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.

PURPOSE: This study aimed to compare the accuracy (trueness and precision) of interim crowns fabricated using DLP (digital light processing) according to postcuring time. MATERIALS AND METHODS: A virtual stone study die of the upper right first molar was created using a dental laboratory scanner. After designing interim crowns on the virtual study die and saving them as Standard Triangulated Language files, 30 interim crowns were fabricated using a DLP-type 3D printer. Additively manufactured interim crowns were post-cured using three different time conditions-10-minute post-curing interim crown (10-MPCI), 20-minute postcuring interim crown (20-MPCI), and 30-minute post-curing interim crown (30-MPCI) (n = 10 per group). The scan data of the external and intaglio surfaces were overlapped with reference crown data, and trueness was measured using the best-fit alignment method. In the external and intaglio surface groups (n = 45 per group), precision was measured using a combination formula exclusive to scan data (10 C2). Significant differences in accuracy (trueness and precision) data were analyzed using the Kruskal-Wallis H test, and post hoc analysis was performed using the Mann-Whitney U test with Bonferroni correction (α=.05). RESULTS: In the 10-MPCI, 20-MPCI, and 30-MPCI groups, there was a statistically significant difference in the accuracy of the external and intaglio surfaces (P <.05). On the external and intaglio surfaces, the root mean square (RMS) values of trueness and precision were the lowest in the 10-MPCI group. CONCLUSION Interim crowns with 10-minute post-curing showed high accuracy.

PURPOSE: This study was to evaluate the effect of rinsing time on the accuracy of interim crowns fabricated by digital light processing. MATERIALS AND METHODS: The maxillary right first molar master die was duplicated using a silicone material, while a study die was produced using epoxy resin. Scans of the epoxy resin die were used in combination with CAD software to design a maxillary right first molar interim crown. Based on this design, 24 interim crowns were fabricated with digital light processing. This study examined the trueness and precision of products that were processed with one of the three different postprocessing rinsing times (1 min, 5 min, and 10 min). Trueness was measured by superimposing reference data with scanned data from external, intaglio, and marginal surfaces. Precision was measured by superimposing the scan data within the group. The trueness and precision data were analyzed using KruskalWallis, nonparametric, and post-hoc tests, and were compared using a MannWhitney U test with Bonferroni correction (α=.05). RESULTS: The trueness of the external and intaglio surfaces of crowns varied significantly among the different rinsing times (P=.004, P=.003), but there was no statistically significant difference in terms of trueness measurements of the marginal surfaces (P=.605). In terms of precision, statistically significant differences were found among the external, intaglio, and marginal surfaces (P=.001). CONCLUSION Interim crowns rinsed for 10 minutes showed high accuracy.

PURPOSE: This study aimed to compare the accuracy (trueness and precision) of interim crowns fabricated using DLP (digital light processing) according to postcuring time. MATERIALS AND METHODS: A virtual stone study die of the upper right first molar was created using a dental laboratory scanner. After designing interim crowns on the virtual study die and saving them as Standard Triangulated Language files, 30 interim crowns were fabricated using a DLP-type 3D printer. Additively manufactured interim crowns were post-cured using three different time conditions-10-minute post-curing interim crown (10-MPCI), 20-minute postcuring interim crown (20-MPCI), and 30-minute post-curing interim crown (30-MPCI) (n = 10 per group). The scan data of the external and intaglio surfaces were overlapped with reference crown data, and trueness was measured using the best-fit alignment method. In the external and intaglio surface groups (n = 45 per group), precision was measured using a combination formula exclusive to scan data (10 C2). Significant differences in accuracy (trueness and precision) data were analyzed using the Kruskal-Wallis H test, and post hoc analysis was performed using the Mann-Whitney U test with Bonferroni correction (α=.05). RESULTS: In the 10-MPCI, 20-MPCI, and 30-MPCI groups, there was a statistically significant difference in the accuracy of the external and intaglio surfaces (P <.05). On the external and intaglio surfaces, the root mean square (RMS) values of trueness and precision were the lowest in the 10-MPCI group. CONCLUSION Interim crowns with 10-minute post-curing showed high accuracy.

Hyaluronic acid (HA) is an almost essential component of extracellular matrices. Early in embryogenesis mesenchymal cells migrate, proliferate and differentiate, in part, because of the influence of HA. Since the features of embryogenesis are revisited during wound repair, including bone fracture repair, this study was initiated to evaluate whether HA has an effect on calcification and bone formation in an in vitro system of osteogenesis. Mouse calvaria Pre-osteoblast (MC3T3-E1) cells were cultured in alpha-MEM medium with microorganism-derivative hyaluronic acid that was produced by Strep. zooepidemicus which of molecular weight was 3 million units. The dosages were categorized in each 0.5, 1.0 and 2.0 mg/ml concentration experimental groups. After 2 and 4 days cultures in expeirmental and control groups, the tendency of cell proliferation, MTT assay, protein synthesis ability, collagen synthesis and alkaline phosphatase activity were analysed and bone nodule formation capacity were measured with Alizarin Red S stain after 29 days cultures. The cell proliferation was increased in time, especially the group of 0.5 and 1.0 mg/ml concentration of HA were showed prominent cell proliferation. After 2 and 4 days culture, experimental groups in general were greater cell activity in MTT assay. The protein synthesis was increased in all experimental groups compared to control group, especially most prominent in 1.0 mg/ml concentration group. The collagen synthesis capacity were increased in HA experimental groups, especially prominent in 1.0 mg/ml group and the activity of alkaline phosphatase were increased, especially also prominent in 1.0 mg/ml group, compared to control group. Above these, the activity of mouse carvarial pre-osteoblast cells was showed greater bone osteogenesis activity in all applied HA experimental group, especially group of 1.0 mg/ml concentration of HA.
Alkaline Phosphatase ; Animals ; Cell Proliferation ; Collagen ; Embryonic Development ; Extracellular Matrix ; Female ; Fractures, Bone ; Hyaluronic Acid* ; Mice* ; Molecular Weight ; Osteogenesis* ; Pregnancy ; Skull* ; Wounds and Injuries

PURPOSE: The butterfly-shaped pigment dystrophy is an extremely rare autosomal dominant retinal disorder. The authors present a case of butterfly-shaped pigment dsytrophy not reported previously in Korea. CASE SUMMARY: A 45-year-old man had bilateral blurred vision for 2 years. His visual acuity was 0.2 in the right eye, and 0.3 in the left and was uncorrected. Funduscopically, yellow pigment deposits were present at the level of retinal pigment epithelium (RPE) in the central macula of both eyes. Fluorescein angiography (FA) revealed a central, dark, butterfly-shaped lesion surrounded by a region of hyperfluorescence, Spectral domain optical coherence tomography (OCT) showed thick elevation of the RPE with hyperreflectivity and disruption of the inner and outer segment (IS/OS) interface of the photoreceptors. The patient had normal color vision, visual field and electroretinograms and reduced electrooculograms. CONCLUSIONS: In general, butterfly-shaped pigment dystrophy is known to have good visual prognosis. However, in some cases the disease can be a chronic progressive disorder with secondary involvement of the photoreceptors, as exemplified this patient. The authors anticipate more detail regarding the natural course of this disease will be obtained through spectral domain OCT.
Butterflies ; Color Vision ; Eye ; Fluorescein Angiography ; Humans ; Middle Aged ; Prognosis ; Retinal Pigment Epithelium ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity ; Visual Fields

It is well known that Rhododendron sclippenbashii contains the toxic material grayanotoxin. So, Koreans do not eat it, but they do eat azalea although it contains grayanotoxin. That is why there have been no reports about Rhododendron sclippenbashii intoxication after ingesting it intentionally, not accidentally. In this case, the patient was admitted to the emergency room with several toxic symptoms after intentionally consuming 50 blossoms of Rhododendron sclippenbashii to get rid of thirst. Treatment with saline infusion and atropine was successful and the outcome was favorable enough in this case to produce a complete cure without any sequelae at discharge. But toxic symptoms were seen for 24 hours, although the symptoms usually fade in 9 hours. Therefore, we should carefully treat and observe, for over 24 hours, the patient who intentionally ingests about 50 blossoms of Rhododendron sclippenbashii.
Adult ; Atropine ; Bradycardia ; Drug Combinations ; Emergencies ; Flowers ; Humans ; Intention ; Piperonyl Butoxide ; Pyrethrins ; Rhododendron ; Thirst

PURPOSE: Chlamydia pneumoniae (CP) infection seems to be related to atherosclerotic diseases. A prospective sero- epidemiologic study was performed to analyze the relationship between CP infection and peripheral vascular disease in Korean patients. The aims of this study were to find the prevalences of CP antibody in the serum and CP antigens in the vascular tissues, and to analyze the differences between several disease groups. METHODS: Our subjects included a total of 61 patients (76 vascular tissues) who had undergone operative procedures for peripheral vascular diseases. They were classified into 3 groups: Group 1; 14 abdominal aortic aneurysm, Group 2; 15 atherosclerosis obliterans, and Group 3; 32 varicose vein cases. The CP antibody titers were determined using the microimmunofluorescence test (MIF) and the CP antigen in the vascular tissues with a semi-nested polymerase chain reaction (PCR) and an in situ hybridization technique (ISH). RESULTS: The prevalences of chronic or past CP infection from the MIF (IgG antibody titer > or = 1: 32) in Groups 1, 2 and 3 were 78.6, 73.3, and 68.8% respectively, but with statistically significant differences. The prevalences of PCR- positive tissues in Groups 1, 2 and 3 were 21.4, 6.7, and 0% respectively. There was no CP DNA detected in the venous tissue. CP DNA was detected more frequently in aneurysmal disease than atherosclerosis obliterans, but this was not statistically significant(p=0.265). In comparison with the varicose veins, aortic aneurysms showed a significantly higher PCR positivity ratio (p=0.002), and a similar result was seen with ISH. There was no relationship between CP antigen positivity and the known risk factors for atherosclerosis. CONCLUSION: A high prevalence of CP antibodies was observed in the serum of Korean patients with vascular disease, which matched that in western populations. CP DNA was also detected in atherosclerotic tissues, which was especially high in aneurysmal disease, implying a possible causative role of CP infection in the pathogenesis of the atherosclerotic disease. This is the first report on the prevalence of CP in vascular tissues in Korean population.
Aneurysm ; Antibodies ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Arterial Occlusive Diseases* ; Atherosclerosis ; Chlamydia* ; Chlamydophila pneumoniae* ; DNA ; Epidemiologic Studies ; Humans ; In Situ Hybridization ; Peripheral Vascular Diseases ; Polymerase Chain Reaction ; Prevalence ; Prospective Studies ; Risk Factors ; Surgical Procedures, Operative ; Varicose Veins ; Vascular Diseases

Nosocomial Legionnaires' disease has often been documented to occur in immunocompromised patients and to be severe, potentially fatal, pneumonia. We report a case of fatal nosocomial Legionnaires' disease developed shortly after steroid pulse therapy. A 39-year old woman with systemic lupus erythematosus was admitted via emergency room due to generalized edema and gross hematuria. Under the diagnosis of lupus nephritis, she was given intravenous steroid pulse therapy for 3 days and then maintained with oral prednisolone. On the 7th day of admission the patient's conditions got worse with progression to acute renal failure and respiratory difficulty. On the 10th day of admission when she was started on hemodialysis, chestradiograph showed newly developed multifocal mass-like consolidations on both lung fields. In spite of empirical therapy with roxithromycin and rifampin, the consolidations were aggravated and rapidly extended to both whole lung fields. On the 15th day of admission she was mechanically ventilated due to respiratory failure, but died of hypoxia and shock on the 19th day. Later, a legionella species was isolated from the tracheal aspirates and identified as L. pneumophila serogroup 1. We also detected L. pneumophila from the tracheal aspirates by duplex PCR which amplified both 5S rRNA and mip genes of L. pneumophila.
Acute Kidney Injury ; Adult ; Anoxia ; Diagnosis ; Edema ; Emergency Service, Hospital ; Female ; Hematuria ; Humans ; Immunocompromised Host ; Legionella pneumophila* ; Legionella* ; Legionnaires' Disease* ; Lung ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Pneumonia ; Polymerase Chain Reaction ; Prednisolone ; Renal Dialysis ; Respiratory Insufficiency ; Rifampin ; Roxithromycin ; Shock