysis or transplantation). RESULTS: 17 patients (26.4%) reached the end points during the follow-up period. 16 patients of 43 patients with decreased renal function reached the end points and only one of 24 patients with preserved renal function reached the end points. A univariate analysis revealed significant correlations between renal outcomes and duration of diabetes, anemia, hypoalbuminemia, BUN, baseline serum creatinine, GFR, serum calcium, phosphorus, uric acid levels and the degree of proteinuria. In our multivariate analysis, proteinuria and baseline serum creatinine level were significantly independent risk factors. The risk of doubling of serum creatinine or development of ESRD among patients with baseline urinary protein excretion rate >or=1g/24h was six times higher compared with the risk among those with urinary protein excretion rate <1g/24h. CONCLUSION: Proteinuria and the degree of baseline kidney dysfunction are significant risk factors that contribute to the deterioration of renal function and the development of ESRD in elderly patients with type 2 diabetes. Proteinuria is the most powerful independent predictor of renal outcomes.
Aged* ; Anemia ; Calcium ; Creatinine ; Diabetes Mellitus ; Diabetic Nephropathies* ; Dialysis ; Follow-Up Studies ; Humans ; Hypoalbuminemia ; Kidney ; Kidney Failure, Chronic ; Korea ; Longevity ; Mortality ; Multivariate Analysis ; Phosphorus ; Prevalence ; Proteinuria ; Retrospective Studies* ; Risk Factors ; Uric Acid