We report a case of pneumomediastinum, subcutaneous emphysema, and mild pneumothorax that occurred after endotracheal intubation with a metallic endotracheal tube for the laser operation. Fortunately, pneumomediastinum and subcutaneous emphysema were self-limited. But potentially life-threatening events such as upper airway obstruction, tension pneumothorax, pneumopericardium, mediastinitis might be possible. These complications may result from mucosal perforation of upper airway. The use of a tube with rigid and relatively narrower internal diameter than polyvinylchloride endotracheal tube, tough endotracheal intubation technique, high peak inspiratory pressure, suction technique and negative pressure are included as complication factors.
Airway Obstruction ; Intubation, Intratracheal ; Mediastinal Emphysema* ; Mediastinitis ; Pneumopericardium ; Pneumothorax ; Subcutaneous Emphysema* ; Suction

PURPOSE: The purpose of this study is to identify factors that affect coping with fatigue in middle-aged men according to Q-methodology and to provide basic strategies for health promotion. METHOD: 25 subjects in Seoul, Incheon, Chung-buk classified 24 selected Q-statements in to 9 points standard. The collected data were analyzed by using a QUNAL pc program. RESULT: Principal component analysis identified 3 types of coping with fatigue among middle-aged Korean men. 1st Type: Coping with fatigue through various kinds of game, using alcohol, smoking cigarette other than rest and sleep. 2nd Type : Coping with fatigue through rest and sleep, taking medicine or food which helps relieving fatigue. 3rd Type : Coping with fatigue through acitivities such as sports or trip other than sleep. CONCLUSION: We have found how Korean middle-aged men cope against fatigue through this research. To setup and apply different nursing intervention on each type based on this result is needed.
Adaptation, Psychological ; Fatigue* ; Health Promotion ; Humans ; Incheon ; Male ; Middle Aged ; Nursing ; Principal Component Analysis ; Seoul ; Smoke ; Smoking ; Sports ; Tobacco Products

This study was performed to verify the possibility of MTA and calcium sulfate as a pulp capping agent through comparing the dental pulp response in dogs after capping with MTA, calcium sulfate, and calcium hydroxide. 24 teeth of 2 dogs, 8 month old, were used in this study. Under general anesthesia, cervical cavities were prepared and pulp was exposed with sterilized #2 round bur in a high speed handpiece. MTA, calcium hydroxide, and calcium sulfate were applied on the exposed pulp. Then the coronal openings were sealed with IRM and light-cured composite. Two months after treatment, the animals were sacrificed. The extracted teeth were fixed in 10% neutral-buffered formalin solution and were decalcified in formic acid-sodium citrate. They were prepared for histological examination in the usual manner. The sections were stained with haematoxylin and eosin. In MTA group, a hard tissue bridges formation and newly formed odontoblasts layer was observed. There was no sign of pulp inflammatory reaction in pulp tissue. In calcium hydroxide group, there was no odontoblast layer below the dentin bridge. In pulpal tissue, chronic inflammatory reaction with variable intensity and extension occurred in all samples. In calcium sulfate group, newly formed odontoblast layer was observed below the bridge. Mild chronic inflammation with a few neutrophil infiltrations was observed on pulp tissue. These results suggest that MTA is more biocompatible on pulp tissue than calcium hydroxide or calcium sulfate.
Anesthesia, General ; Animals ; Calcium Hydroxide* ; Calcium Sulfate* ; Calcium* ; Citric Acid ; Dental Pulp ; Dental Pulp Capping ; Dentin ; Dogs ; Eosine Yellowish-(YS) ; Formaldehyde ; Humans ; Infant ; Inflammation ; Neutrophils ; Odontoblasts ; Pulp Capping and Pulpectomy Agents ; Tooth ; Pemetrexed

PURPOSE: We developed an objective structured oral examination (OSOE) case to assess the medical ethics of students. The aim of this study was to assess the reliability of OSOE with generalizability theory. METHODS: One 10-minute OSOE that contained key questions was developed. The evaluation sheet consisted of 4 domains: moral sensitivity, moral reasoning, decision making, and attitude. The total number of items was 13. The numbers of checklist items and global rating items were 11 and 2, respectively. Items and key questions were validated by 6 professionals. Standardization of the raters and the pilot study was performed before the OSOE. Fifty-four third-year medical students participated in the OSOE. The OSOE was duplicated, and 2 professors assessed 1 student independently. Each station lasted 8 minutes and was followed by a 2-minute interval,during which raters completed the checklist forms. We analyzed the reliability of the OSOE with the GENOVA program. RESULTS: The reliability (generalizability coefficient) was 0.945, and the interrater agreement was 0.867. The type of item, checklist or global rating, was the largest variance component. The reliability of the checklist alone was 0.668 and that of the global rating alone was 0.363. CONCLUSION: The OSOE is reliable and can be used to assess ethics. More research should focus on achieving validity.
Checklist ; Clinical Competence ; Decision Making ; Diagnosis, Oral ; Educational Measurement ; Ethics, Medical ; Humans ; Mental Competency ; Pilot Projects ; Statistics as Topic ; Students, Medical

Behcet disease (BD) is rare in childhood. We report a 9-year-old boy with neuro-Behcet disease who presented diplopia and weakness on the left side after a cerebral concussion. Brain magnetic resonance imaging (MRI) revealed hyperintensity of the right mesodiencephalic junction on T2-weighted and fluid attenuated inversion recovery images. Prednisolone administration resulted in complete remission and normalization of abnormal MRI finding. Brain MRI is a useful diagnostic tool when the neurological sign is the first symptom of subclinical BD.
Behcet Syndrome ; Brain ; Brain Concussion ; Child ; Craniocerebral Trauma ; Diplopia ; Head ; Humans ; Magnetic Resonance Imaging ; Paresis ; Prednisolone

Background: Research is continuously being conducted on the relationship between the airway and malocclusion. The nose, asthe upper part of the respiratory pathway, plays a critical role. While various international studies employ the Nasal Index classification for nasal morphology, domestic research remains scarce. This research investigates the proportions of nasal morphology in malocclusion patients utilizing a 3D software. Methods: The study evaluated 100 malocclusion patients in their 20s (40 Class I, 34 Class II, 26 Class III). Cone-beam computedtomography was used with the Mimics (ver. 22; Materialise) 3D program to model the skull and soft tissues of the patients in three views: coronal, sagittal, and frontal. Results: The results showed that in Class I, there were 5 leptorrhine (long and narrow) cases, 30 mesorrhine (moderate shape)cases, and 5 platyrrhine (broad and short) cases. In Class II, there were 3 leptorrhine, 25 mesorrhine, and 6 platyrrhine cases.In Class III, there were 2 leptorrhine, 21 mesorrhine, and 3 platyrrhine cases. Conclusion The findings of this study indicate that there is no significant correlation between the size of the nose and malocclusionin patients. Additionally, additional research related to this study is expected to be necessary.

This study was done to evaluate transportation of the apical foramen after 0.5 mm overinstrumentation by ProFile, ProTaper and K3 in simulated resin root canal. Sixty simulated resin root canal with a curvature of J and S-shape were divided into two groups. Each group consisted of three subgroups with 10 blocks according to the instruments used: ProFile(R), ProTaper(TM), and K3TM. Simulated resin root canal was prepared by ProFile, ProTaper and K3 with 300 rpm by the crown-down preparation technique. Pre- and post-instrumentation apical foramen images were overlapped and recorded with Image-analyzing microscope 100X (Camcope, Sometech Inc, Korea). The amounts of difference in width and dimension on overlapped images were measured after reference points were determined by Image Analysis program (Image-Pro(R) Express, Media Cybernetic, USA). Data were analyzed using Kruskal-Wallis and Mann-Whitney U-test. The results suggest that ProFile showed significantly less canal transportation and maintained original apical foramen shape better than K3 and ProTaper.
Cybernetics ; Dental Pulp Cavity ; Tooth Apex* ; Transportation*

This study was performed to assess the radiopacity of a variety of root canal sealers according to the specification concerning root canal sealers. Ten materials including Tubli-Seal(TM), Kerr Pulp Canal Sealer(TM), AH 26(R), AH plus(R), AH plus jet(TM), Ad sea l(TM), Sealapex(TM), NOGENOL(TM), ZOB seal(TM), Epiphany(TM) and dentin were evaluated in this study. In the first part, densitometric reading of an each step of aluminum step wedge on occlusal film was performed at different voltage and exposure time. In the second part, ten specimens were radiographed simultaneously with an aluminum step wedges on the occlusal films under decided condition. The mean radiographic den sity values of the materials were transformed into radiopacity expressed equivalent thickness of aluminum (mm Al). The following results were obtained. 1. Among the various conditions, the appropriate voltage and exposure time that meet the requirement density was 60 kVp at 0.2 s. 2. All of the materials had greater radiopacity than 3 mm Al requirement of ANSI/ADA specification No. 57 (2000) and ISO No. 6876 (2001) standards. 3. The radiopacity of materials increased as thickness of materials increased. 4. The mm Al value of each specimen at 1mm in thickness has a significant difference in the statistics. It suggests that root canal sealers have a sufficient radiopacity that meet the requirement.
Aluminum ; Dental Pulp Cavity ; Dentin ; Epoxy Resins ; Root Canal Filling Materials

OBJECTIVES: This study analyzed the difference in color caused by different thickness in enamel layer of composite resins when applied with single and layering placement technique, and evaluated if the results agreed with the shade guide from the manufacturers to verify reliability of the color matching process of the manufacturers. MATERIALS AND METHODS: For single composite resin samples, 6 mm diameter and 4 mm thickness cylindrical samples were fabricated using Ceram-X mono (DENTSPLY DeTrey) and CIE L*a*b* values were measured with spectrophotometer. Same process was done for layering composite resin samples, making 3 dentinal shade samples, 4 mm thickness, for each shade using Ceram-X duo (DENTSPLY DeTrey) and enamel shade resins were layered in 2 mm thickness and CIE L*a*b* values were measured. These samples were ground to 0.2 mm thickness each time, and CIE L*a*b* values were measured to 1 mm thickness of enamel shade resin. RESULTS: Color difference (DeltaE*) between single and layering composite resin was 1.37 minimum and 10.53 maximum when layering thicknesses were between 1 mm and 2 mm and 6 out of 10 same shade groups suggested by manufacturer showed remarkable color difference at any thickness (DeltaE* > 3.3). CONCLUSION: When using Ceram-X mono and duo for composite resin restoration, following the manufacturer's instructions for choosing the shade is not appropriate, and more accurate information for Ceram-X duo is needed on the variation and expression of the shades depending on the thickness of the enamel.
Composite Resins ; Dental Enamel ; Dentin

PURPOSE: Biliary tract disease is one of the most common causes of acute abdominal pain in elderly patients, but there is still some debate over treatment. The aim of this study is to determine the safety and surgical outcomes of laparoscopic cholecystectomy (LC) for benign gallbladder disease in octogenarian patients. METHODS: We selected 42 patients of 80 years or older who underwent LC or open-converted cholecystectomy (OC) from February 1992 to November 2006. We evaluated clinicopathological features, treatment modalities, and surgical outcomes retrospectively. RESULTS: The patients included 17 males and 25 females. The mean age of the patients was 83.3 and 83.7, respectively. Right upper quadrant pain was the most common symptom, present in 85.7% of the patients. Gallstones were present in 85.7%. ASA class II and III comprised 92.9% of the patients. Comorbidities included hypertension, cardiac disease, pulmonary disease, and diabetes mellitus. Preoperatively biliary drainage was performed in 12 cases (endoscopic drainage in 8, percutaneous drainage in 4 cases). Preoperative cholecystostomy was performed in 5 cases. Emergency operations were more frequent than elective surgery (25 vs. 17). Mean hospital stay of LC patients was 5 days, whereas that of OC patients was 13 days. Open conversion rate was 16.7%. No surgical mortality was present and postoperative morbidity included acute myocardial infarction in one patient and wound infection in one patient. CONCLUSION: LC in octogenarian patients was safe. However, since the incidence of comorbidities is high in these patients, great care should be taken to evaluate and manage the comorbidities before surgery.
Abdominal Pain ; Aged ; Aged, 80 and over ; Biliary Tract Diseases ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystostomy ; Comorbidity ; Diabetes Mellitus ; Drainage ; Emergencies ; Female ; Gallbladder Diseases ; Gallstones ; Heart Diseases ; Humans ; Hypertension ; Incidence ; Length of Stay ; Lung Diseases ; Male ; Myocardial Infarction ; Wound Infection