Purpose: This study aimed to analyze the prognosis of implant placement after maxillary sinus perforation repair using a collagen membrane during sinus elevation surgery.Materials and Methods: The radiographic and clinical data of 27 patients who underwent simultaneous or delayed implant placement with perforation repair (using collagen membranes) were retrospectively analyzed. The patients were divided into the following three groups: group 1: perforation repair, bone grafting, and simultaneous implant placement (nine patients, 19 implants); group 2: perforation repair, no bone grafting, and simultaneous implant placement (11 patients, 19 implants); group 3: perforation repair, bone grafting, and delayed implant placement (seven patients, 15 implants). The follow-up period was at least 2 years for all patients. Results: No significant differences in implant survival rates were observed between groups. Marginal bone loss was minimal in all groups with some exceptions. The thickness of the maxillary sinus measured on the day of surgery differed significantly between the groups, potentially attributed to the variations in the surgical materials employed. However, the thickness normalized in all groups at 1-year follow-up. Conclusion This study suggests that simultaneous and delayed implant placement in cases of perforated maxillary sinus membranes repaired with collagen membranes during sinus elevation surgery can achieve favorable long-term outcomes. In certain cases, simultaneous implant placement without bone grafting is a viable option.

Purpose: This study aimed to analyze the prognosis of implant placement after maxillary sinus perforation repair using a collagen membrane during sinus elevation surgery.Materials and Methods: The radiographic and clinical data of 27 patients who underwent simultaneous or delayed implant placement with perforation repair (using collagen membranes) were retrospectively analyzed. The patients were divided into the following three groups: group 1: perforation repair, bone grafting, and simultaneous implant placement (nine patients, 19 implants); group 2: perforation repair, no bone grafting, and simultaneous implant placement (11 patients, 19 implants); group 3: perforation repair, bone grafting, and delayed implant placement (seven patients, 15 implants). The follow-up period was at least 2 years for all patients. Results: No significant differences in implant survival rates were observed between groups. Marginal bone loss was minimal in all groups with some exceptions. The thickness of the maxillary sinus measured on the day of surgery differed significantly between the groups, potentially attributed to the variations in the surgical materials employed. However, the thickness normalized in all groups at 1-year follow-up. Conclusion This study suggests that simultaneous and delayed implant placement in cases of perforated maxillary sinus membranes repaired with collagen membranes during sinus elevation surgery can achieve favorable long-term outcomes. In certain cases, simultaneous implant placement without bone grafting is a viable option.

Purpose: This study aimed to analyze the prognosis of implant placement after maxillary sinus perforation repair using a collagen membrane during sinus elevation surgery.Materials and Methods: The radiographic and clinical data of 27 patients who underwent simultaneous or delayed implant placement with perforation repair (using collagen membranes) were retrospectively analyzed. The patients were divided into the following three groups: group 1: perforation repair, bone grafting, and simultaneous implant placement (nine patients, 19 implants); group 2: perforation repair, no bone grafting, and simultaneous implant placement (11 patients, 19 implants); group 3: perforation repair, bone grafting, and delayed implant placement (seven patients, 15 implants). The follow-up period was at least 2 years for all patients. Results: No significant differences in implant survival rates were observed between groups. Marginal bone loss was minimal in all groups with some exceptions. The thickness of the maxillary sinus measured on the day of surgery differed significantly between the groups, potentially attributed to the variations in the surgical materials employed. However, the thickness normalized in all groups at 1-year follow-up. Conclusion This study suggests that simultaneous and delayed implant placement in cases of perforated maxillary sinus membranes repaired with collagen membranes during sinus elevation surgery can achieve favorable long-term outcomes. In certain cases, simultaneous implant placement without bone grafting is a viable option.

Peri-implantitis, in which inflammation caused by plaque and biofilm on the implant surface spreads to the hard tissue, can be treated by decontamination of the implant surface and reconstruction of the lost hard tissue through surgical methods. We have described the management of 3 peri-implantitis cases by decontamination of the implant surface using a round titanium brush and regenerative therapy. All cases showed clinical improvements, and no further radiographic bone loss was observed during a 2-year follow-up. This treatment method can be effective for clinical improvement and bone regeneration. However, a longer follow-up period is necessary to support these outcomes.

Soil-transmitted helminths, including Ascaris lumbricoides and Trichuris trichiura, are important intestinal parasites mostly affecting younger people in developing countries. In 2014-2015, we performed mass fecal examinations targeting a total of 2,227 schoolchildren in 3 districts (South Dagon, North Dagon, and Hlaing-thar-yar) of Yangon Region, Myanmar, using the Kato-Katz thick smear technique. The egg positive children were subjected to a mass drug administration (MDA) using a single oral dose of 400 mg albendazole. The pre-treatment egg positive rate (EPG/person) of A. lumbricoides averaged 17.2% (15,532); it was 25.2% (21,796), 14.2% (11,816), and 12.8% (12,983) in 3 districts, respectively, and that of T. trichiura averaged 19.4% (1,074), and was 24.1% (1,040), 12.3% (852), and 21.2% (1,330) in 3 districts, respectively. Follow-up fecal examinations performed 4 months post-MDA revealed considerable decreases of A. lumbricoides prevalence (EPG/person) to av. 8.3% (12,429), and 13.7% (17,640), 8.0% (7,797), and 4.5% (11,849) in 3 districts, respectively. However, T. trichiura did not show any recognizable decrease in the prevalence (EPG/person) remaining at av. 18.2% (862), and 18.5% (888), 11.5% (812), and 23.3% (887) in 3 districts, respectively. The results demonstrated difficulty in short-term control of T. trichiura by MDA using albendazole and suggested necessity of either a long-term MDA (>10 years) or changing the albendazole regimen into 2~3-day course (total 800 or 1,200 mg), or using an alternative drug/drug combination.

PURPOSE: Vitamin D deficiency is reported to be more common in type 1 diabetes patients and might be associated with the increased urinary loss of vitamin D binding protein (VDBP) consequent to impaired 25-hydroxyvitamin D (25(OH)D) circulation. We aimed to evaluate the possible increased urinary loss of VDBP, a correlation between VDBP and circulating 25(OH)D level, and risk factors influencing low vitamin D level in pediatric type 1 diabetes patients without microalbuminuria. METHODS: This is a cross-sectional study of subjects who visited Seoul National University Children’s Hospital between January and March 2013. Forty-two type 1 diabetes patients and 29 healthy controls were included. Biochemical parameters including serum and urine VDBP concentrations were analyzed. RESULTS: There was no significant difference in the frequency of vitamin D deficiency or serum 25(OH)D level between the 2 groups. The serum and urine VDBP concentrations did not show any difference between the 2 groups. Serum 25(OH) D level did not correlate with serum or urine VDBP. Multivariate regression analysis revealed that daylight outdoor hours (β=2.948, P=0.003) and vitamin D intake (β=2.865, P=0.003) affected the 25(OH)D level; the presence of type 1 diabetes or urinary VDBP excretion was not significant. CONCLUSIONS: In pediatric type 1 diabetes patients, urinary VDBP excretion did not contribute to low serum 25(OH)D level in the setting of normoalbuminuria. The factors associated with 25(OH)D level during winter periods were daylight outdoor hours and vitamin D intake. Further studies including both micro- and macroalbuminuria patients with type 1 diabetes are warranted.
Albuminuria ; Child ; Cross-Sectional Studies ; Diabetes Mellitus, Type 1 ; Ergocalciferols ; Humans ; Risk Factors ; Seoul ; Vitamin D ; Vitamin D Deficiency ; Vitamin D-Binding Protein* ; Vitamins*

PURPOSE: Altered mental status is common to alcohol intoxicated patients, resulting in difficulties to perform detailed physical examination and history taking. With this condition, the development of appropriate tools for evaluation was required. This study was conducted to investigate a better method for predicting the prognosis among alcohol intoxicated patients in the emergency department by modifying the Korean Triage Acuity Scale (KTAS). METHODS: We retrospectively reviewed the medical records of 1,155 alcohol intoxicated patients who presented to the ED between January and December of 2013. The correlation between admission and demographical characteristics of patients was analyzed. We applied the clinical values to KTAS (overdose category) and modified KTAS (alcoholic intoxication category). The efficiency of two triage methods was compared by using the receiver operating characteristic (ROC) curve analysis. RESULTS: Among these 1,155 patients, 201 were admitted and 954 were discharged. The sensitivity and specificity of the overdose category were 0.736 and 0.623, respectively. Those of the alcoholic intoxication category were 0.647 and 0.979, respectively. The area under ROC curves for overdose category and alcoholic intoxication category were 0.679±0.020 and 0.813±0.021, respectively (95% confidence interval, p<0.001). CONCLUSION: This study showed that the sensitivities of the overdose category and the alcoholic intoxication category were similar. However, the specificity of the alcoholic intoxication category was higher than that of the overdose category. Therefore, the alcoholic intoxication category was superior to the overdose category in predicting the prognosis among alcohol intoxicated patients.
Alcoholic Intoxication* ; Alcoholics* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Medical Records ; Methods* ; Physical Examination ; Prognosis ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Triage*

PURPOSE: Intra-abdominal leiomyosarcoma is an uncommon malignant tumor, and its standard treatment is surgical resection. However, there is no generally preferred treatment for its metastatic mass, especially in the liver.METHODS: According to the sarcoma registry, 476 patients were diagnosed as leiomyosarcoma and received treatment in Asan Medical Center, Seoul, Korea. And from 2003 to 2015, surgical resections of liver metastases were performed in 10 patients with leiomyosarcoma. The characteristics and short-term results were documented.RESULTS: Of the 10 patients, the median age was 48 years and the median survival period was 34.2 months. The mean period from primary resection to liver metastasis was 12.9 months. Six patients had a single metastatic mass, and four had multiple nodules. One patient had an additional distant metastasis outside of the liver. Eight patients had a partial hepatectomy, and the others were treated using segmentectomy or lobectomy. Two patients (20%) died during follow-up. Four patients showed metastasis to other organs after surgical resection of the liver.CONCLUSION: Intra-abdominal leiomyosarcoma with liver metastasis is a very rare disease. Long-term survival can be achieved after surgical resection and should be considered for all patients.
Chungcheongnam-do ; Follow-Up Studies ; Hepatectomy ; Humans ; Korea ; Leiomyosarcoma ; Liver ; Mastectomy, Segmental ; Neoplasm Metastasis ; Rare Diseases ; Sarcoma ; Seoul

PURPOSE: Despite the development of transportation, accessibility of medical service on islands is still poor. Therefore, providing adequate emergency medical services is becoming more important. The purpose of this study is to measure and describe utilization patterns of emergency medical services for the residents of islands. METHODS: A retrospective cross-sectional observational study of transported patients who live on islands and in urban areas from January 1st, 2011 to December 31th, 2013 was conducted. Through review of emergency medical technician (EMT) transfer records, the demographic information of transferred patients, the frequency of emergency medical services (EMS) activation, and the characteristics of transfer were collected. RESULTS: A total of 31,690 people were included; 29,064 people of urban areas and 2,626 people of islands. The mean age was older in the residents of islands (66+/-19 years old vs. 50+/-24 years old, p<0.001). For the residents of islands, the landline phone is the most common means of EMS activation (36.4% vs 29.9%, p<0.001), and the highest frequency of EMS activation was June (10.9% vs. 9.0% in August, p<0.001). The distance of transfer was longer for islands (5 min, 2-12) compared with urban areas (3 min, 2-4) (p<0.001). CONCLUSION: The above is an important indicator of specificity and form of urban residents and island residents using the EMS. It is our purpose that efficient EMS service be provided depending on each specificity.
Emergencies* ; Emergency Medical Services* ; Emergency Medical Technicians ; Humans ; Islands* ; Needs Assessment ; Observational Study ; Retrospective Studies ; Rural Health Services ; Sensitivity and Specificity ; Transportation

BACKGROUND/AIMS: Oxidative stress increases the risk of cardiovascular complications of metabolic syndrome (MetS). This study was conducted to examine the difference in antioxidant capacity according to the presence of MetS, and to characterize the association between antioxidant capacity and MetS-related factors. METHODS: We used the biological antioxidant potential (BAP) test to estimate antioxidant capacity. The BAP test has recently been used as an indicator of antioxidant capacity. We measured BAP levels in 45 patients with MetS (mean age, 44.6 +/- 1.1 years) and 47 age- and sex-matched controls (mean age, 42.7 +/- 1.1 years). To evaluate the association between antioxidant capacity and MetS, adiponectin, high-sensitivity C-reactive protein (hs-CRP), interleukin-6, tumor necrosis factor-alpha, and homeostatic model assessment for insulin resistance (HOMA-IR), linear regression and logistic analyses were performed. RESULTS: The mean BAP of the MetS group (1,937.3 +/- 36.5 micromol/L) was significantly lower than that of the non-MetS group (2,101.7 +/- 29.5 micromol/L). Also, the mean BAP was low in persons having low high density lipoprotein and high triglyceride. Reduced antioxidant capacity was significantly associated with adiponectin, HOMA-IR and hs-CRP after adjusting for age and sex. The odds ratios for MetS with BAP, log adiponectin, log HOMA-IR, and log hs-CRP were 0.63 (95% confidence interval [CI], 0.49 to 0.82), 0.22 (0.10 to 0.51), 14.24 (4.35 to 46.58), and 1.93 (1.36 to 2.75), respectively. CONCLUSIONS: Persons with MetS showed reduced antioxidant capacity. We identified relationships between antioxidant capacity measured by BAP test and MetS, as well as MetS-related factors, such as insulin resistance, hs-CRP, and adiponectin.
Adipokines/blood ; Adult ; Antioxidants/*metabolism ; Biological Markers/blood ; C-Reactive Protein/metabolism ; Case-Control Studies ; Female ; Humans ; Insulin Resistance ; Interleukin-6/blood ; Male ; Metabolic Syndrome X/*blood ; Middle Aged ; Predictive Value of Tests ; Tumor Necrosis Factor-alpha/blood