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1.
Article in English | WPRIM | ID: wpr-891152

ABSTRACT

Tumors that metastasize to the pituitary gland are unusual and metastasis of neuroendocrine neoplasm to the sellar region is extremely rare. We report a 59-yearold man with pituitary metastasis from pulmonary carcinoid tumor who presented with left progressive deterioration of visual field. Sellar dynamic magnetic resonance imaging revealed an enhancing sellar mass invading the left cavernous sinus. We report this unusual case with a review of the relevant literature.

2.
Article in English | WPRIM | ID: wpr-890414

ABSTRACT

Background@#Several noninvasive tools are available for the assessment of nonalcoholic fatty liver disease (NAFLD) including clinical and blood biomarkers, transient elastography (TE), and magnetic resonance imaging (MRI) techniques, such as proton density fat fraction (MRI-PDFF) and magnetic resonance elastography (MRE). In the present study, we aimed to evaluate whether magnetic resonance (MR)-based examinations better discriminate the pathophysiologic features and fibrosis progression in NAFLD than other noninvasive methods. @*Methods@#A total of 133 subjects (31 healthy volunteers and 102 patients with NAFLD) were subjected to clinical and noninvasive NAFLD evaluation, with additional liver biopsy in some patients (n=54). @*Results@#MRI-PDFF correlated far better with hepatic fat measured by MR spectroscopy (r=0.978, P<0.001) than with the TE controlled attenuation parameter (CAP) (r=0.727, P<0.001). In addition, MRI-PDFF showed stronger correlations with various pathophysiologic parameters for cellular injury, glucose and lipid metabolism, and inflammation, than the TE-CAP. The MRI-PDFF and TE-CAP cutoff levels associated with abnormal elevation of serum alanine aminotransferase were 9.9% and 270 dB/m, respectively. The MRE liver stiffness measurement (LSM) showed stronger correlations with liver enzymes, platelets, complement component 3, several clinical fibrosis scores, and the enhanced liver fibrosis (ELF) score than the TE-LSM. In an analysis of only biopsied patients, MRE performed better in discriminating advanced fibrosis with a cutoff value of 3.9 kPa than the TE (cutoff 8.1 kPa) and ELF test (cutoff 9.2 kPa). @*Conclusion@#Our results suggest that MRI-based assessment of NAFLD is the best non-invasive tool that captures the histologic, pathophysiologic and metabolic features of the disease.

3.
Article in English | WPRIM | ID: wpr-898856

ABSTRACT

Tumors that metastasize to the pituitary gland are unusual and metastasis of neuroendocrine neoplasm to the sellar region is extremely rare. We report a 59-yearold man with pituitary metastasis from pulmonary carcinoid tumor who presented with left progressive deterioration of visual field. Sellar dynamic magnetic resonance imaging revealed an enhancing sellar mass invading the left cavernous sinus. We report this unusual case with a review of the relevant literature.

4.
Article in English | WPRIM | ID: wpr-898118

ABSTRACT

Background@#Several noninvasive tools are available for the assessment of nonalcoholic fatty liver disease (NAFLD) including clinical and blood biomarkers, transient elastography (TE), and magnetic resonance imaging (MRI) techniques, such as proton density fat fraction (MRI-PDFF) and magnetic resonance elastography (MRE). In the present study, we aimed to evaluate whether magnetic resonance (MR)-based examinations better discriminate the pathophysiologic features and fibrosis progression in NAFLD than other noninvasive methods. @*Methods@#A total of 133 subjects (31 healthy volunteers and 102 patients with NAFLD) were subjected to clinical and noninvasive NAFLD evaluation, with additional liver biopsy in some patients (n=54). @*Results@#MRI-PDFF correlated far better with hepatic fat measured by MR spectroscopy (r=0.978, P<0.001) than with the TE controlled attenuation parameter (CAP) (r=0.727, P<0.001). In addition, MRI-PDFF showed stronger correlations with various pathophysiologic parameters for cellular injury, glucose and lipid metabolism, and inflammation, than the TE-CAP. The MRI-PDFF and TE-CAP cutoff levels associated with abnormal elevation of serum alanine aminotransferase were 9.9% and 270 dB/m, respectively. The MRE liver stiffness measurement (LSM) showed stronger correlations with liver enzymes, platelets, complement component 3, several clinical fibrosis scores, and the enhanced liver fibrosis (ELF) score than the TE-LSM. In an analysis of only biopsied patients, MRE performed better in discriminating advanced fibrosis with a cutoff value of 3.9 kPa than the TE (cutoff 8.1 kPa) and ELF test (cutoff 9.2 kPa). @*Conclusion@#Our results suggest that MRI-based assessment of NAFLD is the best non-invasive tool that captures the histologic, pathophysiologic and metabolic features of the disease.

5.
Yonsei Medical Journal ; : 563-567, 2021.
Article in English | WPRIM | ID: wpr-896543

ABSTRACT

Central nervous system infections caused by free-living amoeba are very rare, but often fatal. The typical image findings of amebic meningoencephalitis are non-specific, showing ring-like enhancement. We report the first case of fulminant disseminating fatal granulomatous amebic encephalitis caused by Balamuthia mandrillaris in an immunocompetent patient in South Korea. Our case exhibited two interesting features: one was the unusual clinical course and the other was additional image findings. Magnetic resonance imaging revealed a rim-enhancing lesion with intralesional blooming dark signal intensity on susceptibility weighted imaging and low signal intensity on diffusion weighted images and on apparent diffusion coefficient maps. Differential diagnosis was started from a tumor or non-tumorous lesion, and diagnosis was difficult due to the rarity of the disease. Following the clinical and diagnostic courses of our case, we recommend inspecting image findings of granulomatous amebic encephalitis for early diagnosis.

6.
Clinical Endoscopy ; : 85-91, 2021.
Article in English | WPRIM | ID: wpr-874467

ABSTRACT

Background/Aims@#Small bowel malignancies often present a diagnostic challenge due to their relative rarity and nonspecific clinical symptoms. However, technical developments in endoscopic instruments, including video capsule endoscopy (VCE) and enteroscopy, have allowed for the visualization of the entire small bowel. This study aimed to investigate the clinicopathological features of small bowel malignant tumors diagnosed by VCE and double-balloon enteroscopy (DBE) in a single tertiary center. @*Methods@#We retrospectively analyzed VCE and DBE findings from Korea University Guro Hospital from January 2010 through September 2018. @*Results@#A total of 510 VCE and 126 DBE examinations were performed in 478 patients. Small bowel malignancies were diagnosed in 28 patients (15 males; mean age, 61.0 years; range, 42 to 81 years). Among them, 8 had lymphoma, 8 had primary adenocarcinoma, 7 had gastrointestinal stromal tumor (GIST) and 5 had metastatic cancer. Abdominal pain and obstructive symptoms were the most common findings in metastatic cancers (4/5, 80%). On the other hand, obscure gastrointestinal bleeding was the most common symptom of GIST (6/7, 85.7%) and adenocarcinoma (3/8, 37.5%). @*Conclusions@#Approximately 6% of the patients who underwent either VCE or DBE were diagnosed with small bowel malignancy. These findings demonstrated the different clinical characteristics among small bowel malignancies and merit further study.

7.
Yonsei Medical Journal ; : 563-567, 2021.
Article in English | WPRIM | ID: wpr-904247

ABSTRACT

Central nervous system infections caused by free-living amoeba are very rare, but often fatal. The typical image findings of amebic meningoencephalitis are non-specific, showing ring-like enhancement. We report the first case of fulminant disseminating fatal granulomatous amebic encephalitis caused by Balamuthia mandrillaris in an immunocompetent patient in South Korea. Our case exhibited two interesting features: one was the unusual clinical course and the other was additional image findings. Magnetic resonance imaging revealed a rim-enhancing lesion with intralesional blooming dark signal intensity on susceptibility weighted imaging and low signal intensity on diffusion weighted images and on apparent diffusion coefficient maps. Differential diagnosis was started from a tumor or non-tumorous lesion, and diagnosis was difficult due to the rarity of the disease. Following the clinical and diagnostic courses of our case, we recommend inspecting image findings of granulomatous amebic encephalitis for early diagnosis.

8.
Article in English | WPRIM | ID: wpr-900309

ABSTRACT

Purpose@#Laparoscopic sleeve gastrectomy (SG) is now frequently performed as a definitive bariatric procedure. The aim of the study was to evaluate the detailed morphology of remnant stomachs after SG with respect to volume and sleeve migration. @*Materials and Methods@#We performed a retrospective review of prospectively collected data on patients that completed a 12-month postop examination, which included CT volumetry of sleeve, and a questionnaire that addressed postop food tolerance. CT volumetry study included total sleeve volume (TSV), tube volume (TV), antral volume (AV), tube/antral volume ratio (TAVR), and the presence of intrathoracic sleeve migration (ITSM). @*Results@#Fifty-five patients were included in this retrospective study. Mean %TWL (% total weight loss) at 12 months postop was 32.8% (14.3-55.5), and mean TSV, TV, AV, and TAVR were 166.6±63.3 ml, 68.9±35.4 ml, 97.7±42.9 ml, and 0.8±0.6 respectively. TSV was not correlated significantly with %TWL at 12 months postop (r=−0.069, P=0.619). Fourteen patients (14/55, 25.5%) showed ITSM by CT. Patients with ITSM had a significantly lower mean GER score (5.1±2.0 vs. 7.3±2.0, P=0.001), a lower total food tolerance score (21.6±3.8 vs. 24.4±4.6, P=0.048), and a higher proportion showed suboptimal weight loss (35.7% vs. 9.8%, P=0.023). @*Conclusion@#Mean TSV was not found to be significantly correlated with %TWL at 12 months postop.Patients with suboptimal weight loss had higher mean TAVR, and the presence of ITSM indicated more frequent GER symptoms, lower food tolerance, and a higher probability of suboptimal weight loss.

9.
Article in English | WPRIM | ID: wpr-900247

ABSTRACT

Objectives@#To evaluate and compare the clinical outcomes of cervical transforaminal epidural block (CTEB) using local anesthetics with or without a steroid for cervical spondylotic radiculopathy (CSR).Summary of Literature Review: The typical mixture for a CTEB is a combination of local anesthetics with a non-particulate steroid.However, there are potential complications related to steroid injections such as steroid-induced osteoporosis, hypothalamus-pituitaryadrenal gland axis suppression, and hyperglycemia. @*Materials and Methods@#From January 2018 to October 2019, 35 patients who underwent CTEB for CSR were enrolled in this study.Cases with arm pain over 4 on a visual analog scale (VAS) were included. In the first 19 cases, a combination of 1 mL of 1% lidocaine and 1 mL of dexamethasone was used (group A), and in the next 16 cases, 1 mL of 1% lidocaine mixed with 1 mL of normal saline was used (group B). Arm pain VAS and the Neck Disability Index (NDI) were obtained perioperatively. @*Results@#Baseline characteristics were not significantly different between the two groups. In both groups, the arm pain VAS significantly decreased at 30 minutes, 2 weeks, and 6 weeks post-injection compared to pre-injection values. However, the arm pain aggravated 12 weeks post-injection. The NDI of both groups significantly improved 6 weeks post-injection compared to pre-injection. The clinical outcomes of arm pain VAS and NDI at 30 minutes, 2 weeks, and 6 weeks post-injection, as well as the amounts of change, were not significantly different between both groups. @*Conclusions@#CTEB for CSR without a steroid improved symptoms by 6 weeks. The degree of improvement was similar to when CTEB was performed with a steroid in terms of VAS and NDI.

10.
Article in English | WPRIM | ID: wpr-895233

ABSTRACT

Objective@#This study aimed to investigate the clinicopathologic risk factors for type-specific persistence of high-risk human papillomavirus (hrHPV) and residual/recurrent cervical intraepithelial neoplasia (CIN) after surgical treatment. @*Methods@#Patients with CIN-2/3 who underwent conization or loop electrosurgical excision procedure (LEEP) at Korea University Hospital were enrolled. All patients underwent hrHPV testing and genotyping before conization or LEEP followed by both hrHPV genotyping and cytology. The significance of associations between patient characteristics and persistence of infection were assessed by multivariate logistic regression analyses. @*Results@#Among 398 women with pathologically confirmed CIN-2/3, 154 (38.7%) patients showed hrHPV persistence after surgical treatment. In multivariate analysis, high preoperative hrHPV load (P<0.05; odds ratio [OR], 2.063), presence of CIN-2 at treatment (P<0.01; OR, 2.732), and multiple hrHPV infections (P<0.001; OR, 4.752) were associated with hrHPV persistence. HPV 53 was the most likely to persist after treatment (24/43, 55.8%). The risk of residual/recurrent CIN-2/3 was higher in persistent infection with HPV 16 than other types (P<0.05). Menopause (P<0.001; OR, 3.969), preoperative and postoperative hrHPV load (P<0.05; OR, 2.430; P<0.05; OR, 5.351), and infection with multiple hrHPV types (P<0.05; OR, 2.345) were significantly related to residual/recurrent CIN following surgical treatment. @*Conclusion@#HPV load before treatment and infection with multiple hrHPV types were predictors of postoperative hrHPV persistence. HPV 53 was the type most likely to persist, but HPV 16 was the type that was most closely associated with residual/recurrent CIN-2/3.

11.
Article in English | WPRIM | ID: wpr-892605

ABSTRACT

Purpose@#Laparoscopic sleeve gastrectomy (SG) is now frequently performed as a definitive bariatric procedure. The aim of the study was to evaluate the detailed morphology of remnant stomachs after SG with respect to volume and sleeve migration. @*Materials and Methods@#We performed a retrospective review of prospectively collected data on patients that completed a 12-month postop examination, which included CT volumetry of sleeve, and a questionnaire that addressed postop food tolerance. CT volumetry study included total sleeve volume (TSV), tube volume (TV), antral volume (AV), tube/antral volume ratio (TAVR), and the presence of intrathoracic sleeve migration (ITSM). @*Results@#Fifty-five patients were included in this retrospective study. Mean %TWL (% total weight loss) at 12 months postop was 32.8% (14.3-55.5), and mean TSV, TV, AV, and TAVR were 166.6±63.3 ml, 68.9±35.4 ml, 97.7±42.9 ml, and 0.8±0.6 respectively. TSV was not correlated significantly with %TWL at 12 months postop (r=−0.069, P=0.619). Fourteen patients (14/55, 25.5%) showed ITSM by CT. Patients with ITSM had a significantly lower mean GER score (5.1±2.0 vs. 7.3±2.0, P=0.001), a lower total food tolerance score (21.6±3.8 vs. 24.4±4.6, P=0.048), and a higher proportion showed suboptimal weight loss (35.7% vs. 9.8%, P=0.023). @*Conclusion@#Mean TSV was not found to be significantly correlated with %TWL at 12 months postop.Patients with suboptimal weight loss had higher mean TAVR, and the presence of ITSM indicated more frequent GER symptoms, lower food tolerance, and a higher probability of suboptimal weight loss.

12.
Article in English | WPRIM | ID: wpr-892543

ABSTRACT

Objectives@#To evaluate and compare the clinical outcomes of cervical transforaminal epidural block (CTEB) using local anesthetics with or without a steroid for cervical spondylotic radiculopathy (CSR).Summary of Literature Review: The typical mixture for a CTEB is a combination of local anesthetics with a non-particulate steroid.However, there are potential complications related to steroid injections such as steroid-induced osteoporosis, hypothalamus-pituitaryadrenal gland axis suppression, and hyperglycemia. @*Materials and Methods@#From January 2018 to October 2019, 35 patients who underwent CTEB for CSR were enrolled in this study.Cases with arm pain over 4 on a visual analog scale (VAS) were included. In the first 19 cases, a combination of 1 mL of 1% lidocaine and 1 mL of dexamethasone was used (group A), and in the next 16 cases, 1 mL of 1% lidocaine mixed with 1 mL of normal saline was used (group B). Arm pain VAS and the Neck Disability Index (NDI) were obtained perioperatively. @*Results@#Baseline characteristics were not significantly different between the two groups. In both groups, the arm pain VAS significantly decreased at 30 minutes, 2 weeks, and 6 weeks post-injection compared to pre-injection values. However, the arm pain aggravated 12 weeks post-injection. The NDI of both groups significantly improved 6 weeks post-injection compared to pre-injection. The clinical outcomes of arm pain VAS and NDI at 30 minutes, 2 weeks, and 6 weeks post-injection, as well as the amounts of change, were not significantly different between both groups. @*Conclusions@#CTEB for CSR without a steroid improved symptoms by 6 weeks. The degree of improvement was similar to when CTEB was performed with a steroid in terms of VAS and NDI.

13.
Article in English | WPRIM | ID: wpr-785433

ABSTRACT

PURPOSE: The objective of this study was to survey potential candidates for bariatric/metabolic surgery for procedure preferences.METHODS: Questions asked were divided into 5 categories: (1) demographic and anthropometric data, comorbidities, and favored surgery; (2) awareness of safety, effectiveness, and complications of each type of surgery; (3) discordances in opinion between self-selected and medically recommended procedures; and (4, 5) reasons for/against particular surgery.RESULTS: From 1 October to 15 November 2018, 104 respondents adequately responded and were included in the analysis. The number (%) of female respondents was 79 (76.0%). The number (%) of respondents by decade was 17 (16.3%) in their 20s, 65 (62.5%) in their 30s, 19 (18.3%) in their 40s, and 3 (2.9%) in their 60s, respectively. Mean body mass index was 37.1 ± 6.3 kg/m2. Comorbidities were type 2 diabetes in 34 (32.7%) and hypertension in 35 (33.7%). The most favored procedure was sleeve gastrectomy (SG) in 78 (75.0%), adjustable gastric band (AGB) surgery in 12 (11.5%), Roux-en-Y gastric bypass (RYGB) in 6 (5.8%), and gastric plication (GP) in 8 (7.7%). Major reasons for choosing procedures were; “adjustable” for AGB, “stomach sparing” for GP, “excellent weight loss” for SG, and “comorbidity resolution” in RYGB.CONCLUSION: Candidates for bariatric/metabolic surgery favored SG followed by AGB, GP, and RYGB, and their choices were compatible with current evidence-based clinical practice.


Subject(s)
Bariatric Surgery , Body Mass Index , Comorbidity , Female , Gastrectomy , Gastric Bypass , Humans , Hypertension , Obesity , Patient Preference , Surveys and Questionnaires
14.
Article in English | WPRIM | ID: wpr-902937

ABSTRACT

Objective@#This study aimed to investigate the clinicopathologic risk factors for type-specific persistence of high-risk human papillomavirus (hrHPV) and residual/recurrent cervical intraepithelial neoplasia (CIN) after surgical treatment. @*Methods@#Patients with CIN-2/3 who underwent conization or loop electrosurgical excision procedure (LEEP) at Korea University Hospital were enrolled. All patients underwent hrHPV testing and genotyping before conization or LEEP followed by both hrHPV genotyping and cytology. The significance of associations between patient characteristics and persistence of infection were assessed by multivariate logistic regression analyses. @*Results@#Among 398 women with pathologically confirmed CIN-2/3, 154 (38.7%) patients showed hrHPV persistence after surgical treatment. In multivariate analysis, high preoperative hrHPV load (P<0.05; odds ratio [OR], 2.063), presence of CIN-2 at treatment (P<0.01; OR, 2.732), and multiple hrHPV infections (P<0.001; OR, 4.752) were associated with hrHPV persistence. HPV 53 was the most likely to persist after treatment (24/43, 55.8%). The risk of residual/recurrent CIN-2/3 was higher in persistent infection with HPV 16 than other types (P<0.05). Menopause (P<0.001; OR, 3.969), preoperative and postoperative hrHPV load (P<0.05; OR, 2.430; P<0.05; OR, 5.351), and infection with multiple hrHPV types (P<0.05; OR, 2.345) were significantly related to residual/recurrent CIN following surgical treatment. @*Conclusion@#HPV load before treatment and infection with multiple hrHPV types were predictors of postoperative hrHPV persistence. HPV 53 was the type most likely to persist, but HPV 16 was the type that was most closely associated with residual/recurrent CIN-2/3.

15.
Article in Korean | WPRIM | ID: wpr-761448

ABSTRACT

Accurate impression taking for the success of implant prosthesis is a very important process. Methods of taking implant impression include the conventional method using impression coping and impression material, and the digital method using an intraoral scanner and scanbody. However, the impression coping or the scanbody must install after remove healing abutment. Because of this, the dentist must repeat the process of removing and installing the healing abutment, the impression coping or the scanbody several times. In addition, the impression coping or the scanbody rises higher than the occlusal surface, so the patient has the inconvenience of constantly maintaining the open state. Recently, a scannable healing abutment, which can be scanned by a intraoral scanner directly, without the need to remove the healing abutment by applying a scannable part of the scanbody to the healing abutment, was introduced. We present a case of single posterior implant prosthesis using a scannable healing abutment.


Subject(s)
Dentists , Humans , Methods , Prostheses and Implants
16.
Article in English | WPRIM | ID: wpr-762675

ABSTRACT

PURPOSE: Long-term results following bariatric surgery compared to conventional treatments has never been reported in morbidly obese Korean patients. This study aimed to evaluate the long-term efficacy of bariatric surgery in morbidly obese Korean patients compared to conventional medical treatments. METHODS: In this multicenter retrospective cohort study, we reviewed 137 obese subjects between January 2008 and February 2011 with a body mass index (BMI) > 30 kg/m2 who had more than 5 years of follow-up clinical data after bariatric surgery (surgery group, n = 49) or conventional treatment (conventional treatment group, n = 88). Anthropometric data and the status of comorbidities were compared between the 2 groups. RESULTS: The median follow-up period was 72.1 months (range 19.3–109.7 months). At the last follow-up, the surgery group showed a greater amount of total weight loss than the conventional treatment group (24.9% vs. 2.8%, P < 0.001). The prevalence of diabetes and hypertension significantly decreased in the surgery group, while the conventional treatment group showed a marked increase in these comorbidities. In the surgery group, Roux-en-Y gastric bypass and sleeve gastrectomy achieved comparable long-term weight loss (26.5% vs. 22.4%, respectively; P = 0.087). CONCLUSION: In the long-term, bariatric surgery achieved and maintained significantly greater weight reduction, as well as a decrease in obesity-related comorbidities, than did conventional medical therapy in morbidly obese Korean patients.


Subject(s)
Bariatric Surgery , Body Mass Index , Cohort Studies , Comorbidity , Follow-Up Studies , Gastrectomy , Gastric Bypass , Humans , Hypertension , Obesity, Morbid , Prevalence , Retrospective Studies , Weight Loss
17.
Yonsei Medical Journal ; : 782-790, 2019.
Article in English | WPRIM | ID: wpr-762106

ABSTRACT

PURPOSE: Although laparoscopic adjustable gastric bands are considered a standard treatment for severe obesity, their use remains controversial. We evaluated rates of band explantation and the incidences of complications leading to and following band explantation. MATERIALS AND METHODS: This retrospective review was performed on patients that underwent adjustable gastric band explantation. For each of the three groups of patients that underwent explantation, we compared demographic and anthropometric data, band duration in situ, operative approach, and morbidities. RESULTS: Between January 2009 and October 2018, a total of 267 patients underwent primary laparoscopic adjustable gastric band surgery. Of these 267 patients, 99 (37.1%) underwent band explantation. Numbers (%) of patients in the slippage (SL), band erosion (BE), and intolerance (IT) groups were 13 (13.1%), 39 (39.4), and 47 (47.5%), respectively. Mean %EBMIL values at explantation in these groups were 74.6±45.5, 79.7±40.3, and 36.1±46.0, respectively (p<0.001), and mean times for maintaining bands in situ were 45.1±28.0, 39.4±24.3, and 51.2±22.7 months, respectively. Isolated band removal was performed for slippage (SLi, n=12), band erosion (BEi, n=39), and intolerance (ITi, n=31). The numbers (%) of patients in the SLi, BEi, and ITi groups that experienced a surgical complication (Clavien-Dindo class ≥1) were 0 (0.0%), 24 (61.5%), and 3 (9.7%), respectively (p<0.001). In the BEi group, four patients (4/39, 10.3%) underwent reoperation after AGB removal. CONCLUSION: During our 10 years of experience, 37.1% of adjustable gastric band had to be removed. Intra-abdominal abscess and intragastric bleeding were rare but serious complications after explantation. Potential candidates for adjustable gastric band should be informed of the high long-term risk of band explantation and its associated morbidities.


Subject(s)
Abdominal Abscess , Hemorrhage , Humans , Incidence , Obesity, Morbid , Reoperation , Retrospective Studies
18.
Article in English | WPRIM | ID: wpr-764427

ABSTRACT

PURPOSE: This study evaluated the usability of and satisfaction with two types of computer-aided design (CAD) software among users who had experience with dental implant CAD software and those who did not. MATERIALS AND METHODS: Dental technicians (n = 20) who had previous experience with dental implant CAD Software and students from the College of Dentistry (n = 12) who had never designed implant custom abutments were asked to evaluate two types of CAD Software, Exocad and Deltanine. In addition, the participants were asked to fill out a structured questionnaire (Section 1: Entering basic information and retrieving files; Section 2: Setting conditions before abutment design; Section 3: Setting abutment design; and Section 4: Overall satisfaction). For the statistical analysis of the collected data, Mann-Whitney U test was used (α = .05). RESULTS: The ease of design and satisfaction with the implant CAD Software, evaluated with respect to 21 statements divided into four Stages, were significantly higher for Exocad in both groups for Secion 1. For Sections 2 and 3, participants with experience evaluated Deltanine to be significantly better. For Section 4, both groups evaluated Exocad Software to be better. CONCLUSION: Overall, the Exocad Software was evaluated as having better usability and offering greater satisfaction. However, in terms of performance in the core of the design process, i.e. Sections 2 and 3, Deltanine was rated higher by the experienced users. Thus, if the user interface design parts are supplemented, Deltanine CAD Software could be put to a wider use in clinics.


Subject(s)
Computer-Aided Design , Dental Implants , Dental Technicians , Dentistry , Humans
19.
Article in English | WPRIM | ID: wpr-786096

ABSTRACT

PURPOSE: The aim of this retrospective study is to describe changes of gastric mucosa in patients with adjustable gastric band migration, and to evaluate the diagnostic value of these changes.MATERIALS AND METHODS: The postoperative endoscopies of all patients that underwent adjustable gastric band surgery at a single tertiary center were retrospectively reviewed. Gastric mucosal patterns were classified based on the appearance of gastric mucosae compressed by adjustable gastric bands, as follows; Group A: normal appearance, Group B: snakeskin (reticular) appearance without band migration, Group C: snakeskin appearance with band migration, and Group D: recuperated gastric mucosa with advanced band migration.RESULTS: Postoperative endoscopic findings of 109 patients obtained from Jan 2012 to Oct 2018 were available, and these patients were assigned to the four groups, as follows; 82 to group A, 5 to group B, 14 to group C, and 8 to group D. Times (months) between AGB implantation and initial postoperative endoscopy evaluations were 45.2±22.3, 40.0±28.2, 36.2±18.6, and 42.1±17.0, respectively (P=0.531). Of the five patients in Group B, 3 underwent band explantation due to band migration (P=0.000).CONCLUSION: Conclusion A snakeskin pattern of gastric mucosa compressed by adjustable gastric band is strongly associated with adjustable band migration. The presence of this pattern might predict band migration before endoscopic confirmation and its identification might prevent complications associated with long-standing band migration.


Subject(s)
Endoscopy , Gastric Mucosa , Humans , Retrospective Studies
20.
Article in English | WPRIM | ID: wpr-760851

ABSTRACT

Rapunzel syndrome is caused by gastric trichobezoar with extended tail and small bowel obstruction. Patients with gastric trichobezoar can be asymptomatic until the bezoar increases in size. We report a case of a girl who visited the emergency department with abdominal pain. She was finally diagnosed with Rapunzel syndrome that causes multiple small bowel intussusceptions associated with trichophagia. Surgery was needed to reduce the multiple intussusceptions, and to remove the large trichobezoar. This case highlights to consider the possibility of Rapunzel syndrome when diagnosing the main cause of intussusceptions.


Subject(s)
Abdominal Pain , Bezoars , Emergency Service, Hospital , Female , Humans , Intestinal Obstruction , Intussusception , Pica , Tail , Trichotillomania
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