Journal of the korean academy of Pediatric Dentistry
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v.44
no.2
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pp.228-234
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2017
Hydrocephalus is a condition in which the volume of cerebrospinal fluid in the cerebral ventricles is abnormally elevated. Hydrocephalus patients may show macrocephaly and delayed development. Ventriculoperitoneal shunt is the most commonly used treatment but ventriculoatrial shunt is another treatment option. This report discusses the dental management process employed for a 7-year, 6-month old patient with ventriculoperitoneal shunt-treated hydrocephalus. This patient showed dental caries on the deciduous molars, facial swelling, macrocephaly and delayed development. Pulpectomy was performed on the deciduous molars under nitrous oxide sedation and mild protective stabilization. This patient did not appear to have any specific complications until the latest follow-up and was scheduled for the management of overall oral hygiene, development of permanent teeth, and craniofacial asymmetry through periodic follow-up. During dental treatment of shunt-treated patients, care should be taken to avoid applying excessive force to the catheter running along the patient's neck to prevent the displacement of the catheter. A referral to a neurosurgeon is recommended for patients with ventriculoatrial shunts for prophylactic antibiotics. As hydrocephalus patients grow, they may show craniofacial asymmetry or differences in the calcification of the permanent teeth, and require periodic oral and craniofacial assessment.
Journal of the korean academy of Pediatric Dentistry
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v.38
no.2
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pp.194-201
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2011
A dentigerous cyst is the most common developmental odontogenic cyst. Patients with dentigerous cyst usually feel no pain or discomfort. If it is not treated, tooth eruption might not only be impeded, but also let the tooth translocate to the unusual area. So, early detection and appropriate treatment are important. Enucleation & marsupialization are the best options to treat a dentigerous cyst. Treatment plan depends on patient's age, health, preserve & protect of important structures, and sort of cyst. In these dentigerous cysts cases, by marsupialization and using obturator, affected tooth could be achieved spontaneous eruption into the dental arch even though they were badly dislocated.
The Asiatic black bear (Ursus thibetanus) is globally protected species and involved in a species restoration program by the Korea National Park Service. However, the bears could not be released into the wild were required regulation of population due to the limited space of breeding facility, so surgical castration was performed in two males. Bears were immobilized with a combination of 2 mg/kg tiletamine-zolazepam and $40{\mu}g/kg$ medetomidine, and general anesthesia was maintained with isoflurane via endotracheal tube intubation. Orchiectomy was carried out by the closed method using the LigaSure vessel sealing device through pre-scrotal incision. Subcutaneous tissues of the incision site were sutured by continuous pattern with absorbable suture material, and the skin incision was closed with tissue glue. The bears recovered uneventfully from general anesthesia after a duration of 58 min (bear A) and 53 min (bear B). Total surgical time was 26 min (bear A) and 24 min (bear B). No postoperative swelling or complications were observed. This is the first report that describes the use of the LigaSure for orchiectomy in the Asiatic black bear.
Purpose: In this study, we evaluated the ejection fraction (EF) according to the difference of patient position in Gated Blood Pool (GBP) scan. Material and Methods: The analysis was performed to 80 patients ($51.2{\pm}17.4$ years old) who examined GBP scan in Department of nuclear medicine, National Cancer Center from March 2011 to August 2011. We divided the patients into two groups; one group received conventional position (raise left arm up supine) and supine position (group 1) and the other group received conventional position and left arm back down supine position (group 2). To observe the change EF according to patient position difference, the image was reconstructed and analyzed by Xeleris (GE, USA). We measured body mass index (BMI) of patients. Result: In group 1, EF error less than 3% occurred at a rate of 72.5% (29 of the 40 patients). In group 2, EF error less than 3% occurred at a rate of 79% (32 of the 40 patients). The patient's BMI did not affect ejection fraction. Conclusion: The EF error of left arm back down supine position closer to conventional position than in supine position shows the results.
Lee Kyung-Ja;Moon Hye Seong;Kim Seung Cheol;Kim Chong Il;Ahn Jung Ja
Radiation Oncology Journal
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v.21
no.3
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pp.199-206
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2003
Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.
Allergic contact dermatitis (ACD) is an inflammatory skin disease and regarded as a prototype of T-cell mediated delayed-type hypersensitivity reactions. Poly-${\gamma}$-glutamic acid (PGA) is a biodegradable polymer that is produced by Bacillus subtilis. This study was performed to assess the effects of PGA in a canine model of ACD. ACD was induced on the back of dogs induced by sensitization and repeated application by 2,4-dinitro-1-chlorobenzene (DNCB). Topical treatment of PGA was applied once a day for 12 days and skin biophysical parameters including transepidermal water loss (TEWL), skin hydration, skin pH, skin thickness and erythema index, were measured every two days during experimental periods. Histopathology and immunohistochemistry were performed to evaluate the antiinflammatory effect. In skin biophysical parameters, TEWL, skin hydration, skin thickness and erythema index were significantly increased, with a maximum increase appeared on day 2 (p < 0.05). On the other hand, skin pH was significantly decreased, with a maximum decrease appeared on day 2 (p < 0.01). After the completion of PGA treatment, skin biophysical parameters were significantly reached those of baseline in a time-dependent manner (p < 0.05). In histopathology, marked increases of epidermal thicknesses were induced after DNCB challenge with numerous inflammatory cell infiltrations and edematous changes, decreases of connective tissue occupied regions in dermis. In addition, marked increases of cytokine - tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and interferon-${\gamma}$ (IFN-${\gamma}$)-immunoreactivities in the dermis and of apoptotic markers - caspase-3 and PARP-immunoreactivities in the epidermis were observed in DNCB-PBS control as compared with intact control, respectively (p < 0.01). It means, the ACD and related apoptotic changes were induced by DNCB in the present study. However, these ACD induced by DNCB and related apoptosis in epidermis were significantly inhibited by treatment of PGA treated skin, the decreases of infiltrated inflammatory cells and related decreases of pro-inflammatory cytokine immunoreactivities were also observed (p < 0.01). Based on these findings, PGA may have anti-inflammatory and alleviatory effects in the allergic contact dermatitis.
Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.
Histopathological changes and methemoglobinemia of the eels (Anguilla japonica) reared at six culture farms in the vicinity of Y$\check{o}$su city were investigated under the conditions of $22.0{\sim}29^{\circ}C$, 4.33~7.33ppm of D.O., pH 6.1~8.2 and 0.03~10.1ppm of nitrite from December, 1989 to June, 1990. All of the eels showed no any abnormal state in action, color and blood, but the eels reared in pH 6.0 had planty of mucus and stickiness on their body surface. Methemoglobin levels were 1.03~9.86% of total erythrocyes in Dec. and 5.05~25.69% in June, and poikilocyte levels were 5.8~30.17% in Dec. and 8.67~74.45% in June. These results indicate the fact that the water management of the culture farms was worse in summer than in winter, even though not good in winter. Hypertrophy was found in the gill, hepatic and kidney tissue of the eels in all the culture farms. In March and June, Fish of all culture farms appeared the detachment of gill lamella epithelium cells, pyknosis and sinusoids of nucleus in the hepatic tissue and hemosiderosis in the kidney tissue. The trend of increase in methemoglobin levels appeared in the fish of culture farms with high nitrite concentration, which didn't appear equally in all the culture farms. However, in the culture farms of pH 6.0, methemoglobin and poikilocyte levels were increased independently of concentration of nitrite, and degeneration in the tissue of the gill, liver and kidney was also appeared.
Liver transplantation is definitive treatment for the patients suffering from hepatitis, severe liver cirrhosis and liver cancer. In these patients, systemic infections under immunosuppression may occur easily. Therefore, primary object of dental treatments before liver transplantation is absolute removal of oral infection source. In addition, comprehensive dental management plan is essential for success of liver transplantation. The present study has been performed to investigate decayed, missing and filled permanent teeth index(DMFT index), degree of oral hygiene, past medical history, need of dental treatment, completion of dental treatment need and time interval between dental visit and operation date of liver transplantation in liver transplant candidates. Obtained results were as follows; 1. Decayed teeth of the patients were 2.68, missing teeth were 4.02 and filled teeth were 3.42. DMFT index was 10.12. 2. Twenty percents of patients showed moderate to severe food impactions, 42.2% of patients had moderate to heavy calculus and 37.8% of patients displayed gingival inflammation with swelling. 3. Patients needed periodontal treatments more than any other dental treatments. Periodontal treatments were needed for 88.9% of patients, operative & endodontic treatments were 46.7% of patients and 33.3% of patients needed for oral & maxillofacial surgical treatments. 4. Among 90 patients, time interval between scheduled operation date of liver transplantation and dental visit was within 2 weeks for 32.2% of patients, within 1 week for 20.0% of patients. In conclusion, most liver transplant candidates needed dental treatments for removal of potential infection sources. However because of insufficient interval between dental visit and operation date, they had taken liver transplantation procedures without comprehensive dental management. Development of preventive and comprehensive dental management program is mandatory for these patients. Cooperative interdisciplinary management will play a positive role for successful liver transplantation.
The aims of the present study were to characterize the effect of glucocorticosteroids (GCs) on the normal canine skin and to evaluate the effect of a lipid mixture (LM), containing cholesterol, pseudoceramide, and free fatty acid, on the steroid-induced damaged skin of dogs. Five beagles were involved and the skin of the back of each dog was topically applied with four kinds of GCs twice daily for 28 days. LM was applied after that period of GCs application. Transepidermal water loss (TEWL), skin hydration, and skin pH were assessed during experimental periods and histopathological evaluation was performed. TEWL was significantly increased, with a maximum increase obtained on day 28 (p < 0.01). Skin pH was significantly decreased, with a maximum decrease obtained on day 28 (p < 0.01). Skin surface hydration was significantly increased on day 3, but values of skin hydration were progressively decreased and finally reached those of baseline. In histology, as results of steroid application, losses of keratin layers in the stratum corneum and edematous changes in the upper parts of dermis, and consequently, thickness of the epidermis and the stratum corneum were decreased. In addition, the numbers of hair follicles were markedly decreased in steroid control as compared to intact control. However, these skin atrophic changes were markedly inhibited by treatment of LM as compared with steroid control in the present study. Moreover, all biophysical parameters were reached to the baseline after LM treatment. These results showed that the topically applied GCs induced skin barrier impairment and a LM should be effective on repair of disturbed skin barrier function in dogs. Therefore, it is concluded that a LM tested in the present study is expected to treat the steroid-induced skin damages.
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