The optimal treatment and appropriate follow-up period for an unruptured vertebral artery (VA) and/or posterior inferior cerebellar artery (PICA) dissection have not been established. Decisions regarding treatment of these vascular lesions are usually based on the manifesting symptoms and changes in radiologic findings during the follow-up period. We experienced a patient who had a simultaneous unruptured VA dissection and a contralateral PICA dissecting aneurysm. We did not find such a case in other literature.
Aneurysm, Dissecting ; Arteries ; Follow-Up Studies ; Humans ; Pica ; Vertebral Artery ; Vertebral Artery Dissection

This article reviews the designated health care institution for child abuse in Korea and the compatible systems in other countries. The Korean system is ready to be commenced by a relevant law, which came into effect in July 2019. To find lessons for the designated hospital or professional system, we examined the designated institutions for rape victims, tuberculosis patients, and aftercare for emergency department-based suicide attempters. We also looked at safeguarding system of the United Kingdom, which comprises designated and named professionals, and the National Association of Children’s Hospitals and Related Institutions guidelines and specialist system in the United States. The systems in the United States and the United Kingdom may offer insight to improving the planned designated health care institution for child abuse in Korea. This includes policy issues such as qualification control of professionals, role differentiation in accordance with the hospital classification, and assigning the title of the professional and health care institutions.

PURPOSE: The purpose of this study was to evaluate the deformation of the complete denture artificial teeth arrangement after festooning over time. MATERIALS AND METHODS: 10 wax dentures of equal teeth arrangement and equal gingival contour were used in this study. Festooning of the wax dentures were conducted and 3D model scans were conducted every 10 minutes for 120 minutes. Interdental transverse distances were measured with the scanned images. Statistical analyses were performed with SPSS Ver. 22. 0. RESULTS: Interdental transverse distance between teeth varied from 0.0999 mm to 0.1787 mm. Mean rate of deformation showed statistically significant change between the 40 – 50 minute interval and 50 – 60 minute interval and between the 50 – 60 minute interval and 60 – 70 minute interval. No statistically significant change of the mean rate of deformation was observed later on. CONCLUSION: Monitoring of the interdental transverse distance for 120 minute after festooning have shown the deformation and displacment of the artificial teeth arrangement. From after the 60 – 70 minute interval after festooning, the mean deformation showed no statistically significant change of the mean rate of deformation was observed. Within the limitations of this in vitro study results suggest that the final occlusal adjustment in wax denture before complete denture curing should be proceeded at least 60 minutes later after festooning.
Denture, Complete ; Dentures ; In Vitro Techniques ; Occlusal Adjustment ; Tooth ; Tooth Movement ; Tooth, Artificial

Purpose: The purpose is to test and evaluate the physical properties of commonly used temporary restoration materials and newly emerged materials. Materials and Methods: Four groups of polymer materials were evaluated: Polymethyl methacrylate (PMMA) 2 groups, Polyetheretherketone (PEEK), Polycarbonate. Four physical properties were tested: surface hardness, bending strength, abrasion resistance during wear, wear behavior. The 3-axis bending strength and Vickers hardness test were measured using a universal testing machines respectively. The microstructure was observed with a scanning electron microscope and weight comparison was evaluated after 100,000 chewing tests using a chewing simulator. Kruskal wallis test was performed to evaluate statistical significance. Results: The four groups showed the highest flexural strength and Vickers hardness of PEEK, followed by PC, PMMA-H, PMMA-T. Microstructure observation also showed the least surface roughness in the PEEK group, followed by PC, PMMA-H, PMMA-T. Conclusion PC is considered to have sufficient mechanical properties that can be applied to the manufacture of temporary teeth. However, further studies, such as biocompatibility, are considered to be necessary for practical clinical applications.

Williams syndrome is a rare genetic disorder with a frequency of one per 20,000-50,000 live births. It is caused by a deletion of one elastin allele located within chromosome subunit 7q11.23 (long arm). This syndrome is frequently accompanied by congenital heart disease, facial anomalies, and mental retardation and as a result, anesthetic management may be complicated by hemodynamic instability and difficult intubation. Also, as it was reported that this disease is associated with malignant hyperthermia, careful anesthetic selection is required. We experienced the anesthetic management of a 3-year-old girl with Williams syndrome who received dental treatment for severe dental caries under general anesthesia, and of a 4-year-old girl underwent aortoplasty for supravalvular aortic stenosis. Airway management and tracheal intubation was accomplished successfully in both patients. For anesthetic management, propofol, fentanyl and rocuronium, and fentanyl, isoflurane and vecuronium were used in the first and second patients, respectively. Surgeries were performed uneventfully in both cases, and the patients were discharged without complication.
Airway Management ; Alleles ; Anesthesia ; Anesthesia, General ; Aortic Stenosis, Supravalvular ; Child, Preschool ; Dental Caries ; Elastin ; Female ; Fentanyl ; Heart Defects, Congenital ; Hemodynamics ; Humans ; Intellectual Disability ; Intubation ; Isoflurane ; Live Birth ; Malignant Hyperthermia ; Propofol ; Vecuronium Bromide ; Williams Syndrome*

OBJECTIVE: The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury.METHODS: Data from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients’ clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom’s criteria.RESULTS: The C2–7 Cobb and operative segmental angles increased by 3.45±7.61 and 2.94±4.59 in group A; and 2.46±7.31 and 2.88±5.49 in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than “good” using Odom’s criteria.CONCLUSION: The application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.
Allografts ; Asian Continental Ancestry Group ; Cervical Vertebrae ; Diskectomy ; Female ; Humans ; Orthopedics ; Retrospective Studies ; Spinal Cord Injuries ; Spondylosis

PURPOSE: The purpose of this study is to evaluate the displacement of artificial tooth of monolithic complete denture manufactured by milling and 3D printing method in which the denture base and the artificial teeth are simultaneously made. MATERIALS AND METHODS: Twelve upper and lower complete dentures for each were made by milling and 3D printing method. Group Up and Group Lp are a group of upper and lower dentures made by printing, and Group Um and Group Lm are denture groups made by milling. Group Uc and Group Lc are is a group of finally designed upper and lower dentures respectively. Measurements were performed between both central incisors (AB, ab), both canines (CD, cd), both first molars (EF, ef), between an incisor and a first molar (AE, ae), and between incisor and lingual point (AG, ag) for each upper and lower denture. RESULTS: AG and ag value between printed dentures and original ones as well as between milled dentures and original ones showed a statistically significant difference (One-way ANOVA, P<.05) in both lower and upper monolithic dentures. In the lower monolithic ones, ab, cd and ef value revealed a significant difference between Group Lp and Group Lm (One-way ANOVA, P<.05). CONCLUSION: Dentures made using milling or 3D printers revealed statistically significant difference compared with those of original data. However, it showed clinically very accurate reproducibility.
Denture Bases ; Denture, Complete* ; Dentures ; Incisor ; Methods ; Molar ; Printing, Three-Dimensional* ; Tooth, Artificial*

BACKGROUND: Ventilator-induced lung injury (VILI) sustained during mechanical ventilator support is still a cause of a high rate of morbidity and mortality in intensive care units and in operating rooms. VILI is characterized by pulmonary inflammation that appears to be mediated by proinflammatory cytokines. This study investigates whether the volatile anesthetic sevoflurane has an anti-inflammatory effect that attenuates VILI. METHODS: Twenty one male rabbits were anesthetized and were mechanically ventilated with 50% oxygen at a peak inspiratory pressure (PIP) of 10 cmH2O, I : E ratio of 1 : 4, and positive end expiratory pressure of 5 cmH2O. All animals were randomly assigned to one of three groups that were ventilated for 5 h with 10 cmH2O of PIP (Sham group, n = 7); 30 cmH2O of PIP (Control group, n = 7); or 30 cmH2O of PIP and 0.8 vol% sevoflurane (Sevoflurane group, n = 7). The wet/dry weight (W/D) ratio and histopathology of the lung; concentration of interleukin-8 (IL-8) in the bronchoalveolar lavage fluid; and activation of extracellular signal-regulated kinases (ERK) 1/2, p38 mitogen-activated protein kinase, and Akt were measured in the lung tissue after completing the protocol. RESULTS: Histopathology indicated that the sevoflurane group showed fewer inflammatory cells and architectural changes than the control group did. The W/D ratio [(5.36 +/- 0.13) versus (6.61 +/- 0.20)], expression of IL-8 [(144.08 +/- 14.61) versus (228.56 +/- 15.13) pg/ml] and phosphorylation of ERK1/2 and Akt decreased significantly in the sevoflurane group relative to the control group. CONCLUSIONS: Sevoflurane attenuates VILI in rabbits mainly by inhibiting expression of IL-8, and Sevoflurane-induced inhibition of phosphorylated ERK1/2 and Akt might be a possible pathway for protection.
Animals ; Bronchoalveolar Lavage Fluid ; Cytokines ; Extracellular Signal-Regulated MAP Kinases ; Humans ; Intensive Care Units ; Interleukin-8 ; Lung ; Male ; Mortality ; Operating Rooms ; Oxygen ; Phosphorylation ; Pneumonia ; Positive-Pressure Respiration ; Protein Kinases ; Rabbits ; Signal Transduction* ; Ventilator-Induced Lung Injury* ; Ventilators, Mechanical

Proper seat belt use saves lives; however, the use rate decreased in Korea. This study aimed to measure the magnitude of the preventive effect of seat belt on case-fatality across drivers and passengers. We used the Emergency Department based Injury In-depth Surveillance (EDIIS) database from 17 EDs between 2011 and 2012. All of adult injured patients from road traffic injuries (RTI) in-vehicle of less than 10-seat van were eligible, excluding cases with unknown seat belt use and outcomes. Primary and secondary endpoints were in-hospital mortality and intracranial injury. We calculated adjusted odds ratios (AORs) of seat belt use and driving status for study outcomes adjusting for potential confounders. Among 23,698 eligible patients, 15,304 (64.6%) wore seat belts. Driver, middle aged (30-44 yr), male, daytime injured patients were more likely to use seat belts (all P < 0.001). In terms of clinical outcome, no seat belt group had higher proportions of case-fatality and intracranial injury compared to seat belt group (both P < 0.001). Compared to seat belt group, AORs (95% CIs) of no seat belt group were 10.43 (7.75-14.04) for case-fatality and 2.68 (2.25-3.19) for intracranial injury respectively. In the interaction model, AORs (95% CIs) of no seat belt use for case-fatality were 11.71 (8.45-16.22) in drivers and 5.52 (2.83-14.76) in non-driving passengers, respectively. Wearing seat belt has significantly preventive effects on case-fatality and intracranial injury. Public health efforts to increase seat belt use are needed to reduce health burden from RTIs.
Accidents, Traffic/mortality/*prevention & control ; Adult ; Aged ; Craniocerebral Trauma/prevention & control ; Databases, Factual ; Emergency Service, Hospital ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Motor Vehicles ; Odds Ratio ; Republic of Korea/epidemiology ; Seat Belts/*utilization ; Young Adult

PURPOSE: This study was aimed at determining whether a regular follow-up of patients with colorectal cancer can lead to improved re-resectability, and which test is useful for detecting a resectable recurrence. METHODS: The medical records of 397 consecutive patients, who underwent a curative resection for colorectal cancer between January 1996 and December 2000, with a mean follow-up of 36 months, were retrospectively analysed. RESULTS: The overall recurrence rate was 19.6%, with 22.5% and 7.8% in the regular and irregular follow-up groups (P=0.002), respectively. There was a significant difference in the asymptomatic recurrence detection rate (68.1 vs. 16.7%; P=0.021), but a curative intent reoperation was possible in 21 (29.1%) of those patients with a cancer recurrence in the regular follow-up group, and in 1 (16.7%) inform the irregular follow-up group, which was not significantly different (P= 0.454). Careful history taking and a physical examination were beneficial in the detection of a resectable recurrence. Serum carcinoembryonic antigen determination and endoscopy were useful for detecting a recurrence (14 cases and 5 cases, respectively), and of these 4 (28.6%) and 5 cases (100%) could be treated with a curative intent reoperation, respectively. Abdominal CT, or MRI, and a chest radiography were also useful for detecting a recurrence (22 cases and 8 cases, respectively), but the curative intent reoperation rates were slightly low (3 cases (13.6%) and 1 case (12.5%), respectively). CONCLUSION: A regular follow-up after a curative resection for colorectal cancer, although facilitating detection of recurrence before symptoms developed, was unlikely to succeed in increasing the rate of a curative reoperation.
Carcinoembryonic Antigen ; Colorectal Neoplasms* ; Endoscopy ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Physical Examination ; Radiography ; Recurrence ; Reoperation ; Retrospective Studies ; Thorax ; Tomography, X-Ray Computed