There has been so much controversies about the position of upper and lower jaws, and their first permanent molars in normal occlusion and Angle's class I,II,III malocclusions. So, the purpose of this study is to compare the position of upper and lower jaws, and their first molars in normal occlusion and Angle's class IIIIII malocclusions by lateral cephalometric analysis. The sample consisted of one hundred and twenty girls(thirty in each group) who had completed growth. The findings of this study were as follows: 1. In class I malocclusion, both maxilla and mandible were slightly posterior position than normal occlusion, but they showed harmonious relationship. 2. In class II malocclusion, the mandible was greatly retruded, and the maxilla was also slightly retruded to the cranial base as compared with normal occlusion. 3. In class III malocclusion, the maxilla was significantly retruded to the cranial base, but no significant difference was found in mandibular position as compared with normal occlusion. 4. The maxillary first molar was located at posterior position in class II malocclusion, and anterior position in class III malocclusion to the cranium, so that the rotation of mandible was influenced by that. 5. The mandibular first molar showed constant relationship to the mandible in all four groups, but different position to the cranial base in direct proportion to the mandibular position. 6. On the treatment planning of class II malocclusion, it seems to be better to promote the mandibular horizontal growth by inhibiting the vertical growth of maxillary molar area, and on the treatment planning of class III malocclusion, it seems to be better to promote the antero-inferior growth of maxilla and to promote the mandibular vertical growth by inducing the vertical growth of maxillary molar area.
Jaw* ; Malocclusion* ; Mandible ; Maxilla ; Molar* ; Skull ; Skull Base

Tetanus is rare in Korea due to the introduction of vaccination programs and the advancement in public health. Its common signs are trismus, voice disturbance, neck stiffness, and difficulty in swallowing, etc. A 56 years old man was injured by grasping a high voltage electric cable. After the accident, he fell down on a steel plate and had a head trauma. When he visited Emergency Department, there was multiple electric burn wound on left arm and left facial area. He was hospitalized on a department of neurosurgery, because intra cranial hemorrhage was presumed. 12 days later, he was referred to department of OMFS with developed painful masseter spasms and trismus. That night he violently bit his tongue with his denture. Because masseter muscle and temporal muscle constriction was involuntary, tongue was lacerated and denture was distorted. At first we supposed that the symptom was related with neurologic disturbance following head trauma or electric shock. But it was revealed that trismus was caused by tetanus on an electrophysiological test. By using mechanical ventilation and administration of tetanus immunoglobulin, muscle-relaxant, and sedatives at ICU, symptoms had subsided (4-weeks). Because tetanus is rare disease, we rarely suppose tetanus infection to be a cause of a trismus. Especially it is more difficult to diagnose in patient who has head trauma, burn and neurologic problem as in this case.
Arm ; Burns* ; Burns, Electric ; Constriction ; Craniocerebral Trauma ; Deglutition ; Dentures ; Emergency Service, Hospital ; Hand Strength ; Hemorrhage ; Humans ; Hypnotics and Sedatives ; Immunoglobulins ; Korea ; Masseter Muscle ; Middle Aged ; Neck ; Neurosurgery ; Public Health ; Rare Diseases ; Respiration, Artificial ; Shock ; Steel ; Temporal Muscle ; Tetanus* ; Tongue ; Trismus* ; Vaccination ; Voice Disorders ; Wounds and Injuries

The purpose of this study was to investigate a possibility of chronic or intermittent bacteremia in patients undergoing orthodontic treatment with fixed orthodontic appliance. Orthodontic patients who had been injured by orthodontic appliances and/or suffered from gingivitis were selected. They had not taken any antibiotics for 1 month. The number of subjects were 21 including 7 males and 14 females. Blood samples of the subjects were cultured and, IgG, IgA and IgM levels in the serum were quantified. The author found following results. 1. No bacterial growth was found in 7-day culture of all the samples. 2. The immunoglobulin levels in serum were confined in normal range. 3. This study could not deny the possibility of transient bacteremia episode undergoing orthodontic treatment.
Anti-Bacterial Agents ; Bacteremia* ; Female ; Gingivitis ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Male ; Orthodontic Appliances ; Reference Values

This study was undertaken to investigate the midline having the least difference between the right and left structures among the lines that had been used in the study of the craniomaxillofacial asymmetry. The sample of this study consisted of twenty six Korean girls(average 18.9 years old) having normal facial appearance and occlusion. On the frontal cephalometric films of the sample, we divided the whole craniomaxillifacial area into four portions, i.e., cranial, upper facial, lower facial, and dental portion. So, we have found the midlines having the least difference in the whole craniomaxillofacial area itself, and in the each divided four portions, furtherly in the other portions from aimed portion. The findings were as follow: 1. In the whole craniomaxillofacial area, the connecting line between crista galli and anterior nasal spine and the perpendicular bisecting line between right and left foramen rotundums were suitable for the midline. 2. In the cranial portion, established all six lines were suitable for midlines. In the other portions, the perpendicular bisection line between both condylion, the line passing the contact point between right and left mandibular central insisiors among the perpendicular lines between right and left mandibular central incisial tips were suitable midlines for evaluating the asymmetry of cranial portion. 3. In the upper facial portion, the perpendicular bisecting line between right and left zygions was the most suitable midline. In the other portions, the line between the crista galli and the most superior point of the odontoid process, the perpendicular bisecting line between right and left gonions, the perpendicular bisecting line between right and left condylions, and perpendicular bisecting line between right and left foramens rotundum were suitable midlines for evaluating the asymmetry of the upper facial portion 4. In the dental portion, the perpendicular bisecting lines between right and left buccal cusps of both maxillary first molars and between right and left mandibular first molars were suitable midlines. In the other portions, the perpendicular bisecting line between right and left landmarks crossing the lesser wing of the sphenoid bone and orbit, the perpendicular bisecting line between right and left mental foramens, and the connecting line between crista galli and prosthion were suitable midlines for evaluating the asymmetry of dental portion. 5. In the lower facial portion, the perpendicular bisecting lines between right and left condylions and between right and left gonions were suitable midlines. In the other portions, the line between the crista galli and anterior nasal spine, the perpendicular bisecting line between right and left foramen rotundums, and the perpendicular bisecting lines between right and left buccal cusps of both mandibular first molars and between right and left maxillary first molars were suitable midlines for evaluating the asymmetry of the lower facial portion.
Molar ; Odontoid Process ; Orbit ; Sphenoid Bone ; Spine

PURPOSE: We designed this study to find out the risk factors affecting the patency rate after creation of an arteriovenous fistula (AVF) for hemodialysis. METHODS: Between March 1997 and December 2001, a total of 397 AVF operations in 314 patients were performed by a single surgeon using the same surgical technique and principles. One hundred and forty cases (35.3%) were reoperations due to previous AVF failure. Artificial vessels (=PTFE, polytetrafluoroethylene) were used for the AVF in 39 cases (9.8%). The sex, age, diabetes mellitus, previous operation history and type of dialysis center were considered as a possible risk factors affecting the patency rate. RESULTS: After a mean follow-up of 18.3 months, there were 63 cases of patient death, 15 of kidney transplantation, and 104 of AVF failure identified. The overall patency rates of 1, 2 and 3 year were 76.2, 70.9, and 66.9%, respectively. From the multivariate analysis, the previous operation history was the only significant factor affecting the patency rate of AVF (P=0.001, odd ratio=2.58). Although the diabetic patient (odd ratio=1.43) and artificial vessel groups (odd ratio=1.678) showed high odd ratios, these factors were not statistically significant (P>0.05). From the univariate analysis, the reoperation cases also showed a significantly inferior patency rate compared to the first operation cases (1 year patency rate was 65.2% and 83.7%, P=0.001). However, the diabetes and types of vessel showed no significant differences in patency rates. CONCLUSION: A reoperation of an AVF creation was the most significant risk factor affecting the patency rate after its original creation. The first attempt AVF creations showed-favorable patency rates. To improve the overall patency rate of an AVF creation, a more delicate preoperative study and accurate surgical technique will be required at the time of the first AVF operation.
Arteriovenous Fistula* ; Diabetes Mellitus ; Dialysis ; Follow-Up Studies ; Humans ; Kidney Transplantation ; Multivariate Analysis ; Renal Dialysis* ; Reoperation* ; Risk Factors

The superior vena cava (SVC) syndrome refers to all clinical phenomena appeared as bronchial pneumonia, lymphoma, mediastinitis, and aortic aneurysm compress the superior vena cava and the veins in the vicinity in the superior mediastinum. Iatrogenic superior vena cava syndrome due to vascular stenosis or aneurysmal change has occurred by the repeated placement of cardiac pacemaker. Cardiac tamponade and hematoma have been reported in patients with end-stage renal disease due to impairment of blood coagulation caused by uremia. But acutely developed SVC syndrome was not reported after catheterization. In this report, we describe a case of acute SVC syndrome and mediastinal hematoma after insertion of internal jugular catheter for hemodialysis.
Aneurysm ; Aortic Aneurysm ; Blood Coagulation ; Bronchopneumonia ; Cardiac Tamponade ; Catheterization ; Catheters ; Constriction, Pathologic ; Dialysis ; Hematoma ; Humans ; Kidney Failure, Chronic ; Lymphoma ; Mediastinitis ; Mediastinum ; Renal Dialysis ; Superior Vena Cava Syndrome ; Uremia ; Veins ; Vena Cava, Superior

Malignant tumors have been shown to be a major secondary cause of nephrotic syndrome. They have been associated with different glomerulopathy depending on their type. Membranoproliferative glomerulonephritis (MPGN) rarely develops in solid tumors, although cases have been reported in renal cell cancer, melanoma, lung cancer, and tumors in the urogenital system. However, to our knowledge, there have been no case reported of MPGN associated with thyroid cancer. In the present case, we observed MPGN associated with thyroid cancer in a 44-year-old woman with nephrotic syndrome and renal insufficiency. Her thyroid ultrasound revealed a tumor measuring 1.01x1.14x1.48 cm with an indistinct border that was partially calcified. The tumor was confirmed to be papillary carcinoma by percutaneous needle aspiration biopsy. Renal biopsy showed chronic tubulointerstitial nephritis and MPGN. On day 45 of admission, total thyroidectomy and neck lymphadenectomy were performed. After total thyroidectomy, serum total protein, albumin, C3, and C4 normalized. In conclusion, this case represents the first report of simultaneous development of MPGN and thyroid cancer.
Adult ; Biopsy ; Biopsy, Needle ; Carcinoma ; Carcinoma, Papillary ; Carcinoma, Renal Cell ; Female ; Glomerulonephritis, Membranoproliferative ; Humans ; Lung Neoplasms ; Lymph Node Excision ; Melanoma ; Neck ; Needles ; Nephritis, Interstitial ; Nephrotic Syndrome ; Renal Insufficiency ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Urogenital System

BACKGROUND: Alcoholic ketoacidosis (AKA) is known as a benign disease, but the related mortality reported in Korea is high. Acidosis and alcohol change the immunity profile, and these changes can be identified early using the delta neutrophil index (DNI). We aimed to evaluate the use of DNI and other standard laboratory parameters as predictors of prognosis in AKA patients. METHODS: One hundred eighteen males with AKA were evaluated at the Wonju Severance Christian hospital between 2009 and 2014. We performed a retrospective analysis of demographic, clinical, and laboratory parameters data. Receiver operating characteristic curves (ROC) and multivariate Cox regression was used to identify renal survival and mortality. RESULTS: Survival patients had lower initial DNI levels than non-survival patients (4.8±6.4 vs 11.4±12.5, p<0.001). In multivariate-adjusted Cox regression analysis, higher initial increased DNI (HR 1.044, 95% CI 1.003–1.086, p=0.035), and lower initial pH (HR 0.044, 95% CI 0.004–0.452, p=0.008) were risk factors for dialysis during hospitalization. Further, higher initial DNI level (HR 1.037; 95% CI 1.006-1.069; p=0.018), lower initial pH (HR 0.049; 95% CI 0.008–0.312; p=0.001) and lower initial glomerular filtration rate (GFR) (HR 0.981; 95% CI 0.964–0.999; p=0.033) were predictors of mortality. A DNI value of 4.5% was selected as the cut-off value for poor prognosis and Kaplan-Meier plots showed that AKA patients with an initial level DNI ≥4.5% had lower cumulative survival rates than AKA patients with an initial DNI <4.5%. CONCLUSION Increased initial serum DNI levels may help to predict renal survival and prognosis in male AKA patients.

The purpose of this study was to investigate the fluoroquinolone resistance frequency of Enterococcus spp. from normal chicken feces and to analyse mutations of the gyrA and parC gene associated with fluoroquinolone resistance. Among 52 Enterococcus faecalis and 25 E. faecium isolates, 23 (44.2%) E. faecalis and 7 (28.0%) E. faecium were resistant to ciprofloxacin (CIP) by disc diffusion method. Genetic exchange in gyrA and parC gene among 2 CIP intermediate isolates and 15 CIP resistant isolates were found in the amino acid codon of Ser-83 and Asp-87, and Ser-80 and Glu-84, respectively. These mutants contained a change from Ser to Phe, Val, Tyr, Ile, Thr or Pro at codon 83 and from Glu to Gly or Leu at codon 87 in gyrA gene, and a change from Ser to Ile or Thr at codon 80 and from Glu to Asp or Lys at codon 84 in parC gene. The isolates with mutation in gyrA regardless of a mutation in parC showed high resistance (MIC > or =32 microgram/ml) to CIP, enrofloxacin, norfloxacin and ofloxacin. These results suggested that gyrA gene is the primary target for 4 fluoroquinolones resistance in Enterococcus spp.
Chickens* ; Ciprofloxacin ; Codon ; Diffusion ; Enterococcus faecalis ; Enterococcus* ; Feces* ; Fluoroquinolones ; Norfloxacin ; Ofloxacin ; Viperidae

The use of antibiotics, including therapeutically in human and veterinary medicine, or as prophylaxis of growth promotion in animal husbandry, ultimately exerts selective pressure favorable for the propagation of antibiotic resistant bacteria. In this study we have determined the resistance for antibiotics of E. coli from pig farm environment, and investigate genetic relatedness by random amplification of polymorphic DNA (RAPD). Six farms were randomly selected in Gyeongsanman-do and Busan provinces for collecting samples from feces, manure and underground water. A total of 88 isolates from feces, 74 isolates from manure and 1 isolate from underground water were analyzed by antibiotic resistance and RAPD. Antibiotic resistance testing was performed by disk diffusion method using 16 antibiotics. The highest percentage of antibiotic resistance of isolates from feces and manure was found to the following antibiotics; tetracycline (100% and 100%), sulfamethoxazole/trimethoprim (60.2% and 62.2%), streptomycin (50.0% and 68.9%), chloramphenicol (56.8% and 56.8%), ampicillin (50.0% and 81.1%) and cephalothin (50.0% and 51.4%). Of isolates from feces and manure, 22.7% and 20.3% showed multiple resistance to 4 and 5 antibiotics, respectively. The isolates from GE pig farm showed six RAPD patterns. A single pattern, RAPD-C, was predominat in feces isolates (50.0%) and manual isolates (46.7%), and the rest of feces isolates showed RADP-A, B and E pattern and manure isolates showed D and E pattern. One isolate from underground water showed F pattern. The appearance of multiresistant in E. coli isolates from pig farms environment is a problem of major concern of public health and RAPD may offer an useful tool of discrimination for the epidemiological investigation.
Ampicillin ; Animal Husbandry ; Anti-Bacterial Agents ; Bacteria ; Busan ; Cephalothin ; Chloramphenicol ; Diffusion ; Discrimination (Psychology) ; DNA ; Drug Resistance, Microbial* ; Escherichia coli* ; Escherichia* ; Feces ; Groundwater ; Humans ; Manure ; Public Health ; Streptomycin ; Tetracycline ; Veterinary Medicine