Background: and PurposeThis study was designed to investigate differences in the final recommended pressure setting between that derived from an autotitrating continuous positive airway pressure (APAP) device and manual in-laboratory continuous positive airway pressure (CPAP) titration, as well as the factors that influence pressure differences in patients with obstructive sleep apnea (OSA). Methods: This study enrolled 50 patients with OSA. All patients underwent both APAP titration and manual CPAP titration. We obtained the average device pressure ≤90% of the time (APAP90) from the downloaded manual for the APAP machine and the optimal pressure obtained by manual CPAP titration (CPAPmanual). We placed the subjects into three groups based on the pressure difference (ΔP) obtained by subtracting CPAPmanual from APAP90: 1) Prequal (ΔP=0), 2) CPAPmanual+ (ΔP ≤−1), and 3) APAP90+ (ΔP ≥1). Regression analysis was conducted to identify predictive factors associated with ΔP. Results: The values of APAP90 and CPAPmanual were 9.50±3.03 cmH2O and 9.48±2.71 cmH2O (mean±SD), respectively (p=0.95). The Prequal, CPAPmanual+, and APAP90+ groups comprised 9 (18%), 23 (46%), and 18 (36%) subjects, respectively. Regression analyses revealed that male sex [β=3.539, 95% confidence interval (CI)=0.040–7.039], body mass index (BMI) (β=0.186, 95% CI=0.020–0.352), and average usage per day (β=0.768, 95% CI=0.077–1.459) were associated with ΔP. Conclusions While the mean pressure in the overall cohort did not differ significantly between APAP90 and CPAPmanual, there was a discordance majority showing different single pressures obtained when applying the two titration methods. Being Male, having an increased BMI, and having an increased average usage per day of APAP were significantly correlated with increased ΔP in this study.

The respiratory function is relevant to the craniofacial growth and orthodontic diagnosis. The size of the pharyngeal airway was measured in lateral cephalometric view in children visited Kyung Hee University Hospital from January 2015 to August 2017. A total of 74 healthy children (36 boys and 38 girls) aged 7 - 11 years (mean, 8.5 years) with a normodivergent facial pattern were divided into three groups according to anteroposterior jaw relation measuring A point-Nasion-B point (ANB) angle. Lateral cephalometric data were used to measure the airway dimensions. The dimensions of the middle airway were significantly lower, reducing the upper airway space, in large ANB angle group than in other children, suggesting that children with large ANB angle have narrower airway space than others.
Child ; Diagnosis ; Humans ; Jaw ; Malocclusion

The purpose of this study was to compare the effect of different methods of hand washing by counting the number of bacteria on the hand surface. Eighteen clinicians were chosen and divided into three groups, consisting of six clinicians each. Culturing of the right raw palms of all individuals was performed. Individuals in the control group washed hands for 5 seconds with antimicrobial soap. Group 1 washed their hands for 10 seconds with antimicrobial soap. Group 2 washed with an instant alcohol-based hand sanitizer. After the respective washes, re-culturing of the right raw palm was done for each member of all groups. The colony-forming units (CFU) were calculated at each time point, and the reduction rate of CFU among the three groups were statistically evaluated using student t-test. All groups showed a significant decrease in CFU, according to the time applied (P<0.01). In addition, the reduction rate of CFU between the groups were statistically evaluated with ANOVA (P<0.01). It showed statistically difference between the control group and group 1, control group and group 2. The present study confirmed that the hand washing method with antimicrobial soap for 10 seconds and hand sanitizer, including alcohol, were excellent for decreasing the number of bacteria on the hand surface.
Bacteria ; Bacterial Load* ; Hand Disinfection* ; Hand* ; Humans ; Methods* ; Soaps ; Stem Cells

The purpose of this study was to isolate and identify bacteria from the 4 patients with non-odontogenic infectious lesions (mucormycosis, chronic inflammation from wound infection, and two actinomycosis) and determine their antimicrobial susceptibility against eight antibiotics. Bacterial culture was performed under three culture conditions (anaerobic, CO2, and aerobic incubator). The bacterial strains were identified by 16S rRNA gene (16S rDNA) sequence comparison analysis method. For investigating the antimicrobial susceptibility of the bacteria against eight antibiotics, penicillin G, amoxicillin, tetracycline, cefuroxime, erythromycin, clindamycin, vancomycin, and Augmentin(R) (amoxicillin + clavulanic acid), minimum inhibitory concentration (MIC) measurement was performed using broth microdilution assay. Nosocomial pathogens such as Enterococcus faecalis, Klebsiella pneumoniae, Bacillus subtilis, and Neisseria flavescens were isolated from mucormycosis. Veillonella parvula, Enterobacter hormaechei, and Acinetobacter calcoaceticus were isolated from chronic inflammatory lesion. Actinomyces massiliensis was isolated from actinomycosis in parotid gland. Capnocytophaga ochracea was isolated from actinomycosis in buccal region in anaerobic condition. There was no susceptible antibiotic to all bacteria in mucormycosis. Tetracycline was susceptible to all bacteria in chronic inflammation. C. ochracea was resistant to vancomycin and penicillin G; and other antibiotics showed susceptibility to all bacteria in actinomycosis. The results indicated that the combined treatment of two or more antibiotics is better than single antibiotic treatment in mucormycosis, and penicillin is the first recommended antibiotic to treat actinomycosis.
Acinetobacter calcoaceticus ; Actinomyces ; Actinomycosis ; Amoxicillin ; Anti-Bacterial Agents ; Bacillus subtilis ; Bacteria* ; Capnocytophaga ; Cefuroxime ; Clindamycin ; Enterobacter ; Enterococcus faecalis ; Erythromycin ; Genes, rRNA ; Humans ; Inflammation ; Klebsiella pneumoniae ; Microbial Sensitivity Tests ; Mucormycosis ; Neisseria ; Parotid Gland ; Penicillin G ; Penicillins ; Tetracycline ; Vancomycin ; Veillonella ; Wound Infection

Agar ; Bacteria ; Bacterial Load ; Chlorhexidine ; Mouth ; Povidone-Iodine ; Saliva ; Sheep ; Stem Cells

PURPOSE: This study was performed to determine the accuracy of linear measurements on three-dimensional (3D) images using multi-detector computed tomography (MDCT) and cone-beam computed tomography (CBCT). MATERIALS AND METHODS: MDCT and CBCT were performed using 24 dry skulls. Twenty-one measurements were taken on the dry skulls using digital caliper. Both types of CT data were imported into OnDemand software and identification of landmarks on the 3D surface rendering images and calculation of linear measurements were performed. Reproducibility of the measurements was assessed using repeated measures ANOVA and ICC, and the measurements were statistically compared using a Student t-test. RESULTS: All assessments under the direct measurement and image-based measurements on the 3D CT surface rendering images using MDCT and CBCT showed no statistically difference under the ICC examination. The measurements showed no differences between the direct measurements of dry skull and the image-based measurements on the 3D CT surface rendering images (P>.05). CONCLUSION: Three-dimensional reconstructed surface rendering images using MDCT and CBCT would be appropriate for 3D measurements.
Cone-Beam Computed Tomography ; Humans ; Imaging, Three-Dimensional ; Reproducibility of Results ; Skull

PURPOSE: To investigate the reproducibilities and compare the measurements in digital and MDCT-synthesized cephalometric radiograph, and to investigate the effect of head position on the measurement during imaging with MDCT. MATERIALS AND METHODS: Twenty-two dry skulls (combined with mandible) were used in this study. Conventional digital cephalometric radiograph was taken in standard position, and MDCT was taken in standard position and two rotated position (10degrees left rotation and 10degrees right tilting). MDCT data were imported in OnDemand(R) and lateral cephalometric radiograph were synthesized from 3D virtual models. Two types of rotated MDCT data were synthesized with default mode and with corrected mode using both ear rods. For all six images, sixteen angular and eleven linear measurements were made in V-Ceph(R) three times. Reproducibility of measurements was assessed using repeated measures ANOVA and ICC. Linear and angular measurements were compared between digital and five MDCTsynthesized images by Student t-test. RESULTS: All measurements in six types of cephalometric radiograph were not statistically different under ICC examination. Measurements were not different between digital and MDCT-synthesized images (P>.05). Measurements in MDCT-synthesized image in 10degrees left rotation or 10degrees right tilting position showed possibility of difference from digital image in some measurements, and possibility of improvement via realignment of head position using both ear rods. CONCLUSION: MDCT-synthesized cephalometric radiograph can substitute conventional cephalometric radiograph. The error on head position during imaging with MDCT have possibility that can produce measurement errors with MDCT-synthesized image, and these position error can be corrected by realignment of the head position using both ear rods.
Ear ; Head ; Humans ; Skull

A 27-year-old female was referred to our hospital postpartum due to rapid aggravation of facial swelling. She was diagnosed with osteomyelitis on clinical, radiological, and histopathological examinations, but the possibility of malignancy was not excluded. Clinical signs and symptoms such as facial swelling and discomfort were improved with four months of antibiotics treatment. This is a case of an osteomyelitis progressed from infected extraction socket in a woman with physiological changes of pregnancy. Decreased immunological response, increased sex hormone and calcium regulatory hormones regulate the response of the bone infection. We report this case for helping the diagnosis of unusual form of osteomyelitis in pregnancy and postpartum.
Adult ; Anti-Bacterial Agents ; Calcium ; Female ; Humans ; Molar, Third ; Osteomyelitis ; Postpartum Period ; Pregnancy

A 60-year-old female, who complained of delayed healing and swelling after extraction of left lower second molar during chemotherapy, visited our department. She had a history of a resection surgery of breast cancer and postoperative radiotherapy. The conventional radiographs showed diffuse permeative bone destruction in posterior mandibular body, which gave the first radiologic impression of osteonecrosis associated with radiotherapy or chemotherapy. And bone metastasis from the breast cancer was also considered in the differential diagnosis. On the enhanced computed tomography (ECT) the posterior mandibular body was occupied by a large expansile lesion showing central low attenuation with peripheral rim enhancement. Magnetic resonance images revealed that the low attenuated area on ECT did not show as high signal intensity as water on T2 weighted image and indicated solid component of a tumor. The final diagnosis was central squamous cell carcinoma. We present the diagnostic imaging features of the patient with special emphasis on the differential diagnosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Squamous Cell ; Diagnosis* ; Diagnosis, Differential ; Diagnostic Imaging ; Drug Therapy* ; Female ; Humans ; Middle Aged ; Molar ; Neoplasm Metastasis ; Osteonecrosis ; Radiography ; Radiotherapy* ; Water

PURPOSE: To report the results of preschool vision screening of South Korean children in the year of 2001. METHODS: Nation-wide population-based vision screening tests were conducted in a stepwise manner on the preschool children over 3 years of age. The first step of test was home-screening using 5 familiar picture cards. The children who didn't pass the first step (VA < 0.5 in at least one eye) were sent to the Public Health Care Centers and re-tested there with regular vision charts. After this second step of test, some children were referred to the ophthalmologists. The referral criteria for visual acuity were: at 3 years less than 0.5, at 4 or above 4 years less than 0.63 in at least one eye. Data were collected for the 67, 315 children to evaluate the ophthalmologic conditions. RESULTS: Among 67, 315 subjects who had been enrolled, 97% of children had visual acuity of 0.5 or better. Of those screened, 5, 221 (7.8%) children were referred to the ophthalmologists. The feedback results for 3, 058 (4.6%) children could be collected. Of those referred, 2, 488(80.6%) had one or more ophthalmologic disorders. Refractive errors were found in 2183 children. Amblyopia was discovered in 560 children. Manifest strabismus was detected in 144 children. CONCLUSIONS: In this population setting, ocular disorders which can affect visual development were found in 2, 488 children. This attests to the importance of performing early and effective screening tests for preschool children.
Amblyopia ; Child ; Child, Preschool ; Humans ; Korea* ; Mass Screening ; Public Health ; Referral and Consultation ; Refractive Errors ; Strabismus ; Vision Screening* ; Visual Acuity