PURPOSE: Infrared thermography is a diagnostic procedure that can objectively visualizes the status of muscle, in musculoskeletal disease, as myofascial pain syndrome. Thus, we evaluated the clinical significance of infrared thermography in patients with chronic pelvic pain. MATERIALS AND METHODS: Forty-five patients with chronic pelvic pain were enrolled in this study as patient group, with thirty-three normal persons as the control group. The patients with a urinary tract infection and an organic disease were excluded. Before the thermography was checked, we made all patients mark the subject pain site, and inform of the pain severity, on the visual analogue scale (VAS) sheet. We analyzed hot spots on the thermographic images, pain sites and VAS sheets, and the thermographic changes, before and after a 2% lidocaine injection at the tender point, on the physical examination. RESULTS: The sensitivity, specificity and the false positive and negative of infrared thermography were 79.5 (M:F=76.5:81.8), 64.1 (M:F=66.7:61.9), 24.2 (M:F=25.0:23.5) and 32.6% (M:F=31.6:30.8), respectively. However there was no clinical significance between the pain severity and the temperature difference of the thermography. The concordance rate of thermographic and symptomatic changes, after the 2% lidocaine injection at the tender point, was 78.9%. CONCLUSIONS: Infrared thermography can objectively demonstrate the subjective pain, and is a useful method in follow-up, after treatment for chronic pelvic pain with a tender point.
Follow-Up Studies ; Humans ; Lidocaine ; Musculoskeletal Diseases ; Myofascial Pain Syndromes ; Pelvic Pain* ; Physical Examination ; Sensitivity and Specificity ; Thermography* ; Urinary Tract Infections

Monitoring fetal movement serves as an indirect rneasure of fetal well-being, especially for central nervous system integrity and function. Methods to monitor fetal movement vary from the simple approach of having the mother chart perceived movement to highly specialized methods. However there were no reliable objective monitoring methods in Korea. For development of objective method for evaluating fetal movement, during pregnancy, one-hundred and two pregnant patients were entered to this study. All patients were divided into following 3 groups and each type of monitoring methods were applied. Group 1(N=20): Type I using portable FHR Doppler unit(IFD-100 model, Intermed, Korea). Group 2(N=20): Type II using FHR Microphone(Prenatal Listening Kit, Model FS002, Unisar Inc., US). Group 3(N=62): Type III using conventional ultrasound transducer(Corometric 115 Model, US). In this study, accurate counting of the fetal movementutus were best performed using Type III, because of monitoring fetal movements has its greatest efficiency when using conventional ultrasound transducer of fetal monitor. It was also attractive to doctors and nurses as a convenient methods because it needed only single transducer when compared to Type I and II. Although monitoring fetal body movement permits a general assessment of well-being, no perfect technique is still reliable. Futher techniques would be developed using the results of this study for improvement of several factors such as accuracy and objectiveness
Central Nervous System ; Fetal Monitoring ; Fetal Movement* ; Humans ; Korea ; Mothers ; Pregnancy* ; Transducers ; Ultrasonography

PURPOSE: We report a case of a scleral perforation during inferior rectus recession in congenital fibrosis of extraocular muscles and the management of this perforation with a scleral patch graft. CASE SUMMARY: A 20-month-old female with bilateral ptosis, absence of elevation and a chin-up position was diagnosed with congenital fibrosis of extraocular muscles. Because severe esotropia in the downward gaze was observed, we first performed esotropia surgery. After 1 year, she underwent a bilateral ptosis correction. We decided to perform bilateral inferior rectus recession due to an abnormal head posture and the absence of elevation. Because the inferior rectus muscles were extremely tight and adhered to the sclera, hooking and isolating these muscles during surgery was difficult. After muscle suture placement, a portion of the sclera that contacted the left inferior rectus was chipped off as this muscle was disinserted with blunt Westcott scissors. A scleral perforation was observed, thus, we placed a scleral patch graft using the donor sclera and finished the bilateral inferior rectus recession. No abnormal findings for the vitreous or retina were detected. At 8 months after surgery, the patient exhibited exotropia of 12 prism diopters in her primary gaze. Her abnormal head posture nearly disappeared. CONCLUSIONS: Careful isolation and disinsertion of the muscle from the globe is necessary in the treatment of patients who are expected to exhibit severe adhesions between the muscle and sclera, such as patients with congenital fibrosis of extraocular muscles.
Esotropia ; Exotropia ; Female ; Fibrosis* ; Head ; Humans ; Infant ; Muscles* ; Posture ; Retina ; Sclera ; Sutures ; Tissue Donors ; Transplants

PURPOSE: Pink gingival esthetic especially on the anterior teeth has been an important success criterion in implant-supported restoration. Inter-implant papillae are a critical factor for implant esthetics, and various techniques for inter-implant papilla reconstruction have been introduced. The aim of this study is to suggest and evaluate a surgical technique for reconstructing inter-implant papillae. METHODS: A 28-year-old man had an implant placed on the #13 and #14 area. Four months after implant placement, a second stage surgery was planned for inter-implant papilla reconstruction. At the time of the abutment connection, I-type incisions were performed on the #13i & #14i area followed by full-thickness flap elevation and connection of a healing abutment on underlying fixtures without suture. RESULTS: Two weeks after the second stage implant surgery, soft tissue augmentation between the two implants was achieved. CONCLUSIONS: I-shaped incisions for papilla reconstruction performed during the second stage implant surgery were useful for inter-implant papilla reconstruction and showed a good esthetic result.
Adult ; Dental Implants ; Dental Papilla ; Esthetics ; Esthetics, Dental ; Humans ; Sutures ; Tooth

PURPOSE: We report a case of pyogenic arthritis of the shoulder secondary to infective endocarditis. MATERIALS AND METHODS: A 70 year-old male who had suffered from pyogenic arthritis of the left shoulder secondary to infective endocarditis was treated with artificial valvuloplasty, arthroscopic synovectomy and drainage. RESULTS: Infection was cured and the patient achieved a good functional outcome. CONCLUSION: Pyogenic arthritis of the shoulder is rarely associated with infective endocarditis. However, if the symptoms are misdiagnosed as musculoskeletal symptoms associated with infective endocarditis, serious complications may arise. As such, musculoskeletal symptoms associated with infective endocarditis should be paid careful attention.
Arthritis ; Arthritis, Infectious ; Drainage ; Endocarditis ; Humans ; Male ; Shoulder

This study was performed to evaluate the effect on the formation of keratinized attached gingiva when free gingival graft with strip technique was used. After the partial thickness flap was prepared, it was positioned apically more than 7mm using mucoperiosteal suture. At the donor site, strip was achieved with 2mm width, less than 1mm thickness, (mesiodistal teeth length + 6)*2 mm length. Then, it was divided into 2 same pieces and located at the recipient bed apico-coronally with more or less 3mm interval. Follow-up check was made at 1,2,4,8,12 weeks after the operation. The results of this study were as follows : 1. The inter-strip space was mostly filled with keratinized attached gingiva. 2. The contraction of the graft was nigligible, and 92% of planned area was filled with keratinized attached gingiva. 3. The inconvenience of the patients at donor site was minimal. 4. The width of the strip was widened. In conclusion, free gingival graft using strip technique is useful to achieve the keratinized attached gingiva maximally with free gingival graft minimally and to minimize the inconvenience of donor palatal site of the patients.

STUDY DESIGN: This is a retrospective study for radiographically and clinically assessing nonunion after lumbar spine fusion. OBJECTIVES: We wanted to analyze the risk factors for nonunion that requires surgical treatment after lumbar spine fusion SUMMARY OF THE LITERATURE REVIEW: A diagnosis of the nonunion after lumbar spine fusion was made by using only the only radiologic images. The incidence of nonunion has been underreported because there are many asymptomatic patients. MATERIALS AND METHODS: The plain X-ray films were evaluated for 1317 patients who could be followed up more than 1 year after lumbar fusion. Nonunion was diagnosed at 1 year after fusion by instability seen on the flexion-extension radiograph and the clinical findings like as sustained pain and local tenderness at the surgical site. The risk factors we reviewed included age, the number of levels fused, associated diseases, smoking, alcohol drinking, the initial diagnosis, a previous history of spinal operation, infection, a clear zone and malposition of pedicle screws and metal failure. The relations between nonunion and the factors mentioned above were analyzed. RESULTS: Thirty-nine patients were diagnosed as having nonunion underwent reoperation and all had surgically confirmed nonunion. Smoking, infection and a previous history of spine operation had a significant influence on nonunion (p < 0.05). Clear zones persisting more than 1 year and metal failure also had a significant influence on nonunion (p < 0.05). Age, the number of fused levels, the initial diagnosis and alcohol drinking were not shown to influence the rate of nonunion (p < 0.05). CONCLUSION: A through clinical and radiologic evaluation is essential to diagnose nonunion, and this should not be done according to the radiologic images only. Risk factors such as a previous history of spine operation, infection, smoking, the development of a clear zone and metal failure all showed a statistically significant influence on nonunion. Additionally, preoperative and postoperative evaluation of these parameters is needed to achieve bone union.
Alcohol Drinking ; Humans ; Incidence ; Reoperation ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Spine ; X-Ray Film

The purpose of this study was to evaluate the influence of elastic modulus of restorative materials and the number of interfaces of post and core systems on the stress distribution of three differently restored endodontically treated maxillary second premolars using 3D FE analysis. Model 1, 2 was restored with a stainless steel or glass fiber post and direct composite resin. A PFG or a sintered alumina crown was considered. Model 3 was restored by EndoCrown. An oblique 500 N was applied on the buccal (Load A) and palatal (Load B) cusp. The von Mises stresses in the coronal and root structure of each model were analyzed using ANSYS. The elastic modulus of the definitive restorations rather than the type of post and core system was the primary factor that influenced the stress distribution of endodontically treated maxillary premolars. The stress concentration at the coronal structure could be lowered through the use of definitive restoration of high elastic modulus. The stress concentration at the root structure could be lowered through the use of definitive restoration of low elastic modulus.
Aluminum Oxide ; Bicuspid ; Crowns ; Elastic Modulus ; Finite Element Analysis ; Glass ; Stainless Steel

Survival after traumatic atlanto-occipital dislocation is rare. Severe persistent neurological deficits are common in the survivors, but early resuscitation and the use of the newer diagnostic techniques have contributed to improved outcomes. We present here the case of a 42 year old man with traumatic atlanto-occipital dislocation combined with a dens fracture, and the patient obtained good clinical results after we applied a Halo-vest and performed posterior fusion.
Dislocations ; Humans ; Resuscitation ; Survivors

STUDY DESIGN: The influence of lumbar disc degeneration, the space-occupying ratio on MRI and the amount of removed disc on the clinical outcomes of an open discectomy were analyzed retrospectively. OBJECTIVES: This study analyzed the pre and post-operative factors associated with the clinical outcome of an open discectomy. SUMMARY OF LITERATURE REVIEW: Much controversy still exists regarding the factors that influence the clinical outcome following an open discectomy. MATERIALS AND METHODS: Out of 207 patients who had been treated with an open discectomy for a lumber disc herniation, between April 1997 and December 2003, 161 patients who underwent MRI with the same apparatus, with at least 6 months of follow-up, were analyzed. The study group was composed of 111 men and 50 women, with a mean age at the time of surgery of 33.1 years old. The mean follow-up period was 42 months. The degree of disc degeneration was classified according to the Thompson's classification, and the extent of the discectomy was measured by the volume. The postoperative outcomes were judged using Nayer's classification. RESULTS: The highest frequency of disc herniation occurred at the L4-5 level, with being of the subligamentous extrusion type. The disc degeneration observed on MRI had a high statistical correlation with age (p<0.001); however, there was no statistical relationship with the level of disc herniation, sex and the amount of disc removed by discectomy (p>0.05). Clinically, 123 cases were more than fair, and 4 cases underwent reoperation due to recurrence. The clinical outcome, sex, age and space-occupying ratio were of little statistical value (p>0.05). Statistically, the greater the amount of disc removed, the better the clinical outcome (p<0.05). Those with disc degeneration classified as grade 3 from the MRI had unsatisfactory clinical outcomes (p<0.05). CONCLUSIONS: Those with disc degeneration classified as grade 3 from the MRI had unsatisfactory clinical outcomes. The greater the amount of disc removed the more satisfactory the clinical outcomes. No statistical relationships were found between the space-occupying ratio and the clinical outcome.
Classification ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration* ; Magnetic Resonance Imaging* ; Male ; Recurrence ; Reoperation ; Retrospective Studies