PURPOSE: The purpose of the study was to compare CT with scintigraphy in the detection of parenchymal lesionsof acute pyelonephritis in children, and to assess the diagnostic value of CT. MATERIALS AND METHODS: This studyinvolved 32 children with acute pyelonephritis ; their ages ranged from 1 month to 10 years. Renal CT , TC-99mDMSA planar and SPECT images, and medical records were retrospectively reviewed. We evaluated the number, size,shape, density, and location of pyelonephritic lesions, as seen on CT and scintigraphic images. RESULTS: In 43involved kidneys, 193 parenchymal lesions of acute pyelonephritis were identified. The results of CT were abnormalin 42 kidneys (98%), and those of scintigraphy, in 39(91%). CT showed single or multiple hypoenhancing parenchymallesions ; these were streaky(n=151), wedge-shaped (n=34), or oval (n=8), and ranged from about 3-30mm in maximumdiameter. Abscess (n=5), renal fascial thickening (n=6) and thickening of the bridging septae (n=7) wereassociated. Scintigraphic findings were diffuse or localized area of varying degrees of diminished corticalactivity, and these were more precisely identified on SPECT than on planar images. For the detection of 55 of 193pyelonephritic lesions, CT was more sensitive than scintigraphy ; 29 of the 55 lesions were less than 5 mm indiameter. CONCLUSION: For the detection of pyelonephritic lesions, particularly smaller ones, and for theevaluation of complications such as abscess formation, CT is more sensitive than Tc-99m DMSA scintigraphy. Weconclude that in children with subtle scintigraphic findings who are in serious clinical condition or in whomcomplications are suspected, CT is a useful tool for assessing a therapeautic plan and the prognosis of acutepyelonephritis.
Abscess ; Child* ; Humans ; Kidney ; Medical Records ; Prognosis ; Pyelonephritis* ; Radionuclide Imaging* ; Retrospective Studies ; Succimer* ; Tomography, Emission-Computed, Single-Photon

PURPOSE: To assess long-term changes in intraocular pressure (IOP) and the development of glaucoma after early phacoemulsification in acute primary angle closure. METHODS: Retrospective chart review of acute primary angle closure patients treated with phacoemulsification in attack eyes versus fellow eyes. Within a month after the angle closure attack, all subjects underwent cataract surgery and were divided into two groups: group A received cataract surgery on their attack eyes. Group B also received cataract surgery on their fellow eye after phacoemulsification of the attack eyes. Study outcomes were the prevalence of IOP rise (occurrence of IOP >21 mmHg) and the incidence of newly developed glaucoma. RESULTS: Eighty-nine eyes were included, with 62 attack eyes in group A and 27 fellow eyes in group B. Group A (14 eyes, 22.58%) had a higher cumulative rate of IOP rise than group B (3 eyes, 11.11%) at 12 months (p = 0.001). Newly developed glaucoma was not observed in group B; however, 6 patients in group A developed glaucoma during the 12-month follow-up period (p < 0.001). CONCLUSIONS: The attack eyes treated with phacoemulsification showed a significantly higher prevalence of IOP rise and newly developed glaucoma than fellow eyes that received phacoemulsification. These findings suggest that there is a possibility of IOP rise and development of glaucoma even when angle closure and successful IOP control have apparently been achieved after phacoemulsification.
Cataract ; Follow-Up Studies ; Glaucoma ; Glaucoma, Angle-Closure ; Humans ; Incidence ; Intraocular Pressure* ; Phacoemulsification* ; Prevalence ; Retrospective Studies

This case report describes the immediate loading of narrow diameter implants in the mandibular incisor area using full-digital flow. The 3-dimensional position of the implants was planned using digital software, and the corresponding surgical template was fabricated. The implants were inserted immediately after extraction and on the same day, the interim abutment and bridge were placed. At 8 weeks after surgery, the stability of the implants was measured and a digital impression was made using a scan body. Customized titanium abutments and a cementtype full zirconia bridge were delivered. At 36 weeks’ follow-up, no clinical or radiographic complications were detected, and the patient was satisfied with the results.

PURPOSE: To evaluate the clinical usefulness of 2-D Cine PC (phase contrast) technique in visualizing the pattern and the site of abnormal CSF flow and to assess the effect of a third ventriculostomy in patients with hydrocephalus. MATERIALS AND METHODS: The study group consisted of three normal controls and 13 patients with hydrocephalus, as shown on CT or MRI, and two patients who had undergone their third ventriculostomy. The technique was EKG-gated 2-D Cine PC MRI with velocity encoding 5cm/sec, TR 80msec, TE 12.3-15msec, and flip angle 15-60 degrees. Image quality was analyzed for variable sequences, and CSF flow was observed along the CSF flow pathway. We analyzed continuity and intensity of the CSF flow signal, and obstruction site and flow velocity degree were then defined. RESULTS: Systolic high and diastolic low signal intensity along the CSF flow-pathway, with normal asynchronicity and continuation, were clearly seen in normal controls. In three patients, there was obstruction at the ventricular level while others were either normal or showed a normal pattern with a weak signal. 'Normal' was defined as noncommunicating hydrocephalus and the latter as communicating hydrocephalus. In the two patients who had undergone ventriculostomy, a signal was in one case detected at the site of the third operation. CONCLUSION: A 2-D Cine PC CSF flow study enables us to see CSF flow signals noninvasively and to detect the site of obstruction of a CSF flow-pathway. It can therefore be useful for determining the application of a ventriculoperitoneal shunt and assessing the effect of a third ventriculostomy.
Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Ventriculoperitoneal Shunt ; Ventriculostomy

PURPOSE: To evaluate the significance of fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) images for the diagnosis of intracranial tumors. MATERIALS AND METHODS: MR imaging was used to study15 patients with various intracranial tumors and were compared the findings according to fast spin echo and fast FLAIR images. RESULTS: In 12 of 15 patients, tumor signal intensities on FLAIR images were consistent with those shown on T2-weighted (T2W) images. In seven of eight patients who had cystic or necrotic components within the mass, FLAIR images showed isosignal intensity and in the other patient, high signal intensity was seen. There was variation in the signal intensity from cerebrospinal fluid (CSF). In 12 of 13 patients in whom edema was associated with tumor, FLAIR images were clearer than T2W images as their signal intensity was brighter. In eight patients, however, FLAIR and T2W images provided a similar definition of the margin between edema and tumor. In six patients with intratumoral hemorrhage, FLAIR and T2W images showed the same signal intensities at all stages of the hemorrhage except the chronic cystic stage. CONCLUSION: We concluded that in the diagnosis of intracranial tumors, FLAIR images can supplement conventional spin-echo images.
Cerebrospinal Fluid ; Diagnosis ; Edema ; Hemorrhage ; Humans ; Magnetic Resonance Imaging

PURPOSE: The purpose of this randomized clinical trial is to determine whether implant length and the crown-to-implant (C/I) ratio influence implant stability and peri-implant marginal bone loss (MBL). MATERIALS AND METHODS: 46 patients with single tooth missing in the posterior molar region of the mandible were included in this study. 19 implants (CMI IS-III active® long implant) of 5.0 mm diameter and 10 mm length were installed for the control group, while 27 implants (CMI IS-III active® short implant) of 5.5 mm diameter and 6.6, 7.3 or 8.5 mm length were placed for the experimental group. Each implant was inserted and immediately loaded using the digitally pre-fabricated surgical template and provisional restoration. The CAD-CAM monolithic zirconia crown was fabricated at 3 months after the surgery as a definitive restoration. The ISQ value and the MBL was measured at 48 weeks after the surgery. The correlation between the C/I ratio, MBL, and secondary implant stability was analyzed. RESULTS: Successful results in terms of ISQ and MBL were achieved with both groups. There was no significant difference between the groups in terms of ISQ values and MBL at 48 weeks after the surgery (P > 0.05). No significant correlation was found between the C/I ratio and secondary stability as well as the C/I ratio and the MBL (P > 0.05). CONCLUSION: The influence of C/I ratio in both groups was not shown on the stability nor the marginal bone loss in implants supporting single crown of the mandible. Short implant could be a preferable alternative option in the reduced bone height mandible under the limited condition despite its higher C/I ratio.
Computer-Aided Design ; Crowns ; Dental Implants ; Humans ; Mandible ; Molar ; Tooth

Purpose: We investigated the consistent efficacy and safety of eflapegrastim, a novel long-acting granulocyte-colony stimulating factor (G-CSF), in Koreans and Asians compared with the pooled population of two global phase 3 trials. Materials and Methods: Two phase 3 trials (ADVANCE and RECOVER) evaluated the efficacy and safety of fixed-dose eflapegrastim (13.2 mg/0.6 mL [3.6 mg G-CSF equivalent]) compared to pegfilgrastim (6 mg based on G-CSF) in breast cancer patients who received neoadjuvant or adjuvant docetaxel/cyclophosphamide. The primary objective was to demonstrate non-inferiority of eflapegrastim compared to pegfilgrastim in mean duration of severe neutropenia (DSN) in cycle 1, in Korean and Asian subpopulations. Results: Among a total of 643 patients randomized to eflapegrastim (n=314) or pegfilgrastim (n=329), 54 Asians (29 to eflapegrastim and 25 to pegfilgrastim) including 28 Koreans (14 to both eflapegrastim and pegfilgrastim) were enrolled. The primary endpoint, DSN in cycle 1 in the eflapegrastim arm was non-inferior to the pegfilgrastim arm in Koreans and Asians. The DSN difference between the eflapegrastim and pegfilgrastim arms was consistent across populations: –0.120 days (95% confidence interval [CI], –0.227 to –0.016), –0.288 (95% CI, –0.714 to 0.143), and –0.267 (95% CI, –0.697 to 0.110) for pooled population, Koreans and Asians, respectively. There were few treatment-related adverse events that caused discontinuation of eflapegrastim (1.9%) or pegfilgrastim (1.5%) in total and no notable trends or differences across patient populations. Conclusion This study may suggest that eflapegrastim showed non-inferior efficacy and similar safety compared to pegfilgrastim in Koreans and Asians, consistently with those of pooled population.

Hyaluronic acid (HA) has been investigated for biomedical and pharmaceutical applications. This study was conducted to determine the distributions of HA nanoparticles (NPs; size 350–400 nm) and larger HA polymers in mice at intervals after application. ¹⁷⁷Lutetium (Lu)-labeled HA-NPs or HA polymers were intravenously injected (5 mg/kg) into male ICR mice, and radioactivity levels in blood and target organs were measured from 0.25 h to 28 days post-injection. In blood, the radioactivities of HA-NPs and HA polymer peaked at 0.5 h after injection but were remarkably decreased at 2 h; subsequently, they maintained a constant level until 6 days post-injection. HA-NPs and HA polymers were observed in the liver, spleen, lung, kidney, and heart (in ascending order) but were seldom observed in other organs. After 3 days, both the HA-NP and HA polymer levels showed similar steady decreases in lung, kidney, and heart. However, in liver and spleen, the HA-NP levels tended to decrease gradually after 1 day and both were very low after 14 days, whereas the HA polymer level accumulated for 28 days. The results indicate that HA-NPs, with their faster clearance pattern, may act as a better drug delivery system than HA polymers, especially in the liver and spleen.
Animals ; Drug Delivery Systems ; Heart ; Humans ; Hyaluronic Acid* ; Kidney ; Liver ; Lung ; Male ; Mice* ; Mice, Inbred ICR ; Nanoparticles* ; Polymers* ; Radioactivity ; Spleen

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence that could be applicable in real-world practice and suitable for the Korean population. The guideline is provided for all healthcare providers including physicians, diabetes experts, and certified diabetes educators across the country who manage patients with diabetes or the individuals at the risk of developing diabetes mellitus. The recommendations for screening diabetes and glucose-lowering agents have been revised and updated. New sections for continuous glucose monitoring, insulin pump use, and non-alcoholic fatty liver disease in patients with diabetes mellitus have been added. The KDA recommends active vaccination for coronavirus disease 2019 in patients with diabetes during the pandemic. An abridgement that contains practical information for patient education and systematic management in the clinic was published separately.

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence that could be applicable in real-world practice and suitable for the Korean population. The guideline is provided for all healthcare providers including physicians, diabetes experts, and certified diabetes educators across the country who manage patients with diabetes or the individuals at the risk of developing diabetes mellitus. The recommendations for screening diabetes and glucose-lowering agents have been revised and updated. New sections for continuous glucose monitoring, insulin pump use, and non-alcoholic fatty liver disease in patients with diabetes mellitus have been added. The KDA recommends active vaccination for coronavirus disease 2019 in patients with diabetes during the pandemic. An abridgement that contains practical information for patient education and systematic management in the clinic was published separately.