RESUMEN
Anchorage in orthodontics is very important factor for orthodontist to treat malocclusion from diagnosis and treatment planning to end of treatment. Skeletal anchorage like miniscrew is supposed to be more effective method in anchorage control than conventional anchorage which needs patient's good cooperation. So this article will be mentioned about various clinical application of miniscrew through the general investigation and case reports about orthodontic use of miniscrew, specially about screwing area and clinical consideration of miniscrew's screwing on midpalate. The changes of treatment philosophy and methods by using skeletal anchorage were summarized and following results were obtained. 1. The orthodontic anchorage changed from relative concept to absolute one. 2. Bodily movement of teeth gets easier and determinate force system is possible on biomechanical consideration. 3. Some part of treatment that needs surgical intervention is possible by just orthodontic treatment.
Asunto(s)
Diagnóstico , Maloclusión , Ortodoncia , Filosofía , Técnicas de Movimiento Dental , DienteRESUMEN
Pulmonary lymphangioleiomyomatosis is a chronic destruct8ive disease of the lung affecting women of childbearing ages which eventually leads to respiratory failure. Lung transplantation is the only conclusive therapeutic measure because this disease responds poorly to other therapies, To date only a few reports in the literature describes the clinical experience of the bilateral sequential lung transplantation of this rare condition. We performed a bilateral sequential lung transplantation on a 32-year-old woman suffering from lymphangioleiomyo-matosisw. The heart-lung block was harvested from a 51-year-old donor. We transplanted the left lung first through the clam-shell incision. As the hemodynamics deteriorated suddenly during the dissection of the right lung the right lung was transplanted under the cardio-pulmonary bypass. Although the patient's lung function was initially satisfactory the patient died of sepsis and subsequent cardiogenic shock at the postoperative 18th day. Autopsy findings showed infection of Candida albicans on the pericardium and the left lung which had been initiated possibly from the left bronchial anastomosis site,. Through detailed review of the clinical course we concluded that lung transplantation could have been performed safely on this disease provided that early diagnosis and proper management or the opportunistic infection have been carried out.
Asunto(s)
Adulto , Femenino , Humanos , Persona de Mediana Edad , Autopsia , Candida albicans , Diagnóstico Precoz , Hemodinámica , Trasplante de Pulmón , Pulmón , Linfangioleiomiomatosis , Infecciones Oportunistas , Pericardio , Insuficiencia Respiratoria , Sepsis , Choque Cardiogénico , Donantes de TejidosRESUMEN
In order to access the value of computed tomography in mediastinal LN staging of NSCLCa, 581 LN stations of 77 patients were selected from 552 patients who were diagnosed as Lung Ca and operated in Seoul National University Hospital from 1992 to 1995. The selection criteria were as follows ; the patients 1) whose preoperative chest CTs were available; 2) underwent curative resection (lobectomy or more) with complete lymph node dissection; 3) whose final pathologic diagnosis were proven to be non-small cell lung cancer. We adopted Receiver Operating Characteristic curve method to determine a proper size criterion for diagnosing malignant mediastinal adenopathy. From curve analysis, we decided the size criterion of lymph node to 1 cm in their short axis. Using this size criterion, it's sensitivity was 43.9%, specificity was 87.4%, and accuracy was 83.1%. Eventhough we couldn't determine the precise size criterion for the adenoca, it seemed that shorter than 1 cm size criterion should be applied in that particular cell type. Lymph node stations associated with the tuberculosis or bronchiectasis tend to be overestimated in nodal staging and have relatively high false positive rate. The low sensitivity of CT scan suggest that radical and complete dissection or precise mediastinal lymph node evaluation through the surgical approach is mandatory.
Asunto(s)
Humanos , Vértebra Cervical Axis , Bronquiectasia , Carcinoma de Pulmón de Células no Pequeñas , Diagnóstico , Pulmón , Escisión del Ganglio Linfático , Ganglios Linfáticos , Selección de Paciente , Curva ROC , Sensibilidad y Especificidad , Seúl , Tórax , Tomografía Computarizada por Rayos X , TuberculosisRESUMEN
In a small island community with a population of less than 100 residents, nine persons died and five experienced severe illness during the period from November 1986 to May 1988. Their initial symptoms were sore throat and fever. Renal failure and hepatitis developed which one week after the onset. Oral mucosal ulcer developed in some cases. After one week, progressive respiratory failure and dyspnea developed evidently and severe respiratory distress and hypoxia preceded those fatal cases. Chest X-ray findings revealed bilateral diffuse multiple cystic lesion with occasional multiple large emphysematous bullae. Based on these features paraquat poisoning was diagnosed and route of poisoning was investigated. In three sources of drinking water, trace amount of paraquat was detected in November 1988, six months after the incidence of recent fatal case. In November 1988, soybean sauces and soybean pastes from 12 households were found contaminated with high concentration of paraquat, the cause of this mass poisoning has been suggested.