It is well known that oral appliance could improve respiratory difficulty in patients with obstructive sleep apnea (OSA). To evaluate the effect of oral appliance, polysomnography and cephalometry were performed in OSA patients before and after oral appliance was used. Twenty four OSA patients were included in this study. Respiratory difficulty index (RDI) was obtained from polysomnography and the movement of soft palate, tongue, posterior pharygeal wall, hyoid bone, and mandible and the variables of the facial pattern were measured on the cephalogram. The changes of cephalometric parameters were compared to the RDI changes and the correlation was tested. After oral appliance was used, RDI decreased from 46.8 to 13.3. There was significant relationship between RDI improvement and the anterior movement of the mandible and superior movement of the hyoid bone. In 8 patients whose RDI was most improved, RDI improvement rate was correlated with the anterior movement of the on tongue and anterior-posterior (AP) diameter of the airway at the levels between the lower portion of the soft palate and epiglottis. These results could conclude that anterior movement of the tongue and superior movement of the hyoid bone would be favorable cephalometric parameters for the improvement of OSA.
Cephalometry ; Epiglottis ; Humans ; Hyoid Bone ; Mandible ; Palate, Soft ; Polysomnography ; Sleep Apnea, Obstructive* ; Tongue

OBJECTIVE: The purpose of this study was to investigate the stability of mini-implants in relation to loading time. METHODS: A total of 48 mini-implants (ORLUS, Ortholution, Korea) were placed into the buccal alveolar bone of the mandible in 8 male beagle dogs. Orthodontic force (200 - 250 gm) was applied immediately for the immediate loading group while force application was delayed for 3 weeks in the delayed loading group. For the subsequent loading periods (3, 6, 12 weeks), BIC (bone implant contact) and BV/TV (bone volume/total volume) and mobility test were carried out. RESULTS: The immediate loading group showed no changes in BIC from 3 to 12 weeks, while the delayed loading group showed a significant increase in BIC between 3 and 12 weeks (p < 0.05). The BV/TV of the delayed loading group significantly increased from 6 to 12 weeks of loading (p < 0.05), while the BV/TV of the immediate loading group decreased from 3 to 12 weeks of loading. However, there was no significant difference in BV/TV between experimental groups. The mobility of the immediate loading group was not significantly different from that of the delayed loading group after 12 weeks of loading (p < 0.05). CONCLUSIONS: These results showed that immediate loading does not have a negative effect on the stability of mini-implants compared to the early loading method in both the clinical and histomorphometric point of view.
Animals ; Dogs ; Humans ; Male ; Mandible ; Nitrogen Mustard Compounds

Anchorage in orthodontics is very important factor for orthodontist to treat malocclusion from diagnosis and treatment planning to end of treatment. Skeletal anchorage like miniscrew is supposed to be more effective method in anchorage control than conventional anchorage which needs patient's good cooperation. So this article will be mentioned about various clinical application of miniscrew through the general investigation and case reports about orthodontic use of miniscrew, specially about screwing area and clinical consideration of miniscrew's screwing on midpalate. The changes of treatment philosophy and methods by using skeletal anchorage were summarized and following results were obtained. 1. The orthodontic anchorage changed from relative concept to absolute one. 2. Bodily movement of teeth gets easier and determinate force system is possible on biomechanical consideration. 3. Some part of treatment that needs surgical intervention is possible by just orthodontic treatment.
Diagnosis ; Malocclusion ; Orthodontics ; Philosophy ; Tooth Movement* ; Tooth*

The purpose of this study was to evaluate the clinical usefulness of plasma arc light which can reduce the curing time dramatically compared by shear bond strengths and failure patterns of the brackets bonded with visible light in direct bracket bonding. Some kinds of brackets were bonded with the Transbond(R) to the human premolars which were embedded in the resin blocks according to the various conditions. After bonding, the shear bond strength was tested by Instron universal testing machine and in addition , the amount of residual adhesive remaining on the tooth after debonding was measured by the stereoscope and assessed with adhesive remnant index(ARI). The results were as follows : 1. When plasma arc light was used for bonding the brackets, the shear bond strength was clinically sufficient in both metal and ceramic brackets, but resin brackets showed significantly lower bond strength but which was clinically useful. 2. When metal brackets were bonded using visible light, there was no significant difference in shear bond strength due to the light-curing time and the bond strength was clinically sufficient. 3. When the adhesive failure patterns of brackets bonded with plasma arc light were observed by using the adhesive remnant index, the bond failure of the metal and resin bracket occurred more frequently at bracket-adhesive interface but the failure of the ceramic bracket occurred more frequently at enamel-adhesive interface. 4. There was no statistically significant difference of the shear bond strength and adhesive failure pattern between metal bracket bonded for 2 seconds by curing with plasma arc light and 10 seconds by curing with visible light. 6. When metal brackets were bonded using plasma arc light, the shear bond strength decreased as the distance from the light source increased. The above results suggest that plasma arc light can be clinically useful for bonding the brackets without fear of the decrease of the shear bond strength.
Adhesives* ; Bicuspid ; Ceramics ; Humans ; Light ; Plasma* ; Tooth

BACKGROUND: IS6110 DNA fingerprint is a very useful tool for investigating the transmission of tuberculosis. The aim of this study was to identify the epidemiological situations within a given area (one province). METHODS: The 681 Mycbobacterium tuberculosis isolates from patients, who were registered at health centers in Gyeonggi Province from May to December in 2004, were subjected to IS6110 DNA fingerprinting. Patients belonging to clusters were interviewed by health-workers to determine their previous contacts or household TB history. RESULTS: The number of IS6110 copies of the 681 isolates showed diverse fingerprint patterns from 0 to 21 of which the most prevalent copy number was 10 from 120 isolates (17.6%). Thirty-three isolates (4.8%) belonged to the K strain, and 128 isolates (18.8%) belonged to the K family. There were 180 (26.4%) isolates belonged belonging to fifty clusters, of which two clusters were within household transmission. Forty-three (23.9%) out of 180 patients resided in an area under the same health center control. The rate of clusters in those aged 60-70 was higher than in any other age group ( 95% CI of RR : 1.072 ~ 1.988). CONCLUSION: This is the first report of an epidemiological survey based on a whole province using a DNA fingerprinting technique for M. tuberculosis. These results will be helpful in developing a program or policies to prevent the transmission of TB.
Dermatoglyphics ; DNA Fingerprinting* ; DNA* ; Epidemiology ; Family Characteristics ; Gyeonggi-do* ; Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Tuberculosis

OBJECTIVE: This study was conducted to compare the perioperative outcomes in patients with symptomatic uterine myoma who underwent laparoscopic (LM) or laparoscopically assisted myomectomy (LAM). METHODS: A total of 207 patients with myoma underwent LM or LAM in Samsung Medical Center between October 2006 and March 2010. Of them, 121 patients with LM and 50 with LAM met the inclusion criteria and were compared for the perioperative outcomes. RESULTS: The operation time was significantly shorter in the LAM group than in the LM group (111 min versus 139 min; p<.001, respectively). Estimated blood loss was significantly higher in the LAM group (p<.001). Intraoperative, early postoperative complications, hospitalization days and postoperative analgesics use were similar between the 2 study groups. CONCLUSION: LM and LAM is comparable in the perioperative outcomes in patients with symptomatic uterine myoma.
Analgesics ; Female ; Hospitalization ; Humans ; Laparoscopy ; Lipopolysaccharides ; Myoma ; Postoperative Complications

BACKGROUND: A single-arm phase II study of neoadjuvant chemotherapy plus durvalumab and tremelimumab in the treatment of advanced-stage ovarian cancer has begun in Korea. We hypothesized that adding durvalumab (anti-programmed death-ligand 1 antibody) and tremelimumab (anti-cytotoxic T-lymphocyte-associated protein 4 antibody) to chemotherapy in treating this cancer can increase progression-free survival (PFS) with minimal effects on safety. METHODS: During treatment, serial biopsies will be performed on pre-treatment, at interval debulking surgery and progression to identify immune biomarkers and changes in the tumor microenvironment. Patients with histologically confirmed stage IIIC/IV epithelial ovarian cancer are offered durvalumab, tremelimumab plus chemotherapy for neoadjuvant chemotherapy and durvalumab plus chemotherapy for adjuvant chemotherapy. Twenty-four patients will be included from four Korean institutions within 1 year. The primary endpoint is a 12-month PFS rate. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03899610
Biomarkers ; Biopsy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Humans ; Immunotherapy ; Korea ; Ovarian Neoplasms ; Tumor Microenvironment

Objective: Management of heavily pre-treated platinum-resistant ovarian cancer remains a therapeutic challenge. Outcomes are poor with non-platinum, single-agent chemotherapy (CT); however, molecularly targeted anticancer therapies provide new options. Methods: This open-label, investigator-initiated, phase 2 umbrella trial (NCT03699449) enrolled patients with platinum-resistant ovarian cancer (at least 2 prior lines of CT and Eastern Cooperative Oncology Group 0/1) to receive combination therapy based on homologous recombination deficiency (HRD) and programmed death ligand 1 (PD-L1) status determined by archival tumour sample assessment. HRD-positive patients were randomised to either olaparib 200mg bid tablet + cediranib 30mg qd (arm 1) or olaparib 300mg bid tablet + durvalumab 1,500mg q4w (arm 2). HRD-negative patients were allocated to either durvalumab 1,500 mg q4w + pegylated liposomal doxorubicin (PLD) or topotecan or weekly paclitaxel (6 cycles; arm 3, those with PD-L1 expression) or durvalumab 1,500 mg q4w + tremelimumab 75mg q4w (4 doses) + PLD or topotecan or weekly paclitaxel (4 cycles; arm 4, those without PD-L1 expression). Arm 5 (durvalumab 1,500 mg q4w + tremelimumab 300mg [1 dose] + weekly paclitaxel [60 mg/m2 D1,8,15 q4w for 4 cycles] was initiated after arm 4 completed. The primary endpoint was objective response rate (ORR; Response Evaluation Criteria in Solid Tumours 1.1). Results: Between Dec 2018 and Oct 2020, 70 patients (median 57 years; median 3 prior treatment lines [range 2–10]) were treated (n=16, 14, 5, 18, and 17, respectively). Overall ORR was 37.1% (26/70, 95% confidence interval=25.9, 49.5); 2 achieved complete response. ORR was 50%, 42.9%, 20%, 33.3%, and 29.4%, respectively. Grade 3/4 treatment-related adverse events (TRAEs) were reported in 37.5%, 35.7%, 20%, 66.7%, and 35.3% of patients, respectively. No TRAEs leading to treatment discontinuation and no grade 5 TRAEs were observed. Conclusion This study, the first biomarker-driven umbrella trial in platinum-resistant recurrent ovarian cancer, suggests clinical utility with biomarker-driven targeted therapy. All treatment combinations were manageable, and without unexpected toxicities.

Unilateral pulmonary artery hypoplasia (UPAH) is a rare disease in adults and is frequently accompanied by a congenital cardiac anomaly at a young age. The diagnosis is usually based on computed tomography (CT), angiography, and magnetic resonance imaging (MRI). However, no reports are available on retrograde flow in patients with UPAH. We describe a 68-year-old man with isolated UPAH and retrograde blood flow. He was admitted for dyspnea on exertion for the past 23 years. His diagnosis was delayed, as his symptoms and signs mimicked his underlying pulmonary diseases, such as emphysema and previous tuberculous pleurisy sequelae. A discrepancy was detected between the results of a ventilation-perfusion scan and the CT image. This was resolved by MRI, which showed retrograde blood flow from the right to the left pulmonary artery. Using MRI, we diagnosed this patient with isolated pulmonary artery hypoplasia and retrograde flow.
Adult ; Aged ; Angiography ; Dyspnea ; Emphysema ; Humans ; Lung Diseases ; Magnetic Resonance Imaging ; Pulmonary Artery ; Rare Diseases ; Regional Blood Flow ; Tuberculosis, Pleural

METHODS: The efficiency of electroporation-based delivery of AsCpf1/mRNA and AsCpf1/RNP to target exon 3 of leukemia inhibitory factor (Lif) into mouse zygotes was evaluated. Embryos that developed to the two-cell stage after zygote electroporation were transferred into the oviducts of surrogate mothers to produce AsCpf1-mediated LIF KO mice. The genome editing efficiency of blastocysts and pups was tested using the T7E1 assay and/or DNA sequencing. Congenital abnormalities and reproductive phenotypes in LIF KO mice produced by electroporation with AsCpf1/RNP were examined. RESULTS: Survival and two-cell development of electroporated zygotes were comparable between the AsCpf1/mRNA and AsCpf1/RNP groups, whereas genome editing efficiency was relatively higher in the AsCpf1/RNP group (13.3% vs 18.1% at blastocyst and 33.3% vs 45.5% at offspring), respectively. Two mouse lines with a frameshift mutation in exon 3 of the Lif gene were established from the AsCpf1/RNP group. All congenital abnormalities of LIF KO mice produced by AsCpf1/RNP electroporation were observed. AsCpf1-mediated LIF KO mice showed postnatal growth retardation and implantation failure, both of which are major phenotypes of LIF KO mice generated by conventional gene targeting. CONCLUSION Electroporation of AsCpf1/RNP at the zygote stage is an efficient genome editing method to produce KO mice.