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1.
Article in English | WPRIM | ID: wpr-875288

ABSTRACT

Objective@#We aimed to develop a deep neural network for segmenting lung parenchyma with extensive pathological conditions on non-contrast chest computed tomography (CT) images. @*Materials and Methods@#Thin-section non-contrast chest CT images from 203 patients (115 males, 88 females; age range, 31–89 years) between January 2017 and May 2017 were included in the study, of which 150 cases had extensive lung parenchymal disease involving more than 40% of the parenchymal area. Parenchymal diseases included interstitial lung disease (ILD), emphysema, nontuberculous mycobacterial lung disease, tuberculous destroyed lung, pneumonia, lung cancer, and other diseases. Five experienced radiologists manually drew the margin of the lungs, slice by slice, on CT images. The dataset used to develop the network consisted of 157 cases for training, 20 cases for development, and 26 cases for internal validation. Two-dimensional (2D) U-Net and three-dimensional (3D) U-Net models were used for the task. The network was trained to segment the lung parenchyma as a whole and segment the right and left lung separately. The University Hospitals of Geneva ILD dataset, which contained high-resolution CT images of ILD, was used for external validation. @*Results@#The Dice similarity coefficients for internal validation were 99.6 ± 0.3% (2D U-Net whole lung model), 99.5 ± 0.3% (2D U-Net separate lung model), 99.4 ± 0.5% (3D U-Net whole lung model), and 99.4 ± 0.5% (3D U-Net separate lung model).The Dice similarity coefficients for the external validation dataset were 98.4 ± 1.0% (2D U-Net whole lung model) and 98.4 ± 1.0% (2D U-Net separate lung model). In 31 cases, where the extent of ILD was larger than 75% of the lung parenchymal area, the Dice similarity coefficients were 97.9 ± 1.3% (2D U-Net whole lung model) and 98.0 ± 1.2% (2D U-Net separate lung model). @*Conclusion@#The deep neural network achieved excellent performance in automatically delineating the boundaries of lung parenchyma with extensive pathological conditions on non-contrast chest CT images.

2.
Article in English | WPRIM | ID: wpr-875253

ABSTRACT

Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.

3.
Article in English | WPRIM | ID: wpr-837236

ABSTRACT

PURPOSE@#The bond strengths between resin denture teeth with various compositions and denture base resins including conventional and CAD/CAM purposed materials were evaluated to find influence of each material. @*MATERIALS AND METHODS@#Cylindrical rods (6.0 mm diameter × 8.0 mm length) prepared from pre-polymerized CAD/CAM denture base resin blocks (PMMA Block-pink; Huge Dental Material, Vipi Block-Pink; Vipi Industria) were bonded to the basal surface of resin teeth from three different companies (VITA MFT® ; VITA Zahnfabrik, Endura Posterio® ; SHOFU Dental, Duracross Physio® ; Nissin Dental Products Inc.) using resin cement (Super-Bond C&B; SUN MEDICAL). As a control group, rods from a conventional heat-polymerizing denture base resin (Vertex™ Rapid Simplified; Vertex-Dental B.V. Co.) were attached to the resin teeth using the conventional flasking and curing method. Furthermore, the effect of air abrasion was studied with the highly cross-linked resin teeth (VITA MFT® ) groups. The shear bond strengths were measured, and then the fractured surfaces were examined to analyze the mode of failure. @*RESULTS@#The shear bond strengths of the conventional heat-polymerizing PMMA denture resin group and the CAD/CAM denture base resin groups were similar. Air abrasion to VITA MFT® did not improve shear bond strengths. Interfacial failure was the dominant cause of failure for all specimens. @*CONCLUSION@#Shear bond strengths of CAD/CAM denture base materials and resin denture teeth using resin cement are comparable to those of conventional methods.

4.
The Korean Journal of Pain ; : 267-274, 2020.
Article | WPRIM | ID: wpr-835226

ABSTRACT

Background@#General anesthesia (GA) has been considered the anesthetic technique which most frequent leads to phantom limb pain (PLP) after a limb amputation. However, these prior reports were limited by small sample sizes. The aims of this study were to evaluate the incidence of PLP according to the various anesthetic techniques used for limb amputation and also to compare the occurrence of PLP according to amputation etiology using the Korean Health Insurance Review and Assessment Service for large-scale demographic information. @*Methods@#The claims of patients who underwent limb amputation were reviewed by analyzing the codes used to classify standardized medical behaviors. The patients were categorized into three groups—GA, neuraxial anesthesia (NA), and peripheral nerve block (PNB)—in accordance with the anesthetic technique. The recorded diagnosis was confirmed using the diagnostic codes for PLP registered within one year after the limb amputation. @*Results@#Finally, 7,613 individuals were analyzed. According to the recorded diagnoses, 362 patients (4.8%) developed PLP after amputation. Among the 2,992 patients exposed to GA, 191 (6.4%) were diagnosed with PLP, whereas 121 (4.3%) of the 2,840 patients anesthetized with NA, and 50 (2.8%) of the 1,781 patients anesthetized under PNB developed PLP. The relative risks were 0.67 (95% confidence interval [CI], 0.53–0.84; P < 0.001) for NA and 0.43 (95% CI, 0.32–0.59; P < 0.001) for PNB. @*Conclusions@#In this retrospective cohort study, using large-scale population-based databases, the incidence rates of PLP after limb amputations were, in the order of frequency, GA, NA, and PNB.

5.
Article | WPRIM | ID: wpr-830478

ABSTRACT

Objective@#To investigate the articles in the Annals of Rehabilitation Medicine (ARM) using a bibliometric analysis to verify whether there is a correlation between the topics of interest for expert groups and the public media. @*Methods@#A total of 1,088 ARM articles from the third issue of 2011 to the third issue of 2019 were analyzed. We conducted a bibliometric analysis of the articles using conventional metrics (CM) and alternative metrics (AM). The CM was investigated by collating the type of publication, number of citations, and the specific field of rehabilitation medicine for each article. The AM was analyzed using the Altmetric Attention Score (AAS) provided by Altmetric, the leading AM company. The correlation between the number of citations and the AAS was tested using the Spearman rank correlation coefficient. @*Results@#The combined ratio of original articles and case reports was over 90% in this study; however, the total distribution was significantly different compared to previous bibliometric studies (p<0.05). There were 233 articles that satisfied both conditions of at least one citation and at least one AAS point. The number of citations and the AAS were found to have a statistically significant positive linear correlation on a scatter plot (r=0.216, p=0.001). @*Conclusion@#There is a significant correlation between AM and CM, which means itis important to increase the dissemination of academic knowledge through the public media and increase the status of the journal by increasing the citation-related index.

6.
Article in English | WPRIM | ID: wpr-785327

ABSTRACT

BACKGROUND: It is not possible to measure how much activity is required to understand and code a medical data. We introduce an assessment method in clinical coding, and applied this method to neurosurgical terms.METHODS: Coding activity consists of two stages. At first, the coders need to understand a presented medical term (informational activity). The second coding stage is about a navigating terminology browser to find a code that matches the concept (code-matching activity). Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT) was used for the coding system. A new computer application to record the trajectory of the computer mouse and record the usage time was programmed. Using this application, we measured the time that was spent. A senior neurosurgeon who has studied SNOMED CT has analyzed the accuracy of the input coding. This method was tested by five neurosurgical residents (NSRs) and five medical record administrators (MRAs), and 20 neurosurgical terms were used.RESULTS: The mean accuracy of the NSR group was 89.33%, and the mean accuracy of the MRA group was 80% (p=0.024). The mean duration for total coding of the NSR group was 158.47 seconds, and the mean duration for total coding of the MRA group was 271.75 seconds (p=0.003).CONCLUSION: We proposed a method to analyze the clinical coding process. Through this method, it was possible to accurately calculate the time required for the coding. In neurosurgical terms, NSRs had shorter time to complete the coding and higher accuracy than MRAs.


Subject(s)
Animals , Clinical Coding , Humans , Medical Informatics , Medical Record Administrators , Methods , Mice , Neurosurgeons , Systematized Nomenclature of Medicine
7.
Article in English | WPRIM | ID: wpr-728020

ABSTRACT

The authors note that on page 685, the acknowledgement of “This study was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (No. 2017R1D1A1B03031920),” should instead appear as “This study was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (No. 2017R1D1A1B03031920) and Chung-Ang University Research Grants in 2017.”

8.
Article in English | WPRIM | ID: wpr-715617

ABSTRACT

In this study, we investigated the effects of pelargonidin, an anthocyanidin found in many fruits and vegetables, on endothelium-independent vascular contractility to determine the underlying mechanism of relaxation. Isometric contractions of denuded aortic muscles from male rats were recorded, and the data were combined with those obtained in western blot analysis. Pelargonidin significantly inhibited fluoride-, thromboxane A2-, and phorbol ester-induced vascular contractions, regardless of the presence or absence of endothelium, suggesting a direct effect of the compound on vascular smooth muscles via a different pathway. Pelargonidin significantly inhibited the fluoride-dependent increase in the level of myosin phosphatase target subunit 1 (MYPT1) phosphorylation at Thr-855 and the phorbol 12,13-dibutyrate-dependent increase in the level of extracellular signal-regulated kinase (ERK) 1/2 phosphorylation at Thr202/Tyr204, suggesting the inhibition of Rho-kinase and mitogen-activated protein kinase kinase (MEK) activities and subsequent phosphorylation of MYPT1 and ERK1/2. These results suggest that the relaxation effect of pelargonidin on agonist-dependent vascular contractions includes inhibition of Rho-kinase and MEK activities, independent of the endothelial function.


Subject(s)
Animals , Anthocyanins , Aorta , Blotting, Western , Endothelium , Fluorides , Fruit , Humans , Isometric Contraction , Male , Muscle, Smooth, Vascular , Muscles , Myosin-Light-Chain Phosphatase , Phosphorylation , Phosphotransferases , Protein Kinases , Rats , Relaxation , rho-Associated Kinases , Vasoconstriction , Vegetables
9.
Article in Korean | WPRIM | ID: wpr-715025

ABSTRACT

OBJECTIVE: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national health insurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budget effectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by some stakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated the impacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. METHODS: The impact of RSA was investigated by analyzing the health insurance claims data for 2014~2016. The degree of improvement in patient access was determined by the decreased amount of patients' payment. RESULTS: Results showed that the financial impact of RSA was not significant and patients' access to the new drug greatly improved. CONCLUSION: These results show that RSA is a good system for improving patient access to new drugs without additional expense on insurance.


Subject(s)
Budgets , Humans , Insurance Carriers , Insurance , Insurance, Health , National Health Programs
10.
Article in English | WPRIM | ID: wpr-714066

ABSTRACT

The widespread application of ultrasound in clinical anesthesiology has led to an increase in the number of practitioners performing peripheral nerve blocks of the trunk to produce analgesia and anesthesia for surgeries involving the thorax, abdomen, and lower extremities. The use of real-time ultrasound has allowed the peripheral nerves, planes, and plexuses of the trunk to be located more accurately and has improved the success rate of blocks. Compared to central neuraxial techniques, many types of truncal blocks are relatively easy to perform and have low side effect profiles. As a result, truncal blocks have been introduced to provide perioperative analgesia for surgeries involving the thorax and abdomen. The most frequently used truncal block techniques include the paravertebral block, intercostal block, pectoralis and serratus anterior block, rectus sheath block, transversus abdominis plane block, and ilioinguinal and iliohypogastric nerve blocks. Recently introduced techniques also include the quadratus lumborum and erector spinae plane blocks. To apply each block correctly and reduce the likelihood of related side effects and complications, the practitioner must have a thorough understanding of the anatomical region, optimal block positioning, and device selection and management.


Subject(s)
Abdomen , Analgesia , Anesthesia and Analgesia , Anesthesiology , Lower Extremity , Nerve Block , Peripheral Nerves , Thorax , Ultrasonography
11.
Article in English | WPRIM | ID: wpr-717861

ABSTRACT

OBJECTIVE: We hypothesized that open bronchi within target pulmonary lesions are associated with percutaneous transthoracic needle biopsy (PTNB)-related hemoptysis. We sought to analyze and compare patient characteristics and target features as well as biopsy-related factors between patients with and without PTNB-related hemoptysis. MATERIALS AND METHODS: We retrospectively analyzed 1484 patients (870 males and 614 females; median age, 66 years) who had undergone 1569 cone-beam CT (CBCT)-guided PTNBs. Patient characteristics (sex, age, and pathologic diagnosis), nodule features (nodule type, size, location, and presence of an open bronchus in target nodules), and biopsy-related factors (biopsy needle size, pleura-to-target distance, blood test results, open bronchus unavoidability [OBU] index, etc.) were investigated. OBU index, which was assessed using the pre-procedural CBCT, was a subjective scoring system for the probability of needle penetration into the open bronchus. Univariate analysis and subsequent multivariate logistic regression analysis were conducted to reveal the independent risk factors for PTNB-related hemoptysis. For a subgroup of nodules with open bronchi, a trend analysis between the occurrence of hemoptysis and the OBU index was performed. RESULTS: The independent risk factors for hemoptysis were sex (female; odds ratio [OR], 1.918; p < 0.001), nodule size (OR, 0.837; p < 0.001), open bronchus (OR, 2.101; p < 0.001), and pleura-to-target distance (OR, 1.135; p = 0.003). For the target nodules with open bronchi, a significant trend between hemoptysis and OBU index (p < 0.001) was observed. CONCLUSION: An open bronchus in a biopsy target is an independent predictor of hemoptysis, and careful imaging review may potentially reduce PTNB-related hemoptysis.


Subject(s)
Biopsy , Biopsy, Needle , Bronchi , Cone-Beam Computed Tomography , Female , Hematologic Tests , Hemoptysis , Humans , Image-Guided Biopsy , Logistic Models , Lung Neoplasms , Male , Needles , Odds Ratio , Retrospective Studies , Risk Factors
12.
Article in English | WPRIM | ID: wpr-727857

ABSTRACT

Autism spectrum disorders (ASDs) are neurodevelopmental disorders that share behavioral features, the results of numerous studies have suggested that the underlying causes of ASDs are multifactorial. Behavioral and/or neurobiological analyses of ASDs have been performed extensively using a valid model of prenatal exposure to valproic acid (VPA). Abnormal synapse formation resulting from altered neurite outgrowth in neural progenitor cells (NPCs) during embryonic brain development has been observed in both the VPA model and ASD subjects. Although several mechanisms have been suggested, the actual mechanism underlying enhanced neurite outgrowth remains unclear. In this study, we found that VPA enhanced the expression of brain-derived neurotrophic factor (BDNF), particularly mature BDNF (mBDNF), through dual mechanisms. VPA increased the mRNA and protein expression of BDNF by suppressing the nuclear expression of methyl-CpG-binding protein 2 (MeCP2), which is a transcriptional repressor of BDNF. In addition, VPA promoted the expression and activity of the tissue plasminogen activator (tPA), which induces BDNF maturation through proteolytic cleavage. Trichostatin A and sodium butyrate also enhanced tPA activity, but tPA activity was not induced by valpromide, which is a VPA analog that does not induce histone acetylation, indicating that histone acetylation activity was required for tPA regulation. VPA-mediated regulation of BDNF, MeCP2, and tPA was not observed in astrocytes or neurons. Therefore, these results suggested that VPA-induced mBDNF upregulation was associated with the dysregulation of MeCP2 and tPA in developing cortical NPCs.


Subject(s)
Acetylation , Astrocytes , Autism Spectrum Disorder , Brain , Brain-Derived Neurotrophic Factor , Butyric Acid , Histones , Methyl-CpG-Binding Protein 2 , Neurites , Neurodevelopmental Disorders , Neurons , RNA, Messenger , Stem Cells , Synapses , Tissue Plasminogen Activator , Up-Regulation , Valproic Acid
13.
Article in Korean | WPRIM | ID: wpr-39478

ABSTRACT

Provisional restoration plays an important role in the process of restoration with fixed partial denture by providing protection and restoring function and esthetics of abutment tooth. This is especially true in patients requiring use of provisional prosthesis for a long term. However, such situations may lead to higher possibility of provisional prosthesis fracture, and if expected so, reinforcement of provisional prosthesis should be considered. In this article, a patient requiring prosthetic treatment with increase of vertical dimension of occlusion was introduced. Due to increased vertical dimension of occlusion, the provisional restoration was expected to withstand relatively larger amount of load during a relatively long observation period. In order to minimize possible occurrence of fracture, reinforcement of the provisional restoration was sought by insertion of cast-metal framework and by using bis-acryl resin. The reinforced provisional restoration showed satisfactory results during the observation period of 4 months.


Subject(s)
Acrylic Resins , Dental Casting Technique , Denture, Partial, Fixed , Esthetics , Humans , Prostheses and Implants , Tooth , Vertical Dimension
14.
Article in English | WPRIM | ID: wpr-18839

ABSTRACT

The canonical Wnt pathway is critical for embryonic stem cell (ESC) pluripotency and aberrant control of β-catenin leads to failure of exit from pluripotency and lineage commitments. Hence, maintaining the appropriate level of β-catenin is important for the decision to commit to the appropriate lineage. However, how β-catenin links to core transcription factors in ESCs remains elusive. C-terminal-binding protein (CtBP) in Drosophila is essential for Wnt-mediated target gene expression. In addition, Ctbp acts as an antagonist of β-catenin/TCF activation in mammals. Recently, Ctbp2, a core Oct4-binding protein in ESCs, has been reported to play a key role in ESC pluripotency. However, the significance of the connection between Ctbp2 and β-catenin with regard to ESC pluripotency remains elusive. Here, we demonstrate that C-terminal-binding protein 2 (Ctbp2) associates with major components of the β-catenin destruction complex and limits the accessibility of β-catenin to core transcription factors in undifferentiated ESCs. Ctbp2 knockdown leads to stabilization of β-catenin, which then interacts with core pluripotency-maintaining factors that are occupied by Ctbp2, leading to incomplete exit from pluripotency. These findings suggest a suppressive function for Ctbp2 in reducing the protein level of β-catenin, along with priming its position on core pluripotency genes to hinder β-catenin deposition, which is central to commitment to the appropriate lineage.


Subject(s)
Drosophila , Embryonic Stem Cells , Gene Expression , Mammals , Transcription Factors , Wnt Signaling Pathway
15.
Article in English | WPRIM | ID: wpr-211472

ABSTRACT

PURPOSE: Although magnetic attachment is used frequently for overdenture, it is reported that attractive force can be decreased by abrasion and corrosion. The purpose of this study was to establish the clinical basis about considerations and long term prognosis of overdenture using magnetic attachments by investigating the change in attractive force of magnetic attachment applied to the patients. MATERIALS AND METHODS: Among the patients treated with overdenture using magnetic attachments in Dankook University Dental Hospital, attractive force records of 61 magnetic attachments of 20 subjects who re-visited from July 2013 to June 2014 were analyzed. Dental magnet tester (Aichi Micro Intelligent Co., Aichi, Japan) was used for measurement. The magnetic attachments used in this study were Magfit IP-B Flat, Magfit DX400, Magfit DX600 and Magfit DX800 (Aichi Steel Co., Aichi, Japan) filled with Neodymium (NdFeB), a rare-earth magnet. RESULTS: Reduction ratio of attractive force had no significant correlation with conditional variables to which attachments were applied, and was higher when the maintenance period was longer (P<.05, r=.361). Reduction ratio of attractive force was significantly higher in the subject group in which attachments were used over 9 years than within 9 years (P<.05). Furthermore, 16.39% of total magnetic attachments showed detachment of keeper or assembly. CONCLUSION: Attractive force of magnetic attachment is maintained regardless of conditional variables and reduction ratio increased as the maintenance period became longer. Further study on adhesive material, attachment method and design improvement to prevent detachment of magnetic attachment is needed.


Subject(s)
Adhesives , Corrosion , Denture, Overlay , Effect Modifier, Epidemiologic , Humans , Neodymium , Prognosis , Steel
16.
Article in English | WPRIM | ID: wpr-210166

ABSTRACT

The C-terminal domain of RNA polymerase II is an unusual series of repeated residues appended to the C-terminus of the largest subunit and serves as a flexible binding scaffold for numerous nuclear factors. The binding of these factors is determined by the phosphorylation patterns on the repeats in the domain. In this study, we generated a synthetic antibody library by replacing the third heavy chain complementarity-determining region of an anti-HER2 (human epidermal growth factor receptor 2) antibody (trastuzumab) with artificial sequences of 7–18 amino-acid residues. From this library, antibodies were selected that were specific to serine phosphopeptides that represent typical phosphorylation patterns on the functional unit (YSPTSPS)₂ of the RNA polymerase II C-terminal domain (CTD). Antibody clones pCTD-1stS2 and pCTD-2ndS2 showed specificity for peptides with phosphoserine at the second residues of the first or second heptamer repeat, respectively. Additional clones specifically reacted to peptides with phosphoserine at the fifth serine of the first repeat (pCTD-1stS5), the seventh residue of the first repeat and fifth residue of the second repeat (pCTD-S7S5) or the seventh residue of either the first or second repeat (pCTD-S7). All of these antibody clones successfully reacted to RNA polymerase II in immunoblot analysis. Interestingly, pCTD-2ndS2 precipitated predominately RNA polymerase II from the exonic regions of genes in genome-wide chromatin immunoprecipitation sequencing analysis, which suggests that the phosphoserine at the second residue of the second repeat of the functional unit (YSPTSPS)2 is a mediator of exon definition.


Subject(s)
Antibodies , Chromatin Immunoprecipitation , Clone Cells , Complementarity Determining Regions , DNA-Directed RNA Polymerases , Exons , Peptides , Phosphopeptides , Phosphorylation , Phosphoserine , ErbB Receptors , RNA Polymerase II , RNA , Sensitivity and Specificity , Serine
17.
Article in Korean | WPRIM | ID: wpr-647828

ABSTRACT

PURPOSE: The objective of this study is to analyze the radiologic fusion rate in posterior lumbar interbody fusion (PLIF) using silicon-containing porous hydroxyapatite (Si-HA) chips packed within a cage. MATERIALS AND METHODS: Twelve patients who underwent PLIF using Si-HA (BoneMedik-S(TM); Meta-Biomed, Cheongju, Korea) blocks packed within a cage were enrolled. PLIF was performed in the same manner in all patients. A cage filled with Si-HA was inserted into disc space. Serial X-rays and 3-dimensional computed tomography (3D-CT) were performed for evaluation of the fusion status. RESULTS: At postoperative 12 months, 11 cases showed grade IV and one case showed grade III on X-rays. At postoperative 24 months, all cases showed grade IV (complete fusion). Assessment of fusion by 3D-CT also showed grade I in all cases at postoperative 12 months. CONCLUSION: Considering the above results, Si-HA packed in a cage appears to be an effective bone graft material for use in PLIF.


Subject(s)
Durapatite , Humans , Lumbar Vertebrae , Spine , Transplants
18.
Article in Korean | WPRIM | ID: wpr-171203

ABSTRACT

Loss of continuity of the mandible destroys the balance and symmetry of mandibular function, leading to altered mandibular movements and deviation of the residual fragment towards the resected side. Apart from deviation, other dysfunctions include difficulty in swallowing, speech, mandibular movements, mastication, and respiration are accompanied. In general, surgical reconstruction is considered first then proceeds to the prosthetic restorations. However, patients with systemic disease such as BRONJ (Bisphosphonate related osteonecrosis of the Jaw), surgical reconstruction may be limited. Thus, the prosthetic restoration remains as the only resort. Numerous prosthetic methods are employed to minimize deviation and to improve masticatory efficiency, function and esthetics. If a removable partial denture is the selected treatment modality, maximum stability of the partial denture base may be accomplished with a functional impression procedure by means of eliminating lateral and horizontal forces caused by the functional movements of the lips, cheeks and tongue. Also, Twin occlusion is used to obtain a favorable occlusal relationship and check support for esthetics. The purpose of this case report is to demonstrate how neutral zone impression technique and twin occlusion scheme were applied to restore a hemi-mandiblectomy patient with BRONJ syndrome to achieve satisfactory results in functional and esthetic aspects.


Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw , Cheek , Deglutition , Denture, Partial , Denture, Partial, Removable , Esthetics , Health Resorts , Humans , Lip , Mandible , Mandibular Osteotomy , Mastication , Osteonecrosis , Rehabilitation , Respiration , Tongue
19.
Article in Korean | WPRIM | ID: wpr-228688

ABSTRACT

PURPOSE: In this study, the diameter of each implant driver was measured and compared to find out the compatibility of implant drivers. MATERIALS AND METHODS: Drivers from 12 implant systems being used in Dankook University Dental Hospital were included in this study. The shapes of the implant drivers were segregated, and the effective length and the diameter of upper, middle, lower part of driver tips were measured (n=10). The measured data were mathematically analyzed for its compatibility. RESULTS: A driver with the smallest diameter (1.17 mm) had the highest compatibility at the upper part of driver tip. This driver could be used for a bigger driver up to 1.35 mm in diameter. There were several driver groups which had the same diameter so as to be interchangeable each other. In the middle part, the smallest diameter measured was 1.2 mm and this was able to replace a driver up to 1.40 mm diameter. Since the diameter generally became thicker from upper part (the tip of driver) to the lower part (the shank of driver), some drivers with bigger diameter at the upper part so which was failed to show any compatibility became compatible with a driver which had smaller diameter at the upper part but wider in the middle part. The compatibility of torx shape drivers were affected by the inner diameter of the drivers not only by the outer diameter. Furthermore, the inner diameter of torx drivers decided the compatibility between torx and hex drivers. CONCLUSION: From the study it was found that compatibility in drivers existed among certain implant systems and to check its compatibility the diameter at a certain effective length should be measured. However, there has been not enough studies about long-term use of compatible drivers, so effects of using compatible drivers on drivers and implants are unknown. Therefore, usage in inevitable cases only is recommended and further study is needed.

20.
The Korean Journal of Pain ; : 178-185, 2014.
Article in English | WPRIM | ID: wpr-188385

ABSTRACT

Epidural adhesions cause pain by interfering with the free movement of the spinal nerves and increasing neural sensitivity as a consequence of neural compression. To remove adhesions and deliver injected drugs to target sites, percutaneous epidural adhesiolysis (PEA) is performed in patients who are unresponsive to conservative treatments. We describe four patients who were treated with a newly developed inflatable balloon catheter for more effective PEA and relief of stenosis. In the present patients, treatments with repetitive epidural steroid injection and/or PEA with the Racz catheter or the NaviCath did not yield long-lasting effects or functional improvements. However, PEA and decompression with the inflatable balloon catheter led to maintenance of pain relief for more than seven months and improvements in the functional status with increases in the walking distance. The present case series suggests that the inflatable balloon catheter may be an effective alternative to performing PEA when conventional methods fail to remove adhesions or sufficiently relieve stenosis.


Subject(s)
Catheters , Constriction, Pathologic , Decompression , Humans , Peas , Spinal Nerves , Spinal Stenosis , Walking
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