Purpose: Peri-implantitis, a clinical term describing the inflammatory process that affects the soft and hard tissues around an osseointegrated implant, may lead to peri-implant pocket formation and loss of supporting bone. However, this imprecise definition has resulted in a wide variation of the reported prevalence; ${\geq}10%$ of implants and 20% of patients over a 5- to 10-year period after implantation has been reported. The individual reporting of bone loss, bleeding on probing, pocket probing depth and inconsistent recording of results has led to this variation in the prevalence. Thus, a specific definition of peri-implantitis is needed. This paper describes the vast variation existing in the definition of peri-implantitis and suggests a logical way to record the degree and prevalence of the condition. The evaluation of bone loss must be made within the concept of natural physiological bony remodelling according to the initial peri-implant hard and soft tissue damage and actual definitive load of the implant. Therefore, the reason for bone loss must be determined as either a result of the individual osseous remodelling process or a response to infection. Methods: The most current Papers and Consensus of Opinion describing peri-implantitis are presented to illustrate the dilemma that periodontologists and implant surgeons are faced with when diagnosing the degree of the disease process and the necessary treatment regime that will be required. Results: The treatment of peri-implantitis should be determined by its severity. A case of advanced peri-implantitis is at risk of extreme implant exposure that results in a loss of soft tissue morphology and keratinized gingival tissue. Conclusions: Loss of bone at the implant surface may lead to loss of bone at any adjacent natural teeth or implants. Thus, if early detection of peri-implantitis has not occurred and the disease process progresses to advanced peri-implantitis, the compromised hard and soft tissues will require extensive, skill-sensitive regenerative procedures, including implantotomy, established periodontal regenerative techniques and alternative osteotomy sites.
Journal of the Korea Institute of Information and Communication Engineering
/
v.21
no.4
/
pp.836-845
/
2017
Due to the development of endoscopic technology, endoscopic diagnosis and procedures have been actively performed. However, due to the increase in colorectal cancer and the effect of government's early cancer screening project, the number of endoscopic diagnosis and procedures has increased, thus medical accidents such as perforation and bleeding are increasing. Therefore, efforts to reduce such medical accidents are needed. In this paper, we propose a method to provide the direction information of the endoscope and the force applied to the probe in real time. We also propose and evaluate an interpolated complementary filter considering the very slow movement of the endoscope probe. The proposed interpolated complementary filter showed 34.6% and 27.6% performance improvement. The expected user interface for applying the proposed method to the endoscopic system is also presented. This shows that the proposed method is applicable to endoscopy system.
Park, You Kyung;Kang, Ji Eun;Kim, Seong Joon;La, Hyen O;Rhie, Sandy Jeong
Korean Journal of Clinical Pharmacy
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v.26
no.3
/
pp.207-212
/
2016
Objective: Prescription rate of dabigatran and rivaroxaban, which are the direct oral anticoagulants (DOAC), has increased. We have analyzed the prescription trend and medication use of dabigatran and rivaroxaban in patients with non-valvular atrial fibrillation (NVAF). Methods: It was retrospectively studied from September 2012 to April 2014 using the electronic medical records and the progress notes. Patients with NVAF (n=424) were evaluated on the medication use, prescribing preferences, adverse drug reactions (ADRs) and the availability of prescription reimbursement of dabigatran (n=210) and rivaroxaban (n=214). Results: Dabigatran was prescribed higher than rivaroxaban (23.3% versus 7.5%, p<0.001) in the neurology department, but rivaroxaban was prescribed higher compared to dabigatran in the cardiology department (87.4% versus 74.3%, p<0.001). Dabigatran was prescribed more than rivaroxaban in high risk patients with CHADS2 score ${\geq}3$ (44.3% versus 31.3%, p=0.006). Dabigatran patients seemed to have more ADRs than patients with rivaroxaban (25.2% versus 11.2%, p<0.001), but no serious thrombotic events and bleeding were found. Only 35.6% (n=151) were eligible for prescription reimbursement by the National Health Insurance (NHI). Bridging therapy (86, 31.5%) and direct-current cardioversion (57, 20.2%) were main reasons of ineligibility for reimbursement. Conclusion: Prescription preferences were present in choosing either dabigatran or rivaroxaban for patients with NVAF. Inpatient protocols and procedures considering patient-factors in NVAF need to be developed.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.46
no.2
/
pp.116-124
/
2020
Objectives: Postoperative nausea and vomiting (PONV) is considered as one of the most incessant and anguishing factors for patients who have surgery under general anesthesia. The occurrence of PONV after orthognathic surgery can lead to dehydration, infection, bleeding at the surgical site, and patient discomfort, all of which leave a patient with a negative impression of anesthesia and surgery. The purpose of this study is to assess the incidence of PONV after orthognathic surgery and to correlate it with factors related to patient, anesthesia, and surgery. Materials and Methods: A 10-year retrospective survey was done for patients who underwent orthognathic surgery between January 2008 and March 2018. The incidence of PONV was evaluated, correlations with factors related to patient, anesthesia, and surgery were studied, and the duration between the end of surgery and the occurrence of the first episode of PONV was tabulated. Results: The medical records of 109 patients were screened, out of which 101 satisfied the inclusion criteria. Amongst these patients, 60 patients (59.4%) suffered from PONV. Patient's sex, induction agent used, intravenous fluids administered intraoperatively, duration and type of surgery, and the presence of a nasogastric tube were seen to have a significant influence on precipitating PONV. It was noted that among the patients who suffered from PONV, 61.7% of them experienced it 48-96 hours after the end of surgery. Conclusion: Despite the improved anesthetic equipments, drugs, and surgical techniques currently used, the incidence of PONV was high in our study. Certain factors that were seen to influence PONV in this study need to be considered in order to develop an efficacious protocol to reduce PONV in orthognathic surgeries.
Objective : Women's obesity brings prblems not only appearance but also health which men do not have. This study was conducted to investigate the different factors of obesity between men and women. Materials and Methods : We searched papers usin key words (women, gender, and obesity) on pubmed and obesity journal. Result : Women's obesity leads to amenorrhea, abnormal uterine bleeding, infertility, poly cystic ovarian syndrome, abortion, and luteal phase inadequacy. Obesity induces metabolic syndrome, type-2 diabetes, cardiovascular problems, hypertension, cancer, and psychophysiologic diseases. The difference in body morphology and in particular fat distribution between the sexes leads to gender-specific differences in prevalence of chronic diseases, and unique problems for each sex including infertility, problems during pregnancy, polycystic ovarian syndrome, and endometrial carcinoma in women, and prostate and testicular cancer in men. The influence of gender on obesity is had by genetic view, hormones, pregnancy, delivery, and menopause. Conclusion : Obese women have higher risk factors than men by the influence of gender.
Background: Anticoagulant therapy can be required during pregnancy with prosthetic heart valves. Warfarin and heparin provide real protection against thromboembolic phenomena, but they also carry serious risks for the fetus and the mother. In an attempt to identify the best treatment for pregnant women with cardiac valve prostheses who are receiving anticoagulant, we studied 19 pregnancies, the warfarin was discontinued and heparin was administered every 12 hours by subcutaneous injection in doses adjusted to keep the midinterval aPTT in the therapeutic range(at least 2-2.5 control) from the conception to the 12th week of gestation and oral antiocagulant was then administered until the middle of the third trimester in the therapeutic range(at least 2 INR), and heparin therapy was restared until delivery. Also in order to avoid an anticoagulant effect during delivery, it has been our practice to instruct women to either discontinue their heparin injections with the onset of labur or to stop heparin injections 12 hours prior to the elective induction of labour. Result: The outcome of 19 pregnancies managed with above protocol was spontaneous abortion in 3 cases, voluntary termination in 2 cases, premature delivery at 35 weeks in 1 case and delivery at full-term in 14 cases. There was no maternal morbidity and moratality and fetopathy. Conclusion: We conclude that in the second and third trimester of pregnancy, warfarin provide effective protection against thromboembolism, Oral antiocagulant therapy should be avoided in 2 weeks before delivery because of the risk of serious perinatal bleeding caused by the trauma of delivery to the anticoagulated fetus. However, the substitution of heparin at first trimester and 2 weeks before delivery reduce the incidence of complications.
Kim, Choong Hyeon;Cheon, Ji Seon;Choi, Woo Young;Son, Kyung Min
Archives of Craniofacial Surgery
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v.19
no.1
/
pp.41-47
/
2018
Background: The number of surgical risks recalled by a patient after surgery can be used as a parameter for assessing how well the patient has understood the informed consent process. No study has investigated the usefulness of a self-developed mobile application in the traditional informed consent process in patients with a nasal bone fracture. This study aimed to investigate whether delivery of information, such as surgical risks, through a mobile application is more effective than delivery of information through only verbal means and a paper. Methods: This prospective, randomized study included 60 patients with a nasal bone fracture. The experimental group (n=30) received preoperative explanation with the traditional informed consent process in addition to a mobile application, while the control group (n=30) received preoperative explanation with only the traditional informed consent process. Four weeks after surgery, the number of recalled surgical risks was compared for analysis. The following six surgical risks were explained: pain, bleeding, nasal deformity, numbness, nasal obstruction, and nasal cartilage necrosis. Results: The mean number of recalled surgical risks among all patients was $1.58{\pm}0.56$. The most frequently recalled surgical risk was nasal deformity in both groups. The mean number of recalled surgical risks was $1.72{\pm}0.52$ in the experimental group and $1.49{\pm}0.57$ in the control group. There was a significant association between mobile application use and the mean number of recalled surgical risks (p=0.047). Age, sex, and the level of education were not significantly associated with the mean number of recalled surgical risks. Conclusion: This study found that a mobile application could contribute to the efficient delivery of information during the informed consent process. With further improvement, it could be used in other plastic surgeries and other surgeries, and such an application can potentially be used for explaining risks as well as delivering other types of information.
Lee, Jae-Hong;Kweon, Helen Hye-In;Choi, Seong-Ho;Kim, Young-Taek
Journal of Periodontal and Implant Science
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v.46
no.6
/
pp.396-404
/
2016
Purpose: The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015. Methods: Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars. Results: The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion. Conclusions: This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants.
Bas, Bilge;Dinc, Bulent;Oymaci, Erkan;Mayir, Burhan;Gunduz, Umut Riza
Asian Pacific Journal of Cancer Prevention
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v.16
no.13
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pp.5163-5167
/
2015
Background: Colon polyps need to be excised upon detection during colonoscopy due to the risk of malignancy irrespective of their size. In our study, we retrospectively evaluated the clinicopathological characteristics of polyps detected during colonoscopy. Materials and Methods: We assessed 379 patients with polyps detected during colonoscopy between January 2010 and May 2012. The demographics, complaints, colonoscopy findings (shape, place and size of the polyp) and histopathological findings were recorded. We carried out statistical analysis using PASW 18.0 for Windows. Results: There were 227 males (59.9%) and 152 females (40.1%) in the trial. The mean age was 53.8 years (32-90). The most common complaint was rectal bleeding (36.1%), followed by abdominal pain (35.4%). Polyps were detected most commonly in the rectosigmoid region (43.8%), followed by the descending colon (17.4%). Some 239 patients had a single polyp (63.1%) while 140 were found to have multiple polyps (36.9%). While tubular adenoma was the most common pathological type, occurring in 181 patients (47.8%), tubulovillous adenoma (14.2%) and hyperplastic polyp (12.7%) followed, occurring in 54 and 48 patients respectively. While 313 patients (82.6%) did not feature dysplasia, 37 patients (9.7%) exhibited low-grade dysplasia, 28 (7.7%) had high-grade dysplasia and 4 had cancer (1.1%). The rates of villous components and dysplasia were detected to be high among pedunculated polyps and polyps larger than 1 cm (p<0.001). Conclusions: Due to the fact that large-diameter polyps with malignant potential are commonly located in the left colon and have a high prevalence among the middle-aged individuals, it would be appropriate to screen this population at regular intervals via rectosigmoidoscopy.
Objective : Dissection of the middle cerebral artery (MCA) is less common than dissection of vessels in the vertebrobasilar system or carotid artery. Acute complete occlusion related to MCA dissection is extremely rare. We report an endovascular approach in patients with acute complete occlusion due to MCA dissection. Methods : We reviewed retrospectively the endovascular procedure and clinical results for acute-stroke patients who underwent recanalization from October 2014 through December 2018. Initial imaging findings and the endovascular procedure were analyzed for patients with acute complete occlusion due to MCA dissection. Results : We undertook first-line aspiration thrombectomy using a Penumbra catheter in 294 patients with acute occlusion of the M1 segment. Of these patients, seven were confirmed to have acute complete occlusion due to MCA dissection. All patients had angiographic findings of an intimal flap at the proximal occlusion site of the MCA. One patient complained of severe headache during microcatheter passage through the occluded lesion and died due to massive bleeding caused by rupture of the false lumen. The remaining patients underwent initial contact aspiration thrombectomy without microcatheter passage. After aspiration thrombectomy, six patients had delayed flow through the MCA. One patient underwent stenting of the MCA because of progressive symptoms. Conclusion : An intimal flap at the proximal portion of an occluded MCA can suggest the possibility of MCA dissection. Contrast aspiration thrombectomy without microcatheter passage can reduce the risk of false lumen rupture in cases of MCA dissection.
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