Objective: : Distinguishing between an infundibulum and a true aneurysm is clinically important. This study aimed to evaluate whether using source image based new three-dimensional rotational angiography (S-n3DRA) can increase the rate of aneurysm detection and improve distinction between a true aneurysm and an infundibulum. Methods: : Twenty-two consecutive patients with 23 lesions, were evaluated by time-of-flight (TOF) magnetic resonance angiography (MRA), S-n3DRA, and digital subtraction angiography (DSA). The data were retrospectively and independently reviewed by two neurointerventionists, and the diagnoses based on TOF MRA, S-n3DRA, and DSA were compared. The diagnostic efficacy (interobserver agreement and diagnostic performance) of S-n3DRA was compared with that of TOF MRA. Results: : S-n3DRA showed higher interobserver agreement (κ=0.923) than TOF MRA (κ=0.465) and significantly higher accuracy than MRA in distinguishing an aneurysm from an infundibulum (p=0.0039). Conclusion : Compared to MRA, S-n3DRA could provide better screening accuracy and information for distinguishing an aneurysm from an infundibulum. Therefore, S-n3DRA has the potential to reduce the need for DSA.

Objective: : Distinguishing between an infundibulum and a true aneurysm is clinically important. This study aimed to evaluate whether using source image based new three-dimensional rotational angiography (S-n3DRA) can increase the rate of aneurysm detection and improve distinction between a true aneurysm and an infundibulum. Methods: : Twenty-two consecutive patients with 23 lesions, were evaluated by time-of-flight (TOF) magnetic resonance angiography (MRA), S-n3DRA, and digital subtraction angiography (DSA). The data were retrospectively and independently reviewed by two neurointerventionists, and the diagnoses based on TOF MRA, S-n3DRA, and DSA were compared. The diagnostic efficacy (interobserver agreement and diagnostic performance) of S-n3DRA was compared with that of TOF MRA. Results: : S-n3DRA showed higher interobserver agreement (κ=0.923) than TOF MRA (κ=0.465) and significantly higher accuracy than MRA in distinguishing an aneurysm from an infundibulum (p=0.0039). Conclusion : Compared to MRA, S-n3DRA could provide better screening accuracy and information for distinguishing an aneurysm from an infundibulum. Therefore, S-n3DRA has the potential to reduce the need for DSA.

PURPOSE: The purpose of this study was to investigate whether surgical experience could improve surgical competency in medial open wedge high tibial osteotomy (MOWHTO). MATERIALS AND METHODS: One hundred consecutive cases of MOWHTO were performed with preoperative planning using the Miniaci method. Surgical errors were defined as under- or overcorrection, excessive posterior slope change, or the presence of a lateral hinge fracture. Each of these treatment failures was separately evaluated using the cumulative summation test for learning curve (LC-CUSUM). RESULTS: The LC-CUSUM showed competency in prevention of undercorrection, excessive posterior slope change, and lateral hinge fracture after 27, 47, and 42 procedures, respectively. However, the LC-CUSUM did not signal achievement of competency in prevention of overcorrection after 100 procedures. Furthermore, the failure rate for overcorrection showed an increasing tendency as surgical experience increased. CONCLUSIONS: Surgical experience may improve the surgeon’s competency in prevention of undercorrection, excessive posterior slope change, and lateral hinge fracture. However, it may not help reduce the incidence of overcorrection even after performance of 100 cases of MOWHTO over a period of 6 years.
Incidence ; Knee ; Learning Curve ; Learning ; Medical Errors ; Methods ; Osteoarthritis ; Osteotomy ; Treatment Failure

BACKGROUND: Smoking cessation is the most powerful intervention to modify progress of chronic obstructive pulmonary disease (COPD), and nicotine dependence is one of the most important determinants of success or failure in smoking cessation. We evaluated nicotine dependence status and investigated factors associated with moderate to high nicotine dependence in patients with COPD. METHODS: We included 53 current smokers with COPD in the Korean Obstructive Lung Disease II cohort enrolled between January 2014 and March 2016. Nicotine dependence was measured by using Fagerstrom test for nicotine dependence (FTND). Cognitive function was assessed by Korean version of Montreal Cognitive Assessment. RESULTS: The median FTND score was 3, and 32 patients (60%) had moderate to high nicotine dependence. The median smoking amount was 44 pack-years, which was not related to nicotine dependence. Multiple logistic regression analysis revealed that high education status (odds ratio, 1.286; 95% confidence interval, 1.036–1.596; p=0.023), age <70 (odds ratio, 6.407; 95% confidence interval, 1.376–29.830; p=0.018), and mild to moderate airflow obstruction (odds ratio, 6.969; 95% confidence interval, 1.388–34.998; p=0.018) were related to moderate to high nicotine dependence. CONCLUSION: Nicotine dependence does not correlate with smoking amount, but with education level, age, and severity of airflow obstruction. Physicians should provide different strategies of smoking cessation intervention for current smokers with COPD according to their education levels, age, and severity of airflow obstruction.
Cognition ; Cohort Studies ; Education ; Humans ; Logistic Models ; Lung Diseases, Obstructive ; Nicotine* ; Pulmonary Disease, Chronic Obstructive* ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Use Disorder*

The aim of the study was to evaluate the prevalence of restrictive ventilatory defect and to determine the risk factors in subjects with spirometrically-defined restrictive ventilatory defect. We used the population-based, fourth-2, 3 (2008, 2009) and fifth (2010-2012) Korea National Health and Nutrition Examination Survey (KNHANES) to analyze 15,073 subjects, aged > or =40 yr who underwent spirometry. Chest radiographs were also analyzed to identify restrictive lung disease. Spirometrically-defined restrictive ventilatory defect (FEV1/FVC> or =70% and FVC<80% of mean predicted value) was detected in 11.3% (n= 1,709) of subjects aged > or =40 yr. The prevalence increased to 12.3% on using the lower limit of normal (LLN) criteria. Approximately 99.4% of subjects were classified as mild restrictive. Among these, 11.3% had inactive tuberculosis (TB) lesion, 2.2% cardiac disease, 2.0% previous operation scar or radiation injury and/or mediastinal disease, and 7.4% other pulmonary disease suggestive of restrictive lung diseases on chest radiograph. Evidence of previous TB history was independently associated with restrictive ventilatory defect (odds ratios [OR], 1.78; 95% confidence interval, 1.45-2.18) after adjustment for gender, age, smoking, area for residence and body mass index. The prevalence of restrictive ventilatory defect among the nationwide population in Korea was 11.3% with fixed ratio criterion and 12.3% with LLN criterion. Most cases were of the mild restrictive category and previous TB history is the independent risk factor for restrictive ventilatory defect.
Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Educational Status ; Female ; Health Care Surveys ; Housing ; Humans ; Income ; Lung Diseases, Obstructive/*diagnosis/*epidemiology ; Male ; Middle Aged ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Factors ; Sensitivity and Specificity ; Sex Distribution ; Smoking/*epidemiology ; Spirometry/*statistics & numerical data

0.05). Amnesia during local injection was observed in eight patients (34.8%). Compared with the preoperative anxiety score, the intraoperative anxiety score was decreased.CONCLUSION: In this study, we found cardiovascular and respiratory stability in intravenous sedation using dexmedetomidine with pethidine, in plate and screw removal, after orthognathic surgery. Furthemore, intravenous sedation using dexmedetomidine with pethidine shows adequate analgesic and sedative effects.]]>
Amnesia ; Anxiety ; Arterial Pressure ; Blood Pressure ; Dexmedetomidine ; Heart Rate ; Humans ; Hypnotics and Sedatives ; Meperidine ; Orthognathic Surgery ; Oxygen

It is important to identify therapeutic compounds with no adverse effects for use in the chemotherapy of patients with bone-related diseases. The aim of this study was to identify a new compound that inhibits osteoclast differentiation and bone resorption. Herein, we examined the effects of 1',2'-dihydrorotenone on osteoclast differentiation and bone resorption in vitro and in vivo. 1',2'-dihydrorotenone inhibited receptor activator of NF-kappaB ligand (RANKL)-induced osteoclast differentiation of cultured bone marrow macrophages (BMMs) in a dose-dependent manner. However, 1',2'-dihydrorotenone did not exert cytotoxic effect on BMMs. 1',2'-dihydrorotenone suppressed the expression of c-fos and NFATc1 as well as osteoclast-specific genes in BMMs treated with RANKL. Treatment with RANKL inhibited the expression of inhibitors of differentiation/DNA binding (Id)1, 2, and 3; however, in the presence of 1',2'-dihydrorotenone, RANKL did not suppress the expression of Id1, 2, and 3. Furthermore, 1',2'-dihydrorotenone inhibited bone resorption and considerably attenuated the erosion of trabecular bone induced by lipopolysaccharide treatment. Taken together, these results suggest that 1',2'-dihydrorotenone has the potential to be applied in therapies for bone-related diseases.
Bone Marrow ; Bone Resorption ; Humans ; Macrophages ; Osteoclasts ; Receptor Activator of Nuclear Factor-kappa B ; Rotenone

Peutz-Jeghers syndrome (PJS), is a rare autosomal dominant hereditary disorder. Intestinal hamartomatous polyps in association with melanocytic pigmentation of the skin and mucous membranes characterize PJS. Patients with PJS often have complications associated with the polyps, such as intestinal obstruction, intussusception, acute or chronic gastrointestinal bleeding, and the development of various types of cancer. Enteroclysis, small bowel follow-through, and push enteroscopy are generally used to identify the presence and location of small bowel polyps. Wireless capsule endoscopy (CE) has been confirmed as a feasible, safe, and sensitive test for the surveillance of small bowel polyps in patients with PJS and could replace radiographic small bowel surveillance. Here, a case of PJS newly diagnosed by CE is reported. The patient, a 30-year-old man who had developed rectal polyps associated with anal extrusion 7 years previously, had six episodes of hematochezia.
Adult ; Capsule Endoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception ; Mucous Membrane ; Peutz-Jeghers Syndrome ; Pigmentation ; Polyps ; Skin

PURPOSE: Gelatin-hydroxyapatite nanocomposite is similar to inorganic nanostructure of bone. To make a scaffold with osteoinductivity, bone marrow derived stem cells from rabbit femur were impinged into the nanocomposite. This vitro study was to test osteogenic differentiation of the stem cells in the nanocomposite, which was made by authors. MATERIAL & METHODS: Gel-HA nanocomposite with 10g of HA, 3 g of Gel has been made by co-precipitation process. Bone marrow was obtained from femur of New Zealand White rabbits and osteogenic differentiation was induced by culturing of the BMSCs in an osteogenic medium. The BMSCs were seeded into the Gel-HA nanocomposite scaffold using a stirring seeding method. The scaffolds with the cells were examined by scanning electron microscopy (SEM), colorimetry assay, biochemical assay with alkaline phosphatase (ALP) diagnostic kit, osteocalcin ELISA kit. RESULTS: Gel-HA nanocomposite scaffolds were fabricated with relatively homogenous microscale pores (20-40 micrometer). The BMSCs were obtained from bone marrow of rabbit femurs and confirmed with flow cytometry, Alizarin red staining. Attachment and proliferation of BMSCs in Gel-HA nanocomposite scaffold could be identified by SEM, ALP activity and osteocalcin content of BMSCs. CONCLUSION: The Gel-HA nanocomposite scaffold with micropores could be fabricated and could support BMSCs seeding, osteogenic differentiation.
Alkaline Phosphatase ; Anthraquinones ; Bone Marrow ; Colorimetry ; Durapatite ; Enzyme-Linked Immunosorbent Assay ; Femur ; Flow Cytometry ; Microscopy, Electron, Scanning ; Nanocomposites ; Nanostructures ; Osteocalcin ; Rabbits ; Seeds ; Stem Cells