• Journal of Veterinary Science
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• 제22권2호
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• pp.17.1-17.13
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• 2021

Background: Klebsiella spp. is an important conditional pathogen in humans and animals. However, due to the indiscriminate use of antibiotics, the incidence of antimicrobial resistance has increased. Objectives: The purpose of this study was to investigate antimicrobial resistance in strains of Klebsiella strains and the phylogenetic relatedness of extended-spectrum cephalosporin (ESC)-resistance among Klebsiella strains isolated from clinically ill companion animals. Methods: A total of 336 clinical specimens were collected from animal hospitals. Identification of Klebsiella species, determination of minimum inhibitory concentrations, detection of ESC resistance genes, polymerase chain reaction-based replicon typing of plasmids by conjugation, and multilocus sequence typing were performed. Results: Forty-three Klebsiella strains were isolated and, subsequently, 28 were identified as K. pneumoniae, 11 as K. oxytoca, and 4 as K. aerogenes. Eleven strains were isolated from feces, followed by 10 from ear, 7 from the nasal cavity, 6 from urine, 5 from genitals, and 4 from skin. Klebsiella isolates showed more than 40% resistance to penicillin, cephalosporin, fluoroquinolone, and aminoglycoside. ESCresistance genes, CTX-M groups (CTX-M-3, CTX-M-15, and CTX-M-65), and AmpC (CMY-2 and DHA-1) were most common in the K. pneumoniae strains. Some K. pneumoniae carrying CTX-M or AmpC were transferred via IncFII plasmids. Two sequence types, ST709 and ST307, from K. pneumoniae were most common. Conclusions: In conclusion, this is the first report on the prevalence, ESCresistance genotypes, and sequence types of Klebsiella strains isolated from clinically ill companion animals. The combination of infectious diseases and antimicrobial resistance by Klebsiella in companion animals suggest that, in clinical veterinary, antibiotic selection should be made carefully and in conjunction with the disease diagnosis.

• Imaging Science in Dentistry
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• 제51권3호
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• pp.251-260
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• 2021

Purpose: Dental implants are widely used for the rehabilitation of edentulous sites. This study investigated the occurrence of dental implant malpositioning as shown on post-implantation cone-beam computed tomography (CBCT) and to identify related factors. Materials and Methods: Samples with at least 1 malpositioned dental implant were collected from a central radiology clinic in Tehran, Iran from January 2017 to January 2019. Variables such as demographic characteristics, length and diameter of implants, type of implant, sites of implant insertion, different types of implant malpositioning problems (cortical plate perforation, interference with anatomical structures), angulation of the implant, and the severity of malpositioning were assessed. In addition, the incidence of implant fracture and over-drilling was evaluated. Data were statistically analyzed using the chi-square test, 1-sample t-test, and Spearman correlation coefficients. Results: In total, 252 patients referred for implant postoperative CBCT evaluations were assessed. The cases of implant malpositioning included perforation of the buccal cortical plate (19.4%), perforation of the lingual cortical plate (14.3%), implant proximity to an adjacent implant (19.0%), implant proximity to an adjacent tooth (3.2%), interference with anatomical structures(maxillary sinus: 18.3%, mandibular canal: 11.1%, nasal cavity: 6.3%, mental foramen: 5.6%, and incisive canal: 0.4%). Implant fracture and over-drilling were found in 1.6% and 0.8% of cases, respectively. Severity was categorized as mild (9.5%), moderate (35.7%), severe (37.7%), and extreme (17.1%), and 52.4% of implants had inappropriate angulation. Conclusion: CBCT imaging is recommended for detecting dental implant malpositioning. The most common and severe type of malpositioning was buccal cortex perforation.

• Korean Journal of Ophthalmology
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• 제32권6호
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• pp.433-437
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• 2018

Purpose: Various absorbable anti-adhesion agents have been used to prevent postoperative synechia formation after endonasal surgery. The purpose of this study was to evaluate the anti-adhesion effects of HyFence and Mediclore after endonasal dacryocystorhinostomy (DCR) compared to a mixed solution of hyaluronic acid and sodium carboxymethylcellulose (Guardix-Sol). Methods: In this retrospective study, endonasal DCR and silicone tube intubation were performed on 198 eyes of 151 patients. Three different anti-adhesion adjuvants were applied to the osteotomy site in the nasal cavity after standard endonasal DCR procedures. The subjects were classified into three respective groups: group A (71 eyes, Guardix-Sol 1.5 g), group B (89 eyes, HyFence 1.5 mL), and group C (38 eyes, Mediclore 1 cc). The three groups were evaluated by asking patients about subjective symptoms and by performing lacrimal irrigation tests and endoscopic examinations. Results: There were no statistically significant differences in age, sex, timing of tube removal, or follow-up period among the three groups. There were no statistically significant differences in success rates among the three groups (p = 0.990, 91.5% [65 / 71], 92.1% [82 / 89], and 92.1% [35 / 38], respectively). Conclusions: HyFence and Mediclore are safe and effective adjunctive modalities following endonasal DCR compared to Guardix-Sol. Therefore, these agents can be considered good alternatives to Guardix-Sol to increase the success rate of endonasal DCR in treating patients with poor prognosis.

• Imaging Science in Dentistry
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• 제50권4호
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• pp.291-298
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• 2020

Purpose: The detection and exact localization of penetrating foreign bodies are crucial for the appropriate management of patients with dentoalveolar trauma. This study compared the efficacy of cone-beam computed tomography (CBCT) and spiral computed tomography (CT) scans for the detection of different foreign bodies composed of 5 frequently encountered materials in 2 sizes. The effect of the location of the foreign bodies on their visibility was also analyzed. Materials and Methods: In this in vitro study, metal, tooth, stone, glass, and plastic particles measuring 1×1×1 mm and 2×2×2 mm were prepared. They were implanted in a sheep's head in the tongue muscle, nasal cavity, and at the interface of the mandibular cortex and soft tissue. CBCT and spiral CT scans were taken and the visibility of foreign bodies was scored by 4 skilled maxillofacial radiologists who were blinded to the location and number of foreign bodies. Results: CT and CBCT were equally accurate in visualizing metal, stone, and tooth particles of both sizes. However, CBCT was better for detecting glass particles in the periosteum. Although both imaging modalities visualized plastic particles poorly, CT was slightly better for detecting plastic particles, especially the smaller ones. Conclusion: Considering the lower patient radiation dose and cost, CBCT can be used with almost equal accuracy as CT for detecting foreign bodies of different compositions and sizes in multiple maxillofacial regions. However, CT performed better for detecting plastic particles.

• Journal of Korean Neurosurgical Society
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• 제65권1호
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• pp.114-122
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• 2022

Objective : Early descent of the diaphragm sellae (DS) during endoscopic endonasal transsphenoidal surgery (EETS) for pituitary macroadenoma surgery is occasionally a troublesome event by blocking the surgical field. Here we introduce an alternative technique with the new pituitary retractor and present our clinical experiences. Methods : We designed a simple and rigid pituitary retractor with the least space occupation in the nasal cavity to be compatible in EETS. The pituitary retractor was held by external holder system to support the herniated DS stably. We retrospectively reviewed a clinical 22 cases of pituitary macroadenomas underwent EETS using the pituitary retractor. Results : The pituitary retractor stably pushed up the herniated DS in all cases, and the surgeon proceeded the procedure with bimanual maneuver. The pituitary retractor was helpful to remove tumors around the medial cavernous sinus and behind the DS in 16 and seven cases, respectively. In four cases, the meticulous hemostasis was completed with the direct visualization by the DS elevation with this retractor. Gross total tumor resection was performed in 20/22 patients (91%). The impaired visual function and hypopituitarism were improved in 18/20 (90%) and 7/14 (50%) patients after surgery, respectively. There was no complication related with the pituitary retractor. Conclusion : During EETS for pituitary macroadenomas, the novel pituitary retractor reported in this study is a very useful technique when the herniated DS block the surgical field and bimanual maneuver. This pituitary retractor can help to result in the excellent surgical outcomes with minimal morbidity.

• 대한치과교정학회지
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• 제51권3호
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• pp.199-216
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• 2021

Objective: The aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence. Methods: A survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment. Results: The database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis. Conclusions: These findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.

• 구강회복응용과학지
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• 제39권4호
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• pp.229-236
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• 2023

상악골 결손은 양성 및 악성 종양, 외상, 감염 등의 수술적 치료에 의해 발생할 수 있다. 구개부의 결함이 발생하며 부비동과 비강으로 음식이나 액체가 통과하는 연하 문제나 비강으로의 공기 누출로 인해 발음 문제가 발생한다. 이를 해소하기 위해 폐색장치가 일반적으로 사용되나, 장기간 사용 시 구강 점막의 자극, 지대치 손상 등의 문제점이 발생할 수 있다. 최근에는 지대치 상실부위에 임플란트를 활용한 폐색장치 제작법이 각광받고 있다. 본 증례보고에서는 상악의 선암종으로 인한 부분 절제술을 받은 환자가 폐색장치의 장기간 사용 후 지대치가 상실되어 해당 부위를 임플란트로 수복, 임플란트 유지 상악 폐색장치를 제작, 적용하여 결손의 재활 및 저작, 연하, 발음, 심미성 개선 측면에서 양호한 결과를 보여 보고하는 바이다.

• 대한영상의학회지
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• 제85권1호
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• pp.247-251
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• 2024

두경부의 호흡상피 선종양 과오종은 섬모호흡상피로 둘러싸인 선조직으로 구성된 드문 양성종양이다. 두경부의 비강, 부비동 또는 비인강의 호흡상피 선종양 과오종이 현재까지 보고되었다. 호흡상피 선종양 과오종은 드물고 특징적인 영상 소견이 잘 알려져 있지 않기 때문에 흔하지 않은 위치에 비특이적인 낭성종물로 발생한 경우 영상의학적 진단을 내리기가 쉽지 않다. 저자들은 볼쪽공간(상악후방 지방층)에서 낭성종물의 형태로 나타난 병리적으로 진단된 호흡상피 선종양 과오종의 CT 및 MRI 영상 소견을 증례 보고하고자 한다.

• 대한소아치과학회지
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• 제35권4호
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• pp.750-756
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• 2008

과잉치는 상악 정중부에서 주로 발견되며, 과잉치의 발생 기전은 유전적 또는 환경적 원인에 의하여 치배 형성기 동안에 정상 치판의 비정상적 증식에 의한 것으로 보고되었다. 과잉치로 인한 합병증으로는 인접 영구치의 맹출 장애와 전위, 회전, 정중이개, 비강으로의 맹출, 낭종 형성 등 이 있다. 과잉치를 외과적으로 발거하기 위한 시기에 대해서는 논란이 되고 있다. 인접치의 배열과 맹출 장애, 전위를 야기할 수 있기 때문에 조기에 발거하자는 견해와 어린이의 행동 조절 및 인접 영구치의 치근 형성 정도를 고려하여 $8{\sim}10$세 이후에 발거 하자는 견해가 있다. 후자와 같이 외과적 발거 시기를 연기할 경우, 역위 및 수평 매복된 과잉치는 악골 내에서 비강 또는 경구개, 소구치 부위 등으로 이동할 수 있으며, 과잉치의 이동과 전상악골의 수직고경 증가로 인하여 외과적 발거 시 난이도가 높아질 수 있다. 따라서, 역위 및 수평 매복된 과잉치의 외과적 발거 시기를 결정하기 위하여 연기하는 경우에 과잉치의 악골 내 이동을 고려해야 한다. 이 증례는 상악 정중부에 역위 매복된 과잉치가 있어서 내원한 $6{\sim}7$세의 어린이에서 과잉치의 외과적 발거 시기를 결정하기 위하여 주기적인 방사선 학적 검사로 관찰하던 중에 $2{\sim}3$년 후 과잉치 위치가 악골 내에서 초진 시 위치로부터 이동된 경우로 이를 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제19권1호
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• pp.28-38
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• 2002

1999년 6월에서 2000년 6월까지 영남대학교 의과대학 부속병원 이비인후과에 내원하여 내시경 검사와 부비동 전산화단층촬영으로 만성 부비동염 혹은 만성 부비동염과 비용으로 진단받고 한 사람의 수술자에 의해 내시경적 부비동 수술을 시행받은 성인 157명의 환자 중 전향적으로 6개월 이상 추적관찰이 가능하였고 비강음향통기도 검사를 시행한 84명을 대상으로 하였다. 수술 결과는 증상접수, 비내시경점수, 방사선점수, 수술접수, 음향비강통기도 검사치를 각각 구하여 이들의 연관성을 조사하였다. 수술 전과 수술 후 3개월, 수술 전과 수술 후 6개월째의 각각 증상 점수는 통계학적으로 의의 있게 감소하였다. 음향비강통기도 검사상 전비공에서 7cm 후방을 기준으로 측정한 수술 전과 수술 후 3개월 째 비강체적은 $17.10cm^3$에서 $27.37cm^3$로 통계학적으로 의의 있게 증가하였다. 수술 전과 수술 후 3개월 째는 내시경 점수가 낮은 군과 높은 군에서 각각의 증상 점수와 호전도는 차이가 없었다. 수술 전과 수술 후 3개월 째의 증상 접수의 호전도는 모든 증상이 호전되었지만 특히 두통, 후각장애, 안면부 통증 및 중압감, 전반적 불편감이 통계학적으로 의의 있게 CT점수가 높은 군에서 낮은 군보다 높았다. 수술점수가 높은 군과 낮은 군에서 수술 전과 수술 후의 증상 점수의 호전도와 음향비강통기도 검사결과는 차이가 없었다. 이상의 결과로 보아 만성 부비동염 환자에서 내시경적 부비동 수술 후 수술 전-후의 호전도를 분석하기 위해서는 주관적인 증상의 호전여부와 객관적인 음향비강통기도 검사를 통한 비강체적의 측정이 수술 후 결과의 판정에 도움이 될 것으로 사료되고, 수술 전 내시경 점수, 수술 전 CT점수 및 수술점수에 따른 증상의 호전여부에 대한 분석 중 수술 전 CT점수가 수술 결과의 판정에 가장 도움이 될 것으로 사료된다.