Conventional cephalometrics have inherent errors because their evaluation is performed in two-dimension for threedimensional object. To compensate these errors, three-dimensional cephalograms - derivation of three-dimensional data from conventional lateral and postero-anterior cephalograms - were developed. In this study, the accuracy and precision of three dimensional cephalograms were determined by means of 10 linear and 12 angular measurements on 36 acrylic skull models and by the comparison of conventional lateral cephalograms. The results were as follows 1. Mean difference between three-dimensional cephalograms and actual models in linear measurements was 0.94+/-0.62 mm and mean rate of magnification of three-dimensional cephalograms was 100.31+/-0.91%. There were no statistically significant differences between three-dimensional cephalograms and actual models in linear measurements(alpha=0.1). 2. Mean difference between conventional lateral cephalograms and actual models in linear measurements was 6.44+/-1.48 mm and mean rate of magnification of lateral cephalograms was 106.99+/-1.45%. There were statistically significant differences between lateral cephalograms and actual models in linear measurements(P<0.005). 3. Mean difference between three-dimensional cephalograms and actual models in angular measurements was 1.22+/-0.82degrees and mean rate of magnification of three-dimensional cephalograms was 105.71+/-12.07%. There were no statistically significant differences between three-dimensional cephalograms and actual models in angular measurements(alpha=0.1). 4. Mean difference between conventional lateral cephalograms and actual models in angular measurements was 1.70+/-0.94degrees and mean rate of magnification of lateral cephalograms was 106.35+/-15.70%. There were no statistically significant differences between lateral cephalograms and actual models in angular measurements(alpha=0.1). There were similarity between three-dimensional and lateral cephalograms in angular measurements.
Skull

BACKGROUND: A small subgroup of atopic dermatitis (AD) patients show low total and allergen-specific immunoglobulin (IgE) levels. This subgroup has been termed 'intrinsic' AD (IAD) as compared to its counterpart 'extrinsic' AD (EAD). However, the difference of cytokine expression between IAD and EAD has not been fully understood. OBJECTIVE: To compare the expression of various inflammatory cytokines in the peripheral blood mononuclear cells (PBMCs) and lesional skin of patients with IAD and EAD, which are known to be associated with AD pathophysiology. METHODS: We assessed the protein levels of cytokines in the PBMCs and lesional skin. We evaluated the levels of IL-3, IL-4, IL-5, IL-6, IL-10, IL-13, FcepsilonRI and FcepsilonRII from the PBMCs and lesional skin of patients with IAD and EAD. RESULTS: The patients with EAD had elevated levels of the IL-3 expression in their PBMCs and elevated levels of FcepsilonRI in their lesional skin compared to that of the patients with IAD. The expression of other cytokines did not differ in the PBMCs and lesional skin from the two subgroups. CONCLUSION: This study suggests that IL-3 could be associated with the pathophysiology of EAD as compared to that of IAD, along with FcepsilonRI which was previously shown to be highly expressed in EAD patients.
Cytokines ; Dermatitis, Atopic ; Humans ; Immunoglobulins ; Interleukin-10 ; Interleukin-13 ; Interleukin-3 ; Interleukin-4 ; Interleukin-5 ; Interleukin-6 ; Skin

Vitiligo and psoriasis are common dermatoses that occur in 1~3% and 0.5% of the general population, respectively. There have been several reports of the concurrence of these diseases in the English medical literature. Yet the pathogenesis of the association between these two dermatoses is still unknown. Psoriasis may occur coincidentally with vitiligo and it may be strictly confined to the vitiliginous patches or it may occur elsewhere. Despite the reports in the English literature, there has been only one case of vitiligo and psoriasis coexisting in the same patient and these diseases occurred in separate sites in the Korean dermatologic literature. A 30-year-old man recently presented with spreading vitiligo on the right forearm and a 3-month history of guttate psoriasis on the left forearm. He had a family history of psoriasis without any history of associated autoimmune disease. Herein, we report on a case of coexisting vitiligo and psoriasis in the same individual at different sites and we review the relevant literature.
Adult ; Autoimmune Diseases ; Forearm ; Humans ; Psoriasis ; Skin Diseases ; Vitiligo

Erosive pustular dermatosis of the scalp is a rare disorder of the elderly and it is characterized by pustular, erosive and crusted lesions of the scalp with progressive scarring alopecia. The predisposing factors have been reported to be trauma, including mechanical trauma, skin grafting, surgery and prolonged exposure of a bald scalp to UV light. Yet the laboratory data, the bacteriological and mycological investigations and the histopathologic findings of the previously reported cases were generally negative and not diagnostic. We herein present a case of erosive pustular dermatosis of the scalp that occurred after mechanical trauma on the previous skin graft site. This type of case has not been previously reported in the Korean dermatologic literature.
Aged ; Alopecia ; Cicatrix ; Humans ; Scalp ; Skin ; Skin Diseases ; Skin Transplantation ; Transplants ; Ultraviolet Rays

Congenital self-healing reticulohistiocytosis is a rare, congenital, benign, self-healing variant of Langerhans cell histiocytosis. It usually appears as multiple papules or nodules; however, occurrence of the solitary type is very rare. We report on a case of solitary congenital self-healing reticulohistiocytosis in a 29-day-old girl who presented with a papule on her sole. Two months later, the lesion regressed with a slight scar. Based upon clinical and histologic findings, we made a diagnosis of solitary congenital self-healing reticulohistiocytosis. In this report, we summarized reported cases of solitary congenital self-healing retioculohistiocytosis in Korea with a review of the literature.
Cicatrix ; Histiocytosis, Langerhans-Cell ; Korea

PURPOSE: The aim of the present study was to evaluate the clinical utility of Ki 67 labelling index and proliferative indices measured by flow cytometry in breast carcinomas. METHODS: We conducted immunohistochemical assay for Ki 67 and analyzed the DNA content and S-phase fraction by flow cytometry in 113 cases of primary breast carcinomas. Relationship between proliferative indices measured by two method and clinical biological parameters was also analyzed. RESULTS: Ki 67 labelling index than average was increased in 53 tumors (46.9%) and demonstrated a significant correlation with S-phase fraction. Higher Ki 67 labelling index was found in 28 (59.6%) of 47 tumors with high S-phase fraction whereas it was found in only 8 tumors (30.8%) with low S-phase fraction. Concordance between Ki 67 labelling index and S-phase fraction was 63.1% (p=0.017). Tumor with high S-phase fraction had a tendency to have an aneuploid. Ki 67 labelling index correlated significantly with histologic grade (p=0.001) and nuclear grade (p=0.001). An inverse correlation was found between Ki 67 and estrogen receptor expression (p=0.004). CONCLUSION: Ki 67 labelling index significantly correlated with S-phase fraction measured by flow cytometry. Ki 67 labelling index seems to be a clinically useful method because it is rapid, practical and easily performed by immunohistchemical assay.
Aneuploidy ; Breast Neoplasms* ; Breast* ; DNA ; Estrogens ; Flow Cytometry*

OBJECTIVE: To obtain clinical usefulness of knee extension- flexion exercise by comparing the exercise indexes between treadmill exercise and knee extension-flexion exercise and to collect reference of exercise indexes using knee extension-flexion exercise. METHOD: Sixty four young healthy subjects participated in two modes of exercise. Subjects performed exercise using isokinetic dynamometer in one leg knee extension-flexion exercise and treadmill running using Bruce protocol in treadmill exercise. We recorded oxygen consumption, heart rate during rest and exercise. RESULTS: When comparing exercise indexes using treadmill exercise, we obtained relative exercise indexes using knee extension-flexion exercise, male 15.96%, female 15.77% in work rate, male 48.46%, female 52.53% in peak oxygen consumption, male 73.57%, female 80.82% in peak heart rate, male 65.97%, female 65.20% in oxygen pulse, male 56.07%, female 62.50% in peak tidal volume, male 82.56%, female 82.53% in peak respiratory rate, male 47.79%, female 49.48% in peak minute ventilation. In dynamic variables, we obtained male 266.82%, female 292.98% in ratio increase in oxygen consumption to increase in work rate. CONCLUSION: Knee extension-flexion exercise showed enough response to evaluate cardiorespiratory function through low work rate. Therefore knee extension-flexion exercise may be used for an exercise tolerance test in patients who cannot perform established exercise tolerance test.
Exercise Tolerance ; Female ; Heart Rate ; Humans ; Knee* ; Leg ; Male ; Oxygen ; Oxygen Consumption ; Respiratory Rate ; Running ; Tidal Volume ; Ventilation

Emphysematous prostatic abscess is a very rare form of prostatitis. Emphysematous prostatic abscess due to Klebsiella pneumoniae may have a poor prognosis according to a few previous reports. We report a rare case of successfully treated emphysematous prostatic abscess with cystitis due to Klebsiella pneumoniae in a 50-yr-old man with 15-yr history of diabetes mellitus. The patient was referred to the emergency room of our hospital. The KUB film revealed gas shadows in the lower pelvic area suggestive of emphysematous cystitis or emphysematous prostatic abscess. The gas was mainly occupying the prostate and was also seen in the bladder on pelvic CT. The patient was successfully treated with long-term antibiotic use and additional percutaneous drainage of the abscess. Emphysematous prostatic abscess may be misdiagnosed as emphysematous cystitis due to the similar location of gas shadows on radiography. Computerized tomography and transrectal ultrasonography are helpful in making the diagnosis of emphysematous prostatic abscess. Appropriate use of effective antibiotics with drainage of pus is the best treatment. This case emphasizes the importance of timely and accurate diagnosis followed by appropriate treatment in emphysematous prostatic abscess in diabetic patients.
Abscess ; Anti-Bacterial Agents/therapeutic use ; Cystitis/diagnosis ; Diabetes Mellitus/complications ; Drainage ; Emphysema/diagnosis/*microbiology ; Human ; Klebsiella Infections/*diagnosis/drug therapy ; Klebsiella pneumoniae/*metabolism ; Male ; Middle Aged ; Prostate/*microbiology ; Prostatic Diseases/*diagnosis/microbiology/radiography

PURPOSE: There are a variety of approaches to the treatment of esophageal varix. This study evaluates the value of perigastric devascularization with transection of the esophagus, a non-shunt operation, for the management of bleeding esophageal varices. METHODS: We retrospectively analyzed the medical records of 16 patients with esophageal varix bleeding who had undergone perigastric devascularization with transection of the esophagus from 1990 through 2000. RESULTS: The mean age of the patients was 40.8 years and the most common underlying pathology was viral hepatitis. All patients had a history of previous variceal bleeding. Elective and prophylactic surgery was done in 8 and 5 patients respectively, and emergency surgery in 3 patients. One patient in Child group C and underwent emergency surgery, died after operation (mortality rate 6.3%). In the remaining 15 patients, two patients died of hepatocellular carcinoma. None of the patients demonstrated rebleeding or recurrence of the varix in the follow-up period. In 8 patients, the liver function, as measured by Child-Pugh classification, was improved following surgery as compared with measurements at the time of admission. CONCLUSION: According to this study, in spite of the small number of patients, we suggest that perigastric devascularization with transection of the esophagus is a very safe and effective treatment modality for esophageal varix bleeding, particularly if it can be done for an elective or prophylactic purpose. Furthermore, we propose that the operation should be carried out in an elective rather than in emergency manner following the improvement of liver function by non- invasive medical treatment.
Carcinoma, Hepatocellular ; Child ; Classification ; Emergencies ; Esophageal and Gastric Varices* ; Esophagus* ; Follow-Up Studies ; Hemorrhage ; Hepatitis ; Humans ; Hypertension, Portal ; Liver ; Medical Records ; Pathology ; Recurrence ; Retrospective Studies ; Varicose Veins

We present a case of giant coronary arteriovenous fistula between left main coronary artery and pulmonary artery in a 60-year-old female who presented with anginal symptom. Dobutamine stress echocardiography and myocardial perfusion scan with (99m)Tc-MIBI revealed a reversible perfusion defect in the septal region. Coronary angiography demonstrated a giant coronary arteriovenous fistula origination from the left main coronary artery and draining into the pulmonary artery. This appears to be the first case in which dobutamine stress echocardiography and myocardial perfusion scan with (99m)Tc-MIBI demonstrated myocardial ischemia due to coronary steal in patient with a coronary arteriovenous fistula.
Arteriovenous Fistula* ; Coronary Angiography ; Coronary Vessels ; Dobutamine* ; Echocardiography, Stress* ; Female ; Humans ; Middle Aged ; Myocardial Ischemia ; Perfusion ; Pulmonary Artery ; Septum of Brain ; Tomography, Emission-Computed, Single-Photon*