• Hip & pelvis
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• 제34권1호
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• pp.56-61
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• 2022

Purpose: Histopathologic analysis of femoral head specimens following total hip arthroplasty (THA) is a routine practice that represents a significant use of health care resources. However, it occasionally results in discovery of undiagnosed hematopoietic malignancy and other discrepant diagnoses such as avascular necrosis. The purpose of this study was to determine the rate of discordant and discrepant diagnoses discovered from routine histopathological evaluation of femoral heads following THA and perform a cost analysis of this practice. Materials and Methods: A review of patients undergoing primary THA between 2004-2017 was conducted. A comparison of the surgeon's preoperative and postoperative diagnosis, and the histopathologic diagnosis was performed. In cases where the clinical and histopathology differed, a review determined whether this resulted in a change in clinical management. Medicare reimbursement and previously published cost data corrected for inflation were utilized for cost calculations. Results: A review of 2,134 procedures was performed. The pathologic diagnosis matched the postoperative diagnosis in 96.0% of cases. Eighty-three cases (4.0%) had a discrepant diagnosis where treatment was not substantially altered. There was one case of discordant diagnosis where lymphoma was diagnosed and subsequently treated. The cost per discrepant diagnosis was $141,880 and per discordant diagnosis was $1,669 when using 100% Medicare reimbursement and Current Procedural Terminology (CPT) code combination 88304+88311. Conclusion: Histopathologic analysis of femoral head specimens in THAs showed an association with high costs given the rarity of discordant diagnoses. Routine use of the practice should be at the discretion of individual hospitals with consideration for cost and utility thresholds.

• Clinical and Experimental Pediatrics
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• 제49권7호
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• pp.745-750
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• 2006

목 적 : 장바이러스는 모든 연령층에서 무균성 뇌막염의 가장 흔한 원인으로 확진은 뇌척수액에서 직접 바이러스를 검출하는 것이나 시일이 많이 걸리고 민감도가 낮아 뇌척수액, 대변 등 환자의 검체에서 바이러스 RNA를 탐지하는 PCR법이 대두되었다. 무균성 뇌막염 환자에서 뇌척수액과 대변의 채취 시기에 따라 검체별 PCR 양성률이 달라서 이에 관한 평가가 필요하다. 이에 저자들은 소아 환자에서 무균성 뇌막염을 진단함에 있어 증상 발현 후 뇌척수액과 대변 검체의 채취 시기에 따른 검체별 PCR의 유용성을 알고자하였다. 방 법 : 2005년 6월 11일부터 8월 30일까지 부산 일신기독병원에 입원하여 무균성 뇌막염으로 진단 받은 42례를 대상으로 임상 증상의 발현 시점에서 뇌척수액과 대변 채취 시기에 따른 검체별 PCR 결과를 조사하였다. 결 과 : 뇌척수액의 경우 증상 발현 시점부터 검체 채취 시기까지의 기간이 2일 이내였던 18례 중 PCR 양성은 9례(50.0%)로 2일이 지나 채취된 검체 24례 중 PCR 양성 1례(4.2%)에 비해 유의하게 높았다(P=0.001). 반면 대변의 경우는 일주일까지 채취 시점에 관계없이 PCR 양성률이 평균 90.5%로 지속적으로 높았다. 뇌척수액 10례(23.8%)에서 장바이러스 PCR이 양성이었고, 바이러스가 밝혀진 9례(21.4%)에서 coxsackievirus B5 6례, coxsackievirus B3 3례였다. 대변의 경우 42례 중 38례(90.5%)에서 장바이러스 PCR이 양성으로 echovirus 18 7례, echovirus 9 3례, coxsackievirus B5 8례, coxsackievirus B3 3례였다. 뇌척수액과 대변에서 동시에 배양된 경우는 6례로 모두 coxsackievirus B5였다. 결 론 : 대변을 이용한 PCR은 장바이러스 뇌막염 동안 장바이러스를 검출하는 임상적으로 민감한 검사법으로 질병 경과 동안 진단을 예측하게 한다. 결정적인 진단은 뇌척수액 PCR에 의해 얻어지나 발병 2일 후 얻어진 검체에서는 그 유용성이 매우 낮아서 임상 증상이 2일 이상 경과하였을 때는 뇌척수액 PCR 이외에 대변을 이용한 PCR을 같이 검사하는 것이 도움이 된다.

• The Journal of Advanced Prosthodontics
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• 제12권3호
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• pp.131-139
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• 2020

PURPOSE. The purpose of this study is to evaluate the repair bond strength of a nanohybrid resin composite to three CAD/CAM blocks using different intraoral ceramic repair systems. MATERIALS AND METHODS. Three CAD/CAM blocks (Lava Ultimate, Cerasmart, and Vitablocks Mark II) were selected for the study. Thirty-two specimens were fabricated from each block. Specimens were randomly divided into eight groups for the following different intraoral repair systems: Group 1: control group (no treatment); Group 2: 34.5% phosphoric acid etching; Group 3: CoJet System; Group 4: Z-Prime Plus System; Group 5: GC Repair System; Group 6: Cimara System; Group 7: Porcelain Repair System; and Group 8: Clearfil Repair System. Then, nanohybrid resin composite (Tetric Evo Ceram) was packed onto treated blocks surfaces. The specimens were thermocycled before application of repair systems and after application of composite resin. After second thermal cycling, blocks were cut into bars (1 × 1 × 12 ㎣) for microtensile bond strength tests. Data were analyzed using two-way ANOVA and Tukey's HSD test (α=.05). RESULTS. Cimara System, Porcelain Repair, and Clearfil Repair systems significantly increased the bond strength of nanohybrid resin composite to all CAD/CAM blocks when compared with the other tested repair systems (P<.05). In terms of CAD/CAM blocks, the lowest values were observed in Vitablocks Mark II groups (P<.05). CONCLUSION. All repair systems used in the study exhibited clinically acceptable bond strength and can be recommended for clinical use.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.203-209
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• 2015

Background: Induced sputum (IS) has been used to collect airway secretions in subjects who have inadequate sputum production. The aim of this study was to investigate the efficacy of IS for the diagnosis of pulmonary tuberculosis (PTB) in adults unable to expectorate sputum. Methods: Medical records of 39 PTB patients who underwent IS due to absence of spontaneous sputum production between January 2011 and March 2014 at a tertiary hospital in South Korea were reviewed. Results of acid fast bacilli smear, Mycobacterium tuberculosis culture and polymerase chain reaction assay for M. tuberculosis (TB-PCR) of IS specimens from these patients were analyzed. Clinical and high-resolution computed tomography (HRCT) characteristics were also analyzed to find characteristics associated with IS culture positivity. Results: Of the 39 IS specimens from PTB patients, 7 (17.9%) were smear positive and 31 (79.5%) were culture positive. Twenty-four IS specimens were tested for TB-PCR and 13 (54.2%) were positive on TB-PCR. Multivariate analysis showed that younger age (p=0.04) and presence of tree-in-bud appearance on HRCT (p=0.03) were independent predictors of IS culture positivity. Conclusion: IS is useful for the diagnosis of PTB in adults unable to expectorate sputum. Younger age and tree-in-bud appearance on HRCT were associated with IS culture positivity in these patients.

• 한국콘텐츠학회논문지
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• 제10권5호
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• pp.259-266
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• 2010

Clostridium difficile 연관 설사증은 항생제 관련 병원 감염 설사에 매우 중요하며, 최근 병원 내 C. difficile 감염 발생률은 계속 증가해왔다. 본 연구에서는 2005년 1월부터 2008년 12월까지 대변 총 1,329 검체를 검사 하여, C. difficile 발생률과 감염 특성을 분석하였다. 전체 1,329 검체 중 독소 A/B검사(EIA)양성 반응을 나타낸 검체는 총283건이었다. 4년간 평균 양성률은 21.2%였으며, 연령 분포에서는 70세 이상에서 가장 높았다. 내시경 소견에서 PMC 57.7%, 정상 소견 19.5%였으며, 조직학적 소견에서는 PMC26.8%, AAC 52.2% 였다. C. difficile 은 PMC 와 관련이 있으나, 내시경 검사 및 조직 검사 소견에서는 정상에서 PMC 까지 다양하게 나타났다.

• 대한수의학회지
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• 제44권3호
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• pp.407-413
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• 2004

Specimens collected from various pyogenic lesions of dogs were culturally examined for staphylococci and all staphylococcal isolates obtained from the specimens were also tested for susceptibility to 14 antimicrobial agents. A total of 123 isolates of staphylococci were identified. Of these, 120 were Staphylococcus intermedius and 3 were S aureus. All isolates were susceptible to oxacillin, cefazolin, cephalothin and amikacin, whereas more than 85% of the isolates were resistant to ampicillin, penicillin G and tetracycline. S intermedius isolates could be divided into 8 different biotypes by biotyping with the most common type accounting for 66.7% of the isolates. One hundred and seventeen(97.5%) isolates could be also divided into 26 different antibiogram patterns. The predominant antibiogram type accounted for 34.2% of the isolates. Antibiogram typing was found to be effective in distinguishing epidemiologically related isolates of S intermedius.

• 대한치과기공학회지
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• 제42권3호
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• pp.197-201
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• 2020

Purpose: This study aimed to assess the quality of dental prostheses printed by digital light-processing (DLP) technology. Methods: Ten experimental models were prepared. The ten specimens that were printed by DLP technology constituted the DLP group. The ten specimens that were produced in the same model by the casting method constituted the control group. The marginal gaps of the 20 specimens produced were measured. These gaps were measured by a silicon replica technique at two abutments of the specimen. Therefore, 20 marginal gaps were measured in each group. An independent sample t-test was performed to compare the marginal gaps measured in the two groups (α=0.05). Results: According to the results of the measurement, there was a significant difference between the mean marginal gap of the control group (78.8 ㎛) and that of the DLP group (91.5 ㎛), p<0.001. Conclusion: Although the mean marginal gaps of dental fixed prostheses produced by the DLP method was higher than the mean marginal gap of those produced by the casting method, it was considered to be within the clinical threshold value suggested by some previous studies.

• 대한치과보철학회지
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• 제16권1호
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• pp.17-21
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• 1978

The object of this study was to measure of the distortion of various dental waxes under condition simulating clinical usage. Eleven commercial product (table) including the inlay and baseplate waxes were tested, and compared in the study. Test specimens were prepared $5{\times}5{\times}65mm$. split brass mold. Placed this rod wax specimens and the brass wax distortion test mold into the water bath and tested the distortion values for waxes at $35^{\circ}C,\;40^{\cric}C,\;45^{\circ}C\;and\;50^{\circ}C$. Measured the distortion as the difference between the final (Df) and original (Do) distance between the ends of the specimen. Recorded Df, Do and Df-Do (Distortion) to the nearest 0.5mm. A minimum of five specimens were tested for each material. The following conclusions may be drawn from this study. 1) It can be seen that, a significant wax distortion was obtained with the temperature of forming the pattern, and the length of time and the temperature at which it was stored. 2) It was found that, when the storage time was increased, the wax distortion was correspondingly increased. At the sametime, the higher the storage time was employed, the distortion was obviously much greater. 3) It can be observed that the higher the temperature at which the wax was manipulated, the less was the resulting distortion upon storage.

• 미생물학회지
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• 제54권3호
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• pp.214-221
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• 2018

Clostridium difficile infection (CDI) is a rapidly emerging infection that may have devastating consequences. Prompt and accurate diagnosis is crucial for management and control. The aim of this study was to determine the incidence of C. difficile associated diarrhea among hospitalized patients, and to compare different diagnostic laboratory methods for detection of toxin producing strains in clinical specimens. The study was conducted at a university hospital in Cairo during the period from May 2013 till June 2015. Subjects were under antibiotic therapy and presented with hospital-acquired diarrhea. Four hundred and sixty-five stool specimens were processed by different microbiological methods. C. difficile was recovered in culture in 51 of stool specimens. Of these, 86.3% to 98% were positive for toxin production by 2 different methods. This study showed that antibiotic intake is the major risk factor for development of hospital-acquired diarrhea. We evaluated different microbiological methods for diagnosis of C. difficile. We recommend the use of toxigenic culture as a gold standard for microbiological diagnosis of C. difficile.

• The Journal of Advanced Prosthodontics
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• 제13권1호
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• pp.65-70
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• 2021

Purpose. Implant mechanical complications, including screw loosening, can influence dental implant success. It has been shown that torque values are affected by contamination occurred in implant-abutment (I/A) interface. This study aimed to examine the effects of blood, saliva, fluoride and chlorhexidine contamination on reverse torque values (RTVs) of abutment screws in oral conditions. Materials and Methods. 50 fixtures were mounted into the stainless-steel holders and divided into five groups (n = 10). Except control group (NC), fixture screw holes in other groups were contaminated with chlorhexidine (CG), saliva (SG), blood (BG), or fluoride (FG). Abutment screws were tightened with a digital torque meter. I/A assemblies were subjected to thermocycling and cyclic loading. The mean RTVs were recorded and data were analyzed with one-way ANOVA and Tukey test. Results. Except for specimens in SG (20.56 ± 1.33), other specimens in BG (21.11 ± 1.54), CG (22.89 ± 1.1) and FG (24.00 ± 1.12) displayed significantly higher RTVs compared to NC (19.00 ± 1.87). The highest RTVs were detected in CG and FG. Conclusion. The obtained data robustly suggest that RTVs were significantly affected by fluid contaminations. Specimens in FG and CG displayed the highest RTVs. Therefore, clinicians should have enough knowledge about probable contaminations in I/A interface in order to manage them during clinical procedure and to inform patients about using oral care products.