Tumors metastasizing from distant regions to the oral and maxillofacial region are uncommon, comprising only 1%-2% of all malignancies. Cholangiocarcinoma is a malignancy that arises from cholangiocytes, which are epithelial cells that line the bile ducts. These cancers are difficult to diagnose and have a poor prognosis. In this paper, we report a rare case of mandibular metastasis of cholangiocarcinoma diagnosed at the primary site and discuss the radiographic findings observed in this case.
Bile Ducts ; Cholangiocarcinoma* ; Epithelial Cells ; Mandible ; Neoplasm Metastasis* ; Prognosis

Local anesthetics are an essential part of pain control during dental treatment. Despite its effectiveness and safety, patients should constantly be aware of potential adverse effects, including allergic reactions. Allergic reactions to amide-type local anesthetics (LAs), such as lidocaine and mepivacaine, are rare compared to those to ester-type LAs. Herein, we report the case of a patient with a history of allergy to lidocaine and mepivacaine, with symptoms of itching, diffuse erythema of the wrists and hands, dizziness, and pectoralgia. This case report emphasizes the importance of collecting medical and dental histories of patients is necessary, and how an allergy test in the allergy and clinical immunology department helps select safe LAs for patients.

Picture archiving and communication systems (PACS) has widely been used in many hospitals. Film digitizer has been used in order to create digital image file from conventional plain radiographic films for PACS. In this study, we quantitatively assessed the characteristics of film digitizer for both laser and CCD camera-based type used in Severance hospital. We created three test films to measure the quality of digitized images. The test films were then digitized by both laser and CCD camera-based film digitizer. Finally, the image files were transferred to the PC in which spatial resolution, contrast, and uniformity were evaluated. We also measured digitization time to evaluate the speed of digitizer. Modulation transfer function (MTF) was measured to evaluate the spatial resolution. Contrast was evaluated by measuring of useful range of optical density (OD). Contrast uniformity was calculated by the percentage of difference between minimum and maximum pixel values on the digitized images. Spatial resolution of laser digitizer was ~~5.0cycles/mm, while that of CCD-based unit was ~~1.5cycles/mm of spatial resolution at 10% of MTF. Useful range of OD for CCD unit was ~~77%, while that for laser unit was 100%. Contrast uniformities of laser unit were better than those of CCD-based unit. Digitization time was ~~10sec/film using CCD unit, and ~~60sec/film using LASER unit at film size of 17x14 inches. Laser digitizer can provide relatively higher image quality, while CCD-based unit has the advantage of higher speed than laser unit.
Radiology Information Systems ; X-Ray Film

PURPOSE: To investigate the change of bone healing process after endodontic treatment of the tooth with an apical lesion by fractal analysis. MATERIALS AND METHODS: Radiographic images of 35 teeth from 33 patients taken on first diagnosis, 6 months, and 1 year after endodontic treatment were selected. Radiographic images were taken by JUPITER Computerized Dental X-ray System (R). Fractal dimensions were calculated three times at each area by Scion Image PC (R) program. Rectangular region of interest (30 x 30) were selected at apical lesion and normal apex of each image. RESULTS: The fractal dimension at apical lesion of first diagnosis (L0) is 0.940+/-0.361 and that of normal area (N0) is 1.186+/-0.727 (p< 0.05). Fractal dimension at apical lesion of 6 months after endodontic treatment (L1) is 1.076+/-0.069 and that of normal area (N1) is 1.192+/-0.055 (p< 0.05). Fractal dimension at apical lesion of 1 year after endodontic treatment (L2) is 1.163+/-0.074 and that of normal area (N2) is 1.225+/-0.079 (p< 0.05). After endodontic treatment, the fractal dimensions at each apical lesions depending on time showed statistically significant difference. And there are statistically significant different between normal area and apical lesion on first diagnosis, 6 months after, 1 year after. But the differences were grow smaller as time flows. CONCLUSION: The evaluation of the prognosis after the endodontic treatment of the apical lesion was estimated by bone regeneration in apical region. Fractal analysis was attempted to overcome the limit of subjective reading, and as a result the change of the bone during the healing process was able to be detected objectively and quantitatively.
Bone Regeneration ; Diagnosis ; Fractals* ; Humans ; Periapical Diseases ; Prognosis ; Tooth

A combined anterolateral and posterior approach with thoracotomy has been recommended as the traditional surgical approach for the tumors of the thoracic spine. Recently, because of the morbidity associated with open thoracotomy, the thoracoscopically assisted surgical technique was introduced successfully in thoracic spinal surgery. Herein, we report a combined surgical technique for giant cell tumor of the thoracic spine (T10) consisting of bilateral thoracoscopic anterior release of the spine followed by a posterior en bloc spondylectomy and reconstruction by orthopedic surgeons. The thoracoscopic spinal surgery is safe and effective alternative for other open thoracotomic procedures in the approach to the anterior thoracic spine, avoiding the disadvantage inherent to thoracotomy.
Giant Cell Tumors ; Orthopedics ; Spine* ; Thoracoscopy ; Thoracotomy

STUDY DESIGN: A retrospective study. OBJECTIVES: To introduce an endoscopic anterior release and posterior total spondylectomy, and the evaluation of its clinical efficacy. SUMMARY OF LITERATURE REVIEW: A total spondylectomy was introduced for the treatment of primary and metastatic tumors of the spine, with many authors having reported favorable clinical results with its use. Endoscopic surgery has been used for various spinal disorders, including disc diseases or scoliosis, and has been widely used as it offers a minimally invasive technique, with a small surgical incision and very few complications. MATERIAL AND METHODS: Three primary spinal tumor cases were reviewed. The first case was a patient with a Ewing's sarcoma of the sacrum; the second was a giant cell tumor of the sacrum and the last was a giant cell tumor of the T10 vertebra. An endoscopic anterior release was initially performed, including the ligation and release of blood vessels, and soft tissue release, using laparoscopies for the 2 sacral tumors and a thoracoscopy for the thoracic tumor. The total spondylectomy were performed via a posterior approach. In two cases, the one with the Ewing's sarcoma of sacrum and the other with the giant cell tumor of the T10 vertebra, the reconstructions were performed using strut allografts and instrumentations. The average follow-up period was 19 months. RESULTS: Intraoperatively, the endoscopic anterior release made it possible to successful finish the anterior releases, with minimal incisions and blood losses. It also allowed a safer and faster posterior total spondylectomy, without significant complication. At the last follow-up, all patients had favorable clinical results, with no local recurrence in any case or fusions in the two cases that had to undergo reconstruction. CONCLUSION: Endoscopic anterior release and a posterior total spondylectomy was a favorable surgical procedure for primary tumors of spine. It made possible the safe and efficient finish the anterior release and posterior total excision of the affected vertebrae, using small incisions and with no complications.
Allografts ; Blood Vessels ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Laparoscopy ; Ligation ; Recurrence ; Retrospective Studies ; Sacrum ; Sarcoma, Ewing ; Scoliosis ; Spine* ; Thoracoscopy

STUDY DESIGN: A retrospective study. OBJECTIVES: To introduce an endoscopic anterior release and posterior total spondylectomy, and the evaluation of its clinical efficacy. SUMMARY OF LITERATURE REVIEW: A total spondylectomy was introduced for the treatment of primary and metastatic tumors of the spine, with many authors having reported favorable clinical results with its use. Endoscopic surgery has been used for various spinal disorders, including disc diseases or scoliosis, and has been widely used as it offers a minimally invasive technique, with a small surgical incision and very few complications. MATERIAL AND METHODS: Three primary spinal tumor cases were reviewed. The first case was a patient with a Ewing's sarcoma of the sacrum; the second was a giant cell tumor of the sacrum and the last was a giant cell tumor of the T10 vertebra. An endoscopic anterior release was initially performed, including the ligation and release of blood vessels, and soft tissue release, using laparoscopies for the 2 sacral tumors and a thoracoscopy for the thoracic tumor. The total spondylectomy were performed via a posterior approach. In two cases, the one with the Ewing's sarcoma of sacrum and the other with the giant cell tumor of the T10 vertebra, the reconstructions were performed using strut allografts and instrumentations. The average follow-up period was 19 months. RESULTS: Intraoperatively, the endoscopic anterior release made it possible to successful finish the anterior releases, with minimal incisions and blood losses. It also allowed a safer and faster posterior total spondylectomy, without significant complication. At the last follow-up, all patients had favorable clinical results, with no local recurrence in any case or fusions in the two cases that had to undergo reconstruction. CONCLUSION: Endoscopic anterior release and a posterior total spondylectomy was a favorable surgical procedure for primary tumors of spine. It made possible the safe and efficient finish the anterior release and posterior total excision of the affected vertebrae, using small incisions and with no complications.
Allografts ; Blood Vessels ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Laparoscopy ; Ligation ; Recurrence ; Retrospective Studies ; Sacrum ; Sarcoma, Ewing ; Scoliosis ; Spine* ; Thoracoscopy

BACKGROUND: The inferior alveolar nerve block (IANB) is the most common anesthetic techniques in dentistry; however, its success rate is low. The purpose of this study was to determine the correlation between IANB failure and mandibular skeletal characteristics METHODS: In total, 693 cases of lower third molar extraction (n = 575 patients) were examined in this study. The ratio of the condylar and coronoid distances from the mandibular foramen (condyle-coronoid ratio [CC ratio]) was calculated, and the mandibular skeleton was then classified as normal, retrognathic, or prognathic. The correlation between IANB failure and sex, treatment side, and the CC ratio was assessed. RESULTS: The IANB failure rates for normal, retrognathic, and prognathic mandibles were 7.3%, 14.5%, and 9.5%, respectively, and the failure rate was highest among those with a CC ratio < 0.8 (severe retrognathic mandible). The failure rate was significantly higher in the retrognathic group than in normal group (P = 0.019), and there was no statistically significant difference between the other two groups. CONCLUSIONS: IANB failure could be attributable, in part, to the skeletal characteristics of the mandible. In addition, the failure rate was found to be significantly higher in the retrognathic group.
Anesthesia* ; Dentistry ; Mandible ; Mandibular Nerve* ; Molar, Third ; Skeleton

BACKGROUND: The inferior alveolar nerve block (IANB) is the most common anesthetic techniques in dentistry; however, its success rate is low. The purpose of this study was to determine the correlation between IANB failure and mandibular skeletal characteristics METHODS: In total, 693 cases of lower third molar extraction (n = 575 patients) were examined in this study. The ratio of the condylar and coronoid distances from the mandibular foramen (condyle-coronoid ratio [CC ratio]) was calculated, and the mandibular skeleton was then classified as normal, retrognathic, or prognathic. The correlation between IANB failure and sex, treatment side, and the CC ratio was assessed. RESULTS: The IANB failure rates for normal, retrognathic, and prognathic mandibles were 7.3%, 14.5%, and 9.5%, respectively, and the failure rate was highest among those with a CC ratio < 0.8 (severe retrognathic mandible). The failure rate was significantly higher in the retrognathic group than in normal group (P = 0.019), and there was no statistically significant difference between the other two groups. CONCLUSIONS: IANB failure could be attributable, in part, to the skeletal characteristics of the mandible. In addition, the failure rate was found to be significantly higher in the retrognathic group.
Anesthesia* ; Dentistry ; Mandible ; Mandibular Nerve* ; Molar, Third ; Skeleton

In order to identify the sexual difference and the aging changes on the cranial metric dimensions and to clarify the anthropological characteristics of Korean skulls, authors took the radiographs of lateral skull projections and made out perspective drawings and measured 33 cranial metric dimensions using 32 standard points of normal Korean 373 heads. The results were as follows. 1. 4 items of metric dimensions on the calvarial thickness were greater in the male than the female and all the calvarial thicknesses of younger adults were thicker than the older adults. 2. As a result of measuring 11 items of skull size including the maximum cranial length (glabella to opisthocranion diameter) and the cranial height (basion to vertex diameter), all average metric dimensions of the skull were shown the sexual difference. 3. Among the metric dimensions of skull size, the maximum cranial length (glabella to opisthocranion diameter) was not different between the younger and older adults, but the cranial height (basion to bregma diameter) was greater in the younger than the older adults. 4. In according to the metric dimensions of the cranial base, the length and the angle of the cranial base were shown the sexual difference, that is, all dimensions on the cranial basewere greater in the males. 5. The breadth and height of pituitary fossa were greater in the older female than the younger females. 6. Metric dimensions on the sella position related to other cranial landmarks were shown the sexual difference, but there were no differences between the younger and older adults. 7. Metric dimensions on the frontal sinus were shown the greatest sexual difference and there were the differences between the younger and older males, not in the females. Taken all together, all the basic anthropological data of Korean crania in this study will be helpful to the sexual discrimination, and will be applied to other basic medical and dental sciences.
Adult ; Aging* ; Asian Continental Ancestry Group ; Discrimination (Psychology) ; Female* ; Frontal Sinus ; Head ; Humans ; Male* ; Skull ; Skull Base