Three-dimensional solid model has not been widely used in surgical prediction of orthognathic surgery because freque from occlusal restorations or prosthesis limited the usefulness of simulated surgery involving occlusion. We prepared three-dimensional(3D) solid model from CT data and integrated the 3D solid model with dental cast using a face-bow transfer technique combined with skeletal reference measurement and confirmation with cephalometric radiographs. With this simple and easy method, it was possible to predict bony interference between the proximal and distal segment of the mandible so that we can prevent condylar displacement after sagittal split ramus osteotomy of the mandible with prominent asymmetry. The method error was within 2mm and it seemed to be useful in preoperative planning for maxillofacial surgery with maxillo-mandibular occlusal change
Mandible* ; Orthognathic Surgery* ; Osteotomy, Sagittal Split Ramus ; Prostheses and Implants ; Surgery, Oral

No abstract available.
Osteoporosis* ; Radionuclide Imaging*

PURPOSE: This study was performed to investigate the effect of desmopressin on nocturia in patients with irritative symptom who do not respond effectively to first line therapy, such as benign prostatic hyperplasia(BPH) medication(alpha-blocker and finasteride), antimuscarinics or calcium antagonist. MATERIALS AND METHODS: Patients had been treated for unresolved severe nocturia(<3 times per night) in spite of first-line therapy for more than 3 months. Additional medication of desmopressin was recommended to the patients with unresolved nocturia in spite of first line therapy. According to clinical diagnosis, the patients were classified into three groups: Group I of male with BPH, Group II of male without BPH and Group III of female. The response to each first-line therapy and desmopressin treatment was estimated by the number of nocturia and quality of life. Additionally, before and after desmopressin treatment, voiding diary and urodynamic study were evaluated, respectively. RESULTS: A total of 79 patients were enrolled in this study. Severe nocturia patients unresolved to 1st line therapy were improved after combination therapy of 1st line therapy with desmopressin. In 66(83.5%) of the total 78 patients, the number of nocturia was significantly reduced to less than 3 after combination therapy. According to groups, the number of nocturia was significantly reduced to less than 3 in 84.8% of Group I(n=46), 71.4% of Group II(n=21), and 100% of Group III(n=12), respectively. CONCLUSIONS: Combination therapy with desmopressin effectively reduced nocturia in patients with unresolved severe nocturia in spite of first line treatment. We recommend combination therapy of desmopressin with first line treatment for unresolved severe nocturia in adults. Long term efficacy and adverse effects should be assessed for the generalized use of desmopressin.
Adult* ; Calcium ; Deamino Arginine Vasopressin* ; Diagnosis ; Female ; Humans ; Male ; Muscarinic Antagonists ; Nocturia* ; Prostatic Hyperplasia ; Quality of Life ; Urination Disorders ; Urodynamics

Anesthesia, Local ; Cautery ; Epistaxis ; Hemorrhage ; Hemostasis ; Humans ; Ligation

BACKGROUND: The esthetic and functional outcomes of periorbital defect reconstruction are very important because of the complex anatomy and specialized functions of this region. The orbicularis oculi myocutaneous (OOMC) flap is useful for the reconstruction of periorbital defects. But, according to the location and depth of the defects, the reconstruction using OMC flaps with various techniques is rare. The authors have used various kinds of OOMC flaps in various situations and we present an analysis of our experiences. METHODS: From November 2001 to July 2017, we used 36 OOMC flaps to reconstruct 30 periorbital defects in 25 patients. We analyzed the cause of the defect, its location, the type of concomitant surgery, the method of flap movement, and complications. RESULTS: Of the 30 defects, basal cell carcinoma was the most common cause, accounting for 20 cases. When the used OOMC flap was classified according to the location of the defects, the switch flap was used in nine cases among 15 defects of lower eyelid, and the V-Y advancement flap was mainly used for other parts. As surgical methods according to the depth of defect were classified, all cases involving the tarsal plate were reconstructed with a composite graft. In case of skin and muscles, they were reconstructed only with OOMC flap or with full-thickness skin graft. CONCLUSION: The OOMC flap provides good skin quality that is very similar to that of the defect tissue. Depending on the location and depth of the defect, the OOMC flap may be used properly in a variety of ways to achieve good results.
Carcinoma, Basal Cell ; Eyelids ; Humans ; Methods ; Muscles ; Myocutaneous Flap* ; Skin ; Surgical Flaps ; Transplants

No abstract available.
Fibroma ; Maxilla

Laryngeal involvement is a rare complication of systemic lupus erythematosus (SLE) and can range from mild mucosal inflammation, vocal cord paralysis, and edema to necrotizing vasculitis with airway obstruction. Cricoarytenoid arthropathy is rare cause of severe airway obstruction in laryngeal involvement of SLE. In contrast to patients with rheumatoid arthritis, patients with SLE typically present with acute arthritis of cricoarytenoid joints and respond to corticosteroid therapy alone. We describe here a 13-year-old girl with SLE who presented with intermittent fever, swallowing difficulty, vocal cord paralysis and acute dyspnea required emergent tracheostomy as the sole manifestation of active SLE. She was diagnosed as having SLE based on the findings of positive anti-nuclear antibody and anti-ds DNA antibody with high titers, hypocomplementemia, leukocytopenia, and transient polyarthritis and proteinuria. No other clinical symptoms were found. Endoscopic findings showed edema of aryepiglottic fold, bilateral fixation of the vocal cords and edematous supraglottic structure with engorged vessels. Computered tomography scan of the neck showed diffuse soft tissue edema around the arytenoid and cricoid cartilages and enhancement of the aryepiglottic fold.
Adolescent ; Airway Obstruction ; Arthritis ; Arthritis, Rheumatoid ; Cricoid Cartilage ; Deglutition ; DNA ; Dyspnea ; Edema ; Female ; Fever ; Humans ; Inflammation ; Joints ; Larynx ; Leukopenia ; Lupus Erythematosus, Systemic* ; Neck ; Proteinuria ; Tracheostomy ; Vasculitis ; Vocal Cord Paralysis ; Vocal Cords

The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and high incidence of recurrence. TMJ ankylosis has been treated by excision and total joint reconstruction with alloplastic, allogeneic, autogenous materials as interpositional materials. The temporalis myofascial flap had been considered to be a successful interpositional material, due to its anatomical, topographical, and functional properties. This study evaluated the efficacy of the temporalis myofascial flap for nine TMJs (five patients) through the preauricular approach and coronoidectomy. Radiographic and physiologic long term result was investigated in this study. The result reveals that the temporalis myofascial flap is a good autogenous tissue satisfying the criteria of an ideal interpositional material, which offers a material that fulfills the physiological function of the disc. In spite of favorable functional outcome, mild postoperative openbite tendency remains another challenge.
Ankylosis* ; Arthroplasty* ; Incidence ; Joints ; Open Bite ; Recurrence ; Temporomandibular Joint*

PURPOSE: The purpose of this study was to analyze the radiologic findings of primary epiploic appendagitis, with particular attention to the correlation of ultrasonographic, clinical, CT, MR and surgical findings. MATERIALS AND METHODS: Among 14 patients with primary epiploic appendagitis who presented with the rapid onset of a very localized pain and tenderness, we performed ultrasonography in all, CT in eight, and MRI in four of these eight. Surgery was performed in two patients. Follow-up examinations were performed using US, CT and MRI (n=2), US and CT (n=2), US alone (n=2), and with regard to clinical features (n=12). RESULTS: US performed in 14 patients revealed the presence in all of small, well-defined, ovoid, noncompressible hyperechoic (n=12) or isoechoic (n=2) solid masses attached to the colonic wall, without bowel wall change and without communication with bowel lumen. CT performed in 8 patients showed varying hyperattenuating fatty lesions in the same location in the abdomen, without other inflammatory process. MRI findings of four patients were helpful for further evaluation of internal architecture. CONCLUSION: In primary epiploic appendagitis, US findings were sufficiently characteristic to allow accurate diagnosis and valuable for the differential diagnosis of other acute conditions of the abdomen.
Abdomen ; Colon ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Ultrasonography

Polycythemia is a condition in which the red blood cell count is increased due to an inherited or acquired mutation, a physiologic response to hypoxia, autonomous erythropoietin production, or deliberate erythropoietin administration. Higher testosterone levels appear to act as a stimulus for erythropoiesis and testosterone replacement therapies have rarely been reported as causes of polycythemia. We report here a case of a 51-year-old man with polycythemia that was caused by long-acting testosterone undecanoate (Nebido(R)).
Anoxia ; Erythrocyte Count ; Erythropoiesis ; Erythropoietin ; Humans ; Middle Aged ; Polycythemia ; Testosterone