Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

Purpose: This study aimed to propose a methodological approach for reducing the radiation dose in pediatric conebeam computed tomography (CBCT), focusing exclusively on balancing image quality with dose optimization. Materials and Methods: The dose-area product (DAP) for exposure was reduced using copper-plate attenuation of an X-ray source. The thickness of copper (Cu) was increased from 0 to 2.2 mm, and 10 different DAP levels were used. The QUART DVT_AP phantom and pediatric radiologic dentiform were scanned under the respective DAP levels. The contrast-to-noise ratio (CNR), image homogeneity, and modulation transfer function (MTF) were analyzed using the QUART DVT_AP phantom. An expert evaluation (overall image grade, appropriateness of field of view, artifacts, noise, and resolution) was conducted using pediatric dentiform images. The critical DAP level was determined based on phantom and dentiform analysis results. Results: CNR and image homogeneity decreased as the DAP was reduced; however, there was an inflection point of image homogeneity at Cu 1.6 mm (DAP = 138.00 mGy·cm2 ), where the value started increasing. The MTF showed constant values as the DAP decreased. The expert evaluation of overall image grades showed “no diagnostic value” for dentiform images with Cu 1.9-2.2 mm (DAP = 78.00-103.33 mGy·cm2 ). The images with Cu 0-1.6 mm (DAP = 138.00-1697.67 mGy·cm2 ) had a “good,” “moderate,” or “poor but interpretable” grade. Conclusion Reducing DAP beyond a 1.6-mm Cu thickness degraded CBCT image quality. Image homogeneity and clinical image grades indicated crucial decision points for DAP reduction in pediatric CBCT scans.

Objective: The objective of this study is to assess the efficacy and safety of repeated sodium polynucleotide (Conjuran Ⓡ ) treatments in patients with knee osteoarthritis. Methods: The study was conducted by retrospectively examining 45 patients who repeated the treatment course of 5 injections of Conjuran Ⓡ twice within 6 months. For each course, pain reduction by the change of 100-mm Weight-Bearing-Pain Visual-Analog-Scale was compared with before administration until 6 months after administration. Improvement by Clinical Global Impression (CGI) and Patient Global Impression (PGI) were also investigated, as well as adverse reactions. Results: Pain analysis after administration of Conjuran Ⓡ confirmed that VAS decreased by 51.6% until 6 months (p＜0.001), and after that the effect was lost and was repeat for the 2 nd course. In the 2 nd , VAS continued to decrease by 58.7% compared to before the 1 st course (p＜0.001). Analysis of CGI, 88.9% of patients improved after the 1 st and 84.4% of patients improved after the 2 nd . In the PGI results, symptoms improved in 86.7% of patients after the 1 st and 82.2% after the 2 nd . No significant adverse event was reported. Conclusion The safety and efficacy results of patients receiving Conjuran Ⓡ for 2 nd treatment courses were similar to those for 1 st treatment course. In addition, the effect lasts for up to 6 months after administration, and the pain reduction effect is lost thereafter, so it is recommended to apply it at 6-month intervals if additional treatment is needed. Conjuran Ⓡ is an intra-articular injection that is effective in reducing knee pain and can be used repeatedly without adverse reactions.

Intravascular large B-cell lymphoma (IVLBCL) is a rare form of non-Hodgkin’s lymphoma that selectively involves the lumina of vessels, and may present as ischemic stroke. A 62-year-old man presented with progressive aphasia, dementia, seizure and stroke-like symptom. Brain magnetic resonance imaging revealed dynamic progressive fluid attenuated inversion recovery lesions and multiple punctate microbleeds in the bilateral subcortical region. A kidney biopsy revealed IVLBCL. We report a patient with IVLBCL presenting as rapidly progressive encephalopathy.

Purpose: This study aimed to compare the therapeutic effects of corticosteroid irrigations and normal saline irrigations in the early inflammatory state of the salivary gland. Materials and Methods: Adult male Wistar rats were divided into experimental (n=6) and control (n=3) groups. Inflammation was induced in the experimental subjects on both sides of the submandibular gland with ligation. After 14 days, both sides of the glands were de-ligated and retroductal irrigation using saline (n=3) and a corticosteroid (n=3) was performed on the left sides only. The controls (n=3) were used to normalize the gland state for the effects of diet and aging. Magnetic resonance imaging was performed to confirm inflammation and post-irrigation gland recovery by measuring relative signal intensity (SI). The glands were excised for histological examination. Results: All experimental animals showed inflamed glands with increased SI and subsequent recovery of the gland with decreased SI to varying degrees. The SI of the controls showed no significant changes during the overall period. The mean SI change of the irrigated gland was higher than that of the non-irrigated side, without a significant difference. The corticosteroid-irrigated glands showed a greater change in SI than that of the saline-irrigated glands. Histology revealed that inflammation was not observed in most of the irrigated glands, while mild to moderate quantities inflammatory cells were found in non-irrigated glands. Conclusion Corticosteroid irrigation mitigated the early stages of salivary gland inflammation more effectively than normal saline.

Purpose: This study aimed to evaluate the performance of transfer learning in a deep convolutional neural network for classifying implant fixtures. Materials and Methods: Periapical radiographs of implant fixtures obtained using the Superline (Dentium Co. Ltd., Seoul, Korea), TS III (Osstem Implant Co. Ltd., Seoul, Korea), and Bone Level Implant (Institut Straumann AG, Basel, Switzerland) systems were selected from patients who underwent dental implant treatment. All 355 implant fixtures comprised the total dataset and were annotated with the name of the system. The total dataset was split into a training dataset and a test dataset at a ratio of 8 to 2, respectively. YOLOv3 (You Only Look Once version 3, available at https://pjreddie.com/darknet/yolo/), a deep convolutional neural network that has been pretrained with a large image dataset of objects, was used to train the model to classify fixtures in periapical images, in a process called transfer learning. This network was trained with the training dataset for 100, 200, and 300 epochs. Using the test dataset, the performance of the network was evaluated in terms of sensitivity, specificity, and accuracy. Results: When YOLOv3 was trained for 200 epochs, the sensitivity, specificity, accuracy, and confidence score were the highest for all systems, with overall results of 94.4%, 97.9%, 96.7%, and 0.75, respectively. The network showed the best performance in classifying Bone Level Implant fixtures, with 100.0% sensitivity, specificity, and accuracy. Conclusion Through transfer learning, high performance could be achieved with YOLOv3, even using a small amount of data.

Purpose: This study was to investigate the types of imaging modalities, analytical methods for age estimation, and the age of the subjects in research on age estimation using dental radiography through a scoping review, and to investigate the overall trends in age estimation studies. Materials and Methods: A scoping review was designed according to the Arksey and O’Malley guidelines and the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Three electronic databases were used as search sources (Medline, Embase, and Cochrane Library). Studies were classified according to the three main components of the research question. “What are the imaging modalities, analytical methods, and target age in dental imaging-based age estimation studies?”Result: The final 198 studies were selected by two reviewers. The most common imaging modality used in studies was panoramic radiography (69.7%), and studies using cone-beam computed tomography have increased over time. Analytical methods for age estimation were 62.6% in studies based on tooth development and 26.3% in studies using pulp/tooth ratio. The subject age was 27.8% for children and 27.3% for adults. Studies conducted in all age groups comprised the smallest category (5.2%). Conclusion Panoramic radiography has been the most used types of imaging modalities for age estimation, and the most common analytical method was analysis of tooth development. Most studies targeted specific ages, and very few involved all age groups. Dental age estimation studies should be carried out with appropriate consideration of the imaging modality that is analyzed, the methods that are used, and the age that is targeted.