PURPOSE: Determination of pulmonary to systemic blood flow ratio (QP/QS) is important for the management of patients with left-to-right shunt. This study was performed to assess the agreement of Qp/Qs ratio using the radionuclide method and oxymetry, to investigate the factors influencing the agreement, and to know how interchangeable the results of each technique. MATERIALS AND METHODS: We compared the Qp/Qs measured by single-pass radionuclide angiocardiography and oxymetry during catheterization in 207 patients who underwent both studies. In radionuclide method, Qp/Qs was calculated from the pulmonary time-activity curves using a gamma variate fit. The correlation and Bland-Altman analysis were performed according to the levels of shunt and associated lesions. RESULTS: The mean Qp/Qs was 1.83+/10.50 by radionuclide, and 1.74+/10.51 by oxymetry. The overall correlation coefficient was 0.86(p<0.001), and Bland-Altman range of agreement encompassing 4SD was 1.05. For atrial septal defect, ventricular septal defect, patent ductus arteriosus, tricuspid and mitral insufficiency, the correlation coefficient was 0.78, 0.90, 0.84, 0.63 and 0.44, and Bland-Altman range was 1.52, 0.74, 0.96, 1.57, and 1.50, respectively. CONCLUSION: There is good agreement but wide variance between the Qp/Qs ratios by radionuclide method and oxymetry. Associated atrioventricular valvar insufficiency decreases the correlation coefficient and widens the variance. Wide overall variance suggests that Qp/Qs measurements by two techniques should not be used interchangeably.
Angiocardiography* ; Catheterization ; Catheters ; Ductus Arteriosus, Patent ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Mitral Valve Insufficiency

Local anesthesia is administered to control pain, but it may induce fear and anxiety. Root planing is a non-surgical periodontal therapy; however, when it is performed in an extensive manner, some tissue removal is inevitable. Notably, this removal may be so painful that local anesthesia is required to be administered to the area scheduled for the treatment. Although patients tend to accept root planing easily, they frequently express a fear of local anesthesia. Intraosseous anesthesia (IA) is an intraosseous injection technique, whereby local anesthetic is injected into the cancellous bone supporting the teeth. A computer-controlled IA system (CIAS) exhibits multiple benefits, such as less painful anesthesia, reduced soft tissue numbness, and the provision of palatal or lingual, as well as buccal, anesthesia via single needle penetration. In this report, we present two cases of root planing that were performed under local anesthesia, using a CIAS.
Anesthesia ; Anesthesia, Local ; Anxiety ; Humans ; Hypesthesia ; Needles ; Root Planing ; Tooth

Recently, the prevalence of diabetic mellitus patients in Korea has been increasing, and it increasing with age. The treatment goal of diabetes is to prevent complications through blood sugar management, for which it is important to maintain an appropriate nutritional state. Unbalanced diet refers to excessive or insufficient nutrition, which can be generally confirmed through weight conditions. Therefore, medical nutrition therapy in diabetic patients with unbalanced diet aims to maintain a moderate body mass index. Older people with diabetes have a higher risk of unbalanced diet than those without diabetes. Clinical nutritional intervention in diabetic patients should shift from strict dietary restrictions for treatment of metabolic syndrome/obesity to diet for prevention of frailty and sarcopenia with age. Therefore, clinical nutrition therapy for diabetic patients with unbalanced diet should be individualized in consideration of age, gender, and medical condition. Medical nutrition therapy tailored for each patient can contribute to improving the nutritional status of diabetic patients, prolonging healthy life expectancy and improving quality of life.

Motor impairment due to stroke limits patients’ mobility, activities of daily living, and negatively affects their return to the workplace. It also reduces patients’ quality of life and increases the socioeconomic burden of stroke. Therefore, optimizing the recovery of motor impairment after stroke is a very important goal for both individuals and society as a whole. The emergence and improvement of various technologies in the Fourth Industrial Revolution have exerted a major influence on the development of new rehabilitation methods and efficiency enhancements for existing methods. This review categorizes rehabilitation methods that promote the recovery of motor function into upper limb function and lower limb function and summarizes recent advances in stroke rehabilitation. Although debate continues regarding the effects of some rehabilitation therapies, it is hoped that the evidence will be improved through ongoing research so that clinicians can treat patients with a higher level of evidence.

Background: This study compared and analyzed various concentrations of mesoporous bioactive glass (MBG) gel, commercialacidulated phosphate fluoride gel (APF-gel), and Tooth MousseTM (TM) to evaluate the enamel remineralization effect of early dental caries. Methods: The samples prepared using sound bovine teeth were subjected to MBG gel, APF-gel, and TM to measure changes insurface hardness (Vickers hardness number, VHN) and fluorescence loss values compared to those of sound teeth (ΔF).Repeated measures analysis of variance (ANOVA), Friedman’s ANOVA, Wilcoxon signed-rank test, one-way ANOVA, and Kruskal-Wallis test were used for statistical analysis. Results: The VHN was significantly increased after the two treatments compared to the initial VHN in all other groups, with theexception of the APF gel group (p＜0.05). Compared to the initial ΔF, the APF-gel group significantly decreased ΔF after two treatments, and the remaining groups exhibited significantly increased ΔF (p＜0.05). The MBG group exhibited significantly higher ΔF values than those of the APF gel and TM groups (p＜0.05). Conclusion The MBG group exerted a significantly higher remineralization effect than that of the APF gel group and exhibited asimilar or slightly higher remineralization effect compared to that of the TM group.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic autoimmune disease of the peripheral nervous system, primarily treated with corticosteroids and intravenous immunoglobulin as first-line therapies. Early treatment yields better outcome before nerve damage caused by the immune response. Once axonal damage has progressed, immunotherapy becomes ineffective, making early intervention crucial. Additionally, as treatment responses vary among patients, it is essential to assess treatment efficacy objectively and tailor therapy accordingly. Since there are currently no biomarkers that accurately reflect disease status, regular physical examinations are necessary to evaluate treatment effectiveness and adjust maintenance therapy. This review outlines the current clinical guidelines for the treatment of CIDP and explores emerging therapeutic options, including neonatal Fc receptor inhibitors and complement pathway inhibitors.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic autoimmune disease of the peripheral nervous system, primarily treated with corticosteroids and intravenous immunoglobulin as first-line therapies. Early treatment yields better outcome before nerve damage caused by the immune response. Once axonal damage has progressed, immunotherapy becomes ineffective, making early intervention crucial. Additionally, as treatment responses vary among patients, it is essential to assess treatment efficacy objectively and tailor therapy accordingly. Since there are currently no biomarkers that accurately reflect disease status, regular physical examinations are necessary to evaluate treatment effectiveness and adjust maintenance therapy. This review outlines the current clinical guidelines for the treatment of CIDP and explores emerging therapeutic options, including neonatal Fc receptor inhibitors and complement pathway inhibitors.

Background: This study compared and analyzed various concentrations of mesoporous bioactive glass (MBG) gel, commercialacidulated phosphate fluoride gel (APF-gel), and Tooth MousseTM (TM) to evaluate the enamel remineralization effect of early dental caries. Methods: The samples prepared using sound bovine teeth were subjected to MBG gel, APF-gel, and TM to measure changes insurface hardness (Vickers hardness number, VHN) and fluorescence loss values compared to those of sound teeth (ΔF).Repeated measures analysis of variance (ANOVA), Friedman’s ANOVA, Wilcoxon signed-rank test, one-way ANOVA, and Kruskal-Wallis test were used for statistical analysis. Results: The VHN was significantly increased after the two treatments compared to the initial VHN in all other groups, with theexception of the APF gel group (p＜0.05). Compared to the initial ΔF, the APF-gel group significantly decreased ΔF after two treatments, and the remaining groups exhibited significantly increased ΔF (p＜0.05). The MBG group exhibited significantly higher ΔF values than those of the APF gel and TM groups (p＜0.05). Conclusion The MBG group exerted a significantly higher remineralization effect than that of the APF gel group and exhibited asimilar or slightly higher remineralization effect compared to that of the TM group.