1.Clinical Features of Molar Root-Incisor Malformation: A Retrospective Study
Sejin CHUN ; Hyuntae KIM ; Ji-Soo SONG ; Teo Jeon SHIN ; Hong-Keun HYUN ; Jung-Wook KIM ; Ki-Taeg JANG ; Young-Jae KIM
Journal of Korean Academy of Pediatric Dentistry 2024;51(3):279-289
This study aimed to identify the clinical characteristics of molar root-incisor malformation (MRIM) and provide clinical considerations for treatments. Panoramic radiographs and electronic medical records of 64 patients with MRIM were retrospectively reviewed. Age, gender, follow-up period, medical history, complications, distribution of MRIM teeth, treatment, and prognosis were analyzed. Females were affected 1.56 times more than males, and the average age was 8.2 years. Dental complications, including periapical lesions, abscesses, and alveolar bone loss, were observed in 71.9%, and eruption disturbance of adjacent teeth was noticed in 37.5%. Most patients had medical histories in the first year of life. The most prevalent history was prematurity or low birthweight, followed by neurological conditions, surgeries, medications, and infections. All patients had MRIM on permanent first molars. The primary second molars were the second most frequently involved, followed by maxillary permanent central incisors and primary first molars. The prevalence was low on permanent lateral incisors and canines. Extraction was the most prevalent treatment done on MRIM-affected teeth, and most extraction sockets were managed by the eruption of permanent second molars. Few cases received endodontic treatment but with low success rates. Early detection of MRIM and prompt, appropriate treatment are important to avoid unnecessary discomfort from complications.
2.The clinical analysis of traumatic occult pneumothorax in the emergency room
Chun Moo SHIN ; Seog Ki LEE ; Sang Hyun JOO ; Sun Pyo KIM
Journal of the Korean Society of Emergency Medicine 2024;35(6):377-383
Objective:
Traumatic occult pneumothorax is defined as a pneumothorax that cannot be identified with a simple chest X-ray and can be detected only by chest computed tomography (CT). The purpose of this study was to retrospectively recognize the difference between thoracostomy and conservative treatment of traumatic occult pneumothorax.
Methods:
Among the thoracic trauma inpatients who visited a single emergency room (ER) from January 2021 to May 2022, adult patients aged over 18 years, diagnosed with traumatic pneumothorax who survived their ER stay and with abnormalities were included as the final study subjects and their histories were compared.
Results:
Of the total of 269 thoracic trauma patients, 110 were diagnosed with traumatic pneumothorax, of which 30 were traumatic occult pneumothorax patients. Multiple logistic regression analyses performed in the traumatic occult pneumothorax patient group showed that as the pneumothorax size increased, the probability of finding an occult pneumothorax decreased (odds ratio [OR]=0.93; 95% confidence interval [CI], 0.89-0.98). In very severe cases of rib fractures (OR=0.65; 95% CI, 0.43-0.98), the probability of detecting occult pneumothorax was reduced. Among the patients with traumatic occult pneumothorax, 15 patients underwent thoracostomy. Cases of hemothorax (70%; P=0.05), surgery (26.67%; P<0.01), and higher injury severity scores (12.87±7.69; P=0.02) were more common in the thoracostomy group.
Conclusion
Usually traumatic occult pneumothorax is treated conservatively with regular follow-up, but thoracostomy is necessary when it is accompanied by hemothorax and for patients requiring surgery and having a higher injury severity score.
3.Clinical Features of Molar Root-Incisor Malformation: A Retrospective Study
Sejin CHUN ; Hyuntae KIM ; Ji-Soo SONG ; Teo Jeon SHIN ; Hong-Keun HYUN ; Jung-Wook KIM ; Ki-Taeg JANG ; Young-Jae KIM
Journal of Korean Academy of Pediatric Dentistry 2024;51(3):279-289
This study aimed to identify the clinical characteristics of molar root-incisor malformation (MRIM) and provide clinical considerations for treatments. Panoramic radiographs and electronic medical records of 64 patients with MRIM were retrospectively reviewed. Age, gender, follow-up period, medical history, complications, distribution of MRIM teeth, treatment, and prognosis were analyzed. Females were affected 1.56 times more than males, and the average age was 8.2 years. Dental complications, including periapical lesions, abscesses, and alveolar bone loss, were observed in 71.9%, and eruption disturbance of adjacent teeth was noticed in 37.5%. Most patients had medical histories in the first year of life. The most prevalent history was prematurity or low birthweight, followed by neurological conditions, surgeries, medications, and infections. All patients had MRIM on permanent first molars. The primary second molars were the second most frequently involved, followed by maxillary permanent central incisors and primary first molars. The prevalence was low on permanent lateral incisors and canines. Extraction was the most prevalent treatment done on MRIM-affected teeth, and most extraction sockets were managed by the eruption of permanent second molars. Few cases received endodontic treatment but with low success rates. Early detection of MRIM and prompt, appropriate treatment are important to avoid unnecessary discomfort from complications.
4.The clinical analysis of traumatic occult pneumothorax in the emergency room
Chun Moo SHIN ; Seog Ki LEE ; Sang Hyun JOO ; Sun Pyo KIM
Journal of the Korean Society of Emergency Medicine 2024;35(6):377-383
Objective:
Traumatic occult pneumothorax is defined as a pneumothorax that cannot be identified with a simple chest X-ray and can be detected only by chest computed tomography (CT). The purpose of this study was to retrospectively recognize the difference between thoracostomy and conservative treatment of traumatic occult pneumothorax.
Methods:
Among the thoracic trauma inpatients who visited a single emergency room (ER) from January 2021 to May 2022, adult patients aged over 18 years, diagnosed with traumatic pneumothorax who survived their ER stay and with abnormalities were included as the final study subjects and their histories were compared.
Results:
Of the total of 269 thoracic trauma patients, 110 were diagnosed with traumatic pneumothorax, of which 30 were traumatic occult pneumothorax patients. Multiple logistic regression analyses performed in the traumatic occult pneumothorax patient group showed that as the pneumothorax size increased, the probability of finding an occult pneumothorax decreased (odds ratio [OR]=0.93; 95% confidence interval [CI], 0.89-0.98). In very severe cases of rib fractures (OR=0.65; 95% CI, 0.43-0.98), the probability of detecting occult pneumothorax was reduced. Among the patients with traumatic occult pneumothorax, 15 patients underwent thoracostomy. Cases of hemothorax (70%; P=0.05), surgery (26.67%; P<0.01), and higher injury severity scores (12.87±7.69; P=0.02) were more common in the thoracostomy group.
Conclusion
Usually traumatic occult pneumothorax is treated conservatively with regular follow-up, but thoracostomy is necessary when it is accompanied by hemothorax and for patients requiring surgery and having a higher injury severity score.
5.Clinical Features of Molar Root-Incisor Malformation: A Retrospective Study
Sejin CHUN ; Hyuntae KIM ; Ji-Soo SONG ; Teo Jeon SHIN ; Hong-Keun HYUN ; Jung-Wook KIM ; Ki-Taeg JANG ; Young-Jae KIM
Journal of Korean Academy of Pediatric Dentistry 2024;51(3):279-289
This study aimed to identify the clinical characteristics of molar root-incisor malformation (MRIM) and provide clinical considerations for treatments. Panoramic radiographs and electronic medical records of 64 patients with MRIM were retrospectively reviewed. Age, gender, follow-up period, medical history, complications, distribution of MRIM teeth, treatment, and prognosis were analyzed. Females were affected 1.56 times more than males, and the average age was 8.2 years. Dental complications, including periapical lesions, abscesses, and alveolar bone loss, were observed in 71.9%, and eruption disturbance of adjacent teeth was noticed in 37.5%. Most patients had medical histories in the first year of life. The most prevalent history was prematurity or low birthweight, followed by neurological conditions, surgeries, medications, and infections. All patients had MRIM on permanent first molars. The primary second molars were the second most frequently involved, followed by maxillary permanent central incisors and primary first molars. The prevalence was low on permanent lateral incisors and canines. Extraction was the most prevalent treatment done on MRIM-affected teeth, and most extraction sockets were managed by the eruption of permanent second molars. Few cases received endodontic treatment but with low success rates. Early detection of MRIM and prompt, appropriate treatment are important to avoid unnecessary discomfort from complications.
6.The clinical analysis of traumatic occult pneumothorax in the emergency room
Chun Moo SHIN ; Seog Ki LEE ; Sang Hyun JOO ; Sun Pyo KIM
Journal of the Korean Society of Emergency Medicine 2024;35(6):377-383
Objective:
Traumatic occult pneumothorax is defined as a pneumothorax that cannot be identified with a simple chest X-ray and can be detected only by chest computed tomography (CT). The purpose of this study was to retrospectively recognize the difference between thoracostomy and conservative treatment of traumatic occult pneumothorax.
Methods:
Among the thoracic trauma inpatients who visited a single emergency room (ER) from January 2021 to May 2022, adult patients aged over 18 years, diagnosed with traumatic pneumothorax who survived their ER stay and with abnormalities were included as the final study subjects and their histories were compared.
Results:
Of the total of 269 thoracic trauma patients, 110 were diagnosed with traumatic pneumothorax, of which 30 were traumatic occult pneumothorax patients. Multiple logistic regression analyses performed in the traumatic occult pneumothorax patient group showed that as the pneumothorax size increased, the probability of finding an occult pneumothorax decreased (odds ratio [OR]=0.93; 95% confidence interval [CI], 0.89-0.98). In very severe cases of rib fractures (OR=0.65; 95% CI, 0.43-0.98), the probability of detecting occult pneumothorax was reduced. Among the patients with traumatic occult pneumothorax, 15 patients underwent thoracostomy. Cases of hemothorax (70%; P=0.05), surgery (26.67%; P<0.01), and higher injury severity scores (12.87±7.69; P=0.02) were more common in the thoracostomy group.
Conclusion
Usually traumatic occult pneumothorax is treated conservatively with regular follow-up, but thoracostomy is necessary when it is accompanied by hemothorax and for patients requiring surgery and having a higher injury severity score.
7.Clinical significance and outcomes of adult living donor liver transplantation for acute liver failure: a retrospective cohort study based on 15-year single-center experience
Geun-hyeok YANG ; Young-In YOON ; Shin HWANG ; Ki-Hun KIM ; Chul-Soo AHN ; Deok-Bog MOON ; Tae-Yong HA ; Gi-Won SONG ; Dong-Hwan JUNG ; Gil-Chun PARK ; Sung-Gyu LEE
Annals of Surgical Treatment and Research 2024;107(3):167-177
Purpose:
This study aimed to describe adult living donor liver transplantation (LDLT) for acute liver failure and evaluate its clinical significance by comparing its surgical and survival outcomes with those of deceased donor liver transplantation (DDLT).
Methods:
We retrospectively reviewed the medical records of 267 consecutive patients (161 LDLT recipients and 106 DDLT recipients) aged 18 years or older who underwent liver transplantation between January 2006 and December 2020.
Results:
The mean periods from hepatic encephalopathy to liver transplantation were 5.85 days and 8.35 days for LDLT and DDLT, respectively (P = 0.091). Among these patients, 121 (45.3%) had grade III or IV hepatic encephalopathy (living, 34.8% vs. deceased, 61.3%; P < 0.001), and 38 (14.2%) had brain edema (living, 16.1% vs. deceased, 11.3%; P = 0.269) before liver transplantation. There were no significant differences in in-hospital mortality (living, 11.8% vs. deceased, 15.1%; P = 0.435), 10-year overall survival (living, 90.8% vs. deceased, 84.0%; P = 0.096), and graft survival (living, 83.5% vs. deceased, 71.3%;P = 0.051). However, postoperatively, the mean intensive care unit stay was shorter in the LDLT group (5.0 days vs. 9.5 days, P < 0.001). In-hospital mortality was associated with vasopressor use (odds ratio [OR], 3.40; 95% confidence interval [CI], 1.45–7.96; P = 0.005) and brain edema (OR, 2.75; 95% CI, 1.16–6.52; P = 0.022) of recipient at the time of transplantation. However, LDLT (OR, 1.26; 95% CI, 0.59–2.66; P = 0.553) was not independently associated with in-hospital mortality.
Conclusion
LDLT is feasible for acute liver failure when organs from deceased donors are not available.
8.Lazertinib versus Gefitinib as First-Line Treatment for EGFR-mutated Locally Advanced or Metastatic NSCLC: LASER301 Korean Subset
Ki Hyeong LEE ; Byoung Chul CHO ; Myung-Ju AHN ; Yun-Gyoo LEE ; Youngjoo LEE ; Jong-Seok LEE ; Joo-Hang KIM ; Young Joo MIN ; Gyeong-Won LEE ; Sung Sook LEE ; Kyung-Hee LEE ; Yoon Ho KO ; Byoung Yong SHIM ; Sang-We KIM ; Sang Won SHIN ; Jin-Hyuk CHOI ; Dong-Wan KIM ; Eun Kyung CHO ; Keon Uk PARK ; Jin-Soo KIM ; Sang Hoon CHUN ; Jangyoung WANG ; SeokYoung CHOI ; Jin Hyoung KANG
Cancer Research and Treatment 2024;56(1):48-60
Purpose:
This subgroup analysis of the Korean subset of patients in the phase 3 LASER301 trial evaluated the efficacy and safety of lazertinib versus gefitinib as first-line therapy for epidermal growth factor receptor mutated (EGFRm) non–small cell lung cancer (NSCLC).
Materials and Methods:
Patients with locally advanced or metastatic EGFRm NSCLC were randomized 1:1 to lazertinib (240 mg/day) or gefitinib (250 mg/day). The primary endpoint was investigator-assessed progression-free survival (PFS).
Results:
In total, 172 Korean patients were enrolled (lazertinib, n=87; gefitinib, n=85). Baseline characteristics were balanced between the treatment groups. One-third of patients had brain metastases (BM) at baseline. Median PFS was 20.8 months (95% confidence interval [CI], 16.7 to 26.1) for lazertinib and 9.6 months (95% CI, 8.2 to 12.3) for gefitinib (hazard ratio [HR], 0.41; 95% CI, 0.28 to 0.60). This was supported by PFS analysis based on blinded independent central review. Significant PFS benefit with lazertinib was consistently observed across predefined subgroups, including patients with BM (HR, 0.28; 95% CI, 0.15 to 0.53) and those with L858R mutations (HR, 0.36; 95% CI, 0.20 to 0.63). Lazertinib safety data were consistent with its previously reported safety profile. Common adverse events (AEs) in both groups included rash, pruritus, and diarrhoea. Numerically fewer severe AEs and severe treatment–related AEs occurred with lazertinib than gefitinib.
Conclusion
Consistent with results for the overall LASER301 population, this analysis showed significant PFS benefit with lazertinib versus gefitinib with comparable safety in Korean patients with untreated EGFRm NSCLC, supporting lazertinib as a new potential treatment option for this patient population.
9.Estimation of Attributable Risk and Direct Medical and Non-Medical Costs of Major Mental Disorders Associated With Air Pollution Exposures Among Children and Adolescents in the Republic of Korea, 2011–2019
Yae Won HA ; Tae Hyun KIM ; Dae Ryong KANG ; Ki-Soo PARK ; Dong Chun SHIN ; Jaelim CHO ; Changsoo KIM
Journal of Korean Medical Science 2024;39(30):e218-
Background:
Recent studies have reported the burden of attention deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and depressive disorder. Also, there is mounting evidence on the effects of environmental factors, such as ambient air pollution, on these disorders among children and adolescents. However, few studies have evaluated the burden of mental disorders attributable to air pollution exposure in children and adolescents.
Methods:
We estimated the risk ratios of major mental disorders (ADHD, ASD, and depressive disorder) associated with air pollutants among children and adolescents using time-series data (2011–2019) obtained from a nationwide air pollution monitoring network and healthcare utilization claims data in the Republic of Korea. Based on the estimated risk ratios, we determined the population attributable fraction (PAF) and calculated the medical costs of major mental disorders attributable to air pollution.
Results:
A total of 33,598 patients were diagnosed with major mental disorders during 9 years. The PAFs for all the major mental disorders were estimated at 6.9% (particulate matter < 10 μm [PM10 ]), 3.7% (PM2.5 ), and 2.2% (sulfur dioxide [SO2 ]). The PAF of PM10 was highest for depressive disorder (9.2%), followed by ASD (8.4%) and ADHD (5.2%). The direct medical costs of all major mental disorders attributable to PM10 and SO2 decreased during the study period.
Conclusion
This study assessed the burden of major mental disorders attributable to air pollution exposure in children and adolescents. We found that PM10, PM2.5 , and SO2 attributed 7%, 4%, and 2% respectively, to the risk of major mental disorders among children and adolescents.
10.Safety and Efficacy of Everolimus-Eluting Bioresorbable Vascular Scaffold Versus Second-Generation Drug-Eluting Stents in Real-World Practice
Joo Myung LEE ; Hyun Sung JOH ; Ki Hong CHOI ; David HONG ; Taek Kyu PARK ; Jeong Hoon YANG ; Young Bin SONG ; Jin-Ho CHOI ; Seung-Hyuk CHOI ; Jin-Ok JEONG ; Jong-Young LEE ; Young Jin CHOI ; Jei-Keon CHAE ; Seung-Ho HUR ; Jang-Whan BAE ; Ju-Hyeon OH ; Kook-Jin CHUN ; Hyun-Joong KIM ; Byung Ryul CHO ; Doosup SHIN ; Seung Hun LEE ; Doyeon HWANG ; Hyun-Jong LEE ; Ho-Jun JANG ; Hyun Kuk KIM ; Sang Jin HA ; Eun-Seok SHIN ; Joon-Hyung DOH ; Joo-Yong HAHN ; Hyeon-Cheol GWON ; On behalf of the SMART-REWARD Investigators
Journal of Korean Medical Science 2023;38(5):e34-
Background:
The risk of device thrombosis and device-oriented clinical outcomes with bioresorbable vascular scaffold (BVS) was reported to be significantly higher than with contemporary drug-eluting stents (DESs). However, optimal device implantation may improve clinical outcomes in patients receiving BVS. The current study evaluated mid-term safety and efficacy of Absorb BVS with meticulous device optimization under intravascular imaging guidance.
Methods:
The SMART-REWARD and PERSPECTIVE-PCI registries in Korea prospectively enrolled 390 patients with BVS and 675 patients with DES, respectively. The primary endpoint was target vessel failure (TVF) at 2 years and the secondary major endpoint was patientoriented composite outcome (POCO) at 2 years.
Results:
Patient-level pooled analysis evaluated 1,003 patients (377 patients with BVS and 626 patients with DES). Mean scaffold diameter per lesion was 3.24 ± 0.30 mm in BVS group.Most BVSs were implanted with pre-dilatation (90.9%), intravascular imaging guidance (74.9%), and post-dilatation (73.1%) at proximal to mid segment (81.9%) in target vessel.Patients treated with BVS showed comparable risks of 2-year TVF (2.9% vs. 3.7%, adjusted hazard ratio [HR], 1.283, 95% confidence interval [CI], 0.487–3.378, P = 0.615) and 2-year POCO (4.5% vs. 5.9%, adjusted HR, 1.413, 95% CI, 0.663–3.012,P = 0.370) than those with DES. The rate of 2-year definite or probable device thrombosis (0.3% vs. 0.5%, P = 0.424) was also similar. The sensitivity analyses consistently showed comparable risk of TVF and POCO between the 2 groups.
Conclusion
With meticulous device optimization under imaging guidance and avoidance of implantation in small vessels, BVS showed comparable risks of 2-year TVF and device thrombosis with DES.

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