The propose of this study was to quantify the changes of soft tissue profile following orthodontic treatment and to evaluate the relationship of those to the skeletal elements. Pre-and post-treatment lateral cephalometric head films of 40 cases(20 extraction cases, 20 non-extraction camas) were traced, and the changes following treatment were measured and quantified by digital subtraction method, and statisticall analyzed. The obtained results were as follows; 1. in extraction group, the change of upper lip area(UL) was 558.60+/-355.17 pixels, that of lower lip area(LL) was 941.15+/-364.07 pixels. But, in non-extraction group the change of uper lip area(UL) was 125.65+/-404.16 pixels, that of lower lip area(LL) was 104.05+/-440.93 pixels, which was significantly lesser than those in extraction group. 2. In extraction group, there was significant correlationship between upper lip area change(UL) and difference of upper incisor point(deltaUIP). Lower lip area change(LL) was significantly correlated with difference of upper incisor(deltaUIP), difference of Frankfort upper incisor angle(deltaFUIA) or difference of interincisal angle(deltaIIA). 3. In extraction group, the ratio of difference of upper incisor point(deltaUIP) to difference of labrale superius(deltaLS) was 1.68; difference of lower incisor point(deltaLIP) to difference of labrale inferius(deltaLI) was 1.19; difference of upper incisor point(deltaUlP) to increment in upper lip thickness(deltaTUL) was 1.95. 4. In non-extraction group, there was a significant cortelationship between upper lip area change(UL) and difference of upper incisor point(deltaUIP).
Head ; Incisor ; Lip

PURPOSE: This study was undertaken to compare fracture and flexural strength of provisional restorative resins fabricated by additive manufacturing, subtractive manufacturing, and conventional direct technique. MATERIALS AND METHODS: Five types of provisional restorative resin made with different methods were investigated: Stereolithography apparatus (SLA) 3D printer (S3Z), two digital light processing (DLP) 3D printer (D3Z, D3P), milling method (MIL), conventional method (CON). For fracture strength test, premolar shaped specimens were prepared by each method and stored in distilled water at 37℃ for 24 hours. Compressive load was measured using a universal testing machine (UTM). For flexural strength test, rectangular bar specimens (25 × 2 × 2 mm) were prepared by each method according to ISO 10477 and flexural strength was measured by UTM. RESULTS: Fracture strengths of the S3Z, D3Z, and D3P groups fabricated by additive manufacturing were not significantly different from those of MIL and CON groups (P>.05/10=.005). On the other hand, the flexural strengths of S3Z, D3P, and MIL groups were significantly higher than that of CON group (P<.05), but the flexural strength of D3Z group was significantly lower than that of CON group (P<.05). CONCLUSION: Within the limitation of our study, provisional restorative resins made from additive manufacturing showed clinically comparable fracture and flexural strength as those made by subtractive manufacturing and conventional method.
Bicuspid ; Hand ; Methods ; Printing, Three-Dimensional ; Water

PURPOSE: Laparoscopy is a standard treatment for many diseases. We developed a laparoscopy training protocol that provides a learning experience equivalent to that of an animal laboratory based laparoscopic training course. We proved that the rabbit can be used as an appropriate model for a laparoscopy training program. MATERIALS AND METHODS: Three operators undertook laparoscopic procedures on 15 rabbits using our developed protocol. We checked both objective and subjective parameters, such as operation times and complications for the former, and hand-eye coordination, tactile sensation, tool handling and total skill difficulty for the later, using visual analogue scores. RESULTS: For the first 5 rabbits, the mean operative times (min.) for the 3 operators were 41, 48 and 46.2 for a simple nephrectomy (SN), 62, 68.2 and 66.2 for a partial nephrectomy (PN), 28.8, 36 and 31.8 for an adrenalectomy (Ax) and 65.4, 69 and 60.6 for a simple cystectomy (SC). For the second 5 rabbits the mean operative times (min.) were; SN 32.2, 46.2 and 40.2, PN 57.8, 66.2 and 61.8, Ax 22.8, 32.6 and 32 and SC 65.4, 64.2 and 57.4. For all 15 rabbits the mean operative times (min.) were; SN 20.6, 35.4 and 30, PN 48.6, 54.6 and 53.4, Ax 15.8, 26.2 and 26.2 and CS 48.2, 53.6 and 47.6. CONCLUSIONS: Our laparoscopic training model, using a small animal, provides practicing urologist with the concepts of laparoscopy concept. The rabbit model is appropriate for addressing laparoscopic procedures, with economic benefits. Based on this model, it would be possible for residents to familiarize themselves with laparoscopic procedures.
Adrenalectomy ; Animals* ; Cystectomy ; Education ; Laparoscopy ; Learning ; Models, Animal* ; Nephrectomy ; Operative Time ; Rabbits ; Sensation ; Urology*

Behcet's disease is a multisystem disorder presented with recurrent oral and genital ulcerations as well as ocular involvement. The principal manifestations in the urinary system are glomerulonephritis, cystitis, epididymitis, orchitis, and genital ulcerations. Urethrovaginal fistula is an unusual complication. The primary lesion of the disease is a small vessel vasculitis with endothelial deposition of immunocomplexes, and consequent inflammatory and necrotizing process of the vascular wall. We experienced a 19-year-old woman with Behcet's disease, who had a large urethrovaginal fistula on the anterior vaginal wall. The size of fistula was 2x1cm. For this patient, we tried combining bulbocavernosus muscle and labial fat pad flap (Martius flap) urethral reconstruction. This operative method seemed to be safe and effective for the urethral defect with Behcet's disease.
Adipose Tissue ; Behcet Syndrome ; Cystitis ; Epididymitis ; Female ; Fistula* ; Glomerulonephritis ; Humans ; Male ; Orchitis ; Ulcer ; Vasculitis ; Young Adult

Purpose: We aimed to investigate whether the use of cardiovascular drugs in coronavirus disease 2019 (COVID-19) patients with hypertension as a comorbidity has a significant effect on the incidence and associated mortality rate of COVID-19. Materials and Methods: Data covering the period between January 1, 2020 and June 4, 2020 were extracted from The National Health Insurance Service-COVID-19 (NHIS-COVID-19) database in South Korea and analyzed as a population-based cohort study. Results: A total of 101657 hypertensive adults aged 20 years or older were included for final analysis. Among them, 1889 patients (1.9%) were diagnosed with COVID-19 between January 1, 2020 and June 4, 2020, and hospital mortality occurred in 193 patients (10.2%). In a multivariable model, the use of beta-blockers was associated with an 18% lower incidence of COVID-19 [odds ratio (OR): 0.82, 95% confidence interval (CI): 0.69–0.98; p=0.029]. Among 1889 hypertensive patients diagnosed with COVID-19, the use of a calcium channel blocker (CCB) was associated with a 42% lower hospital mortality rate (OR: 0.58, 95% CI: 0.38–0.89; p=0.012). The use of other cardiovascular drugs was not associated with the incidence of COVID-19 or hospital mortality rate among COVID-19 patients. Similar results were observed in all 328374 adults in the NHIS-COVID-19 database, irrespective of the presence of hypertension. Conclusion In South Korea, beta-blockers exhibited potential benefits in lowering the incidence of COVID-19 among hypertensive patients. Furthermore, CCBs may lower the hospital mortality rate among hypertensive COVID-19 patients. These findings were also applied to the general adult population, regardless of hypertension.

Purpose: We aimed to investigate whether the use of cardiovascular drugs in coronavirus disease 2019 (COVID-19) patients with hypertension as a comorbidity has a significant effect on the incidence and associated mortality rate of COVID-19. Materials and Methods: Data covering the period between January 1, 2020 and June 4, 2020 were extracted from The National Health Insurance Service-COVID-19 (NHIS-COVID-19) database in South Korea and analyzed as a population-based cohort study. Results: A total of 101657 hypertensive adults aged 20 years or older were included for final analysis. Among them, 1889 patients (1.9%) were diagnosed with COVID-19 between January 1, 2020 and June 4, 2020, and hospital mortality occurred in 193 patients (10.2%). In a multivariable model, the use of beta-blockers was associated with an 18% lower incidence of COVID-19 [odds ratio (OR): 0.82, 95% confidence interval (CI): 0.69–0.98; p=0.029]. Among 1889 hypertensive patients diagnosed with COVID-19, the use of a calcium channel blocker (CCB) was associated with a 42% lower hospital mortality rate (OR: 0.58, 95% CI: 0.38–0.89; p=0.012). The use of other cardiovascular drugs was not associated with the incidence of COVID-19 or hospital mortality rate among COVID-19 patients. Similar results were observed in all 328374 adults in the NHIS-COVID-19 database, irrespective of the presence of hypertension. Conclusion In South Korea, beta-blockers exhibited potential benefits in lowering the incidence of COVID-19 among hypertensive patients. Furthermore, CCBs may lower the hospital mortality rate among hypertensive COVID-19 patients. These findings were also applied to the general adult population, regardless of hypertension.

Primary biliary cirrhosis(PBC) is a chronic cholestatic liver disease of unknown origin. The small and medium sized intrahepatic bile ducts are destroyed by an inflammatory process, which, it has been suggested, is of the autoimmune type. It is strongly associated with the presence of antimitochondrial antibodies, predominantly IgM and IgG. The liver changes are classified into four stages, of which stage IV represents the development of cirrhosis, which required orthotropic liver transplantation in the longrun. The prevalence rates was reported 128 per millon in Sweden , but the disease is relatively rare in Oriental area. In medical treatment, long-term administration of ursodeoxycholic acid improves both clinical and biochemical signs, slows the progression of the disease and reduces the complication requiring liver transplantation. We report two cases of PBC, one with histologically proven cirrhosis, and the other with bile duct destruction consistent with stage III and hypothyroidism.
Antibodies ; Bile Ducts ; Bile Ducts, Intrahepatic ; Fibrosis ; Hypothyroidism ; Immunoglobulin G ; Immunoglobulin M ; Liver ; Liver Cirrhosis, Biliary* ; Liver Diseases ; Liver Transplantation ; Prevalence ; Sweden ; Ursodeoxycholic Acid

Transjugular intrahepatic portosystemic shunt (TIPSS) is a promising method of treatment for gastric or esophageal variceal bleeding. This study was performed to determine the prognostic factors contributing to the survival of patients after TIPSS for gastric or esophageal variceal bleeding. One hundred and fifty-five patients who underwent TIPSS between September 1991 and March 2001 were followed up by clinical examination, upper gastrointestinal endoscopy, and Duplex sonography. The mean portohepatic pressure gradient prior to TIPSS was 20.5 +/-9.93 mmHg and dropped to 10.7 +/-6.62 mmHg after TIPSS (p<0.001). The cumulative survival rate was 75.1% at 6 months, 66.6% at 1 yr, 58.4% at 2 yr, and 38.1% at 5 yr. Survival after TIPSS was inversely related to the Child-Pugh classification (p<0.05). The rebleeding rate was 18.3% at 6 months, 21.0% at 1 yr, 32.8% at 2 yr, and 53.1% at 5 yr. The causes of deaths were hepatic failure (53.5%), recurrent variceal bleeding (11.6%), pneumonia (4.6%), sepsis (3.5%), hepatic encephalopathy (2.3%), and unknown (17.4%). Multivariate analysis (Cox proportional hazard model) revealed that the Child-Pugh classification and age were statistically significant independent prognostic factors. In conclusion, TIPSS is an effective method of treatment for variceal bleeding in cases where other treatment modalities including endoscopic therapy are unsuccessful and the most important prognostic factors are preprocedural hepatic reserve (Child-Pugh class) and age.
Adolescent ; Adult ; Endoscopy ; Female ; Fibrosis/diagnosis ; Follow-Up Studies ; Gastrointestinal Hemorrhage/*diagnosis/*mortality/*therapy ; Humans ; Male ; Middle Aged ; *Portasystemic Shunt, Transjugular Intrahepatic ; Prognosis ; Recurrence ; Time Factors ; Treatment Outcome

Shock wave lithotripsy(SWL) has been considered as a contraindication in a patient with bleeding diathesis. However, appropriate pre-treatment made it possible recently. We present a case of ureteral stone patient with hemophilia A which was resolved successfully using SWL and this would be the first report concerning SWL in a hemophilia A patient in our country.
Disease Susceptibility ; Hemophilia A* ; Hemorrhage ; Humans ; Lithotripsy* ; Shock* ; Ureter

A case of seminal vesicle cysts with ipsilateral renal agenesis is uncommon. An excision of a seminal vesicle cyst was successfully performed using a transperitoneal laparoscopic approach in 27-year-old male affected by recurrent perineal discomfort and post-ejaculatory pain. The operative time and blood loss were 85 minutes and 50ml, respectively. No postoperative complications were noted, and the patient discharged on the 5th postoperative day. Laparoscopic excision of seminal vesicle cystic disease is an effective surgical procedure, with excellent intraoperative access and minimal postoperative morbidity.
Adult ; Humans ; Laparoscopy ; Male ; Operative Time ; Postoperative Complications ; Seminal Vesicles*