In adult patients with dental phobia, dental treatment may be difficult, or may not be possible. Depending on the level of fear or anxiety, non-pharmacological or pharmacological behavior management techniques are used in the dental treatment of such patients. Among the pharmacological behavior management techniques, minimal sedation, that is, the lowest depth of sedation, can be easily obtained in adult patients using oral sedatives, does not require special equipment or tools, and does not affect ventilatory and cardiovascular function. Diazepam is an anxiolytic drug belonging to the benzodiazepine family that, in addition to relieving anxiety, produces muscle relaxation, and is a representative drug used in adult patients with fear of dental treatment. Herein, we report the case of a 50-year-old woman with severe dental fear who successfully underwent long-term dental treatment in approximately 20 visits with minimal sedation using oral diazepam. In addition, we reviewed the considerations for the use of benzodiazepines for minimal sedation.

In adult patients with dental phobia, dental treatment may be difficult, or may not be possible. Depending on the level of fear or anxiety, non-pharmacological or pharmacological behavior management techniques are used in the dental treatment of such patients. Among the pharmacological behavior management techniques, minimal sedation, that is, the lowest depth of sedation, can be easily obtained in adult patients using oral sedatives, does not require special equipment or tools, and does not affect ventilatory and cardiovascular function. Diazepam is an anxiolytic drug belonging to the benzodiazepine family that, in addition to relieving anxiety, produces muscle relaxation, and is a representative drug used in adult patients with fear of dental treatment. Herein, we report the case of a 50-year-old woman with severe dental fear who successfully underwent long-term dental treatment in approximately 20 visits with minimal sedation using oral diazepam. In addition, we reviewed the considerations for the use of benzodiazepines for minimal sedation.

The present study was performed to evaluate the clinical effects following local application of 30% minocycline strip(polycaprolactone), 2% minocycline gel(hydro-carbon gel) and 12% minocycline strip(polylactide, Minodent) to augment scaling and root planing in patients with chronic adult periodontitis. Forty teeth with periodontitis were enrolled in the study anddistributed into 4 groups including control group. All patients performed standardized oral hygiene instructions and mechanical debridement at the beginning of the study and then each local delivery drugs were inserted into periodontal pocket in each groups. Examinations regarding plaque index(PI), papillary bleeding index (PBI), probing pocket depth (PPD) were carried out at 0, 2, 4 weeks. All experimental groups showed statistically significant differences between baseline and 2 and 4 weeks in every clinical indices. Especially, 30%minocycline strip and Minodent group showed a significant improvement in PBI at 2 weeks and in PPD at 2 and 4 weeks. In conclusion, highly bio-resorbable Minodent delivered subgingivally as an adjunct to scaling and root planing induces better clinical effects for periodontal health than 2% minocycline gel and control group.
Adult ; Male ; Female ; Humans

No abstract available.
Animals ; Coculture Techniques* ; Embryonic Structures* ; Mice*

PURPOSE: Regional lymphadenitis is the most common complication of BCG vaccination and has various clinical course and prognosis, but there are no accurate guidelines for the management BCG lymphadenitis. This study was performed to reveal the clinical course of BCG lymphadenitis and provide guidelines for its management by comparison of observation and medication groups. METHODS: Between January, 2002 and April, 2003, 45 patients with non-suppurative lymphadenitis were reviewed. They were divided into two groups, and retrospectively compared. Group I consisted of 25 observation cases and group II of 20 antituberculous medication cases. RESULTS: The most prevalent age group of the 45 cases was three months old, and the most prevalent site of lesion was the ipsilateral axilla. A palpable single lesion was the most common finding. According to treatment (observation vs. antituberculous medication), the medication did not affect the prevention of suppuration. CONCLUSION: For the management of BCG lymphadenitis, systemic antituberculous medication and observation are not recommended, with active surgical resection being the treatment of choice.
Axilla ; Humans ; Lymphadenitis* ; Mycobacterium bovis* ; Prognosis ; Retrospective Studies ; Suppuration ; Vaccination

Objective: Macrophages have been shown to play important roles in various pathophysiological processes of the central nervous system via neuroinflammation, leading to an increased interest in macrophage biology. Circulating blood monocytes are among the first cells to infiltrate the brain after ischemic stroke; however, the role of innate immune cells such as monocytes and macrophages remains to be elucidated. Here, we investigated the association between blood monocytes and infarct size following ischemic stroke. Methods: We induced stroke using a focal ischemia mouse model through middle cerebral artery suture occlusion. To deplete circulating blood monocytes, clodronate was injected intraperitoneally 24 h before the surgery. Animals were sacrificed at specified time points, and the infarct size and mRNA expression were then measured. Results: The clodronate-injected mice showed significantly smaller infarct size than the control mice. Immunohistochemical staining revealed that monocyte depletion significantly blocked the infiltration of macrophages and microglia. The mRNA expression levels of macrophage and microglia markers were higher in the left infarcted brain than in the right non-infarcted brain. Conclusions In summary, monocyte depletion reduced the infarct size and mitigated neurological deficits in mice following ischemic stroke, likely by blocking the infiltration of inflammatory cells such as macrophages and microglia.

The authors report a case of renal cell carcinoma in a right malrotated (horizontal axis) kidney. The patient was treated by hand-assisted laparoscopic radical nephrectomy. This is the first report of a horizontal axis malrotated kidney with renal cell carcinoma.
Axis, Cervical Vertebra ; Carcinoma, Renal Cell ; Humans ; Kidney ; Nephrectomy

A 32 year-old-man was admitted because of paraparesis. Hypertension and hypokalemia was noted with increased aldosterone level in his serum. Computerized tomography of abdomen showed well-defined an ovoid mass of low density in the right adrenal gland. Right adrenalectomy was done and pathologic findings showed a golden yellow color adenoma with large clear cells. Postoperatively there was reversal of hypertension and hypokalemia. We present a case of periodic paralysis due to aldosterone producing adrenal cortical adenoma with brief review of literature.
Abdomen ; Adenoma ; Adrenal Glands ; Adrenalectomy ; Adrenocortical Adenoma* ; Aldosterone* ; Hypertension ; Hypokalemia ; Paralysis* ; Paraparesis

PURPOSE: Contralateral jugular lymph node metastasis (CJLNM) of papillary thyroid cancer (PTC) is rarely found during operative procedures. HoweverPTC is being diagnosed with increasing frequency and lymph node metastasis is now recognized as a factor of prognosis and recurrence. Therefore, this study was conducted to evaluate the clinical and histological characteristics of papillary thyroid cancer and to determine the factors that lead to CJLNM. METHODS: Two-hundred patients with PTC were treated in our hospital between March 2005 and October 2006. A retrospective analysis of the patient's clinical and histological features and lymph node metastasis was conducted. RESULTS: The total ratio of CJLNM to PTC was approximately 7.5%, the male to female ratio was 1:6.5, and the mean tumor size was 14.93 mm. In addition, the multiplicity was 53.3% and the bilatrality was 53.3%. Further, there were 4 cases involving benign thyroid disease combined with goiter. In addition, the capsule invasion was 100%. Age under 40 years, bilaterality and capsule invasion were found to be significant clinicopathologic factors of CJLNM induced by PTC. CONCLUSION: A contralateral jugular lymph node biopsy of PTC may be considered in cases involving patients under 40 years of age with, bilaterality and capsular invasion.
Biopsy ; Female ; Goiter ; Humans ; Lymph Node Excision* ; Lymph Nodes* ; Male ; Neoplasm Metastasis* ; Prognosis ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: The growth velocity in patients with central precocious puberty during treatment cannot be predicted. There is a positive correlation in growth among the long bones of the body and the length of the femur and tibia may determine individual height. We want to determine whether the second metacarpal bone can be used as a predictive index for growth velocity during gonadotropin-releasing hormone (GnRH) agonist treatment. METHODS: Thirty-four female children who were diagnosed with precocious puberty at our clinic and treated with GnRH agonist for about 1 year were included in this study. Patients who had growth-related disease, such as growth hormone deficiency and thyroid diseases were excluded. We reviewed their medical records retrospectively. We measured their height and the second metacarpal length from the X-ray film (left hand Anterior-Posterior at the time of their diagnosis and about a year after their GnRH agonist treatment. RESULTS: The age of the subjects was 8.5+/-0.6 years. The growth velocity during treatment was 4.9+/-1.2 cm/yr. There was a positive correlation between height and the second metacarpal length at diagnosis (P = 0.000, r = 0.666) and at one year after treatment (P = 0.000, r = 0.654). There was no correlation between the second metacarpal length at diagnosis and growth velocity during treatment for 1 year. CONCLUSION: We could not find the correlation between the second metacarpal length and growth velocity during GnRH agonist treatment for 1 year. However, the second metacarpal length showed a positive correlation with height before and after treatment. Therefore further study should be done to discovering the mechanisms working during GnRH agonist treatment including bone age, midparental height and so on.
Body Height ; Child ; Female ; Femur ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Hand ; Humans ; Medical Records ; Metacarpal Bones ; Puberty, Precocious ; Retrospective Studies ; Thyroid Diseases ; Tibia ; X-Ray Film