No abstract available.
Child* ; Humans ; Thyroid Gland* ; Thyroid Nodule*

PURPOSE: The aim of this study was to evaluate the feasibility and safety of our antivenin treatment protocol for patients with Korean Viperidae envenomation. METHODS: We developed an antivenin treatment protocol for Korean Viperidae envenomation, based on previous data, and applied this treatment to the enrolled patients. In brief, antivenin was not used for patients with grade 0. Patients with grade I and II received one vial of antivenin. Those with grade III and IV received two and three vials of antivenin, respectively. Adult patients who visited the emergency department (ED) after receiving a snakebite between July 2008 to August 2010 were included. Follow ups were performed at 24 hours, 7 days, and 28 days after the snakebite. RESULTS: A total of 62 patients were enrolled. At the initial evaluation, 6 patients (9.7%) were grade 0, 47 patients (75.8%) were grade I, and 9 patients (14.5%) were grade II. Upon the follow-up evaluation, 14 patients (29.8%) progressed from grade I to grade II and 2 patients (22.2%) progressed from grade II to III. Coagulopathy developed in 5 patients (8.0%) and rhabdomyolysis in 5 patients (8.0%). Urticaria developed in 2 patients (3.2%) and cellulitis in 3 patients (4.8%) as delayed complications. As an antivenin-related complication, serum sickness developed in only 1 patient (1.6%). There were no severe complications and all clinical and laboratory abnormalities disappeared within 28 days. CONCLUSION: Our antivenin treatment protocol was feasible and safe. To confirm our data, multicenter validation studies are needed.
Adult ; Antivenins ; Cellulitis ; Clinical Protocols ; Emergencies ; Follow-Up Studies ; Humans ; Rhabdomyolysis ; Serum Sickness ; Snake Bites ; Snake Venoms ; Urticaria ; Viperidae

BACKGROUND: The target of lumbar sympathetic ganglion block is the anterolateral surface of the L2, 3 and 4 vertebral bodies, where the lumbar sympathetic ganglion usually lies. In most cases, a block-needle is inserted approximately 5-8 cm lateral to spinous process on the skin and directed to the anterolateral surface of vertebral body obliquely. The purpose of this study is to determine the safe entry angle and entry point in Korean by using the abdominal CT scan images. METHODS: The abdominal CT images of eighty five patients were recruited to this study. The minimal angle aimed at the lumbar sympathetic ganglion that can pass through the lateral aspect of body and maximal angle that avoids puncturing the kidney, ureter or retroperitoneal space were measured. The distance from midline to skin entry point was also measured. RESULTS: There was no significant difference in entry angle among L2, 3, and 4 level. The entry angle was similar in the right and left side, and in males and females. The entry angle of old age group was significantly smaller than that of young age group. The calculated safe entry angle was 30.5 +/- 0.4degrees and entry point was 7.7 +/- 0.2 cm and 6.7 +/- 0.1 cm lateral from midline in males and females respectively. CONCLUSION: These measurements can be used as a reference for lumbar sympathetic ganglion block and radiofrequency lesioning. Prior to performing the lumbar sympathetic ganglion block for cancer patients, the abdominal CT scan should be reviewed to prevent complications.
Female ; Ganglia, Sympathetic ; Humans ; Kidney ; Male ; Retroperitoneal Space ; Skin ; Ureter

Tuberculosis of the breast is a rare disease. Its diagnosis is difficult because clinical and radiological appearances are not specific and because isolation of the tubercle bacillus from the lesion is seldom possible. This disease is more common in women between 20 to 40 years of age, but is rare in male, elderly patients and prepubertal women. Difinite diagnosis rests on bacterilogical proof and histopathological findings -formation of a granuloma and usually caseous necrosis with or without demonstrable acid-fast bacilli. Treatment of the disease requires a combination of surgery and antitubercular drugs. We experienced 10 cases of tuberculosis of the breast and report with on them along a literature review.
Aged ; Antitubercular Agents ; Bacillus ; Breast* ; Diagnosis ; Female ; Granuloma ; Humans ; Male ; Necrosis ; Rare Diseases ; Tuberculosis*

PURPOSE: The purpose of this preliminary study was to investigate the effects of adding 4,4'-bis(N,N-diethylamino) benzophenone (DEABP) as a co-initiator to a binary photoinitiating system (camphorquinone-amine) to analyze on the degree of conversion (DC) of a light-cured resin for dental 3D printing. MATERIALS AND METHODS: Cylindrical specimens (N=60, n=30 per group, o5 mm x 1 mm) were fabricated using bisphenol A glycerolate dimethacrylate (BisGMA) both with and without DEABP. The freshly mixed resins were exposed to light in a custom-made closed chamber with nine light-emitting diode lamps (wavelength: 405 nm; power: 840 mW/cm2) for polymerization at each incidence of light-irradiation at 10, 30, 60, 180, and 300 seconds, while five specimens at a time were evaluated at each given irradiation point. Fourier-transform infrared (FTIR) spectroscopy was used to measure the DC values of the resins. Two-way analysis of variance and the Duncan post hoc test were used to analyze statistically significant differences between the groups and given times (alpha=.05). RESULTS: In the DEABP-containing resin, the DC values were significantly higher at all points in time (P<.001), and also the initial polymerization velocity was faster than in the DEABP-free resin. CONCLUSION: The addition of DEABP significantly enhanced the DC values and, thus, could potentially become an efficient photoinitiator when combined with a camphorquinone-amine system and may be utilized as a more advanced photopolymerization system for dental 3D printing.
Glycerol ; Incidence ; Polymerization ; Polymers ; Spectrum Analysis

To evaluate the clinical usefulness of radionuclide(RI) cisternography in patients with hydrocephalus, we retrospectively analyzed RI cisternographic findings of 47 patients by using our classification which was modified from Baum's. and correlated them with CT(n=37) or MRI(n=10) findings and clinical outcome in selected patients with hydrocephalus(n=37). Modified RI cisternographic patterns of 37 patients were type I in three cases(8%), type II in seven(18%), type III-A in six(16%), no case of type III-B, type IV-A in 12(32%), and type IV-B in nine(24%). RI cisternography enabled to differentiate communicating hydrocephalus(27 cases, 73%) from noncommunicating hydrocephalus (10 cases, 27%). There was marked clinical improvement in 17 patients(46%), slight improvement in 11 patients(30%), and no improvement in nine patients(24%). The clinical outcome of patients with RI cisternographic type IV-B was worse than that of other types. CT and MRI could neither predict the clinical outcome nor differentiate type IV-B from Type IV-A(p>.05). Ventricular size index (VSI( was significantly higher in patients with type IV than that with other types(p<.001). RI cisternographic patterns of communicating hydrocephalus were relatively correlated with clinical outcome (r=-0.53, P=.001), VIS(r=0.59, p=.001), and dilatation of fourth ventricle(r=0.41, p<.05). We suggest that our modified classification of RI cisternographic patterns can provide more strict physiological assessment of the CSF dynamics and RI cisternography may be still useful to differentiate communicating hydrocephalus from noncommunicating hydrocephalus and to predict the clinical outcome in conjunction with CT/MR findings and clinical presentation.
Classification ; Dilatation ; Humans ; Hydrocephalus* ; Magnetic Resonance Imaging* ; Retrospective Studies

PURPOSE: The purpose of this study was to spectrophotometrically evaluate the shade difference between of maxillary and mandibular anterior teeth in the Korean by the standard of vita classical shade guide using SpectroShade(TM). MATERIAL AND METHODS: In this study, the shades of healthy anterior teeth were examined and analyzed using the digital shade analysis of SpectroShade(TM). This study examined 80 individuals in their twenties, thirties, fourties, fifities ages and 40 males and 40 females, presenting 12 healthy, unrestored maxillary and mandibular anterior teeth. Tooth brushing and oral prophylaxis were performed prior to evaluation. The SpectoShadeTM was used to acquire images of the 12 maxillary and mandibular anterior teeth. These images were analyzed using SpectroShade(TM) Software, and shade maps of each tooth were acquired. The shade difference of upper and lower, and gender differences and ages difference were investigated and analyzed with CIE L*a*b* color order system. One-Way ANOVA test was used to find out if there were significant differences between groups tested and Sheffe multiple comparison was used to identify where the differences were. RESULTS: 1. Shade differences were significant (P < .05) between maxillary and mandibular central incisor, lateral incisor, canine. 2. No significant differences in shade distribution were seen between lateral incisors and central incisors. 3. Canine's shade difference were more significant than central incisor's and lateral incisors's. 4. No significant differences in shade distribution were seen between genders in maxillary and mandibulr central incisor, lateral incisor, canine. 5. No significant differences in shade distribution were seen in order of years in maxillary and mandibulr central incisor, lateral incisor, canine. CONCLUSIONS: The results of this study show that 1. Shade difference was founded in maxillary and mandibular anterior teeth and deltaE* value was more than 2.0. 2. Canine's shade difference were more significant than central incisor's and lateral incisors's and between central incisors and lateral incisors shade differences were no significant. 3. No significant differences in shade distribution were seen between genders in maxillary and mandibular anterior teeth. 4. No significant differences in shade distribution were seen in order of years grade in maxillary and mandibular anterior teeth.
Female ; Humans ; Incisor ; Male ; Tooth

In this study we estimated a geometric correlation among digitally reconstructed radiographic image (DRRI), kV x-ray image (kVXI) from the On-Board Imager (OBI) and electric portal image (EPI). To verify geometric correspondence of DRRI, kVXI and EPI, specially designed phantom with indexed 6 ball bearings (BBs) were employed. After accurate setup of the phantom on a treatment couch using orthogonal EPIs, we acquired set of orthogonal kVXIs and EPIs then compared the absolute positions of the center of the BBs calculated at each phantom plane for kVXI and EPI respectively. We also checked matching result for obliquely incident beam (gantry angle of 315 degrees) after 2D-2D matching provided by OBI application. A reference EPI obtained after initial setup of the phantom was compared with 10 series of EPIs acquired after each 2D-2D matching. Imaginary setup errors were generated from -5 mm to 5 mm at each couch motion direction. Calculated positions of all center positions of the BBs at three different images were agreed with the actual points within a millimeter and each other. Calculated center positions of the BBs from the reference and obtained EPIs after 2D-2D matching agreed within a millimeter. We could tentatively conclude that the OBI system was mechanically quite reliable for image guided radiation therapy (IGRT) purpose.
Radiotherapy, Image-Guided

Objectives: Botulinum toxin type A (BTX), a powerful neurotoxin, can be an effective treatment choice for diverse muscular disorders and can reduce abnormal muscle activities. Abnormal movements of the mandible can be caused by involuntary and uncontrolled contractions of the lateral pterygoid muscle (LP) in various pathological situations. Previous reports have shown that BTX can reduce abnormal contractions of the LP. However, needle placement into the LP for BTX injection requires skill, experience, and sufficient anatomical knowledge. To place the needle precisely into the LP, ultrasonography (USG) can be used as an effective needle-guidance modality. USG is a non-invasive imaging modality able to create real-time imageswithout any potential risks, including radiation exposure. Patients and Methods: The patients who had been performed USG-guided BTX injection into the LP using an intraoral approach were included in this study with a literature review and case presentations. Using the USG, four patients received BTX injections to treat recurrent temporomandibular dislocation and oromandibular dystonia resulting from involuntary LP activity.Result: Involuntary movements of the mandible were improved successfully in all patients, and showed satisfactory results without significant complication. Conclusion The intraoral approach could prevent potential complications during needle placement. USG-guided BTX injection is an effective, con-venient, and safe method that provides real-time imaging without unnecessary pain to the patient.

PURPOSE: This study aimed to evaluate the effect of pretreatment of three different universal adhesives (Single Bond Universal [SBU], All-Bond Universal [ABU], and Prime&Bond universal [PBU]) on the bonding durability of an adhesive (Panavia F 2.0, PF) and a conventional (Duo-Link, DL) resin cements to air-abraded zirconia. MATERIALS AND METHODS: Rectangular-shaped zirconia specimens were prepared. The chemical composition and surface energy parameters of the materials were studied by Fourier transform infrared spectroscopy and contact angle measurement, respectively. To evaluate resin bonding to the zirconia, all the bonding specimens were immersed in water for 24 h and the specimens to be aged were additionally thermocycled 10000 times before the shear bond strength (SBS) test. RESULTS: The materials showed different surface energy parameters, including the degree of hydrophilicity/hydrophobicity. While the DL/CON (no pretreatment) showed the lowest SBS and a significant decrease in the value after thermocycling (P < .001), the PF/CON obtained a higher SBS value than the DL/CON (P < .001) and no decrease even after thermocycling (P = .839). When the universal adhesives were used with DL, their SBS values were higher than the CON (P < .05), but the trend was adhesive-specific. In conjunction with PF, the PF/SBU produced the highest SBS followed by the PF/ABU (P = .002), showing no significant decrease after thermocycling (P > .05). The initial SBS of the PF/PBU was similar to the PF/CON (P = .999), but the value decreased after thermocycling (P < .001). CONCLUSION The universal adhesive pretreatment did not necessarily show a synergistic effect on the bonding performance of an adhesive resin cement, whereas the pretreatment was beneficial to bond strength and durability of a conventional resin cement.