This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice, but combined endodontic-periodontic treatment allowed the tooth to be saved.
Dental Pulp Necrosis ; Diagnosis ; Incisor* ; Membranes ; Periodontal Diseases ; Tooth ; Transplants

PURPOSE: F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been proven to be useful in the differential diagnosis of breast mass and staging of breast cancer. This study assessed the diagnostic accuracy of F-18-FDG PET in the differentiation of breast mass and staging of breast cancer. MATERIALS AND METHODS: Total 42 patients who had breast mass underwent F-18-FDG PET (all female, 40+/-10 year old). We compared F-18 FDG PET results with pathologic findings in 24 patients RESULTS: In the differentiation of breast mass, sensitivity and specificity were 95% (19/20) and 77% (7/9) respectively. Three false positive cases were due to inflammation and one false negative patient had small tumor less than 1 cm. In the assessment of axillary lymph node status, sensitivity and specificity were 73% (8/11) and 100% (7/7) respectively. We found distant metastasis that were not suspected before F-18-FDG PET in 2 patients. CONCLUSION: F-18-FDG PET shows good diagnostic performance in differentiation of breast mass and staging of breast cancer.
Breast Neoplasms* ; Breast* ; Diagnosis, Differential* ; Female ; Humans ; Inflammation ; Lymph Nodes ; Neoplasm Metastasis ; Positron-Emission Tomography ; Sensitivity and Specificity

PURPOSE: Subscapularis tendon tears associated with supraspinatus tendon tears are often found during rotator cuff repair. However, there have been only a few reports about both subscapularis and rotator cuff repair. The authors conducted arthroscopic repair for cuff tear associated with subscapularis tendon tear and assessed its outcomes. MATERIALS AND METHODS: We evaluated 320 cases of arthroscopic repair following rotator cuff tear between June 2006 and January 2009 at Gil Medical Center. Out of 66 cases (21%) associated with subscapularis tear, forty cases of bone to tendon repair using suture anchor were selected except for 26 cases of tendon to tendon repair. Clinical outcomes of 25 cases followed up for over a year were finally assessed. Clinical outcomes were evaluated using the following measures: range of shoulder motion, muscle strength, belly press test, Visual Analogue Scale (VAS) on pain, and University of California Los Angeles (UCLA) score. RESULTS: The average VAS pain scale improved from 5.3 preoperatively to 1.4 postoperatively. Internal rotation strength increased from its preoperative level, 4.1 to 4.2 in postoperative 6 months and to 4.6 at last follow-up. Range of internal rotation increased from the second lumbar level at postoperative 6 months to the 11th thoracic level at last follow-up. UCLA score had significantly improved from 17.4 to 30.8 (p<0.05). CONCLUSION: It is recommended that concurrent repair of the subscapularis tendon during rotator cuff repair for a satisfactory treatment result.
California ; Follow-Up Studies ; Los Angeles ; Muscle Strength ; Rotator Cuff ; Shoulder ; Suture Anchors ; Tendons

The purpose of this study was to compare the sealing abilities of four endodontic temporary restorative materials using a methylene blue dye penetration test under dynamic loading. Standardized access cavities were prepared in forty-four intact human permanent molar teeth, and the cavities were restored with Caviton, MD-Temp, IRM, or ZOE. After thermocycling, an intermittent load of 98 N at 1 Hz was applied for 1,000 cycles to the long axis of the functional cusp of each of the teeth, which were immersed in a 1% methylene blue solution. The teeth were split in half, and the linear depth of dye penetration was evaluated according to the criteria. The results were analyzed using one-way ANOVA (p = 0.05) and Duncan's multiple range test. The results demonstrated that Caviton and MD-Temp showed significantly lower microleakage than IRM and ZOE. It was concluded that Caviton and MD-Temp exhibited better sealing ability than IRM and ZOE under dynamic loading.
Axis, Cervical Vertebra ; Calcium Sulfate ; Dental Cements ; Humans ; Methylene Blue ; Molar ; Root Canal Filling Materials ; Tooth ; Vinyl Compounds ; Zinc Oxide

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) is increasing in Asian countries. Functional dyspepsia (FD) or irritable bowel syndrome (IBS) are also prevalent and commonly overlapped with GERD. This study was conducted to compare the proportion and risk factors for overlapping reflux esophagitis (RE) and non-erosive reflux disease (NERD) with functional gastrointestinal disorders (FGIDs). METHODS: A total of 2,388 [male, 55.9%; mean age (+/- SD), 43.2 years (+/- 8.4)] Korean subjects who underwent the upper endoscopy for health screening were prospectively included. The subjects were asked about demographic, medical and social history by using a structured questionnaire, and FD and IBS were assessed according to the Rome III criteria. RESULTS: The subjects with RE were 286 (12.0%, male 88.5%, 42.8 years) and 74 subjects had NERD (3.1%) while the prevalence of FD and IBS were 8.1% and 10.1%, respectively. The proportion of FD and IBS in NERD was higher than that of RE (74.3% vs. 10.5%, p = 0.000; 41.9% vs. 11.2%, p = 0.000, respectively). The epigastric pain syndrome (EPS) was more prevalent than postprandial distress syndrome in NERD. According to multiple regression analysis, high somatization score and the presence of FD increased the odd ratio for NERD. However, male gender and current smoker were significant risk factors for RE. CONCLUSIONS: Compared to RE, NERD is more frequently overlapped with FD, especially EPS, and also are associated with significantly increased frequency of IBS. Our data draws attention to the possibility of subgrouping FGIDs and GERD to be important in understanding the pathophysiology of these conditions.
Asian Continental Ancestry Group ; Dyspepsia ; Endoscopy ; Esophagitis, Peptic ; Gastroesophageal Reflux ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Male ; Mass Screening ; Prevalence ; Prospective Studies ; Surveys and Questionnaires ; Risk Factors ; Rome

Drugs are well known causes of eosinophilic lung disease. In many patients, drug-induced eosinophilic lung disease presents with transient eosinophilic infiltrates that disappear after discontinuation of the drug. Some patients, however, experience a fulminant, acute eosinophilia-like disease. Recently, we experienced a case of amitriptyline-associated acute eosinophilic pneumonia with respiratory failure in a diabetic hemodialysis patient. Eight days after treatment with amitriptyline, sudden fever, chill, dry cough and dyspnea developed. Subsequently, multiple patch consolidations appeared on the chest radiographs. Bronchoalveolar lavage (BAL), established a diagnosis of acute eosinophilic pneumonia. After immediate discontinuation of amitriptyline, a rapid clinical and radiological improvement was observed. The present case indicates that the possibility of acute eosinophilic pneumonia should be fully considered in dialysis patients developing unexplained respiratory symptoms while on amitriptyline therapy.
Acute Disease ; Adult ; Amitriptyline/*adverse effects ; Antidepressive Agents, Tricyclic/*adverse effects ; Female ; Human ; Pulmonary Eosinophilia/*etiology ; *Renal Dialysis

BACKGROUND: Primary angiitis of the central nervous system (PACNS) is a rare disorder and is often difficult to diagnose due to the lack of a confirmatory test. PACNS can generally be diagnosed based on typical angiographic findings. We describe herein a patient diagnosed with PACNS despite the presence of normal findings on conventional angiography. CASE REPORT: A 44-year-old man with a recent history of ischemic stroke in the right posterior cerebral artery territory developed acute-onset vertigo. Diffusion-weighted imaging revealed an acute infarction within the left posterior inferior cerebellar artery. His medical history was unremarkable except for hyperlipidemia; the initial examination revealed mild gait imbalance. During the 10 days of hospital admission, the patient experienced four recurrent ischemic strokes within the posterior circulation territory (occipital lobe, pons, and cerebellum). He was diagnosed with recurrent cerebral infarctions due to PACNS. The basilar artery exhibited no demonstrable luminal stenosis, but there were direct imaging signs of central nervous system angiitis including wall thickening and contrast enhancement. High-dose intravenous steroid therapy followed by oral prednisolone was administered. There was no further stroke recurrence and follow-up imaging of the arterial walls showed normalization of their characteristics. CONCLUSIONS: The present case emphasizes the importance of wall imaging in the diagnosis and treatment of PACNS.
Adult ; Angiography ; Arteries ; Basilar Artery ; Central Nervous System* ; Cerebral Infarction ; Constriction, Pathologic ; Diagnosis* ; Follow-Up Studies ; Gait ; Humans ; Hyperlipidemias ; Infarction ; Inflammation ; Magnetic Resonance Imaging* ; Phenobarbital ; Pons ; Posterior Cerebral Artery ; Prednisolone ; Recurrence ; Stroke ; Vasculitis* ; Vasculitis, Central Nervous System ; Vertigo

Objectives: This research delves into the application of texture analysis in spine computed tomography (CT) scans and its correlation with bone mineral density (BMD), as determined by dual-energy X-ray absorptiometry (DXA).It specifically addresses the discordance between the 2 measurements, suggesting that certain spinal-specific factors may contribute to this discrepancy. Methods: The study involved 405 cases from a single institution collected between May 6, 2012 and June 30, 2021. Each case underwent a spinal CT scan and a DXA scan. BMD values at the lumbar region (T12 to S1) and total hip were recorded. Texture features from axial cuts of T12 to S1 vertebrae were extracted using gray-level co-occurrence matrices, and a regression model was constructed to predict the BMD values. Results: The correlation between CT texture analysis results and BMD from DXA was moderate, with a correlation coefficient ranging between 0.4 and 0.5. This discordance was examined in light of factors unique to the spine region, such as abdominal obesity, aortic calcification, and lumbar degenerative changes, which could poten tially affect BMD measurements. Conclusions Emerging from this study is a novel insight into the discordance between spinal CT texture analysis and DXA-derived BMD measurements, highlighting the unique influence of spinal attributes. This revelation calls into question the exclusive reliance on DXA scans for BMD assessment, particularly in scenarios where DXA scanning may not be feasible or accurate.

For HDR intracavitary brachytherapy with ovoids and a tandem, we compared the dose discrepancy of treatment plans using two different Ir-192 sources (microSelectron, Varian) and generated on two different treatment planning systems (PLATO, BrachyVision). The treatment plans of ten patient treated from Oct. 2007 to Jan. 2008 were selected for these comparisons. For the comparison of dose calculation using different sources, the average discrepancies were -0.91+/-0.09%, 0.27+/-0.07%, 0.22+/-0.39%, and 0.88+/-0.37% in total treatment time and at B-point and ICRU bladder and rectum reference point, respectively. Comparing the two systems, the average dose discrepancies between treatment planning programs were -0.22+/-0.42%, -0.25+/-0.29%, -0.23+/-0.63%, and -0.17+/-0.76%, and the average dose discrepancies between positioning methods (PLATO with film and BrachyVision with digitial image) were -0.61+/-0.59%, -0.77+/-0.45%, -0.72+/-1.70%, and 0.35+/-2.82% at A-point, B-point, and ICRU bladder and rectum reference points, respectively. The rectal dose discrepancies between two systems were reached 5.87%. The difference in the dwell position expected by each TPS are mainly affected by the differences in the positioning method in TPSs and have an effect on dose calculations of rectal and bladder located in AP direction.
Brachytherapy ; Humans ; Rectum ; Urinary Bladder

PURPOSE: Sarcomas arising in intraperitaneal cavity and retroperitoneal space are relatively uncommon. Thus, studies characterizing the results of long-term follow-up are limited. The purpose of this study was to identify the clinicopathologic features and prognostic factors of intraperitoneal and retroperitoneal sarcomas. Materials and Method: Thirtyeight patients with intraperitaneal or retroperitoneal sarcoma who had been treated at Department of Surgery, Korea Cancer Center Hospital during the period from January 1987 to December 1997 were reviewed retrospectively. RESULTS: The ratio between male to female was 0.9: 1. The mean age of the patients was 48.3 (32-75) years. The most common symptom was abdominal pain or discomfort (61%), followed by palpable mass (55%), GI bleeding (34%), weight loss (26%), and change of bowel habits (21%). The most comman histologic type was leiomyosarcoma (73.7%), followed by liposarcoma (23.7%), and malignant fibrous histiocytoma (2.6%). The mean tumor size was 15.5 x12.1 x 8.7 cm. Among 38 cases, 25 cases developed in intraperitoneal cavity and 13 cases arose in retroperitoneal space. Overall, 44 operations were performed in 31 patients. Among them, complete surgical resection constituted 73%. In 20 cases, combined resection of adjacent organ was performed to accomplish complete surgical resection of tumors. During the median follow up period of 23 months (3~116 months), the overall 5-year survival rate was 34.7%. The patients who had been treated by complete surgical resection showed better survival than those in whom palliative resection or biopsy only was performed (38.6% vs 0% of 5 YSR, P=0.015). Liposarcoma showed better prognosis than leiomyosarcoma (41.7% vs 34.2% of 5 YSR, P=0.0000). The size of tumor (10 cm>vs 10 cm< or =) was not a statistically significant prognostic factor. CONCLUSION: In this series, The histologic type and complete surgical resection were important factors that can affect the survival of the patients. Aggressive surgical resections are therefore wananted to obtain better outcome of the patients with intraperitoneal and retroperitoneal sarcomas.
Abdominal Pain ; Biopsy ; Female ; Follow-Up Studies ; Hemorrhage ; Histiocytoma, Malignant Fibrous ; Humans ; Korea ; Leiomyosarcoma ; Liposarcoma ; Male ; Prognosis ; Retroperitoneal Space ; Retrospective Studies ; Sarcoma* ; Survival Rate ; Weight Loss