• 제목/요약/키워드: Site Report

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Establishment of an intravenous conscious sedation service at a University Dental Clinic in Tanzania

  • Karpal Singh Sohal;Frank Bald;Samwel Mwalutambi;Paulo J Laizer;David K Deoglas;Jeremiah Robert Moshy;Baraka Kileo;Noah Joshua;Sospeter Sewangi
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제23권2호
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    • pp.83-89
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    • 2023
  • Background: With advances in safety measures for anesthesia, conscious sedation has gained popularity in the field of dentistry and has become essential in dental practice worldwide. However, in Tanzania, intravenous (IV) sedation is rarely practiced in the dental field. Therefore, we report the establishment of sustainable IV conscious sedation in dental practices and subsequently train local OMS residents in Tanzania. Methods: In 2019, intravenous conscious sedation was initiated at the University Dental Clinic of the Muhimbili University of Health and Allied Science (MUHAS), Tanzania. During the preparatory phase of the program, local oral and maxillofacial surgeons (OMSs) were given a series of lecture notes that concentrated on different aspects of IV conscious sedation in dentistry. During the on-site training phase, an oral surgeon from the United States joined the OMSs for case selection, IV-conscious sedation procedures, and patient follow-up. Patients were recruited from existing patient records at the MUHAS Dental Clinic. Results: The first conscious IV sedation program in dentistry was successfully launched at the University Dental Clinic in Tanzania. The local team of OMSs was trained on the safe administration of sedative agents (midazolam or ketamine) to perform various minor surgical procedures in a dental office. Nine patients with different ages, body masses, and medical conditions benefited from the training. No complications were associated with IV conscious sedation in the dental office. Conclusion: This was the first successful "hands-on" training on IV conscious sedation provided to OMSs in Tanzania. It laid the foundation for the sustainable care of patients with special needs requiring oral health-related care in the country.

Toward Next Generation Solar Coronagraph: Diagnostic Coronagraph Experiment

  • Cho, Kyung-Suk;Yang, Heesu;Lee, Jaeok;Bong, Suchan;Choi, Seonghwan;Kim, Jihun;Park, JongYup;Park, YoungDeuk;Kim, Yeon-Han
    • The Bulletin of The Korean Astronomical Society
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    • 제44권2호
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    • pp.42.2-42.2
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    • 2019
  • Korea Astronomy and Space Science Institute (KASI) has been developing a next-generation coronagraph (NGC) in cooperation with NASA to measure the coronal electron density, temperature, and speed using four different filters around 400 nm. To demonstrate technology for the measurement through the 2017 total solar eclipse across the USA, KASI organized an expedition team to demonstrate the coronagraph measurement scheme and the instrumental technology. The observation site was in Jackson Hole, Wyoming, USA. We built an eclipse observation system, so-called Diagnostic Coronal Experiment (DICE), which is composed of two identical telescopes to improve a signal to noise ratio. The observation was conducted with 4 wavelengths and 3 linear polarization directions according to the planned schedule in a limited total eclipse time of about 140 seconds.Polarization information of corona from the data was successfully obtained but we failed to get the coronal electron temperature and speed information due to a low signal-to-noise ratio of the optical system. In this study, we report the development of DICE and observation results. TSE observation and analysis by using our own developed instrument gave an important lesson that a coronagraph should be carefully designed to archive the scientific purpose. This experience through TSE observation will be very useful for a success of NASA-KASI joint missions called the Balloon-borne Investigation of the Temperature and Speed of Electrons in the Corona (BITSE) and COronal Diagnostic EXperiment (CODEX).

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Discovery of a Radio Relic in the Massive Merging Cluster SPT-CL J2023-5535 from the ASKAP-EMU Pilot Survey

  • Kim, HyeongHan;Jee, M. James;Rudnick, Lawrence;Parkinson, David;Finner, Kyle;Yoon, Mijin;Lee, Wonki;Brunetti, Giangranco;Bruggen, Marcus;Collier, Jordan D.;Hopkins, Andrew M.;Michalowski, Michal J.;Norris, Ray P.;Riseley, Chris
    • The Bulletin of The Korean Astronomical Society
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    • 제45권1호
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    • pp.30.1-30.1
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    • 2020
  • The ASKAP-EMU survey is a deep wide-field radio continuum survey designed to cover the entire southern sky and a significant fraction of the northern sky up to +30°. Here, we report a discovery of a radio relic in the merging cluster SPT-CL J2023-5535 at z=0.23 from the ASKAP-EMU pilot 300 square degree survey (800-1088 MHz). The deep high-resolution data reveal a ~2 Mpc-scale radio halo elongated in the east-west direction, coincident with the intracluster gas. The radio relic is located at the western edge of this radio halo stretched ~0.5 Mpc in the north-south orientation. The integrated spectral index of the radio relic within the narrow bandwidth is α1088MHz800MHz = -0.76 ± 0.06. Our weak-lensing analysis shows that the system is massive (M200 = 1.04 ± 0.36 × 1015M⊙) and composed of at least three subclusters. We suggest a scenario, wherein the radio features arise from the collision between the eastern and middle subclusters. Furthermore, the direct link between the local AGN and the relic along with the discontinuities in X-ray observation hint us that we are looking at the site of re-acceleration.

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A Case of Long Term Survival of Gastric Cancer on Trastuzumab Based Treatment (Trastuzumab으로 장기 생존한 진행성 위암 증례 1예)

  • Jihye Park;Sang Kil Lee
    • Journal of Digestive Cancer Research
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    • 제3권1호
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    • pp.39-41
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    • 2015
  • We report a case of long term survival on trastuzumab based treatment. A 51-year-old man with dyspepsia received esophagogastroduodenoscopy on another hospital and was transferred for further evaluation under the impression of advanced gastric cancer, Borrmann type III, antrum, lesser curvature. After further studies in our hospital, the patient was diagnosed with advanced gastric cancer, adenocarcinoma, moderately differentiated with pancreas invasion and lymph node metastasis. Though he was recommended with chemotherapy, he refused and left for oriental herbal medicine. After 4 months, the patient was admitted through emergency room for hematemesis. Diagnosed with gastric outlet obstruction due to gastric cancer in the antrum, he underwent the placement of pyloric metal stent insertion. Immunohistochemical staining showed HER2-positive finding, and he was treated with palliative chemotherapy of trastuzumab, capecitabine, and cisplatin, 16 times during 11 months. The patient showed neutropenia after the therapy, so cisplatin was left out, and he received combination chemotherapy of trastuzumab and capecitabine, 34 times during 25 months. Response evaluation showed no remarkable change in extent of primary stomach cancer, lymph node metastasis, and regression of metastasis site, and the patient is continuing chemotherapy.

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Treatment of Multiple Gingival Recessions Using Vestibular Incision Subperiosteal Tunnel Access with Platelet-rich Fibrin: Two Cases Reports

  • Sung-Min Hwang;Jo-Young Suh
    • Journal of Korean Dental Science
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    • 제16권2호
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    • pp.218-226
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    • 2023
  • Treatment of multiple gingival recession defects is usually more challenging than that of single gingival recession. Various techniques for the treatment of multiple gingival recession have been established. Recently, vestibular incision subperiosteal tunnel access (VISTA) technique has been considered to exhibit high predictive ability. Connective tissue graft (CTG) has also been considered a gold standard technique owing to its high predictability of root coverage. However, this technique requires a suitable donor site and has clinical disadvantages, such as additional pain. Thus, in this case presentation, platelet-rich fibrin (PRF) was used as an alternative material for CTG along with VISTA. We herein report cases of two patients with Miller's class I and III multiple gingival recession defects, respectively. These patients underwent VISTA along with the use of a PRF membrane. They were followed up for 12 months postoperatively, and their clinical parameters, including probing depth, depth of gingival recession, clinical attachment level, and width of attached gingiva at baseline and at 2, 6, and 12 months postoperatively, were assessed. The patient with class 1 recession defects exhibited a significant amount of root coverage, which remained stable during the follow-up period. Whereas the patient with class 3 recession defects had lesser amount of coverage compared to class 1 patient. The partial coverage observed may be attributed to not only anatomical factors but also the technique-sensitive nature of the procedure. Considering these results, the use of VISTA along with PRF is a viable option for treating gingival recession, as it does not cause discomfort to patients. However, various factors need to be considered during the surgical procedure.

Ectopic Adrenal Adenoma in Renal Sinus: A Case Report (신장의 이소성 부신 선종: 증례 보고)

  • John Baek;See Hyung Kim;Seung Hyun Cho;Won Hwa Kim;Hye Jung Kim;Hun Kyu Ryeom;Ghilsuk Yoon
    • Journal of the Korean Society of Radiology
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    • 제83권5호
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    • pp.1116-1120
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    • 2022
  • The kidney is a rare site of ectopic adrenal adenoma. To the best of our knowledge, some cases of ectopic adrenal adenoma have been found in the kidney, but few of these cases explain the CT and MRI findings of the lesion. We reported a case of ectopic adrenal adenoma in the left renal sinus. A 47-year-old male patient underwent abdominal CT for routine health check-ups, which revealed a 1.2 cm enhancing mass in the left renal sinus. The MRI showed a signal drop of the mass in T1 weighted in- and opposed-phase, which indicates fat components. The mass was confirmed as an ectopic adrenal adenoma after surgery.

Pleomorphic Adenoma of the Upper Lip: A Case Report (윗 입술에서 발생한 다형선종: 증례보고)

  • Tae Hyun Kim;Seong Heum Jeong;Chung Hun Kim
    • Korean Journal of Head & Neck Oncology
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    • 제40권1호
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    • pp.33-36
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    • 2024
  • Pleomorphic adenoma (PA) is a commonly occurring benign tumor originating in the salivary glands. The incidence is mostly in the parotid glands (85%) followed by minor salivary glands (10%). Pleomorphic adenoma from minor salivary glands of the lips is a rare neoplasm. Here, we present a case of a patient with PA in the upper lip, reporting a common neoplasm in a rare site. A 82-year-old male with a slowly progressing swelling that occurred 20years ago on the upper white lip. This tumor is not associated with pain and tenderness. The mass was about 1.5x1.5cm sized, circumscribed, sessile and firm on the external upper lip without oral side bulging (Fig. 1). The tumor was removed completely with a elliptical incision under local anesthesia. The encapsulated mass was measured 0.9x0.9x0.6cm. On histology, a well-circumscribed growth was seen comprising epithelial and stromal components. The epithelial component formed glandular structures lined by round-to oval cells having small nuclei, pink cytoplasm and myoepithelial basal cell layer while the stroma had a fibromyxoid appearance(Fig. 2). Postoperatively wound was well healed without recurrence after 6months. Pleomorphic adenoma of the upper lip is a rare neoplasm, especially not intraoral growth. For aesthetic good result, the mass was removed without hesitation. It is required a high index of suspicion and a long-term follow-up because it could recur and rarely be transformed into malignancy.

A Myxofibroma of the Soft Tissue of Face: A Rare Case Report (드물게 발생한 얼굴 연조직의 점액섬유종에 대한 증례보고)

  • Kuylhee Kim;Donghyun Lee;Soyeon Jung;Chul Hoon Chung;SeongJin Cho;Yongjoon Chang
    • Korean Journal of Head & Neck Oncology
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    • 제40권1호
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    • pp.55-58
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    • 2024
  • Myxoma is a locally invasive neoplasm usually involving the jaw bones, typically occurs between the second and fourth decades. This tumor may comprise 3%-6% of odontogenic tumors. Myxomas of the soft tissue of the face are very rare. We present an unusual case of myxofibroma occurring in a 13-year-old man involving the soft tissue of the face. It congenitally occurred and was a 1 cm sized, ovoid in shape, swelling located on the glabella without any symptoms. An excisional biopsy was performed. A well encapsulated ovoid mass was attached to the corrugator supercilli muscle below the frontalis muscle. It was measured 1.1 × 1 × 0.8 cm and completely excised. Histological examination revealed myxofibroma showing stellate and spinde-shaped cells throughout myxoid ground substance. The unusual features of this case are the site of the tumor, which was localized to the non-tooth bearing area of the mandible and its congenital occurrence history.

Percutaneous Transhepatic Removal of Migrated Biliary Stent from a Chronic Biloma Cavity (만성 담즙종 공동 내로 이동한 담도 스텐트의 경피경간적 제거)

  • Hyoung Nam Lee
    • Journal of the Korean Society of Radiology
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    • 제81권2호
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    • pp.442-447
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    • 2020
  • Iatrogenic foreign bodies are a challenging complication to both the interventional radiologist and patient, resulting in impaired quality of life and substantial financial cost. The case report describes a successful percutaneous transhepatic removal of an intra-abdominal foreign body. A 72-year-old man underwent surgery for placement of a retrievable covered stent for refractory bile leakage after left hemihepatectomy. Three days after placement, stent folding and migration into a chronic biloma cavity occurred via the bile leakage site. By using a balloon catheter technique, the folded stent could be straightened and repositioned into the bile duct to minimize stent-strut injury during retrieval. The interventional approach could be a valid treatment option for intra-abdominal foreign bodies, as well as intravascular foreign bodies. A thorough understanding of devices and techniques can provide the interventional radiologist with valuable information regarding procedural planning and the management of iatrogenic foreign bodies.

Bronchoesophageal fistula in a patient with Crohn's disease receiving anti-tumor necrosis factor therapy

  • Kyunghwan Oh;Kee Don Choi;Hyeong Ryul Kim;Tae Sun Shim;Byong Duk Ye;Suk-Kyun Yang;Sang Hyoung Park
    • Clinical Endoscopy
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    • 제56권2호
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    • pp.239-244
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    • 2023
  • Tuberculosis is an adverse event in patients with Crohn's disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn's disease who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient's condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.