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Comparing the Possible Complications of Endoscopy Dependent on Time in Caustic Poisoned Patients (부식제 중독 환자에서 시간에 따른 내시경 합병증 비교)

  • Choi, Jin Geul;Kim, Oh Hyun;Kim, Hyun;Lee, Dong Keon;Go, Jin;Kim, Tae Hoon;Cha, Kyoung Chul;Lee, Kang Hyun;Hwang, Sung Oh;Cha, Yong Sung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.2
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    • pp.70-76
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    • 2014
  • Purpose: Endoscopy has been recommended as a primary procedure for determining the extent of damage and prognosis in patients with caustic ingestions. Endoscopy within the first 24 hours has been suggested, however, such immediate endoscopy is not always possible. Therefore, we wanted to determine complications and possible delayed sequelae after the endoscopy performed dependent on time, including less than 24 hours and more than 24 hours, after ingestion of relatively high toxic caustic agents. Methods: From January 2005 to May 2013, 105 consecutive patients were diagnosed with caustic poisoning in the emergency department of the Wonju Severance Christian Hospital. Out of 95 patients who underwent endoscopy, while excluding 49 patients who ingested sodium hypochlorite and 15 patients due to insufficient data, 41 patients were ultimately included. We compared general characteristics, complications related to endoscopy, late sequelae, total admission length, and mortality between two groups. Results: Twenty eight patients (68.3%) were diagnosed with acid ingestion. Median endoscopy time was 17.8 (IQR 9.7-36.9) hours and performed in 16 patients (39%) after 24 hours. There were no complications, such as perforation and bleeding in either endoscopy within 24 hours group or endoscopy after 24 hours group. In addition, no difference in ingested materials, endoscopy grade, or late sequelae was observed between endoscopy within 24 hours group and endoscopy after 24 hours group. Conclusion: No difference in complications and late sequelae was observed between endoscopy within 24 hours group and endoscopy after 24 hours group when endoscopy was performed based on a clinician's assessment.

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Characteristics of the Perception of the Somatic Symptoms and the Cognitive Emotion Regulation Strategies in Patients With Posttraumatic Stress Disorder (외상후스트레스장애 환자의 신체증상 지각 특성과 인지적 정서조절전략)

  • Kwon, Joo-Han;Park, Jong-Il;Sakong, Jeong-Kyu;Yang, Jong-Chul
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.102-110
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    • 2021
  • Objectives : The purpose of this study is to investigate the characteristics of the perception of the somatic symptoms and the cognitive emotion regulation strategies in patients with posttraumatic stress disorder (PTSD). Methods : A total of 48 patients meeting DSM-5 criteria for PTSD and 48 normal controls were recruited for participation in this study. We evaluated subjects using Clinician-Administered PTSD Scale (CAPS), Somato-Sensory Amplification Scale (SSAS), Hamilton Anxiety Scale (HAM-A) and Cognitive Emotion Regulation Questionnaire (CERQ). We analyzed data using an independent t-test and Pearson's correlation analysis. Results : In terms of SSAS, PTSD patients presented higher average SSAS scores than normal controls but the result is not statistically significant. In PTSD patients, the severity of PTSD is significantly correlated with CERQ-rumination and CERQ-catastrophizing. The SSAS scores of PTSD patients show the significant positive correlation with PTSD hyperarousal symptoms, CERQ-catastrophizing and CERQ-blaming others. Conclusions : These results reveal that patients with PTSD have maladaptive cognitive emotion regulation strategies such as rumination and catastrophizing. Somato-sensory amplification seems to be related with PTSD hyperarousal, CERQ-catastrophizing and CERQ-blaming others. Therefore, reducing somato-sensory amplification, rumination and catastrophizing can be helpful to reduce PTSD symptoms and somatic symptoms in PTSD patients.

Association of the Risk of Leukemia and Non-Hodgkin's Lymphoma (NHL) with Environmental Agents (모 지역의 소아 백혈병 및 악성림프종 발병 사례와 환경적 요인의 연관성 조사)

  • Park, Dong-Uk;Choi, Sangjun;Youn, Kanwoo;Kim, So-Yeon;Kim, Hee-Yun;Park, Yun-Kyung;Kim, Won;Iim, Sanghyuk;Park, Jihoon
    • Journal of Environmental Health Sciences
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    • v.45 no.3
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    • pp.203-212
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    • 2019
  • Objective: A total of five students at same middle school were reported to be diagnosed with pediatric leukemia (n=2), non-Hodgkin's lymphoma (NHL, n=1) and aplastic anemia (n=2) between 2016 and 2017. The aims of this study are to assess exposure to environmental hazardous agents known to be associated with the risk of leukemia and to examine whether the environment of school is associated with the risk leukemia. Method: A total of 11 environmental agents causing childhood leukemia were monitored using international certified method in schools where patients had ever attended. Radon & Thoron detector was used to monitor real-time airborne radon and thoron level ($Bq/m^3$). Clinician interviewed two among nine patients who agreed to participate in this study in order to examine the association of demographic and genetic factors by individually. Leukemia, NHL, and aplastic anemia were grouped into lymphohematopoietic disorder (LHP). Results: Except for airborne radon level, no environmental agents in school and household where patients may be exposed were found to higher than recommended airborne level. Clinical investigation found no individual factors that may be associated with the risk of LHP. Higher airborne radon level than Korea EPA's airborne radon criteria ($148Bq/m^3$) was monitored at most of several after-class room of one elementary school, where two leukemia patients graduated. Significant radon level was not monitored at class-room. Significant exposure to radon of patients was not estimated based on time-activity pattern. Conclusions: Our results have concluded that there have been no environmental factors in school and household environment that may be associated the risk of LHP.

Application of 3D printer in dental clinic (치과 진료실에서 3D 프린트의 활용)

  • Kim, Hyun Dong
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.27 no.2
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    • pp.82-96
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    • 2018
  • 3D printing is a process of producing 3d object from a digital file in STL format by joining, bonding, sintering or polymerizing small volume elements by layer. The various type of 3d printing is classified according to the additive manufacturing strategies. Among the types of 3D printer, SLA(StereoLithography Apparatus) and DLP(Digital Light Processing) 3D printer which use polymerization by light source are widely used in dental office. In the previous study, a full-arch scale 3d printed model is less precise than a conventional stone model. However, in scale of quadrant arch, a 3d printed model is significantly precise than a five-axis milled model. Using $3^{rd}$ Party dental CAD program, full denture, provisional crowns and diagnostic wax-up model are fabricated by 3d printer in dental office. In Orthodontics, based on virtual setup model, indirect bracket bonding tray can be generated by 3d printer. And thermoforming clear aligner can be fabricated on the 3d printed model. 3D printed individual drilling guide enable the clinician to place the dental implant on the proper position. The development of layer additive technology enhance the quality of 3d printing object and shorten the operating time of 3D printing. In the near future, traditional dental laboratory process such as casting, denture curing will be replaced by digital 3D printing.

Computer-aided design and manufacturing-based full mouth rehabilitation for a patient with excessive attrition and restricted vertical dimension: A case report (심한 치아 마모와 수복 공간 부족을 보이는 환자에서 CAD/CAM 기술을 활용한 완전 구강 회복: 증례 보고)

  • Cho, Jun-Ho;Yoon, Hyung-In;Yeo, In-Sung;Han, Jung-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.495-505
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    • 2019
  • This study reported the treatment of a patient with excessive worn dentition and limited maxillo-mandibular space for restoration, utilizing the computer-aided design and computer-aided manufacturing (CAD/CAM) technology. After the thorough examination of the patient's occlusal vertical dimension (OVD), full mouth rehabilitation was planned with increase of the OVD. The patient was satisfied with the provisional restorations establishing the increased OVD. The horizontal and vertical data of the patient's jaw relation that the provisional restorations contained were transferred to the definitive metal ceramic fixed prostheses by double scanning and three-dimensional printing. After the fixed restorations were cemented to the abutments, electronic surveying and three-dimensional printing were used to fabricate metal frameworks for the patient's removable partial dentures. The mandibular definitive removable prostheses were delivered to the patient's mouth and the full mouth rehabilitation procedures were completed. The digital technologies used for this case produced fixed and removable restorations satisfactory in masticatory, phonetic and aesthetic functions to both the patient and the dental clinician.

Full mouth rehabilitation with implant-supported fixed prosthesis via dental CAD-CAM system (Dental CAD-CAM system을 통한 고정성 전악 임플란트 수복 증례)

  • Hong, Jeong-Min;Han, Jung-Suk;Yoon, Hyung-In;Yeo, In-Sung Luke
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.97-106
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    • 2021
  • Dental implants should be placed at ideal sites for implant-supported restorations. For a patient with insufficient residual ridge, mouth preparation including surgical intervention can be indicated to establish a soft and hard tissue environment favorable for a definitive prosthesis. Prosthodontic design based on computer-guided surgery and computer-aided design-computer-aided manufacturing (CAD-CAM) provides a visual blueprint allowing a clinician to assess the necessity of such a surgical intervention beforehand. In this case, a definitive restoration was planned and made via a CAD-CAM system according to the patient's oral status before treatment, simulated surgical interventions and serial provisional restorations. Based on the planning, a guided template was made and the implants were installed with bone augmentation using the template. Customized abutments, the first and the second provisional restorations were designed and fabricated by CAD-CAM. The definitive restorations were digitally made following the shape of the second provisional prostheses, which were confirmed in the patient's mouth. The patient was satisfied with the masticatory, phonetic and aesthetic functions of these definitive prostheses.

Restoration of implant-supported fixed dental prosthesis using the automatic abutment superimposition function of the intraoral scanner in partially edentulous patients (부분무치악 환자에서 구강스캐너의 지대주 자동중첩기능을 이용한 임플란트 고정성 보철물 수복 증례)

  • Park, Keun-Woo;Park, Ji-Man;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.79-87
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    • 2021
  • The digital workflow of optical impressions by the intraoral scanner and CADCAM manufacture of dental prostheses is actively developing. The complex process of traditional impression taking, definite cast fabrication, wax pattern making, and casting has been shortened, and the number of patient's visits can also be reduced. Advances in intraoral scanner technology have increased the precision and accuracy of optical impression, and its indication is progressively widened toward the long span fixed dental prosthesis. This case report describes the long span implant case, and the operator fully utilized digital workflow such as computer-guided implant surgical template and CAD-CAM produced restoration after the digital impression. The provisional restoration and customized abutments were prepared with the optical impression taken on the same day of implant surgery. Moreover, the final prosthesis was fabricated with the digital scan while utilizing the same customized abutment from the provisional restoration. During the data acquisition step, stl data of customized abutments, previously scanned at the time of provisional restoration delivery, were imported and automatically aligned with digital impression data using an 'A.I. abutment matching algorithm' the intraoral scanner software. By using this algorithm, it was possible to obtain the subgingival margin without the gingival retraction or abutment removal. Using the digital intraoral scanner's advanced functions, the operator could shorten the total treatment time. So that both the patient and the clinician could experience convenient and effective treatment, and it was possible to manufacture a prosthesis with predictability.

Web viewer for sharing of prosthesis design between laboratory and clinic: Case report (웹뷰어를 이용한 기공실과 진료실 측 간의 보철물 설계 형태의 공유: 증례 보고)

  • Jang, Sung Won;Lee, Ho Jin;Kim, So-Yeun;Lee, Du-Hyeong
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.3
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    • pp.276-282
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    • 2022
  • Close communication between clinicians and dental technicians is an important factor in providing successful prostheses. The exchange of opinions with laboratories has mainly been in the form of written prescriptions and a photos, but it has been reported that information transmission may be limited. Currently, as digital technology-based prosthesis fabrication is common, 3D image objects can be stored on the web and can be easily viewed through a mobile web browser. In this article, we introduce cases where the design of the prosthesis was improved by designing the prosthesis using CAD software and reviewing the prosthesis designed with the clinical side through a web viewer. Through this protocol, it was possible to improve the occlusal surface and crown contour, the opposing teeth condition, the size of the gingival embrasure, and the shape of pontic. The process of sharing, discussing, and modifying the prosthesis design with the clinician and technician through a web viewer contributes to reflecting the diversity of oral conditions and individualized needs, thereby helping to make functional and esthetic prostheses.

Rehabilitation of a patient by converting poorly maintained fixed implant prosthesis into implant overdenture: a case report (기존 임플란트 보철물의 불량한 유지관리를 개선하기 위해 임플란트 피개의치로의 상부 보철물 전환 증례)

  • Kim, Yeong-Kyu;Jeong, Chang-Mo;Yun, Mi-Jung;Lee, So-Hyoun;Huh, Jung-Bo
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.1
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    • pp.127-134
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    • 2022
  • Among many contributing factors of implant failure, excessive loading and inflammation contribute mainly to increasing implant failure rate. Especially, poor oral hygiene around implants is one of the most common reasons for implant failure. When implant prosthesis fails to function, the clinician should re-diagnose and plan treatment using the remaining implants. Additional implantation may be needed to make a new type of prosthesis or either implant-assisted RPD and implant overdenture treatment may be performed using the remaining implants. In this article, a patient whose fixed implant prosthesis in the maxilla had failed of poor oral hygiene maintenance was reported to be recovered with removable implant overdenture by using remaining implant abutments and a milled bar with additional retentive elements. Through this treatment, the clinical results were satisfactory in terms of esthetics, masticatory function recovery and oral hygiene management.

Update on the Taxonomy of Clinically Important Anaerobic Bacteria (임상적으로 중요한 무산소성 세균의 분류 업데이트)

  • Myungsook, Kim
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.4
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    • pp.239-248
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    • 2022
  • The taxonomy of bacteria in the field of clinical microbiology is in a state of constant flux. A large-scale revamping of the classification and nomenclature of anaerobic bacteria has taken place over the past few decades, mainly due to advances in molecular techniques such as 16S rRNA and whole genome sequencing (WGS). New genera and species have been added, and existing genera and species have been reclassified or renamed. A major role of the clinical microbiological laboratories (CMLs) is the accurate identification (ID) and appropriate antimicrobial susceptibility testing (AST) for clinically important bacteria, and rapid reporting and communication of the same to the clinician. Taxonomic changes in anaerobic bacteria could potentially affect the choice of appropriate antimicrobial agents and the antimicrobial breakpoints to use. Furthermore, current taxonomy is important to prevent treatment failures of emerging pathogenic anaerobes with antimicrobial resistance. Therefore, CMLs should periodically update themselves on the changes in the taxonomy of anaerobic bacteria and suitably inform clinicians of these changes for optimum patient care. This article presents an update on the taxonomy of clinically important anaerobic bacteria, together with the previous names or synonyms. This taxonomy update can help guide antimicrobial therapy for anaerobic bacterial infections and prevent treatment failure and can be a useful tool for both CMLs and clinicians.