• The korean journal of orthodontics
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• v.39 no.1
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• pp.43-53
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• 2009

Objective: The purpose of this study was to compare the difference in three dimensional tooth movement using three different wire sizes($0.018{\times}0.025-in,\;0.016{\times}0.022-in$ 0.016-in) on a NiTi scissors-bite corrector. Methods: Computed tomography(CT) images of the experimental model before and after tooth movement were taken and reconstructed into three dimensional models for superimposition. The direction and the amount of tooth movement were measured and analyzed statistically. Results: The lingual and intrusive movements of the crown of the maxillary second molar were increased as the size of the NiTi wire increased. The roots of the maxillary second metals moved buccally except for the 0.016-in group. The intrusive movement of the roots of the maxillary second molars was increased as the size of the NiTi wire increased. Due to the use of orthodontic mini-implants, anchorage loss was under 0.2 mm on average. Conclusions: The $0.018{\times}0.025-in$ NiTi wire was most effective in lingual and intrusive movement of the maxillary second molar which was in scissors-bite position. Indirect skeletal anchorage with a single orthodontic mini-implant was rigid enough to prevent anchorage loss.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.365-373
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• 1999

Background: Despite widespread use of tracheostomy in intensive care unit, it is still controversial to define the best timing from endotracheal intubation to tracheostomy under prolonged mechanical ventilation. Early tracheostomy has an advantage of easy airway maintenance and enhanced patient mobility whereas a disadvantage in view of nosocomial infection and tracheal stenosis. However, there is a controversy about the proper timing of tracheostomy. Methods: We conducted a retrospective study of the 35 medical and 15 surgical ICU patients who had admitted to Ewha Womans University Mokdong Hospital from January 1996 to August 1998 with the observation of APACHE III score, occurrence of nosocomial infections, and clinical outcomes during 28 days from tracheostomy in terms of early (n=25) vs. late (n=25) tracheostomy. We defined the reference day of early and late tracheostomy as 7th day from intubation. Results: The number of patients were 25 each in early and late tracheostomy group. The mean age were $48{\pm}18$ years in early tracheostomy group and $63{\pm}17$ years in late tracheostomy group, showing younger in early tracheostomy group. The median duration of intubation prior to tracheostomy was 3 days and 13 days in early and late tracheostomy groups. Organs that caused primary problem were nervous system in 27 cases(54%), pulmonary 14(28%), cardiovascular 4(8%), gastrointestinal 4(8%) and genitourinary 1(2%) in the decreasing order. Prolonged ventilation was the most common reason for the purpose of tracheostomy in both groups. APACHE m scores at each time of intubation and tracheostomy were slightly higher in late tracheostomy group but not significant statistically. Day to day APACHE III scores were not different between two groups with observation upto 7th day after tracheostomy, Occurrence of nosocomial infections, weaning from mechanical ventilation, and mortality showed no significant difference between two groups with observation of 28 days from tracheostomy. The mortality was increased as the APACHE m score upto 7 days after tracheostomy increased, but there were no increment for the mortality in terms of the time of tracheostomy and the days of ventilator use before tracheostomy, Conclusion: The early tracheostomy seems to have no benefit with respect to severity of illness, nosocomial infection, duration of ventilatory support, and mortality. It suggests that the time of tracheostomy is better to be decided on clinical judgement in each case. And in near future, prospective, randomized case-control study is required to confirm these results.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.8-14
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• 2012

Background: Although airway obstruction in chronic obstructive pulmonary disease (COPD) is due to pathologic processes in both the airways and the lung parenchyma, the contribution of these processes, as well as other factors, have not yet been evaluated quantitatively. We therefore quantitatively evaluated the factors contributing to airflow limitation in patients with COPD. Methods: The 213 COPD patients were aged >45 years, had smoked >10 pack-years of cigarettes, and had a post-bronchodilator forced expiratory volume in one second ($FEV_1$)/forced vital capacity (FVC) <0.7. All patients were evaluated by medical interviews, physical examination, spirometry, bronchodilator reversibility tests, lung volume, and 6-minute walk tests. In addition, volumetric computed tomography (CT) was performed to evaluate airway wall thickness, emphysema severity, and mean lung density ratio at full expiration and inspiration. Multiple linear regression analysis was performed to identify the variables independently associated with $FEV_1$ - the index of the severity of airflow limitation. Results: Multiple linear regression analysis showed that CT measurements of mean lung density ratio (standardized coefficient ${\beta}$=-0.46; p<0.001), emphysema severity (volume fraction of the lung less than -950 HU at full inspiration; ${\beta}$=-0.24; p<0.001), and airway wall thickness (mean wall area %; ${\beta}$=-0.19, p=0.001), as well as current smoking status (${\beta}$=-0.14; p=0.009) were independent contributors to $FEV_1$. Conclusion: Mean lung density ratio, emphysema severity, and airway wall thickness evaluated by volumetric CT and smoking status could independently contribute to the severity of airflow limitation in patients with COPD.

• Journal of dental hygiene science
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• v.17 no.2
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• pp.123-133
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• 2017

The aim of this study was to analyze in depth the standardized Clinical dental hygiene curriculum of the Fones School in the United States. We investigated the clinical dental hygiene curriculum in 2015~2016 including title, credit, hours, contents, goals, competencies, and evaluation. We obtained the course syllabus and data related to each subject, for each grade, from the professors and students at the university. The goals and competencies, of the clinical dental hygiene program, which were based on the goals of the Fones School and the mission of the University of Bridgeport, were developed in accordance with the dental hygienist practice standards proposed by the American Dental Hygienists Association. The curriculum consisted of theory to teach proper dental hygiene care procedures and incorporated practical exercises that modeled an actual clinical setting. The students had to document the procedures performed for each client/patient and improve their clinical competency through discussion with the professors. Dental hygiene care should be provided for children, adolescents, adults, elderly, and patients, which includes patients with moderate or severe periodontal status. Students were evaluated by a paper test or case study presentation and their clinical evaluation was based on their clinical competency. In particular, professors evaluated students on a rotational basis, so they could evaluate the level of achievement of clinical competency of all students and find ways to improve any weaknesses. Therefore, the current study suggested that clinical dental hygiene program in Korea could be improved if based on the curriculum of Fones School in the United States.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.1
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• pp.14-22
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• 2006

Purpose: To identify factors that influence serum zinc concentrations in children with acute gastroenteritis. Methods: Thirty-two children under 5 years of age (15 boys and 17 girls) were selected randomly among those who visited to an pediatric emergency room of Ehwa Womans University Mokdong Hospital with acute gastroenteritis from May to August 2005. This study estimated the association between serum zinc concentrations and clinical, biochemical variables in patients with acute gastroenteritis. Results: Serum zinc concentration was lower in febrile patients than afebrile patients with acute gastroenteritis ($67.5{\pm}25.3$ vs $85.5{\pm}14.2$, p<0.05). It also was lower in patients with positive C-reactive protein (CRP) than those with negative CRP ($63.9{\pm}25.4$vs $86.7{\pm}13.8$, p<0.05). Serum zinc concentration was negatively correlated (r=-0.494, p<0.05) with CRP concentration, whereas positively correlated with hematocrit (r=0.370, p<0.05), total protein (r=0.474, p<0.05), and albumin (r=0.636, p<0.05). Twelve patients (37.5%) showed very low serum zinc concentration (< $70{\mu}g/dL$) without clinical symptoms of deficiency or growth retardation. Frequency of febrile illness or positive CRP is significantly greater in group with zinc < $70{\mu}g/dL$ than the group with zinc ${\geq}70{\mu}g/dL$ (91.7% vs 55%, p<0.05; 91.7% vs 40%, p<0.05, respectively). Conclusion: In patients with acute gastroenteritis, serum zinc concentration was influenced by various factors such as fever, CRP, and biochemical factors. For evaluating zinc status in the body. factors.

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.154-163
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• 2015

Purpose: Osteoarticular infections in children and adolescents are important because it can cause functional compromise if appropriate treatment is delayed. Therefore, this study was designed to describe the clinical presentations and causative organisms of osteoarticular infections in children and adolescents in order to propose early diagnosis method and an appropriate empiric antimicrobial therapy. Methods: Forty-two medical records were reviewed retrospectively, which were confirmed as osteomyelitis (OM) or septic arthritis (SA) at Department of Pediatrics or Orthopedic Surgery in patients under 18 years old of Ewha Womans University Mokdong Hospital from March 2008 to March 2015. Results: We identified 21 cases of OM, 13 cases of SA and 8 cases of OM with SA. There were 31 males and 11 females and mean age was 7.1 years old. The most common symptoms were pain and tenderness of involved site. Major involved bones were femur (10 cases, 34.5%), tibia (7 cases, 24.1%) and major involved joints were hip (9 cases, 42.9%), and knee (5 cases, 23.8%). Increased serum C-reactive protein and erythrocyte sedimentation rate were observed in 37 cases (88.1%) respectively. Magnetic resonance imaging was performed in 40 cases among 42 cases and was used to demonstrate osteoarticular infections and other adjacent infections. Nine cases (23.7%) among 38 cases and 20 cases (50.0%) among 40 cases were positive in blood culture and infected site culture respectively. The most common causative organism was Staphylococcus aureus, which was represented in 22 cases (75.9%), of which nine cases (40.9%) were resistant to methicillin. Conclusions: S. aureus was the most common causative organism of osteoarticular infections in children and adolescents and the proportion of MRSA was high in this study. Therefore, we recommend vancomycin as the first empiric antimicrobial therapy and suggest that further study is necessary to elucidate an appropriate guideline for treatment which takes into account MRSA proportion.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.669-679
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• 2022

Purpose To evaluate the feasibility of pediatric low-dose facial CT reconstructed with filtered back projection (FBP) using adequate kernels. Materials and Methods We retrospectively reviewed the clinical and imaging data of children aged < 10 years who underwent facial CT at our emergency department. The patients were divided into two groups: low-dose CT (LDCT; Group A, n = 73) with a fixed 80-kVp tube potential and automatic tube current modulation (ATCM) and standard-dose CT (SDCT; Group B, n = 40) with a fixed 120-kVp tube potential and ATCM. All images were reconstructed with FBP using bone and soft tissue kernels in Group A and only bone kernel in Group B. The groups were compared in terms of image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Two radiologists subjectively scored the overall image quality of bony and soft tissue structures. The CT dose index volume and dose-length product were recorded. Results Image noise was higher in Group A than in Group B in bone kernel images (p < 0.001). Group A using a soft tissue kernel showed the highest SNR and CNR for all soft tissue structures (all p < 0.001). In the qualitative analysis of bony structures, Group A scores were found to be similar to or higher than Group B scores on comparing bone kernel images. In the qualitative analysis of soft tissue structures, there was no significant difference between Group A using a soft tissue kernel and Group B using a bone kernel with a soft tissue window setting (p > 0.05). Group A showed a 76.9% reduction in radiation dose compared to Group B (3.2 ± 0.2 mGy vs. 13.9 ± 1.5 mGy; p < 0.001). Conclusion The addition of a soft tissue kernel image to conventional CT reconstructed with FBP enables the use of pediatric low-dose facial CT protocol while maintaining image quality.

• Korean Journal of Radiology
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• v.24 no.2
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• pp.145-154
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• 2023

Objective: We aimed to evaluate the efficacy of EmboTrap II in terms of first-pass recanalization and to determine whether it could yield favorable outcomes. Materials and Methods: In this multicenter, prospective study, we consecutively enrolled patients who underwent mechanical thrombectomy using EmboTrap II as a front-line device. The primary outcome was the first pass effect (FPE) rate defined by modified Thrombolysis In Cerebral Infarction (mTICI) grade 2c or 3 by the first pass of EmboTrap II. In addition, modified FPE (mFPE; mTICI grade 2b-3 by the first pass of EmboTrap II), successful recanalization (final mTICI grade 2b-3), and clinical outcomes were assessed. We also analyzed the effect of FPE on a modified Rankin Scale (mRS) score of 0-2 at 3 months. Results: Two hundred-ten patients (mean age ± standard deviation, 73.3 ± 11.4 years; male, 55.7%) were included. Ninety-nine patients (47.1%) had FPE, and mFPE was achieved in 150 (71.4%) patients. Successful recanalization was achieved in 191 (91.0%) patients. Among them, 164 (85.9%) patients underwent successful recanalization by exclusively using EmboTrap II. The time from groin puncture to FPE was 25.0 minutes (interquartile range, 17.0-35.0 minutes). Procedure-related complications were observed in seven (3.3%) patients. Symptomatic intracranial hemorrhage developed in 14 (6.7%) patients. One hundred twenty-three (58.9% of 209 completely followed) patients had an mRS score of 0-2. Sixteen (7.7% of 209) patients died during the follow-up period. Patients who had successful recanalization with FPE were four times more likely to have an mRS score of 0-2 than those who had successful recanalization without FPE (adjusted odds ratio, 4.13; 95% confidence interval, 1.59-10.8; p = 0.004). Conclusion: Mechanical thrombectomy using the front-line EmboTrap II is effective and safe. In particular, FPE rates were high. Achieving FPE was important for an mRS score of 0-2, even in patients with successful recanalization.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.127-137
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• 2022

Purpose To assess the prevalence of incidentally detected lumbar spondylolysis in children. Materials and Methods We retrospectively reviewed the data of 809 patients under the age of 11 years (mean age, 7.0 ± 2.7 years; boys:girls = 479:330) who underwent abdominal and pelvic CT between March 2014 and December 2018. We recorded the presence, level, and laterality (unilateral or bilateral) of spondylolysis. Patients were divided into two groups based on the presence of spondylolysis: the spondylolysis (SP) and non-SP groups. Results In total, 21 cases of spondylolysis were detected in 20 patients (20/809, 2.5%). The mean age of the SP group was higher than that of the non-SP group (7.8 ± 1.8 vs. 6.9 ± 2.7 years, p > 0.05). The prevalence of spondylolysis in boys was higher than that in girls (15/479 [3.1%] vs. 5/330 [1.5%], p > 0.05). The prevalence of spondylolysis in school-age children (6-10 year olds) was higher than that in preschool-age children (0-5 year olds) (17/538 [3.2%] vs. 3/271 [1.1%], p > 0.05). L5 was the most common level of spondylolysis (76.2%); one 8-year-old boy had two-level spondylolysis. One case of isthmic spondylolisthesis was detected in a 10-year-old boy (1/809, 0.1%). There were 11 unilateral spondylolysis cases (11/21, 52.4%). Conclusion In our study, the prevalence of spondylolysis in children under the age of 11 was 2.5%. The prevalence was higher in boys than in girls and in school-age than in preschool-age children, despite the lack of any statistically significant differences.

• Dementia and Neurocognitive Disorders
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• v.23 no.1
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• pp.54-66
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• 2024

Background and Purpose: Dementia subtypes, including Alzheimer's dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography (¹⁸F-FDG PET) in differentiating these subtypes for precise treatment and management. Methods: A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of ¹⁸F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the goldstandard clinical diagnosis for dementia subtypes. Results: From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88-0.98) and specificity was 0.84 (95% CI, 0.70-0.92). In the case of AD versus DLB, ¹⁸F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70-0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80-0.91) and the specificity was 0.88 (95% CI, 0.80-0.91). The studies mostly used case-control designs with visual and quantitative assessments. Conclusions: ¹⁸F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.