Background To evaluate gingival inflammation from fixed-dose combinations of vitamin C, vitamin E, lysozyme and carbazochrome (CELC) in the treatment of chronic periodontitis following scaling and root planing. Methods One hundred patients were randomly assigned to receive CELC (test) or placebo (control) for the first 4 weeks at a 1:1 ratio, and both groups received CELC for the remaining 4 weeks. Primary outcome was the mean change in the gingival index (GI) after 4 weeks. Secondary outcomes included mean change in GI after 8 weeks and plaque index, probing depth, clinical attachment level, and VAS at 4 weeks and 8 weeks. Results Ninety-three patients completed the study. The GI in the test group significantly decreased after 4 weeks ( p < 0.001) and 8 weeks ( p < 0.001). The mean change from baseline in GI significantly decreased in the test group compared to the control group after 4 weeks ( p = 0.015). In the GEE model adjusting for age, gender and visits, the test group showed 2.5 times GI improvement compared to the control group ( p = 0.022). Conclusions Within the study, CELC showed a significant reduction in gingival inflammation compared with a placebo. Other parameters, however, were similar between groups. Trial registration KCT0001366 (Clinical Research Information Service, Republic of Korea) and 29 Jan 2015, retrospectively registered.

PurposeThe aim of this study was to analyze the results of children treated with hemodialysis (HD) at Severance Hospital over 35 years in terms of incidence, etiologies, characteristics, complications, and clinical outcomes.Materials and MethodsWe analyzed 46 children admitted to Severance Hospital who had undergone HD between January 1979 and December 2013.ResultsThe main etiologies of the 23 end-stage renal disease (ESRD) patients who had received HD were chronic glomerulonephritis (7 patients, 30.4%) and congenital anomalies of the kidney and urinary tract (7 patients, 30.4%), whereas the etiology of the 23 acute kidney injury (AKI) patients was hemolytic uremic syndrome (6 patients, 26.1%). Compared with ESRD patients, hemocatheter placement in the femoral vein was preferred over the subclavian or internal jugular vein in the AKI patients (p=0.012). The most common complication was catheter related complication (10 patients, 21.7%). The site of hemocatheter insertion was not related to the frequency of oozing. Placing the hemocatheter in the femoral vein resulted in significantly more events of catheter obstruction than insertion in the internal jugular vein or the subclavian vein (p=0.001). Disequilibrium syndrome occurred more frequently in older patients (p=0.004), as well as patients with a greater body weight (p=0.008) and a higher systolic and diastolic blood pressure before HD (systolic: p=0.021; diastolic: p=0.040).ConclusionBased on the 35 years of experience in our center, HD can be sufficiently and safely carried out even in children without significant complications.

Chiari malformations are a congenital anomaly of the hindbrain. The most common, Chiari malformation type I (CM-I), is characterized by herniation of the cerebellar tonsils extending at least 3 mm below the plane of the foramen magnum. Consequently, CM-I is associated with hydrocephalus and symptoms involving compression of the cervicomedullary junction by ectopic tonsils. Several studies have reported the clinical symptoms associated with CM-I, including suboccipital headache, weakness in the upper extremities, facial numbness, loss of temperature sensation, ataxia, diplopia, dysarthria, dysphagia, vomiting, vertigo, nystagmus, and tinnitus. Syncope is one of the rarest presentations in patients with CM-I. There are many hypotheses regarding the causes of syncope in patients with CM-I; however, the mechanisms are not clearly understood. Although surgical decompression for CM-I in patients with syncope has yielded good clinical results in some studies, such cases are rarely reported. We report a case of orthostatic syncope in a patient with CM-I who was treated with surgical intervention.