• The Journal of Korean Academy of Prosthodontics
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• v.53 no.4
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• pp.310-317
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• 2015

Purpose: The purpose of this study was to evaluate the validity of reference points for edentulous patient by examining the correlation of teeth and face, and intraoral anatomic landmarks. Materials and methods: We examined a facial outline, length, bizygomatic width, nasion - gnathion length, glabella - nasion distance in 270 men and 280 women satisfied with inclusion criteria from Seoul National School of Dentistry. The shape of maxillary central incisor, mesiodistal crown width and length of maxillary 6 incisors, distance from incisive papilla to labial surface of maxillary central incisor, and perpendicular distance from incisive papilla to intercanine line were measured in the stone model. We analyzed the ratio and relevant relation statistically. Results: The probability on having the same shape of face and the relative same shape maxillary incisor was 55.56% and 46.43% for men and women. The facial length proved to be a more valuable measurement in women in the tooth selection. The ratio of bizygomatic width to mesiodistal width of maxillary central incisor, and the ratio of bizygomatic width to width of maxillary 6 incisors were 16.8 : 1 and 3.0 : 1 and were positively correlated with each other. The distance of the canines from the maxillary incisal papilla was $1.33{\pm}1.28mm$. The distance between the center of the incisal papilla and the labial surface of their maxillary central incisor was $9.23{\pm}1.20mm$. Conclusion: It was showed that anatomical reference points in tooth selection and arrangement for edentulous patient are useful and have validity in our limited study.

• Advances in pediatric surgery
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• v.8 no.1
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• pp.16-22
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• 2002

Between March 1999 and January 2000, 82 boys with the diagnosis of inguinal hernias (12 bilateral and 70 unilateral hernias), underwent Ultrasound (US) examination of both sides of the groin, a total of 164 inguinal imaging prior to surgery. The patients ages ranged from 3 days to 12 years with a mean of 32.6 months. Ninty four examinations were on the clinically symptomatic side and 70 were on the asymptomatic side. The US criteria for the diagnosis of an inguinal hernia were as follows: 1) visceral hernia, the presence of bowel loops, or omentum in the inguinal canal, 2) communicating hydrocele, the presence of fluid in the processus vaginalis, 3) widening of patent processus vaginalis at the level of internal inguinal ring. The width of patent processus vaginalis at the level of internal inguinal ring over 4 mm is considered an occult hernia. Among the 94 symptomatic groins, US findings showed 31 (33%) visceral hernias, 18 (19%) communicating hydroceles, and 38 (41%) widening of the internal inguinal ring, and 7 (7%) groins without abnormalities. In 70 asymptomatic groins, there were 4 (6%) visceral hernias, 5 (7%) communicating hydroceles, 11 (16%) widening of the internal inguinal ring, and 50 (70%) groins without abnormalities. Among the 70 asymptomatic groins there were US abnormalities in 20 (28%). One hundred and seven groins with positive US findings were surgically explored. Among 107 operated sites, the operative findings were compatible with the US diagnosis in 104, a sensitivity for US of 97.2%. In patients with US findings of widening of internal inguinal ring (>4 mm), there was patent processus vaginalis in 36 out of 38 symptomatic groins and 10 of 11 asymptomatic groins. The sensitivity of US to the operative findings in widening of internal inguinal ring was 93.8%. For visceral hernia and communicating hydrocele, the sensitivity of positive US findings was 100%. Ultrasonography for inguinal hernias appears to be a rapid, reliable, and noninvasive screening diagnostic tool with high positive specificity. Therefore, we recommend the use of US as a routine diagnostic tool in pediatric patients with inguinal hernias and hydroceles.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.1
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• pp.91-98
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• 2007

The aim of this study was to examine the difference of the depth of sedation using the Bispectral index assessment with and without the added submucosal Midazolam to oral Chloral hydrate and Hydroxyzine for pediatric patients. Twenty seven sedation cases were performed in this study Selection criteria included good health(ASA I), 2 to 6 years of age, the need for sedation to receive dental treatment including anesthesia, and restorative procedure over at least two teeth. Patients were randomly classified into one group taking oral Chloral hydrate(60 mg/kg) and Hydroxyzine(1 mg/kg) and the other group recieving Chloral hydrate(60 mg/kg), Hydroxyzine(1 mg/kg) and submucosal Midazolam(0.1 mg/kg). Nitrous Oxide(50%) was used for both group during sedation. Patients were monitored using a pulse oximeter and a Bispectral monitor. A behavior scale was rated as quiet(Q), crying(C), movement(M), or struggling(S) every 2 minutes watching a recorded videotape. Analysis showed a significant difference in mean Bispectral index and SD during sedation across two groups(P<0.001). The group of patients injected with submucosal Midazolam in addition to oral Chloral hydrate and Hydroxyzine showed a lower mean Bispectral index and a narrower SD. PR and SpO2 for both groups remained within the normal values. Submucosal Midazolam improved the sedation quality by deepening sedation depth without compromising safety and enabled the sedation pattern to be kept more stable.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.3
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• pp.317-327
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• 2010

Among the permanent teeth, the first permanent molars play the greatest role in occlusion and function. So, early diagnosis for congenital missing, abnormal eruption and abnormal formation is very important to the first permanent molars in the course of arch development. The aim of this study is to analyse the differences between right and left first permanent molar's formation and eruption and between upper and lower one. A total of 545 children were selected am ong children who had visited our clinic, investigate eruption and calcification stage of permanent first molar, based on Gleiser and Hunt criteria for this study. 1. Gingival emergence of mandibular first molar is faster than maxillary first molar by 0.75~0.8 years, gingival emergence of maxillary first molar in girls faster than boys by 0.45 years, and that of mandibular first molar in girls faster than boys by 0.5 years. 2. There is the significant difference between right and left first molar on the eruption score and the calcification stage ; 5 year old children show the significant difference on the eruption score. 7 year old children show the significant difference on both the eruption score and calcification stage. 3. It shows the most active eruption movement of crown on the maxilla while the root is rapidly widening its furcation and completing root formation to 2/3, on the other hand, the most active crown emerging on mandible is shown when the root formation completed to 1/4 to 1/2.

• Journal of Radiation Protection and Research
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• v.23 no.3
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• pp.123-138
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• 1998

Characteristics of element responses of Panasonic UD802 personnel dosimeters in the X, ${\beta}$, ${\gamma}$, ${\gamma}/X$, ${\gamma}/{\beta}$ and ${\gamma}$/neutron mixed fields were assessed. A dose-response algorithm has been developed to decide the high probability of a radiation type and energy by using the distribution in all six ratios of the multi-element TLD. To calculate the 4-element response factors and ratios between the elements of the Panasonic TLDs in the X, $\beta$, and $\gamma$ radiation fields, Panasonic’s UD802 TLDs were irradiated with KINS’s reference irradiation facility. In the photon radiation field, this study confirms that element-3 (E3) and element-4 (E4) of the Panasonic TLDs show energy dependent both in low- and intermediate-energy range, while element-1 (E1) and element-2 (E2) show little energy dependency in the entire whole range. The algorithm, which was developed in this study, was applied to the Panasonic personnel dosimetry system with UD716AGL reader and UD802 TLDs. Performance tests of the algorithm developed was conducted according to the standards and criteria recommended in the ANSI N13.11. The sum of biases and standard deviations was less than 0.232. The values of biases and standard deviations are distributed within a triangle of a lateral value of 0.3 in the ordinate and abscissa, With the above algorithm, Panasonic TLDs satisfactorily perform optimum dose assessment even under an abnormal response of the TLD elements to the energy imparted. This algorithm can be applied to a more rigorous dose assessment by distinguishing an unexpected dose from the planned dose for the most practical purposes, and is useful in conducting an effective personnel dose control program.

• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.85-95
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• 1996

Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

• Tuberculosis and Respiratory Diseases
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• v.48 no.4
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• pp.522-529
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• 2000

Backgrounds : Assessment of the presence and degree of reversibility of airflow obstruction is clinically important in patients with asthma or chronic obstructive pulmonary disease. The measurement of peak expiratory flow(PEF) is a simple, fast, and cheap method to assess the severity of obstruction and its degree of reversibility. Assessing the reversibility of airflow obstruction by peak expiratory flow(PEF) measurements is practicable in general practice, but its usefulness has not been well investigated. We compared PEF and $FEV_1$ in assessing reversibility of airflow obstruction in patients with chronic obstructive pulmonary disease or asthma and developed a practical criterion for assessing the presence of reversibility in general practice. Methods : PEF measurements were performed (Spirometry) in 80 patients(aged 24-78) with a history of asthma or chronic obstructive lung disease before and after the inhalation of 200 g salbutamol. The change in PEF was compared with the change in forced expiratory volume in one second($FEV_1$). Reversible airflow obstruction was analyzed according to American Thoracic Society(ATS) criteria. Results : A 12% increase above the prebronchodilator value and a 200ml increase in either FVC or $FEV_1$ reversibility were observed in 45%(36) of the patients. Relative operating characteristic(ROC) analysis showed that an absolute improvement in PEF of 30 l/min gave optimal discrimination between patients with reversible and irreversible airflow obstruction(the sensitivity and specificity of an increase of 30 l/min in detecting a 12% increase above the prebronchodilator value and a 200ml increase in either FVC or $FEV_1$ were 72.2% and 72.7% respectively, with a positive predictive value of 68.4%). Conclusions : Absolute changes in PEF can be used to diagnose reversible airflow obstruction.

• Tuberculosis and Respiratory Diseases
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• v.55 no.5
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• pp.478-487
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• 2003

Background : There have been several studies showing that the angiotensin II and angiotensin converting enzyme(ACE) contributes to the apoptosis of alveolar epithelial cells in idiopathic interstitial pneumonia and the activation of fibroblasts during the process of pulmonary fibrosis. These results suggest that the pulmonary fibrosis can be inhibited by the angiotensin II receptor antagonist(AGIIRA). This study was performed to identify the therapeutic effect of AGIIRA in idiopathic pulmonary fibrosis(IPF). Method : Thirteen patients with IPF, who were diagnosed with an open lung biopsy(6 patients) and furfilling the ATS criteria(7 patients) between March 1999 and October 2001 at the Gachon medical center, were enrolled in this study. Of these patients, eight patients were treated with a regimen including AGIIRA(AT group), and five were treated without AGIIRA(NT group). The pulmonary function tests and dyspnea(ATS scale) were measured at diagnosis and 1 year after treatment. All the data was collected to analyze the therapeutic effect of AGIIRA on the patients with IPF. Results : The AT group contained 8 patients(M:F=4:4) and the NT group contained 5 patients(M:F=3:2). There was no significant difference in the serum angiotensin II level between the two groups($202.5{\pm}58.5$ vs $163.7{\pm}47.3pg/ml$, p>0.05). The AT group showed an upward trend in TLC(+3%), FVC(+4%), FEV1(+3%) and DLco(+2%) compared to the NT group(TLC(-14%), FVC(-3%), FEV1(-4%) except for DLco(+5%)). The dyspnea score in the AT group improved significantly but not in the NT group. Conclusion : These results suggest that the angiotensin II receptor antagonist may have an effect on stabilizing IPF.

• Tuberculosis and Respiratory Diseases
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• v.54 no.4
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• pp.386-394
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• 2003

Background : ATS(American Thoracic Society) defined new guidelines for COPD(chronic obstructive lung disease) in April 2001, following the results of the global initiative for chronic obstructive lung disease. The most important concept of COPD is an airflow limitation which is not fully reversible compared to bronchial asthma(BA). The criteria for COPD are postbronchodilator $FEV_1$ less than 80% of the predicted value and an $FEV_1$ per FVC ratio less than 70%. The global initiative for asthma(GINA) study defined asthma, which included immune-mediated chronic airway inflammatory airway disease, and found that airflow limitation was wide spread, variable and often completely reversible. Taken together COPD and BA may be combined in airflow limitation. This study was designed to evaluate the prevalence of BA in patients with COPD of moderate to severe airflow limitation. Methods : COPD was diagnosed by symptoms and spirometry according to ATS guidelines. Enrolled subjects were examined for peak flow meters(PFM), sputum eosinophils and eosinophil cationic protein(ECP) levels, serum total IgE with allergy skin prick test, and methacholine bronchial provocation test(MBPT). Results : About 27% of COPD patients with moderate to severe airflow limitation were combined with BA. There was significantly decreased response to PFM in severe COPD. However, there was no significant relationship between BA and COPD according to the degree of severity. The BA combined with COPD group showed significantly high eosinophil counts and ECP level in induced sputum. However, neutrophil counts in induced sputum showed significant elevation in the pure COPD group. Conclusion : Twenty-seven percent of COPD patients with moderate to severe ventilation disorder were combined with BA, but there were no significant differences according to the degree of severity.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.45-56
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• 2003

Background : Mycobacterium abscessus is the most common respiratory pathogen in rapidly growing mycobacteria and is resistant to all of the first-line antituberculosis drugs. This report describes the clinical and radiographic characteristics in patients with pulmonary disease caused by M. abscessus. Materials and Methods : Twelve patients with pulmonary disease caused by M. abscessus who fulfilled the 1997 American Thoracic Society diagnostic criteria for a nontuberculous mycobacterial pulmonary infection were observed over a five-and-a-half year period. The clinical characteristics and chest radiographic findings were analyzed, retrospectively. Results : The patients were predominantly female(11/12, 92%) and nonsmokers(12/12, 100%). Coughing (10/12, 83%), sputum(10/12, 83%) and hemoptysis(10/12, 83%) were the common symptoms and they had prolonged periods from the onset of symptoms to the diagnosis of their disease(median 6.5 years). Eleven (92%) patients had a previous history of being treated for pulmonary tuberculosis. The sputum specimens were acid-fast bacilli smear-positive in all patients. All patients were administered antituberculosis drugs. Six (50%) patients were treated with second-line antituberculosis drugs on account of persistent smear-positive sputum specimens. The chest radiographs showed that reticulonodular opacities(11/12, 92%) were the most common pattern of abnormality, followed by cavitary lesions(5/12, 42%). The computed tomography findings suggested bronchiolitis from the centrilobular nodules with a tree-in-bud appearances(9/10, 90%) and bronchiectasis (9/10, 90%) were the most common, followed by well-defined nodules smaller than 10-mm in diameter(7/10, 70%). Conclusions : M. abscessus pulmonary disease should be recognized as a cause of chronic mycobacterial lung disease, and respiratory isolates should be assessed carefully.