PURPOSE: The aim of this study was to investigate a comparison of implant bone bed preparation with Er,Cr:YSGG laser and conventional drills on the relationship between implant stability quotient (ISQ) values and implant insertion variables. MATERIALS AND METHODS: Forty implants were inserted into two different types of pig rib bone. One group was prepared with conventional drills and a total of 20 implants were inserted into type I and type II bone. The other group was prepared with a Er,Cr:YSGG laser and a total of 20 implants were inserted into type I and type II bone. ISQ, maximum insertion torque, angular momentum, and insertion torque energy values were measured. RESULTS: The mean values for variables were significantly higher in type I bone than in type II bone (P < .01). In type I bone, the ISQ values in the drill group were significantly higher than in the laser group (P < .05). In type II bone, the ISQ values in the laser group were significantly higher than in the drill group (P < .01). In both type I and type II bone, the maximum insertion torque, total energy, and total angular momentum values between the drill and laser groups did not differ significantly (P > or = .05). The ISQ values were correlated with maximum insertion torque (P < .01, r = .731), total energy (P < .01, r = .696), and angular momentum (P < .01, r = .696). CONCLUSION: Within the limitations of this study, the effects of bone bed preparation with Er,Cr:YSGG laser on the relationship between implant stability quotient (ISQ) values and implant insertion variables were comparable to those of drilling.
Mandrillus ; Ribs ; Salicylates ; Torque

Hereditary hemorrhagic telangiectasia (HHT) or Osler-Weber-Rendu disease is an autosomal dominant disorder characterized by repeated episodes of bleeding. Multiple telangiectases consisting of thin-walled, dilated vascular channels with arteriovenous communication may involve, for example, mucocutaneous tissue, the gastrointestinal tract, and the liver, lung, and brain. We report the imaging findings of two cases of HHT involving arteriovenous malformation of both the lungs and liver, a rare condition. Chest radiography revealed a round mass, while helical CT showed a feeding artery and draining vein with arteriovenous malformation in the lung. Color Doppler sonography revealed an enlarged and tortuous hepatic artery with high systolic velocity. CT demonstrated an enlarged hepatic artery, arteriovenous shunt, and early draining hepatic vein in the liver. Celiac angiography showed arteriovenous malformation.
Angiography ; Arteries ; Arteriovenous Malformations* ; Brain ; Gastrointestinal Tract ; Hemorrhage ; Hepatic Artery ; Hepatic Veins ; Liver* ; Lung* ; Radiography ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis ; Thorax ; Tomography, Spiral Computed ; Veins

BACKGROUND: Pneumonia is the most common cause of death among patients with infectious disease in Korea. However, studies of pneumonia with septic shock in patients presenting to the emergency department are limited. The aim of this study was to investigate the prognostic factors associated with pneumonia with septic shock in patients presenting to the emergency department. METHODS: From January 2008 to September 2014, patients with pneumonia with septic shock admitted through the emergency department were retrospectively examined. RESULTS: Of the 561,845 patients who visited the emergency department, 398 were admitted for pneumonia with septic shock. The 28-day mortality rate in these patients was 36.4%. The independent prognostic factors were old age (>70 yrs) (odds ratio [OR], 2.42; 95%, confidence interval [CI], 1.35-4.32), Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR, 1.04; 95% CI, 1.01-1.08), leukopenia (OR, 3.63; 95% CI, 1.48-8.94), prolonged PT-INR (OR, 2.53; 95% CI, 1.41-4.54), and hypoxemia (OR, 2.88; 95% CI, 1.30-6.38). CONCLUSIONS: A poor prognosis of patients with pneumonia is associated with old age (>70 yrs), increased APACHE II score, leukopenia, prolonged PT-INR, and hypoxemia.
Anoxia ; APACHE ; Cause of Death ; Communicable Diseases ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Korea ; Leukopenia ; Mortality ; Pneumonia* ; Prognosis ; Retrospective Studies ; Shock, Septic*

Lichen aureus is regarded as an uncommon variant of the pigmented purpuric dermatosis and resistant to treatment. Recently several authors reported the PUVA therapy to be effective in the pigmented purpuric dermatosis, but there was no report that the PUVA therapy was tried to the lichen aureus. We tried topical PUVA therapy on a 54-year-old male with bilateral lichen aureus. After 23 times of topical PUVA therapy, the lesion improved markedly. This report may provide a new method of treatment for lichen aureus.
Humans ; Lichens* ; Male ; Middle Aged ; PUVA Therapy* ; Skin Diseases

No abstract available.
Echocardiography* ; Humans ; Infant, Newborn*

BACKGROUND: The aim of this study was to assess the relationship between acute physiologic and chronic health examination (APACHE) II and sequential organ failure assessment (SOFA) scores and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia (TH). METHODS: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between January 2010 and December 2012 were retrospectively evaluated. We captured all components of the APACHE II and SOFA scores over the first 48 hours after intensive care unit (ICU) admission (0 h). The primary outcome measure was in-hospital mortality and the secondary outcome measure was neurologic outcomes at the time of hospital discharge. Receiver-operating characteristic and logistic regression analysis were used to determine the predictability of outcomes with serial APACHE II and SOFA scores. RESULTS: A total of 138 patients were enrolled in this study. The area under the curve (AUC) for APACHE II scores at 0 h for predicting in-hospital mortality and poor neurologic outcomes (cerebral performance category: 3-5) was more than 0.7, and for SOFA scores from 0 h to 48 h the AUC was less than 0.7. Odds ratios used to determine associations between APACHE II scores from 0 h to 48 h and in-hospital mortality were 1.12 (95% confidence interval [CI], 1.03-1.23), 1.13 (95% CI, 1.04-1.23), and 1.18 (95% CI, 1.07-1.30). CONCLUSIONS: APACHE II, but not SOFA score, at the time of ICU admission is a modest predictor of in-hospital mortality and poor neurologic outcomes at the time of hospital discharge for patients who have undergone TH after return of spontaneous circulation following OHCA.
APACHE ; Area Under Curve ; Cardiopulmonary Resuscitation ; Hospital Mortality ; Humans ; Hypothermia* ; Hypothermia, Induced ; Intensive Care Units ; Logistic Models ; Odds Ratio ; Organ Dysfunction Scores* ; Out-of-Hospital Cardiac Arrest* ; Outcome Assessment (Health Care) ; Retrospective Studies ; Survivors

Pigmented villonodular synovitis(PVNS) is a synovial lesion of joints or tendon sheaths, characterized by villous and nodular overgrowth of the synovial membrane. It commonly occurs in synovial joints of the appendicular skeleton, particularly those of the knee and hip, but rarely affecting those of the spine. We report a case of PVNS of the lumbar spine mimicking epidural mass.
Hip ; Joints ; Knee ; Skeleton ; Spine* ; Synovial Membrane ; Synovitis ; Synovitis, Pigmented Villonodular* ; Tendons

Objectives: Insomnia is a disorder that involves poor sleep quality at nighttime and various symptoms in the daytime. Although it is known to increase cardiovascular risk as well as psychiatric comorbidities such as depression and anxiety, less attention has been paid to daytime sleepiness in patients with insomnia. This study aimed to investigate clinical and polysomnographic characteristics and identify factors influencing excessive daytime sleepiness in patients with insomnia. Methods: Between 2014 and 2022, 1,241 patients with insomnia as the primary symptom who underwent polysomnography were included in the study. Patients with an Epworth sleepiness scale ≥10 were classified as having insomnia accompanied by daytime sleepiness, and sleep-related questionnaire responses and polysomnography findings were utilized for analysis. Results: A total of 327 patients (26.3%) had daytime sleepiness, and a higher prevalence was observed in younger and male individuals. Poor sleep quality, severe depression, and insomnia were identified through the questionnaire. Polysomnography showed longer total sleep times, a higher proportion of stage N3 sleep, and higher sleep efficiency. The variables related to the Epworth sleepiness scale identified in multiple regression analysis were age, the Korean Beck Depression Inventory-II, sleep latency, and the apnea-hypopnea index on polysomnography. Conclusions Insomnia with excessive daytime sleepiness was more affected by depression than indicated by polysomnography findings. The pathophysiology is presumed to be related to sleep misperception, and further studies are needed to elucidate the discrepancy between excessive daytime sleepiness and polysomnography findings.

Objectives: The diagnosis of hypersomnia may be changed by the repeated multiple sleep latency test (MSLT). We investigated the long-term reliability of MSLT in the diagnosis of narcolepsy type 1(NT1) and 2 (NT2). Methods: We reviewed the data of patients with NT1 and NT2 who underwent MSLT at least twice between 2008 and 2020. The clinical information and polysomnography/MSLT data were thoroughly assessed, and two sleep experts evaluated the consistency and reliability of diagnosis independently. Results: Eighty patients (38 with NT1 and 42 with NT2 as a final diagnosis) were included in this study. Of the 80 patients, 20 (nine with NT1 and 11 with NT2) underwent the 3rd MSLT. No significant differences were found in the sleep data and Epworth Sleepiness Scale at baseline. During the 2nd MSLT, 18.4% (n=7) patients with NT1 and 47.6% (n=20) patients with NT2 did not satisfy the diagnosis of narcolepsy. At the 3rd MSLT, six out of nine patients with NT1 and seven of 11 patients with NT2 were not suitable for narcolepsy. Two of the initial NT1 (5.2%) and 10 of the initial NT2 (23.8%) patients were found to be normal. Three patients who were confirmed to have NT1 through consecutive MSLTs had significantly shorter sleep latency and more number of sleep-onset rapid eye movements than the other patients. Conclusions The reliability of MSLT were not robust in the diagnosis of NT1 and NT2 in this long-term follow-up study. The MSLT results should be interpreted with careful consideration based on elaborate preparations.

Objectives: The diagnosis of hypersomnia may be changed by the repeated multiple sleep latency test (MSLT). We investigated the long-term reliability of MSLT in the diagnosis of narcolepsy type 1(NT1) and 2 (NT2). Methods: We reviewed the data of patients with NT1 and NT2 who underwent MSLT at least twice between 2008 and 2020. The clinical information and polysomnography/MSLT data were thoroughly assessed, and two sleep experts evaluated the consistency and reliability of diagnosis independently. Results: Eighty patients (38 with NT1 and 42 with NT2 as a final diagnosis) were included in this study. Of the 80 patients, 20 (nine with NT1 and 11 with NT2) underwent the 3rd MSLT. No significant differences were found in the sleep data and Epworth Sleepiness Scale at baseline. During the 2nd MSLT, 18.4% (n=7) patients with NT1 and 47.6% (n=20) patients with NT2 did not satisfy the diagnosis of narcolepsy. At the 3rd MSLT, six out of nine patients with NT1 and seven of 11 patients with NT2 were not suitable for narcolepsy. Two of the initial NT1 (5.2%) and 10 of the initial NT2 (23.8%) patients were found to be normal. Three patients who were confirmed to have NT1 through consecutive MSLTs had significantly shorter sleep latency and more number of sleep-onset rapid eye movements than the other patients. Conclusions The reliability of MSLT were not robust in the diagnosis of NT1 and NT2 in this long-term follow-up study. The MSLT results should be interpreted with careful consideration based on elaborate preparations.