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

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

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 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

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

BACKGROUND: The effective ventricular function during ejection and filling is likely to depend on the coordinated action of the longitudinally and circumferentially orientated myocardial fibers and the function of these longitudinal fibers has not been extensively studied. METHODS: The role of longitudinally and circumferentially orientated fibers in left ventricular wall motion was evaluated by M-mode echocardiograms of the mitral ring(whose motion reflect long axis change) and the standard minor axis(left ventricular posterior wall), simultaneous recordings of phonocardiograms and electrocardiograms on the paper (speed 100mm/sec), in 24 healty individuals, 17 patients with mitral stenosis, 11 patients with open mitral commissurotomy and 17 mitral valve replaced patients. RESULTS: In the controls long axis shortening significantly preceded minor axis shortening (phase difference between two axes : 20+/-3 msec, mean+/-SEM) during early systole, indicating left ventricle become more spherical. This phase difference was also observed in the patients with mitral stenosis and in those with open mitral commissurotomy. In patients with mitral valve replacement(MVR) whose papillary muscles had been sectioned, the onset of long axis shortening was more delayed during early systole than that of short axis(-33+/-6msec) and the end of shortening was also prolonged to early diastole more than that of normal controls (54+/-3 msec vs 90+/-8 msec, mean+/-SEM, p<0.01 by t-test). CONCLUSION: We observed the time relations between long and short axis motion in normal controls. It can be concluded that the reversed time relation in patients with MVR is one of the important factors which may effect negatively on ventricular function and long-term prognosis, thus the surgical procedures to preserve papillary annular continuity should be considered in patients with mitral valvular disease. And the controlled, prospective, clinical trials with homogenous groups of patients are needed to evaluate the potential benefits of papillary annular continuity in preserving atrio-ventricular interaction in patients undergoing mitral valvular surgery.
Axis, Cervical Vertebra* ; Diastole ; Echocardiography ; Electrocardiography ; Heart Valve Diseases* ; Heart Ventricles ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Papillary Muscles ; Prognosis ; Systole ; Ventricular Function

PURPOSE: To compare the techniques and complications of intra-arterial port implantation for intra-arterialchemotherapy between PIPS and the port system. MATERIALS AND METHODS: For intra-arterial port implantation, 27cases in 27 patients were retrospectively evalu-ated using PIPS(PIPS-200, William Cook Europe, Denmark) while for21 cases in 19 patients a pediatric ve-nous port system(Port-A-Cath, 5.8F, SIMS Deltec, U.S.A.) was used. Allintra-arterial port implantation was performed percuteneously in an angiographic ward. Hepatocellular carcinomawas diagnosed in 18 patients and hepatic metastasis in 16. Peripheral cholangiocarcinoma, and pancreatic gastric,ovarian, renal cell and colon carcinoma were included. We compared the techniques and complications between PIPSand the port system. The follow up period ranged from 23 to 494(mean, 163) days in PIPS and from 12 to 431(mean,150) days in the port system. RESULTS: In all cases, intra-arterial port implantations were technicallysuccessful. Port catheter tips were locat-ed in the common hepatic artery(n=8), proper hepatic artery(n=7), righthepatic artery(n=5), gastroduodenal artery(n=2), left hepatic artery(n=1), pancreaticoduodenal artery(n=1),inferior mesenteric artery(n=1), lum-bar artery(n=1), and renal artery(n=1) in PIPS, and in the proper hepaticartery(n=6), gastroduodenal artery(n=6), common hepatic artery(n=3), right hepatic artery(n=4), inferiormesenteric artery(n=1), and in-ternal iliac artery(n=1) in the port system. Port chambers were buried ininfrainguinal subcutaneous tissue. Using PIPS, complications developed in seven cases(25.9%) and of these, four(57.1%) were catheter or cham-ber related. In the port system, catheter or chamber related complications developedin four cases(19.0%). CONCLUSION: Because PIPS and the port system have relative merits and demetrits, successfulintra-arterial port implantation is possible if equipment is properly selected.
Catheters ; Cholangiocarcinoma ; Colon ; Drug Therapy* ; Europe ; Follow-Up Studies ; Hepatic Artery ; Humans ; Neoplasm Metastasis ; Retrospective Studies ; Subcutaneous Tissue ; Vascular Access Devices

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