Background: Recently developed imaging techniques, such as cone beam computed tomography (CBCT) and CAD/CAM technology, have facilitated reliable implant planning and implant surgical guide production by 3D printing. This study compared the accuracy of implant-guided surgery using the R2GATE® program with CBCT before and after surgery. Patients and methods: The study included patients who visited the Department of Oral and Maxillofacial Surgery at Chonnam National University Hospital from September 2021 to March 2022. Twenty-four implants were placed in eleven patients. Using R2GATE® Windows (Megagen implant, Daegu, Korea) software, implant placement was planned. The difference was measured by the CBCT before and after surgery. The cervical and apical distance and angular deviation of the implants were measured. Statistical analysis was performed using an independent t-test, Pearson correlation, and multiple regression analyses. Results: The three-dimensional linear distance difference between the planned implant and the placed implant was 0.97 ± 0.37 mm at the cervical and 1.13 ± 0.36 mm at the apical. The difference in angle deviation between the planned implant and the placed implant was 3.42 ± 2.12°. Among the variables affecting the accuracy of implant placement, a statistically significant difference was found when using a tissue-supported implant guide, implant diameter and implant length. Conclusion Based on these results, using the R2GATE® program is useful to use an implant digital surgical guide, and it will be used in various clinic.

Central venous catheterization (CVC) can be difficult, especially with pediatric patients in critical care. Accessing the subclavian vein (SCV) can cause serious complications, including pneumothorax, arterial puncture, and hemothorax. Recently, the ultrasonographic (USG) technique has gained popularity, but its efficiency is not yet confirmed. Subclavian venous catheterization (SCVC) through the supraclavicular approach (SCA) with USG or accessing the brachiocephalic vein through the infraclavicular approach (ICA) has been reported in the past. A useful technique is reported that involves the use of a 40 mm probe rather than the usual 25 mm probe in order to confirm the location of the needle while successfully performing subclavian venous catheterization in pediatric patients weighing 1.1 kg to 15.0 kg.
Brachiocephalic Veins ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Critical Care ; Hemothorax ; Humans ; Infant ; Needles ; Pneumothorax ; Punctures ; Subclavian Vein

BACKGROUND: 5-HT3 receptor antagonist, dexamethasone and droperidol were used for the prevention of postoperative nausea and vomiting (PONV). Recently, neurokinin-1 (NK1) antagonist has been used for PONV. We evaluated the effect of oral aprepitant premedication in addition to ondansetron. METHODS: A total 90 patients scheduled for elective rhinolaryngological surgery were allocated to three groups (Control, Ap80, Ap125), each of 30 at random. Ondansetron 4 mg was injected intravenously to all patients just before the end of surgery. On the morning of surgery, 80 mg and 125 mg aprepitant were additionally administered into the Ap80 group and Ap125 group, respectively. The rhodes index of nausea, vomiting and retching (RINVR) was checked at 6 hr and 24 hr after surgery. RESULTS: Twelve patients who used steroids unexpectedly were excluded. Finally 78 patients (control : Ap80 : Ap125 = 24 : 28 : 26) were enrolled. Overall PONV occurrence rate of Ap125 group (1/26, 3.9%) was lower (P = 0.015) than the control group (7/24, 29.2%) at 6 hr after surgery. The nausea distress score of Ap125 group (0.04 +/- 0.20) was lower (P = 0.032) than the control group (0.67 +/- 1.24) at 6 hr after surgery. No evident side effect of aprepitant was observed. CONCLUSIONS: Oral aprepitant 125 mg can be used as combination therapy for the prevention of PONV.
Dexamethasone ; Droperidol ; Humans ; Morpholines ; Nausea ; Ondansetron ; Postoperative Nausea and Vomiting ; Premedication ; Receptors, Neurokinin-1 ; Receptors, Serotonin, 5-HT3 ; Steroids ; Vomiting

PURPOSE: To compare Icare rebound tonometer (IRT) and Goldmann applanation tonometer (GAT) and investigate the clinical usefulness of IRT. METHODS: In a retrospective study of 131 eyes with glaucoma and glaucoma suspect, intraocular pressure (IOP) was measured with IRT and GAT. The correlation between IRT and GAT and the influence of refractive error (spherical equivalent; SE) and central corneal thickness (CCT) were analyzed. RESULTS: A distinct correlation between IRT and GAT was found. IOP measured with GAT was 2.23 +/- 3.16 mm Hg higher than with IRT (p < 0.001). As CCT increased, IOP was measured higher with both GAT and IRT. IOP in myopic eyes (SE > or = -5 diopter) was measured relatively lower than in hyperopic eyes (SE < -5 diopter) with GAT (+1.50 +/- 0.68 mm Hg) and IRT (+1.88 +/- 0.75 mm Hg). CONCLUSIONS: IRT showed strong correlation with GAT, but IOP measured approximately 2 mm Hg lower. The IOP tends to measure lower at low CCT and in myopic eyes.
Eye ; Glaucoma ; Intraocular Pressure ; Iron-Dextran Complex ; Manometry ; Peptides ; Refractive Errors ; Retrospective Studies

Intussusception of the appendix is not only extremely rare but also presents with symptoms similar to appendicitis. Therefore, preoperative diagnosis is unusual. On the other hand, appendiceal mucocele refers to obstructive dilatation of the appendiceal lumen caused by mucus. It has been reported in 0.2~0.3% of appendectomy specimens. A 22-year-old woman visited the Emergency Department because of right lower abdominal tenderness with hematochezia. Abdominal CT scan revealed a target sign in the right lower quadrant area that was suggestive of intussusception. The patient underwent emergency surgical reduction of the intussusception and appendectomy. The pathology showed an appendiceal mucocele.
Appendectomy ; Appendicitis ; Appendix ; Dilatation ; Emergencies ; Female ; Gastrointestinal Hemorrhage ; Hand ; Humans ; Intussusception ; Mucocele ; Mucus ; Young Adult

Mycobacterium genavense, first identified in 1990, is known as a pathogen that mimics disseminated Myocobacterium avium-intracellulare complex (MAC) infection with particular propensity for the gastrointestinal tract. In Korea, no case with the organism has been reported. Herein we report a case of Mycobacterium genavense infection that manifested with erosive lesion of duodenum in a patient with acquired immune deficiency syndrome. The patient presented with epigastric pain and fever, diarrhea. Duodenal biopsy showed histiocytic infiltration with numerous acid-fast bacilli. Identification of the mycobacterial isolate by the polymerase chain reaction restriction analysis of 16S rRNA gene revealed Mycobacterium genavense.
Acquired Immunodeficiency Syndrome ; Biopsy ; Diarrhea ; Duodenum* ; Fever ; Gastrointestinal Tract ; Genes, rRNA ; HIV Infections* ; HIV* ; Humans ; Korea ; Mycobacterium* ; Polymerase Chain Reaction

Mycobacterium genavense, first identified in 1990, is known as a pathogen that mimics disseminated Myocobacterium avium-intracellulare complex (MAC) infection with particular propensity for the gastrointestinal tract. In Korea, no case with the organism has been reported. Herein we report a case of Mycobacterium genavense infection that manifested with erosive lesion of duodenum in a patient with acquired immune deficiency syndrome. The patient presented with epigastric pain and fever, diarrhea. Duodenal biopsy showed histiocytic infiltration with numerous acid-fast bacilli. Identification of the mycobacterial isolate by the polymerase chain reaction restriction analysis of 16S rRNA gene revealed Mycobacterium genavense.
Acquired Immunodeficiency Syndrome ; Biopsy ; Diarrhea ; Duodenum* ; Fever ; Gastrointestinal Tract ; Genes, rRNA ; HIV Infections* ; HIV* ; Humans ; Korea ; Mycobacterium* ; Polymerase Chain Reaction

BACKGROUND: Hepatitis B virus (HBV)-associated glomerulonephritis (HBGN) occurs with high prevalence in Asia, and accounts for over 30% of secondary glomerulonephritis in Korea. However, the association between HLA and HBGN has been hardly reported upon in the literature. METHODS: A total of 50 Korean patients with HBGN, 100 HBsAg (-) healthy controls and 89 HBsAg (+) controls (subjects with chronic HBV infection, HBsAg positive at least for 6 months) were included. HLA-DR typing was done using a reverse sequence specific oligonucleotide typing kit and HLA-DRB1 genotyping was done for HLA-DR2 positive samples by PCR-single strand conformational polymorphism method. RESULTS: In the HBGN patients, HLA-DR2 was highly significantly increased compared with HBsAg (-) controls (p=0.0002, corrected p=0.002, OR=4.0) and also compared with HBsAg (+) controls (p= 0.0005, corrected p=0.006, OR=3.7). Different HLA- DR2 alleles were strongly associated with different pathologic subtypes of HBGN: DRB1*1502 was associated with membranoproliferative glomerulonephritis (MPGN) (p=0.0003, corrected p=0.004, OR=14.5), and DRB1*1501 with membranous nephropathy (MN) (p= 0.05, OR=3.8). These associations were also found to be significant compared with HBsAg (+) controls (HBV-MPGN, p=0.002; HBV-MN, p=0.04). DR13 was found to have some protective effect in HBV infection (p=0.01, OR=0.3) and DR11 was found to be weakly associated with HBV infection (p=0.01, OR= 4.6), however these HLA alleles were not associated with disease susceptibility to HBGN. CONCLUSION: These results suggest that HLA- DR2 or a closely associated genetic factor is associated with disease susceptibility to HBGN, and different HLA-DR2 subtypes are associated with different pathologic subtypes of HBGN in Koreans.
Alleles ; Asia ; Disease Susceptibility ; Fibrinogen ; Glomerulonephritis* ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; HLA-DR Antigens* ; HLA-DR2 Antigen ; HLA-DRB1 Chains ; Humans ; Korea ; Prevalence

BACKGROUND AND OBJECTIVES: The 5-HT2A receptor is one of the main mediators of a serotonin-evoked coronary artery contraction. This is because vasoconstriction is selectively blocked by the 5-HT2 receptor antagonist, with the 5-HT2A receptor gene mRNA being detected in spastic coronary arteries. The relationship between the T102C polymorphism of the 5-HT2A receptor gene and the response to the 5-HT2A antagonist (clozapine) has recently been established, suggestive of a functional implication. Previous studies have observed an association between low cholesterol levels and mental disorders, but the underlying cause has not been determined. It has been established that the T102C polymorphism of the 5-HT2A serotonin receptor gene and a variety of psychological problems are related, but the relationship between the serum lipid level and this genetic polymorphism has not been reported. We investigated the influence of this polymorphism on coronary artery disease, including vasospastic angina and the clinical parameters, such as the lipid profile. SUBJECTS AND METHODS: After a diagnostic angiography was performed, the genotype was identified from the genomic DNA extracted from the peripheral blood of 646 patients without specific psychiatric diseases. RESULTS: There were no differences in the genotype frequencies between coronary artery disease, coronary artery disease with vasospasm, and the normal control groups, even from a subgroup analysis of the clinical parameters. Contrary to previous reports, the genotype distribution was not related to a myocardial infarction or hypertension. The lipid profile analysis showed significantly lower total cholesterol (193.5 vs. 202.1mg/dL, p=0.016) and HDL-cholesterol (42.7 vs. 46.2mg/dL, p=0.003) levels in the CC genotype than the other genotypes, and the frequencies of CC genotype showed a significantly decreasing trend between the HDL-cholesterol (p=0.003) and total cholesterol (p=0.003) quartiles. From a multivariate analysis, only the HDL-cholesterol level was significantly associated with a lower frequency of the CC genotype (p=0.006). CONCLUSION: The T102C polymorphism is not related to coronary artery disease, including vasospasm of the coronary artery, but the CC genotype of this polymorphism is related to low HDL-cholesterol. We identified a novel genetic polymorphism of the serotonin receptor, which affects the HDL-cholesterol level. Because previous observational studies have shown an association between low cholesterol levels and mental disorders, our data should be considered when analyzing the serum lipid levels and serotonin receptor function in humans.
Angiography ; Cholesterol ; Coronary Artery Disease* ; Coronary Vessels* ; DNA ; Genotype ; Humans ; Hypertension ; Mental Disorders ; Multivariate Analysis ; Muscle Spasticity ; Myocardial Infarction ; Polymorphism, Genetic ; Receptor, Serotonin, 5-HT2A* ; RNA, Messenger ; Serotonin ; Serotonin 5-HT2 Receptor Antagonists ; Vasoconstriction

Ganglioglioma comprises about 2% of all intracranial neoplasm, however, it is rarely originated from the brain stem. We report a case of ganglioglioma arising from the brain stem. A 15-year-old girl presented with gait disturbance and dysarthria. Magnetic resonance image revealed a high signal intensity mass with cystic cavities in the right cerebellum and the brain stem. The patient underwent subtotal resection and microscopic examination revealed a ganglioglioma. It is suggested that ganglioglioma should be included in the differential diagnosis of posterior fossa tumors, even located in the brain stem.
Adolescent ; Brain Neoplasms ; Brain Stem* ; Brain* ; Cerebellum ; Diagnosis, Differential ; Dysarthria ; Female ; Gait ; Ganglioglioma* ; Humans ; Infratentorial Neoplasms ; Magnetic Resonance Imaging