No abstract available.

Meningioma en plaque (MEP) is a rare tumor characterized more by its clinical and biological behavior than its histological appearance. Hyperostosis of the skull is one of the characteristic signs of MEP. This bony change can produce clinical symptoms and signs in MEP by pressing against adjacent structures. The authors report a rare case of an osteolytic MEP extending from the sphenoid wing into the orbital wall, middle fossa, and temporalis muscle.
Hyperostosis ; Meningioma ; Muscles ; Orbit ; Skull

OBJECTIVES: The purpose of this study was to compare the marginal and internal fit of nano-composite CAD-CAM restorations. MATERIALS AND METHODS: A full veneer crown and an mesio-occluso-distal (MOD) inlay cavity, which were prepared on extracted human molars, were used as templates of epoxy resin replicas. The prepared teeth were scanned and CAD-CAM restorations were milled using Lava Ultimate (LU) and experimental nano-composite CAD/CAM blocks (EB) under the same milling parameters. To assess the marginal and internal fit, the restorations were cemented to replicas and were embedded in an acrylic mold for sectioning at 0.5 mm intervals. The measured gap data were pooled according to the block types and measuring points for statistical analysis. RESULTS: Both the block type and measuring point significantly affected gap values, and their interaction was significant (p = 0.000). In crowns and inlays made from the two blocks, gap values were significantly larger in the occlusal area than in the axial area, while gap values in the marginal area were smallest (p < 0.001). Among the blocks, the restorations milled from EB had a significantly larger gap at all measuring points than those milled from LU (p = 0.000). CONCLUSIONS: The marginal and internal gaps of the two nano-composite CAD/CAM blocks differed according to the measuring points. Among the internal area of the two nano-composite CAD/CAM restorations, occlusal gap data were significantly larger than axial gap data. The EB crowns and inlays had significantly larger gaps than LU restorations.
Computer-Aided Design ; Crowns ; Fungi ; Humans ; Inlays ; Molar ; Tooth

OBJECTIVES: The purpose of this study was to compare the marginal and internal fit of nano-composite CAD-CAM restorations. MATERIALS AND METHODS: A full veneer crown and an mesio-occluso-distal (MOD) inlay cavity, which were prepared on extracted human molars, were used as templates of epoxy resin replicas. The prepared teeth were scanned and CAD-CAM restorations were milled using Lava Ultimate (LU) and experimental nano-composite CAD/CAM blocks (EB) under the same milling parameters. To assess the marginal and internal fit, the restorations were cemented to replicas and were embedded in an acrylic mold for sectioning at 0.5 mm intervals. The measured gap data were pooled according to the block types and measuring points for statistical analysis. RESULTS: Both the block type and measuring point significantly affected gap values, and their interaction was significant (p = 0.000). In crowns and inlays made from the two blocks, gap values were significantly larger in the occlusal area than in the axial area, while gap values in the marginal area were smallest (p < 0.001). Among the blocks, the restorations milled from EB had a significantly larger gap at all measuring points than those milled from LU (p = 0.000). CONCLUSIONS: The marginal and internal gaps of the two nano-composite CAD/CAM blocks differed according to the measuring points. Among the internal area of the two nano-composite CAD/CAM restorations, occlusal gap data were significantly larger than axial gap data. The EB crowns and inlays had significantly larger gaps than LU restorations.
Computer-Aided Design ; Crowns ; Fungi ; Humans ; Inlays ; Molar ; Tooth

PURPOSE: This study aimed to assess the diagnostic efficacy of Korean Thyroid Imaging Reporting and Data System (K-TIRADS) features for distinguishing follicular thyroid adenoma (FTA) from follicular thyroid carcinoma (FTC). METHODS: From January 2013 to July 2016, 46 follicular neoplasms in 45 patients who underwent preoperative thyroid ultrasonography (US) and thyroid surgery were included. The US features of each thyroid nodule were retrospectively evaluated by a single radiologist using a picture archiving and communication system. The diagnostic indices of K-TIRADS for follicular neoplasms were calculated according to whether K-TIRADS category 4 lesions were excluded or classified as benign or malignant. RESULTS: Of the 46 follicular neoplasms (mean size, 3.1±1.6 cm), 37 were FTAs (mean size, 3.1±1.7 cm) and nine were FTCs (mean size, 3.0±1.5 cm). A statistically significant difference was found between FTAs and FTCs regarding the margin (P=0.035), while no significant differences were observed in the composition, echogenicity, shape, orientation, calcification, or vascularity of the lesions (P<0.05). The FTAs belonged to K-TIRADS categories 3 (n=22) and 4 (n=15), while the FTCs belonged to K-TIRADS categories 3 (n=4), 4 (n=4), and 5 (n=1). However, there was no statistically significant difference in the distribution of K-TIRADS categories between FTAs and FTCs (P=0.184). CONCLUSION: K-TIRADS features were not helpful for distinguishing FTA from FTC, although follicular neoplasms showed a high prevalence of K-TIRADS categories 3 and 4.
Adenocarcinoma, Follicular ; Humans ; Information Systems* ; Prevalence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Ultrasonography

PURPOSE: Hydroxychloroquine has been used as the antimalarial agent and drug of the treatment for autoimmune disease such as rheumatoid arthritis. Hydroxychloroquine retinopathy can cause serious visual disturbance although the incidence is low. This report is to describe a case of Hydroxycholoroquine retinopathy on 73 year old female. CASE SUMMARY: A 73 year old female patient presented our clinic with complaints of visual disturbance for several months. She had taking 400 mg/day (8.8 mg/kg of lean body weight/day) of hydroxychloroquine for 2 years. The best corrected visual acuity was 20/30 in both eyes. Bull's eye maculopathy was observed on her fundus examination and Humphrey Automated Visual Field 24-2 showed central scotoma in both eyes. Parafoveal thinning of photoreceptor layers, loss of the inner and outer segment junction and external limiting membrane was observed on spectral domain Optical Coherence Tomography. Window defect was visible at the parafoveal area on fluorescein angiography. Electroretinogram revealed subtle dysfunction of cone cell and multifocal ERG trace array showed decreased amplitudes at the parafoveal area. Electrooculogram showed decreased Arden ratio. CONCLUSIONS: We strongly advise that all patients taking Hydorxycholoroquine therapy have a regular examination to find hydroxychloroquine retinopathy in early stage especially in the patients having high risk factors.
Arthritis, Rheumatoid ; Autoimmune Diseases ; Electrooculography ; Eye ; Female ; Fluorescein Angiography ; Humans ; Hydroxychloroquine ; Incidence ; Membranes ; Risk Factors ; Scotoma ; Tomography, Optical Coherence ; Visual Acuity ; Visual Fields

OBJECTIVES: Previous studies have reported that symptoms of patients with major depressive disorder (MDD) are different according to age groups, and the Hamilton Depression Rating Scale (HDRS) is the most widely used measure to evaluate the symptoms of MDD. However, few previous studies have compared the symptoms of HDRS between the elderly and non-elderly groups. METHODS: The study population consisted of 574 subjects with MDD who were > or =18 years old, evaluated using the Mini International Neuropsychiatric Interview and 17 items of HDRS. Differences between two groups were analyzed using independent t-test. A multivariate logistic regression model was used to evaluate associations between age and 17 items from HDRS after controlling for gender, years of education, marital status, and employment status. RESULTS: Among 574 patients with MDD, there were 80 elderly patients (age> or =65) and 494 non-elderly patients (age between 18 and 64). Elderly patients had higher scores on item 5 (middle insomnia) (t=-2.271, p=0.024) and item 6 (late insomnia) (t=-2.280, p=0.023), whereas they had lower scores on item 1 (depressed mood) (t=2.860, p=0.004), item 3 (suicide) (t=2.258, p=0.024), and item 9 (agitation) (t=2.031, p=0.043), although no significant difference in the total HDRS scores was observed between elderly and non-elderly. Multivariate logistic regression showed significant association of elderly with hypochondriasis [adjusted odds ratio (AOR)=1.894, 95% confidence interval (CI) 1.01-3.56] and agitation (AOR=0.50, 95% CI 0.29-0.87). CONCLUSION: Elderly MDD patients showed more insomnia and hypochondriasis and less depressed mood, suicidal ideation, and agitation than non-elderly.
Aged* ; Depression* ; Depressive Disorder, Major* ; Dihydroergotamine ; Education ; Employment ; Humans ; Hypochondriasis ; Logistic Models ; Marital Status ; Odds Ratio ; Outpatients* ; Sleep Initiation and Maintenance Disorders ; Suicidal Ideation

Bone Resorption ; Incisor ; Lip ; Membranes ; Patient Satisfaction ; Prostheses and Implants ; Survival Rate ; Tooth, Deciduous ; Transplants

A recent application of anal endosonography has been popularized in adult patients to access staging of the rectal cancer and other lesions of the anorectum; however, this study has not been familiar to pediatric surgeons. We performed anal endosonography in 30 children without anorectal disease in order to obtain standard morphology of the anorectum. Internal anal sphincter (IAS) was clearly identified as a homogeneous hypoechoic circular band, extending caudally to a level just proximal to anal verge. The external anal sphincter (EAS) showed mixed echogenicity and different architecture along anal canal ; the EAS had U-shape in the upper canal and it showed circular pattern in the lower canal. In the upper canal of girls, the perineal body and the vagina were shown just anterior of the anal canal, which made the U shape of the EAS, whereas in male the sphincter tapered anteriorly into two arcs that met in the midline. The perineal body was prominent in female. Posteriorly, the anococcygeal ligament showed triangular shadow in both sex. The thickness of the IAS was measured in 3 directions, left, right and posterior, at 3 levels, upper, middle and lower of the anal canal. The average thiskness was 0.86-2.40mm between 6 and 18 months of age (Group 1), 0.88-3.20mm between 19 and 36 (Group 2), 1.07-2.20mm between 37 and 54 (Group 3) and 1.18-2.42mm more than 54-month-old (Group 4). The thickness was correlated wtih the age of the children only in the right upper(p=0.008) and the left middle portion (p=0.015). We could obtain standard morphologic features of normal anal canal in children with anal endosonography and we also believe that this technique is a safe and an effective procedure to evaluate anorectal lesions in children.
Adult ; Anal Canal* ; Child* ; Endosonography ; Female ; Humans ; Ligaments ; Male ; Rectal Neoplasms ; Vagina

PURPOSE: To evaluate the effectiveness of a cycloplegic regimen using 0.5% tropicamide and 0.5% phenylephrine (Tropherine, Hanmi Pharm), in addition to 1% cyclopentolate, in hyperopic children. METHODS: The medical records of hyperopic patients below the age of 14 years who had undergone cycloplegic retinoscopy were retrospectively reviewed. Cycloplegic refractions were performed using one of two cycloplegic regimens. Regimen 1 was a Tropherine-added regimen comprising the administration of one drop of 1% cyclopentolate followed by two to three drops of Tropherine added at 15-minute intervals. Regimen 2 was a cyclopentolate-only regimen comprising the administration of three to four drops of 1% cyclopentolate at 15-minute intervals. The mean difference between noncycloplegic and cycloplegic refraction was compared between the two regimens. RESULTS: A total of 308 eyes of 308 hyperopic children were included. The mean difference (±standard deviation) in the spherical equivalent (SE) between cycloplegic and noncycloplegic refraction was significantly larger in regimen 2 than in regimen 1, with values of +1.70 ± 1.03 diopters (D) and +1.25 ± 0.89 D, respectively (p=0.001). The SE change after cycloplegia was significantly different between the two regimens only in patients aged 5 years or younger (p=0.001), particularly in those with high hyperopia with an SE ≥5 D (p=0.005) or fully accommodative esotropia (p=0.009). There was no significant difference between the two regimens in patients older than 5 years, regardless of the presence of high hyperopia or fully accommodative esotropia. CONCLUSIONS: The Tropherine-added regimen exerted a weaker cycloplegic effect than the cyclopentolate-only regimen, particularly in children under the age of 5 years with high hyperopia or fully accommodative esotropia. However, the difference in refraction between the two regimens was small. A Tropherine-added regimen can be effective in hyperopic children, with less associated discomfort than the instillation of cyclopentolate.
Child* ; Cyclopentolate* ; Esotropia ; Humans ; Hyperopia ; Medical Records ; Phenylephrine* ; Retinoscopy ; Retrospective Studies ; Tropicamide*