Kawasaki Disease with Fever and Cervical Lymphadenopathy as the Sole Initial Presentation

BACKGROUND AND OBJECTIVES: Some patients with Kawasaki disease (KD) present with fever and cervical lymphadenopathy alone. The purpose of this study was to characterize the clinical features of these unusual KD patients and determine whether this is a severe form of KD associated with increased risks of intravenous immunoglobulin (IVIG) resistance and coronary artery lesions (CALs). SUBJECTS AND METHODS: A total of 146 children with KD were reviewed retrospectively, and classified into two groups according to initial clinical features. Those presenting with only fever and cervical lymphadenopathy (LKD) were classified as LKD patients. Other-KD patients included all except the LKD patients. RESULTS: Among 146 KD patients, 13 (8.9%) were classified as LKD patients. The LKD patients were significantly older and admitted earlier. The duration between fever onset and KD diagnosis was significantly longer in the LKD patients (5.9 days vs. 4.9 days, p=0.023). The frequency of IVIG resistance was not different between the two groups., In the LKD patients, the incidence of CALs was significantly higher in the acute phase, and without significant difference in the convalescent phase. The percentage of neutrophils and C-reactive protein, albumin, and total bilirubin levels were significantly higher in LKD patients. CONCLUSION: Even though LKD patients were older, admitted earlier, and had higher inflammatory marker levels, they did not have a greater risk of CALs or IVIG resistance. However, echocardiography may be helpful in the acute stage if patients have only fever and cervical lymphadenopathy and are unresponsive to empirical antibiotics.

Removable implant-supported partial denture using milled bar with Locator(R) attachments in a cleft lip & palate patient: A clinical report / 대한치과보철학회지

Due to the limitations of conventional removable partial denture prostheses to treat a cleft lip & palate patient who shows scar tissue on upper lip, excessive absorption of the maxillary residual alveolar ridge, and class III malocclusion with narrow palate and undergrowth of the maxilla, 4 implants were placed on the maxillary edentulous region and a maxillary removable implant-supported partial denture was planned using a CAD/CAM milled titanium bar. Unlike metal or gold casting technique which has shrinkage after the molding, CAD/CAM milled titanium bar is highly-precise, economical and lightweight. In practice, however, it is very hard to obtain accurate friction-fit from the milled bar and reduction in retention can occur due to repetitive insertion and removal of the denture. Various auxiliary retention systems (e.g. ERA(R), CEKA(R), magnetics, Locator(R) attachment), in order to deal with these problems, can be used to obtain additional retention, cost-effectiveness and ease of replacement. Out of diverse auxiliary attachments, Locator(R) has characteristics that are dual retentive, minimal in vertical height and convenient of attachment replacement. Drill and tapping method is simple and the replacement of the metal female part of Locator(R) attachment is convenient. In this case, the Locator(R) attachment is connected to the milled titanium bar fabricated by CAD/CAM, using the drill and tapping technique. Afterward, screw holes were formed and 3 Locator(R) attachments were secured with 20 Ncm holding force for additional retention. Following this procedure, satisfactory results were obtained in terms of aesthetic facial form, masticatory function and denture retention, and I hereby report this case.

Shade perception ability among different dental personnel / 대한치과보철학회지

Statement of problem: Many factors influence shade determination in clinical practice and shade matching is highly affected by the viewing conditions. Purpose: This study investigated the differences in shade perception among distinct groups of dental personnel (10 prosthodontists, 10 general practitioners, 10 last-year dental students and 10 dental technicians). Material and method: Four groups of dental personnel were investigated. They were tested to eliminate color blindness. To compare shade selection ability, they were asked to match four test tabs of shades A3, B2, C2 and D4 (VITAPAN. Classical shade guide. The identification codes of the shade tabs were masked to prevent shade memory.) against another full set of VITAPAN. Classical shade guide under similar lighting conditions. Shade selections were randomly repeated five times every week and then the repeatability between dental personnel was evaluated. To compare value perception ability, they were asked to arrange randomly selected five test tabs (B1, A2, D2, C3, A4) in descending order from the brightest to the darkest. To compare hue determination ability, they were asked to divide selected eight test tabs (A2, A3, B2, B3, C2, C3, D2, D3) into four groups by manufacturer as follows: Group A-Reddish brown, Group B-Reddish yellow, Group C-Grey, Group D-Reddish grey. Results and conclusion: The obtained results were as follows: 1. For the value perception ability and hue determination ability, there was no significant difference among 4 groups: prosthodontists, general practitioners, dental students, dental technicians(P>.05). 2. For shade selection ability, the prosthodontists and dental technicians were significantly higher than dental students(P<.05). 3. The repeatability of selected shade in the dental technicians was significantly higher than that of general practitioners and dental students(P<.05). 4. The prosthodontists and dental technicians had significantly higher selection ability than dental students for shade B2(P<.05).