• Title/Summary/Keyword: Long-term prognosis

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Periodontal attachment loss of extracted teeth for periodontal reasons (발거치에 나타난 부착상실의 양상에 대한 연구)

  • Kim, Jung-Hyun;Kim, Sung-Jo;Choi, Jeom-Il;Lee, Ju-Youn
    • Journal of Periodontal and Implant Science
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    • v.36 no.1
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    • pp.61-68
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    • 2006
  • The factors influencing long-term prognosis of teeth must be carefully considered. Among these, attachment level is strongly associated with tooth loss. The purpose of the present study was to estimate pattern of attachment loss based on attachment area in extracted teeth. 197 satisfied the criteria for assessment after staining. The protocol described by Waerhaug(l975) was performed. An indir ect method, based on digital image abstracted from digital camera and digital imaging software program, was used to calculate the root surface area and the attachment loss area. The data were analysed using SPSS. Except maxillary central incisior and mandibular canine, no statistical significant differences between each root surfaces were observed in anterior teeth. In posterior teeth, statistical significant differences in palatal surface of maxillary molar and mandibular molar compared with others were observed. Statistical significant difference in buccal surface compared with others was lowly observed in single and multi rooted. This study did not reveal progressive loss pattern of attachment area in each root surface but clarified root surface that has relative high loss rate of attachment area at extraction. Thus understanding this pattern of attachment loss is helpful for dentist to treat the periodontitis.

A Case of Acute Interstitial Pneumonia with Invasive Pulmonary Aspergillosis (침습성 폐 아스페르길루스증을 동반한 급성 간질성 폐렴 1예)

  • Lee, Young-Min;Yoon, Hye-Kyoung;Kim, Joo-In
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.62-69
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    • 2002
  • Acute interstitial pneumonia (AIP) is a rare fulminant form of lung injury that presents acutely; usually in a previously healthy individual. It corresponds to a subset of cases of idiopathic adult respiratory distress syndrome (ARDS). Invasive pulmonary aspergillosis is a disease occuring predominantly with defects in immunity such as hematologic malignancy, influenza infection, postchemotherapy, long-term corticosteroid treatment. Invasive aspergillosis has worse prognosis and most cases are diagnosed at postmortem autopsies. We experienced a case of acute interstitial pneumonia with an invasive aspergillosis during corticosteroid treatment. Acute interstitial pneumonia with invasive aspergillosis was diagnosed by an open lung biopsy using thoracoscopy, showing fungal hyphae with sepsis and an acute angle branching invasion of the lung tissue and blood vessels. The patient was treated with IV amphotericin-B, but died due to septic shock.

Interface Phenomena between Prosthodontic Crown and Abutment Sprayed with Die Spacer (Die Spacer가 도포된 보철용 크라운과 어버트먼트의 계면현상)

  • Park, K.H.;Choe, H.C.
    • Journal of the Korean institute of surface engineering
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    • v.40 no.4
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    • pp.197-202
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    • 2007
  • Fit of the restoration and its cementation procedure is crucial to both its short and long term prognosis. Marginal fit is affected by many variables during the fabrication process. These variables, being intrinsic properties of the materials or the clinical technique used, can cause changes in the size and shape of the definitive restoration. Even if all variables are controlled carefully, the seating of a restoration can still be affected due to insufficient space for the luting agent. The use of die spacer can reduce the elevation of a cast restoration of a prepared tooth, decreased seating time, improve the outflow of excess cement, and lower the seating forces. The purpose of this study was to evaluate the marginal fidelity according to die spacer application times and measurement site. Casting alloys were prepared and fabricated using non-precious metal at $950^{\circ}C$. Specimens are divided into four groups: I(die spacer painted casting for wax pattern), II(die spacer non painted casting for wax pattern). The specimens were cut and polished for marginal gap observation. The marginal gap was observed using scanning electron microscopy (SEM).

A Review of Gaucher Disease in Korea

  • Sohn, Young Bae
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.5 no.1
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    • pp.1-7
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    • 2021
  • Gaucher disease (GD, OMIM #230800 OMIM#230800) is a rare, autosomal recessive inherited metabolic disorder caused by mutation in GBA1 encoding the lysosomal enzyme, glucocerebrosidase. The deficiency of glucocerebrosidase leads to an accumulation of its substrate, glucosylceramide in macrophages of various tissues. Common clinical manifestations include cytopenia, splenomegaly, hepatomegaly, and bone lesions. The phenotype of GD is classified into three clinical categories: Type 1 (non-neuronopathic) is characterized by involvements on the viscera, whereas types 2 and 3 (neuronopathic) are associated with not only visceral symptoms but also neurological impairment, either severe in type 2 or variable in type 3. A diagnosis of GD can be confirmed by demonstrating the deficiency of acid glucocerebrosidase activity in leukocytes. Mutations in the GBA1 should be identified as they may be of prognostic value in some cases. Biomarkers including Chitotriosidase, CCL18, and glucosylsphingosine (lyso-GL1) are useful in diagnosis and treatment monitoring. Currently available disease-specific treatment in Korea consists of intravenous enzyme replacement therapy and substrate reduction therapy. For enhancing long-term prognosis, the onset of Parkinson's disease and Lewy body dementia, or the occurrence of a blood disease or cancer (hepatocellular carcinoma) should be monitored in older patients. The development of new strategies that can modify the neurological phenotype are expected, especially in Asia including Korea, where the prevalence of neuronopathic GD is relatively higher than that in western countries.

The Osteoporotic Condition as a Predictive Factor for Hemorrhagic Transformation in Acute Cardioembolic Stroke

  • Won, Yu Deok;Kim, Jae-Min;Ryu, Je-Il;Koh, Seong-Ho;Han, Myung-Hoon;Cheong, Jin-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.763-775
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    • 2021
  • Objective : Hemorrhagic transformation (HT) can be occurred after acute cerebral infarction. HT can worse symptoms in severe cases and adversely affect long-term prognosis. As bone and vascular smooth muscle are composed of type 1 collagen, we aimed to identify a potential relationship between bone mineral density (BMD) and HT after acute cardioembolic stroke. Methods : As an indicator of BMD, we used mean frontal skull Hounsfield unit (HU) values on brain computed tomography (CT). Multivariative hazard ratios were calculated using Cox regression analysis to identify whether the osteoporotic condition was an independent predictor of HT after acute cardioembolic stroke. Results : This 11-year analysis enrolled 506 patients who diagnosed as acute cardioembolic infarction. The first tertile of skull HU value was an independent predictor of HT development compared to the third tertile (hazard ratio, 2.12; 95% confidence interval, 1.13-3.98; p=0.020). We observed no interactions between age and skull HU with respect to HT statistically. Conclusion : The results of this study revealed an association between osteoporotic conditions and HT development after acute cardioembolic stroke. A convenient method to measure the cancellous bone HU value of the frontal skull using brain CT images may be useful for predicting HT in patients with acute cerebral infarction.

Cranioplasty for Multilobular Osteochondrosarcoma Using 3-Dimensional Printing Technology in Dogs: A Report of Two Cases with a Long-Term Follow-Up

  • Heo, Seong-Hyeon;Lee, Hae-Beom;Jeong, Jae-Min;Jeon, Young-Jin;Kim, Dae-Hyun;Jeong, Seong-Mok;Roh, Yoon-Ho
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.246-252
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    • 2022
  • Multilobular osteochondrosarcoma (MLO) reportedly has a good prognosis after complete resection. This study reports the successful treatment of MLO in two dogs using 3-dimensional (3D) printing technology. A nine-year-old castrated male Maltese (Case 1) and a five-year-old castrated male poodle (Case 2) both presented with a mass in the skull. Diagnostic imaging revealed a cranial mass arising from the cranio-orbital and parieto-occipital bones. The masses were resected using 3D-printed osteotomy guides, and the resulting defects were reconstructed using 3D-printed patient-specific implants. Histopathological results confirmed the resection of MLOs with clean margins. Patients routinely recover from surgery without complications. To date, the two patients remain alive without clinical signs of tumor recurrence at 20 and 12 months postoperatively, respectively. In the management of MLO in dogs, 3D printing technology can allow accurate tumor resection, reduced surgical time, and successful reconstruction of large defects.

Review of two immunosuppressants: tacrolimus and cyclosporine

  • HyunJong Lee;Hoon Myoung;Soung Min Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.6
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    • pp.311-323
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    • 2023
  • Immunosuppressants are vital in organ transplantation including facial transplantation (FT) but are associated with persistent side effects. This review article was prepared to compare the two most used immunosuppressants, cyclosporine and tacrolimus, in terms of mechanism of action, efficacy, and safety and to assess recent trials to mitigate their side effects. PubMed and Google Scholar queries were conducted using combinations of the following search terms: "transplantation immunosuppressant," "cyclosporine," "tacrolimus," "calcineurin inhibitor (CNI)," "efficacy," "safety," "induction therapy," "maintenance therapy," and "conversion therapy." Both immunosuppressants inhibit calcineurin and effectively down-regulate cytokines. Tacrolimus may be more advantageous since it lowers the likelihood of acute rejection, has the ability to reverse allograft rejection following cyclosporine treatment, and has the potential to reinnervate nerves. Meanwhile, graft survival rates seem to be comparable for the CNIs. To avoid nephrotoxicity, various immunosuppressants other than CNIs have been studied. Despite averting nephrotoxicity, these medications show increases in acute rejection or other types of adverse effects compared to CNIs. FT has been a topic of interest for oral and maxillofacial surgeons, and the postoperative usage of immunosuppressants is crucial for the long-term prognosis of FT. As contemporary transplantation regimens incorporate novel medications along with CNIs, further research is required.

Update of Korean Standard Classification of Diseases for Rectal Carcinoid and Its Clinical Implication (직장 유암종 질병 분류 코드 변경과 임상적 의의)

  • Kim, Eun Soo
    • Journal of Digestive Cancer Research
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    • v.9 no.2
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    • pp.57-59
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    • 2021
  • Carcinoid tumor is called as neuroendocrine tumor and is classified into neuroendocrine tumor Grade 1, neuroendocrine tumor Grade 2, and neuroendocrine carcinoma based on the differentiation of tumors. Recently, the incidence of rectal carcinoid tumor has been increasing probably due to the increased interest on screening colonoscopy and the advancement of endoscopic imaging technology. As the rectal carcinoid shows a wide range of clinical characteristics such as metastasis and long-term prognosis depending on the size and histologic features, it is a challenge to give a consistent diagnostic code in patients with the rectal carcinoid. If the rectal carcinoid tumor is less than 1 cm in size, it can be given as the code of definite malignancy or the code of uncertain malignant potential according to International Classification of Diseases for Oncology (ICD-O) by World Health Organization (WHO). Because patients get different amount of benefit from the insurance company based on different diagnostic codes, this inconsistent coding system has caused a significant confusion in the clinical practice. In 2019, WHO updated ICD-O and Statistics Korea subsequently changed Korean Standard Classification of Diseases (KCD) including the code of rectal carcinoid tumors. This review will summarize what has been changed in recent ICD-O and KCD system regarding the rectal carcinoid tumor and surmise its clinical implication.

Current Unmet Needs and Clues to the Solution in the Management of Tricuspid Regurgitation

  • Byung Joo Sun;Jae-Hyeong Park
    • Korean Circulation Journal
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    • v.52 no.6
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    • pp.414-428
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    • 2022
  • Although tricuspid regurgitation (TR) is a general medical issue with growing prevalence and socioeconomic burden, most clinicians have not paid much attention to TR in the past. Several problems of TR have been pointed out in clinical practice, which include: ambiguous clinical manifestations and the difficulty in initial detection, limitations in generally used diagnostic tools, the absence of objective criterion for therapeutic intervention, high operative morbidity and mortality, and lack of long-term clinical data after the intervention for TR. Therefore, patients with TR usually visit clinicians at a much-advanced state, and this delay gives a major dilemma in clinical decision-making in a routine clinical practice. To improve the clinical outcome of TR, we need more knowledge about TR for solving the current problems and making strategies for better clinical practice. With this background, we have discussed in the present article about the pathophysiology of TR and the problems frequently experienced by clinical physicians in the diagnosis and treatment of TR. Furthermore, we have discussed the future strategy to improve the treatment of TR.

Short-term Prognosis according to Time of Treatment of Patients with Acute Cerebral Infarction : Measurement by NIHSS (급성기 뇌경색환자의 치료시기에 따른 단기 예후 평가 : NIHSS를 이용한 후향적 연구)

  • Park, Seung Chan;Cho, Seung Mo;Kim, Do Gyoung;Lim, Chi Yeon;Lee, Jae Wook;Hong, Jin Woo;Lee, In;Lee, In Sun;Kim, Young Kyun;Kwon, Jung Nam
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.6
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    • pp.929-933
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    • 2012
  • This study was done to examine the prognosis according to onset and duration of treatment in acute ischemic cerebral infarction patients. We analysed NIHSS(National Institutes of Health Stroke Scale) score of acute ischemic cerebral infarction patients who visited department of Internal Korean Medicine, one medical center in Busan from January to December 2009. We divided patients into two groups by the initial time of treatment. Group A is admitted within 7 days, Group B is admitted from 7 to 14 days. We used NIHSS for functional recovery after 3 weeks later from admission day, and analyzed prognostic factor by analysis of covariance. All patients showed statistically significant improvement after 1week, 2weeks, 3weeks from admission, and between 1st week and 2nd week. However, there was no significant difference between 2nd week and 3rd week. NIHSS recovery score after 3weeks were analysed according to the timing of treatment. There was a statistically significant difference between two groups. The percentage of aggravated patients showed no statistically significant difference between the two groups. This study suggests that earlier admission care has an effect on functional recovery of patients with acute ischemic cerebral infarction. Further research on the large scale and long-term follow up is required.