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1.
Article in English | WPRIM | ID: wpr-915530

ABSTRACT

Background@#During the coronavirus disease 2019 (COVID-19) pandemic, the incidence of rhinovirus (RV) is inversely related to the intensity of non-pharmacological interventions (NPIs), such as universal mask wearing and physical distancing. @*Methods@#Using RV surveillance data, changes in the effect of NPIs were investigated in South Korea during the pandemic. The time to the first visible effect of NPIs after the onset of NPIs (T1), time to the maximum effect (T2), and duration of the maximum effect (T3) were measured for each surge. For each week, the RVdiff [(RV incidence during the pandemic) − (RV incidence within 5 years before the pandemic)] was calculated, and number of weeks for RVdiff to be below zero after NPIs (time to RVdiff ≤ 0) and number of weeks RVdiff remains below zero after NPIs (duration of RVdiff ≤ 0) were measured for each surge. @*Results@#During the study period, four surges of COVID-19 were reported. As the pandemic progressed, T1 and T2 increased, but T3 decreased. Additionally, the “time to RVdiff of ≤ 0” increased and “duration of RVdiff of ≤ 0” decreased. These changes became more pronounced during the third surge (mid-November 2020), before the introduction of the COVID-19 vaccine, and from the emergence of the delta variant. @*Conclusion@#The effect of NPIs appears slower, the duration of the effect becomes shorter, and the intensity also decreases less than a year after the onset of the pandemic owing to people’s exhaustion in implementing NPIs. These findings suggest that the COVID-19 response strategy must be completely overhauled

2.
Article in English | WPRIM | ID: wpr-892154

ABSTRACT

Background@#The temporal changes in the Staphylococcus aureus genotypes causing S. aureusbacteremia (SAB) and the corresponding clinical changes over the last decade in South Korea are rarely investigated. @*Methods@#A longitudinal study of adult SAB patients was conducted in a large referral hospital in Seoul, South Korea. Adult monomicrobial SAB patients were enrolled between August 2008 and December 2018. Genotyping was performed by multilocus sequence typing (MLST) and staphylococcal protein A (spa) typing. Trends in changes were identified by linear regression analysis. @*Results@#Of 1782 adult SAB patients, the blood isolates of 1,778 (99.8%) and 1,634 (91.7%) were determined to be MLST and spa type, respectively. ST5 (–2.626%/year) and ST239 (–0.354%/year) decreased during the study period (P < 0.001 for both), but ST72 (2.009%/ yr)-and ST8 (0.567%/yr) increased (P < 0.001 for both). The most common genotype was changed from ST5 in 2008 (44.9%) to ST72 in 2018 (36.3%). Panton-Valentine leukocidinpositive spa-t008-MRSA (USA300) was found in 28.6%. Central venous catheter (CVC)-related SAB (–2.440%/yr) and persistent SAB (–1.016%/yr) decreased, but mortality and recurrence rates were unchanged. @*Conclusion@#Over the last decade, the hospital clones ST5 and ST239 have been replaced by community genotype ST72. This was associated with decreased CVC-related and persistent SAB. Increased USA300 was observed in community and hospital settings. Further research is required to identify the reasons for the ST72 epidemic and predict the impending epidemic of ST8 strains, including USA300.

3.
Article in English | WPRIM | ID: wpr-890932

ABSTRACT

Background@#Pyomyositis (PM) is a serious soft tissue infection and despite its clinical importance, previous studies have not been able to fully determine the clinical characteristics and microbial epidemiology of PM in Korea, which we therefore aimed to investigate. @*Materials and Methods@#We retrospectively identified 140 adult patients diagnosed with PM from 13 general hospitals between January 2012 and December 2015. We analyzed the clinical and microbial characteristics of community-onset PM and compared them with communityacquired (CA) and healthcare-associated (HCA) PM. @*Results@#One hundred eleven organisms were isolated from 96 (68.6%) patients with PM.Staphylococcus aureus (38 patients) was the most common pathogen, followed by streptococci (24 patients), and enteric Gram-negative organisms (27 patients). Methicillin-resistant S.aureus (MRSA) was identified in four (2.9%) patients and in-hospital mortality reached 8.6% (12/140). Enterococci isolates were identified in the HCA PM subgroup only The proportion of MRSA isolates was not comparable between CA and HCA PM subgroups. In the 83 patients with PM infected by monomicrobial pathogens, isolates of Gram-negative organisms were more commonly found in HCA PM subgroup than in CA PM subgroup (47.6% [10/21] of patients with HCA PM vs. 20.7% [12/58] of patients with CA PM; P = 0.01). @*Conclusion@#Gram-positive cocci such as S. aureus and streptococci were dominant etiologies in community-onset PM, whereas MRSA appears to an uncommon causative organism of PM in Korea. Enteric Gram-negative organisms should also be considered as major etiologies, especially in HCA PM patient population in Korea.

4.
Article in English | WPRIM | ID: wpr-874152

ABSTRACT

Background@#Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains were first detected in hospitals in Korea between the late 2000s and early 2010s.However, there is limited information regarding the prevalence of CA-MRSA strains among hospital isolates and their phenotypic changes over the last decade. We investigated the prevalence trend of CA-MRSA strains isolated from different clinical specimens and their phenotypic changes between September 2009 and September 2019. @*Methods@#CA-MRSA strains were phenotypically identified by confirming their resistance to penicillin (PCN) and oxacillin (OXA) and evaluating their susceptibility to trimethoprimsulfamethoxazole, rifampin, fusidic acid, tetracycline, and at least one of the following four antimicrobials: clindamycin (CLI), erythromycin (ERY), ciprofloxacin (CIP), and gentamicin (GEN). A CA-MRSA strain that exhibited resistance to ERY, CLI, CIP, or GEN was classified as having resistance pattern I, II, III, or IV, respectively, regardless of its resistance to other antimicrobial agents. @*Results@#Of the 8,278 MRSA isolates identified in specimens obtained two days after admission, 1,385 (16.73%) were CA-MRSA strains. The prevalence of CA-MRSA strains increased from 12.2% to 26.6% (3.21% per period, P = 0.05). Resistance type analysis revealed an increasing trend in the prevalence of PCN/OXA-resistant (1.84%; P = 0.049) and PCN/OXA/ERY/CLI/CIP-resistant (0.98%; P = 0.04) CA-MRSA strains and in resistance pattern III strains (2.08%; P = 0.004). @*Conclusions@#The prevalence of CA-MRSA strains in Korea has increased significantly over the last decade, and CA-MRSA strains have gained phenotypic diversity beyond PCN/OXAresistance, including antimicrobial resistance to non-β-lactams, especially CIP.

5.
Article in English | WPRIM | ID: wpr-899858

ABSTRACT

Background@#The temporal changes in the Staphylococcus aureus genotypes causing S. aureusbacteremia (SAB) and the corresponding clinical changes over the last decade in South Korea are rarely investigated. @*Methods@#A longitudinal study of adult SAB patients was conducted in a large referral hospital in Seoul, South Korea. Adult monomicrobial SAB patients were enrolled between August 2008 and December 2018. Genotyping was performed by multilocus sequence typing (MLST) and staphylococcal protein A (spa) typing. Trends in changes were identified by linear regression analysis. @*Results@#Of 1782 adult SAB patients, the blood isolates of 1,778 (99.8%) and 1,634 (91.7%) were determined to be MLST and spa type, respectively. ST5 (–2.626%/year) and ST239 (–0.354%/year) decreased during the study period (P < 0.001 for both), but ST72 (2.009%/ yr)-and ST8 (0.567%/yr) increased (P < 0.001 for both). The most common genotype was changed from ST5 in 2008 (44.9%) to ST72 in 2018 (36.3%). Panton-Valentine leukocidinpositive spa-t008-MRSA (USA300) was found in 28.6%. Central venous catheter (CVC)-related SAB (–2.440%/yr) and persistent SAB (–1.016%/yr) decreased, but mortality and recurrence rates were unchanged. @*Conclusion@#Over the last decade, the hospital clones ST5 and ST239 have been replaced by community genotype ST72. This was associated with decreased CVC-related and persistent SAB. Increased USA300 was observed in community and hospital settings. Further research is required to identify the reasons for the ST72 epidemic and predict the impending epidemic of ST8 strains, including USA300.

6.
Article in English | WPRIM | ID: wpr-898636

ABSTRACT

Background@#Pyomyositis (PM) is a serious soft tissue infection and despite its clinical importance, previous studies have not been able to fully determine the clinical characteristics and microbial epidemiology of PM in Korea, which we therefore aimed to investigate. @*Materials and Methods@#We retrospectively identified 140 adult patients diagnosed with PM from 13 general hospitals between January 2012 and December 2015. We analyzed the clinical and microbial characteristics of community-onset PM and compared them with communityacquired (CA) and healthcare-associated (HCA) PM. @*Results@#One hundred eleven organisms were isolated from 96 (68.6%) patients with PM.Staphylococcus aureus (38 patients) was the most common pathogen, followed by streptococci (24 patients), and enteric Gram-negative organisms (27 patients). Methicillin-resistant S.aureus (MRSA) was identified in four (2.9%) patients and in-hospital mortality reached 8.6% (12/140). Enterococci isolates were identified in the HCA PM subgroup only The proportion of MRSA isolates was not comparable between CA and HCA PM subgroups. In the 83 patients with PM infected by monomicrobial pathogens, isolates of Gram-negative organisms were more commonly found in HCA PM subgroup than in CA PM subgroup (47.6% [10/21] of patients with HCA PM vs. 20.7% [12/58] of patients with CA PM; P = 0.01). @*Conclusion@#Gram-positive cocci such as S. aureus and streptococci were dominant etiologies in community-onset PM, whereas MRSA appears to an uncommon causative organism of PM in Korea. Enteric Gram-negative organisms should also be considered as major etiologies, especially in HCA PM patient population in Korea.

7.
Article in English | WPRIM | ID: wpr-915366

ABSTRACT

Purpose@#(i) To evaluate the biologic properties of a bi-layered 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride-cross-linked collagen membrane (CCM) In Vitro. (ii) To assess the efficacy of CCM for localized bone regeneration In Vivo. @*Materials and Methods@#Biodegradation of CCM compared to a native collagen membrane (NCM) was assessed In Vitro. In Vivo, twelve male New Zealand White rabbits were used. Four calvarial, circular defects (diameter 8 mm) were created in each animal. The sites were randomly allocated to i) CCM+biphasic calcium phosphate (BCP) (CCM-BCP group), ii) CCM alone (CCM), iii) BCP alone (BCP) and, iv) negative control (control). Animals were sacrificed at 2 (n=6) and 8 weeks (n=6). Outcome measures included: micro-computed tomography (μCT) analysis (total augmented volume [TAV], new bone volume) and histomorphometry (total augmented area [TAA], newly formed bone, remaining membrane thickness [RMT]).Result: CCM was more resistant to degradation than NCM. μCT analysis showed CCM-BCP (196.43±25.30 mm 3 ) and BCP (206.23±39.13 mm 3 ) groups had significantly (P<0.01) larger TAV than the control (149.72±12.28 mm 3 ) after 8 weeks. Histomorphometrically, CCM-BCP group (17.75±5.97 mm 2 ) had significantly (P<0.01) greater TAA compared to the CCM group (7.74±2.25 mm 2 ) and the control (8.13±1.81 mm 2 ) after 8 weeks. After 8 weeks, RMT was reduced by 67%. @*Conclusion@#CCM can be a favorable choice of barrier membrane when performing guided bone regeneration (GBR) in localized bone defects. CCM has better resistance to degradation than the natural collagen membrane, In Vitro. In Vivo, CCM provides an advantageous integration of prolonged barrier function and biocompatibility for GBR.

8.
Article in English | WPRIM | ID: wpr-915365

ABSTRACT

Purpose@#The alveolar ridge preservation (ARP) is widely conducted for implant placement. However, experimental results using deproteinized porcine bone mineral (DPBM) have been scarce. This retrospective study evaluated factors affecting the primary stability of implants in an area where ARP was performed using DPBM. @*Materials and Methods@#Thirty-eight patients were divided into two groups based on the primary stability, with torque value of 30 Ncm as borderline. To determine the factors that affect the primary stability of implants, we collected data from patients’ medical records including age, sex, reentry time, socket location, remaining bone wall at the time of extraction, and type of collagen membrane, as well as from radiographs and histomorphometric analysis.Result: The results showed statistically significant difference for the remaining extraction socket wall (P=0.014), residual graft (P=0.029), and fibrovascular tissue (P=0.02) between the two groups. There was an insignificant tendency toward the time of reentry surgery (P=0.052) and location (P=0.077). All implants placed in sites using DPBM functioned well up to 3 years. @*Conclusion@#Within the limitations of the present study, extraction socket wall, residual graft, and fibrovascular tissue can affect the primary stability at the time of implant placement on grafted sites using DPBM and collagen membranes. In addition, reentry time and locations can be considered. In future studies, comparative experiments in quantified models will be required to supporting the findings.

9.
Article in English | WPRIM | ID: wpr-914930

ABSTRACT

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.

10.
Korean Journal of Medicine ; : 134-140, 2020.
Article | WPRIM | ID: wpr-836674

ABSTRACT

Respiratory tract infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originating from China began in late 2019 and became prevalent worldwide in early 2020. Korea was one of the closest countries to China and was forced to go through this pandemic. In the absence of vaccines or effective antiviral drugs, we have no choice but to re-use the old preventive measures used by humans in the past. In this review, I would like to discuss the preventive measures used in Korea during the pandemic.

11.
Article | WPRIM | ID: wpr-835975

ABSTRACT

Irritation fibroma is a reactive hyperplastic lesion caused by chronic stimuli with low intensity in the oral cavity. Irritation fibroma is common in middle-aged females but it may also occur at any age and sex. Clinical characteristics of irritation fibroma are similar to other reactive lesions or benign tumors, therefore, histological examination is essential to make an accurate diagnosis. This case report presents two cases of irritation fibroma occurred on the gingiva in young males. Two male patients in their 20s and 30s of age visited the clinic for the evaluation and treatment of painless gingival overgrowth in the anterior region. Clinically, the lesions were well-defined and firm, with similar color and texture to the adjacent normal gingiva. Excisional biopsy under local anesthesia was conducted with a scalpel, and the lesions were completely removed. Histopathologically, connective tissue consisting of dense collagen bundles, proliferation of fibroblasts and minor infiltrated inflammatory cells were observed. Based on the clinical and histopathological findings, the diagnosis of irritation fibroma was confirmed in both cases.

12.
Article in English | WPRIM | ID: wpr-811261

ABSTRACT

PURPOSE: To overcome several drawbacks of chemically-crosslinked collagen membranes, modification processes such as ultraviolet (UV) crosslinking and the addition of biphasic calcium phosphate (BCP) to collagen membranes have been introduced. This study evaluated the efficacy and biocompatibility of BCP-supplemented UV-crosslinked collagen membrane for guided bone regeneration (GBR) in a rabbit calvarial model.METHODS: Four circular bone defects (diameter, 8 mm) were created in the calvarium of 10 rabbits. Each defect was randomly allocated to one of the following groups: 1) the sham control group (spontaneous healing); 2) the M group (defect coverage with a BCP-supplemented UV-crosslinked collagen membrane and no graft material); 3) the BG (defects filled with BCP particles without membrane coverage); and 4) the BG+M group (defects filled with BCP particles and covered with a BCP-supplemented UV-crosslinked collagen membrane in a conventional GBR procedure). At 2 and 8 weeks, rabbits were sacrificed, and experimental defects were investigated histologically and by micro-computed tomography (micro-CT).RESULTS: In both micro-CT and histometric analyses, the BG and BG+M groups at both 2 and 8 weeks showed significantly higher new bone formation than the control group. On micro-CT, the new bone volume of the BG+M group (48.39±5.47 mm3) was larger than that of the BG group (38.71±2.24 mm3, P=0.032) at 8 weeks. Histologically, greater new bone area was observed in the BG+M group than in the BG or M groups. BCP-supplemented UV-crosslinked collagen membrane did not cause an abnormal cellular reaction and was stable until 8 weeks.CONCLUSIONS: Enhanced new bone formation in GBR can be achieved by simultaneously using bone graft material and a BCP-supplemented UV-crosslinked collagen membrane, which showed high biocompatibility and resistance to degradation, making it a biocompatible alternative to chemically-crosslinked collagen membranes.


Subject(s)
Absorbable Implants , Animals , Bone Regeneration , Calcium , Collagen , Membranes , Osteogenesis , Rabbits , Skull , Transplants , Ultraviolet Rays
13.
Article in English | WPRIM | ID: wpr-900524

ABSTRACT

Purpose@#This study was conducted to analyze specific RNA expression profiles in gingival tissue and saliva samples in periodontitis patients and healthy individuals, and to determine their correlations in light of the potential use of microarray-based analyses of saliva samples as a periodontal monitoring tool. @*Methods@#Gingival tissue biopsies and saliva samples from 22 patients (12 with severe periodontitis and 10 with a healthy periodontium) were analyzed using transcriptomic microarray analysis. Differential gene expression was assessed, and pathway and clustering analyses were conducted for the samples. The correlations between the results for the gingival tissue and saliva samples were analyzed at both the gene and pathway levels. @*Results@#There were 621 differentially expressed genes (DEGs; 320 upregulated and 301 downregulated) in the gingival tissue samples of the periodontitis group, and 154 DEGs (44 upregulated and 110 downregulated) in the saliva samples. Nine of these genes overlapped between the sample types. The periodontitis patients formed a distinct cluster group based on gene expression profiles for both the tissue and saliva samples. Database for Annotation, Visualization and Integrated Discovery analysis revealed 159 enriched pathways from the tissue samples of the periodontitis patients, as well as 110 enriched pathways In the saliva samples. Thirty-four pathways overlapped between the sample types. @*Conclusions@#The present results indicate the possibility of using the salivary transcriptome to distinguish periodontitis patients from healthy individuals. Further work is required to enhance the extraction of available RNA from saliva samples.

14.
Article in English | WPRIM | ID: wpr-892820

ABSTRACT

Purpose@#This study was conducted to analyze specific RNA expression profiles in gingival tissue and saliva samples in periodontitis patients and healthy individuals, and to determine their correlations in light of the potential use of microarray-based analyses of saliva samples as a periodontal monitoring tool. @*Methods@#Gingival tissue biopsies and saliva samples from 22 patients (12 with severe periodontitis and 10 with a healthy periodontium) were analyzed using transcriptomic microarray analysis. Differential gene expression was assessed, and pathway and clustering analyses were conducted for the samples. The correlations between the results for the gingival tissue and saliva samples were analyzed at both the gene and pathway levels. @*Results@#There were 621 differentially expressed genes (DEGs; 320 upregulated and 301 downregulated) in the gingival tissue samples of the periodontitis group, and 154 DEGs (44 upregulated and 110 downregulated) in the saliva samples. Nine of these genes overlapped between the sample types. The periodontitis patients formed a distinct cluster group based on gene expression profiles for both the tissue and saliva samples. Database for Annotation, Visualization and Integrated Discovery analysis revealed 159 enriched pathways from the tissue samples of the periodontitis patients, as well as 110 enriched pathways In the saliva samples. Thirty-four pathways overlapped between the sample types. @*Conclusions@#The present results indicate the possibility of using the salivary transcriptome to distinguish periodontitis patients from healthy individuals. Further work is required to enhance the extraction of available RNA from saliva samples.

15.
Article in English | WPRIM | ID: wpr-719659

ABSTRACT

PURPOSE: Recent studies have suggested microscopic positive resection margin should be revised according to the presence of tumor cells within 1mm of the margin surface in resected specimens of pancreatic cancer. However, the clinical meaning of this revised margin status for R1 resection margin was not fully clarified. METHODS: From July 2012 to December 2014, the medical records of 194 consecutive patients who underwent pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head were analyzed retrospectively. They were divided into 3 groups on margin status; revised microscopic negative margin (rR0) – tumor exists more than 1 mm from surgical margin, revised microscopic positive margin (rR1) – tumor present within less than 1 mm from surgical margin, classic microscopic positive margin (cR1) – tumor is exposed to surgical margin. RESULTS: There were 76 rR0 (39.2%), 100 rR1 (51.5%), and 18 cR1 (9.3%). There was significant difference in disease-free survival rates between cR1 vs. rR1 (8.4 months vs. 24.0 months, P = 0.013). Margin status correlated with local recurrence rate (17.1% in rR0, 26.0% in rR1, and 44.4% in cR1, P = 0.048). There is significant difference in recurrence at tumor bed (11.8% in rR0 vs. 23.0 in rR1, P = 0.050). Of rR1, adjuvant treatment was found to be an independent risk factor for local recurrence (hazard ratio, 0.297; 95% confidence interval, 0.127–0.693, P = 0.005). CONCLUSION: Revised R1 resection margin (rR1) affects recurrence at the tumor bed. Adjuvant treatment significantly reduced local recurrence of rR1. Accordingly, adjuvant chemoradiation for rR1 group should be taken into account.


Subject(s)
Adenocarcinoma , Carcinoma, Pancreatic Ductal , Disease-Free Survival , Head , Humans , Medical Records , Pancreatic Neoplasms , Pancreaticoduodenectomy , Recurrence , Retrospective Studies , Risk Factors
16.
Article in English | WPRIM | ID: wpr-786138

ABSTRACT

No abstract available.

17.
Article in English | WPRIM | ID: wpr-786135

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the effectiveness of conventional sandblasted, large-grit, acid-etched (SLA) surface coated with a pH buffering solution based on surface wettability, blood protein adhesion, osteoblast affinity, and platelet adhesion and activation.METHODS: Titanium discs and implants with conventional SLA surface (SA), SLA surface in an aqueous calcium chloride solution (CA), and SLA surface with a pH buffering agent (SOI) were prepared. The wetting velocity was measured by the number of threads wetted by blood over an interval of time. Serum albumin adsorption was tested using the bicinchoninic acid assay and by measuring fluorescence intensity. Osteoblast activity assays (osteoblast adhesion, proliferation, differentiation, mineralization, and migration) were also performed, and platelet adhesion and activation assays were conducted.RESULTS: In both the wetting velocity test and the serum albumin adsorption assay, the SOI surface displayed a significantly higher wetting velocity than the SA surface (P=0.000 and P=0.000, respectively). In the osteoblast adhesion, proliferation, differentiation, and mineralization tests, the mean values for SOI were all higher than those for SA and CA. On the osteoblast migration, platelet adhesion, and activation tests, SOI also showed significantly higher values than SA (P=0.040, P=0.000, and P=0.000, respectively).CONCLUSIONS: SOI exhibited higher hydrophilicity and affinity for proteins, cells, and platelets than SA. Within the limits of this study, it may be concluded that coating an implant with a pH buffering agent can induce the attachment of platelets, proteins, and cells to the implant surface. Further studies should be conducted to directly compare SOI with other conventional surfaces with regard to its safety and effectiveness in clinical settings.


Subject(s)
Adsorption , Blood Platelets , Calcium Chloride , Coated Materials, Biocompatible , Dental Implants , Fluorescence , Hydrogen-Ion Concentration , Hydrophobic and Hydrophilic Interactions , Immunoassay , In Vitro Techniques , Miners , Osteoblasts , Serum Albumin , Surface Properties , Titanium , Wettability
18.
Article in English | WPRIM | ID: wpr-766093

ABSTRACT

PURPOSE: The aim of this study was to evaluate the computed tomography (CT) imaging findings and clinical symptoms of patients who complained of neurosensory disturbances after mandibular implant surgery, and to investigate the relationships of these parameters with the prognosis for recovery. METHODS: CT scans were reviewed in 56 patients with nerve disturbance after mandibular implant surgery. Two oral radiologists classified the imaging findings into intrusion, contact, close, and separate groups according to the distance from the inferior border of the implant to the roof of the mandibular canal (MC). The symptoms of 56 patients were classified into 8 groups and the frequency of each group was investigated. Patients were categorized according to symptom improvement into no recovery and recovery groups, and the relationships of recovery with the CT classification and specific symptom groups were analyzed. RESULTS: Thirty-eight of the 56 nerve disturbance cases showed improvement. The close and separate groups in the CT classification had a strong tendency for recovery (90.9% and 81.8%, respectively) (P<0.05). Although the lowest recovery rate was found in the intrusion group, it was non-negligible, at 50%. The 6 patients with a worm crawling feeling all improved, while the 8 cases with a tightening sensation showed the lowest recovery rate, at 12.5%, and the symptom of a tightening sensation occurred only in the intrusion and contact groups. CONCLUSIONS: The closer the implant fixture was to the MC on CT images, the less likely the patient was to recover. Regarding paresthesia symptoms, while a worm crawling feeling is thought to be a predictor of recovery, a tightening sensation appeared to be associated with a lower recovery rate.


Subject(s)
Classification , Humans , Mandibular Nerve , Paresthesia , Prognosis , Sensation , Tomography, X-Ray Computed
19.
Article in English | WPRIM | ID: wpr-766087

ABSTRACT

PURPOSE: This study was designed to observe the resorption pattern of biphasic calcium phosphate (BCP) used for maxillary sinus augmentation over a 3- to 6-year healing period, and to investigate factors affecting the resorption of BCP. METHODS: A total of 47 implants placed in 27 sinuses of 22 patients were investigated. All patients had residual bone height less than 5 mm at baseline. The modified Caldwell-Luc approach was used to elevate the maxillary sinus membrane, and the sinus cavity was filled with BCP (70% hydroxyapatite and 30% β-tricalcium phosphate). Implant placement was done simultaneously or in a staged manner. Serial radiographic analysis was performed up to 6 years postoperatively. RESULTS: During the follow-up period, no implant loss was reported. The mean reduced height of the augmented sinus (RHO) was 0.27±1.08 mm at 36 months, and 0.89±1.39 mm at 72 months postoperatively. Large amounts of graft material (P=0.021) and a long healing period (P=0.035) significantly influenced the amount of RHO. In particular, there was a significant relationship between a healing period longer than 40 months and RHO. CONCLUSIONS: BCP can achieve proper dimensional stability with minimal reduction of the graft height in a 3- to 6-year healing period after maxillary sinus augmentation. The healing period and the amount of graft material influenced the resorption of BCP.


Subject(s)
Bone Substitutes , Calcium , Dental Implants , Durapatite , Follow-Up Studies , Humans , Maxillary Sinus , Membranes , Sinus Floor Augmentation , Transplants
20.
Article in English | WPRIM | ID: wpr-739588

ABSTRACT

PURPOSE: Recent studies have analyzed the short-term clinical outcomes of ndovascular management. However, the long-term outcomes are unknown. This study aimed to investigate clinical outcomes after endovascular management for ruptured pseudoaneurysm in patients after pancreaticoduodenectomy (PD). METHODS: The medical records of 2,783 patients who underwent PD were retrospectively reviewed at a single center. Of 62 patients who received intervention after pseudonaeurysm rupture, 57 patients (91.9%) experienced eventual success of hemostasis. The patients were composed as follows: (embolization only [EMB], n = 30), (stent-graft placement only [STENT], n = 19) and (both embolization and stent-graft placement simultaneously or different times [EMB + STENT], n = 8). Long-term complications were defined as events that occur more than 30 days after the last successful endovascular treatment. RESULTS: Among 57 patients, short-term stent-graft related complications developed in 3 patients (5.3%) and clinical complication developed in 18 patients (31.5%). Nine (15.8%) had long-term stent-graft related complications, which involved partial thrombosis in 5 cases, occlusion in 3 cases and migration in 1 case. Except for 1 death, the remaining 8 cases did not experience clinical complications. The stent graft primary patency rate was 88.9% after 1 month, 84.2% after 1 year, and 63.2% after 2 years. Of 57 patients, 30 days mortality occurred in 8 patients (14.0%). CONCLUSION: After recovery from initial complication, most of patients did not experience fatal clinical complication during long-term follow-up. Endovascular management is an effective and safe management of pseudoaneurysm rupture after PD in terms of long-term safety.


Subject(s)
Aneurysm, False , Blood Vessel Prosthesis , Embolization, Therapeutic , Follow-Up Studies , Hemostasis , Humans , Medical Records , Mortality , Pancreaticoduodenectomy , Retrospective Studies , Rupture , Stents , Thrombosis
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