Sacral pressure sores have been treated by a variety of surgical methods. complete treatment needs wide excision and coverage with healthy tissue which has constant and sufficient blood supply. Use of gluteus maximus muscle flap with or without overlying skin is a revolutionary method because of the reliability of blood supply. However, it is technically a little bit complicated, and future reconstruction for recurrent decubitus is especially limited in paraplegic patients. The development of gluteal perforator-based flap with para-sacral perforator introduce a new treatment modality for the sacral pressure sores. Total 10 cases of sacral pressure sores were treated with gluteal perforator-based flap. There were minimal postoperative complications except wound dehiscence in one case. This flap has a many advantage of no transection or sacrifice of the gluteus maximus muscle, elevation time for the flap is short, reliable blood flow of the perforator, large rotation arc and no post-operative hindrance to walking in patients who are not paraplegic. The disadvantages of this perforator-based flaps are the anatomical variation in the location of perforators and the need for technically careful dissection.
Humans ; Postoperative Complications ; Pressure Ulcer* ; Skin ; Walking ; Wounds and Injuries

No abstract available.
Animals ; Ischemia* ; Muscle, Skeletal* ; Rats* ; Reperfusion*

No abstract available.
Animals ; Antibodies, Neutralizing* ; Immunization* ; Mice*

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.
Acetazolamide* ; Arteriovenous Malformations* ; Brain* ; Humans ; Perfusion* ; Prognosis* ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: The aim of this study is to reveal the detailed clinical features of diarrhea- associated benign infantile convulsion. METHODS: We studied 34 patients with diarrhea-associated benign infantile convulsion between March 2000 and February 2004. RESULTS: There were 34 patients with diarrhea-associated benign infantile convulsion : 19 boys and 15 girls. The age of the disease onset ranged from 3 to 34(mean; 18.7+/-6.6) months. The incidence was high from November to March. The types of the seizures were generalized tonic-clonic or generalized tonic in 32(94%) of 34 episodes, while the seizure types changed during episodes for 2 patients. The durations of seizures were from 3 sec to 10 min. 2 or more seizures occurred in 22(64.7%) episodes. A family history of febrile or afebrile convulsions was noted in 3 patients. There were no abnormalities in serum biochemistry tests. 12 out of 22 patients showed positive rotavirus antigen tests. Interictal EEG's were normal in 26 out of 30 episodes. CT or MRI demonstrated no neuroradiological abnormalities in 13 out of 14 patients. 4 patients experienced recurrence of diarrhea-associated benign infantile convulsion, but none had more than 2 episodes. Epilepsy developed in none of the patients during the follow-up period. CONCLUSION: Diarrhea-associated benign infantile convulsion is characterized by a cluster of seizures. A continous or intermittent antiepileptic treatment is not required because recurrence or later development of epilepsy is rare. Appropriate treatment for a cluster of seizures will be the subject of future studies.
Biochemistry ; Diarrhea ; Epilepsy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Infant ; Magnetic Resonance Imaging ; Recurrence ; Rotavirus ; Seizures*

PURPOSE: To evaluate position of the mandibular condyle within articular fossa in an asymptomatic population radiographically by a cone beam computed tomography. MATERIALS AND METHODS: Cone beam computed tomography of 60 temporomandibular joints was performed on 15 males and 15 females with no history of any temporomandibular disorders, or any other orthodontic or prosthodontic treatments. Position of mandibular condyle within articular fossa at centric occlusion was evaluated. A statistical evaluation was done using a SPSS. RESULTS: In the sagittal views, mandibular condyle within articular fossa was posteriorly located at medial and central sections. In the coronal views, mandibular condyle within articular fossa was laterally located at central section. Mandibular condyles in the right and left sides were showed asymmetric positional relationship at medial,central, and lateral sections. CONCLUSION: Mandibular condyle within articular fossa in an asymptomatic population was observed nonconcentric position in the sagittal and coronal views.
Cone-Beam Computed Tomography* ; Female ; Humans ; Male ; Mandibular Condyle* ; Prosthodontics ; Temporomandibular Joint ; Temporomandibular Joint Disorders

PURPOSE: To assess the internal echo intensity and morphological variability of masseter muscles on ultrasonography and to establish diagnostic criterion of estimation. MATERIALS AND METHODS: Participants consisted of 50 young adults (male 25, female 25) without pathologic conditions and with full natural dentitions. Sonographic examinations were done with real time ultrasound equipment as Logiq 500 (GE Medical Systems, Seoul, Korea) at 3 parts according to lines paralleling with ala-tragus line as reference line. The thickness and area of masseter muscles according to reference line in cross-sectional images were measured at rest and at maximum contraction. The visibility and width of the internal echogenic intensity of the masseter muscles were also assessed and the muscle appearance was classified into 4 types. Data were statistically analyzed by paired t-test and chi-square-test. RESULTS: 1. When comparing the thickness and area of masseter muscles concerning with gender, there was few significant difference between right and left sides, however, there were significant differences between males and females except for the greatest thickness of left side. 2. The changes of the greatest thickness and the area between rest and maximum contraction showed that the part of the least thickness manifested more increase at maximum contraction. 3. Each part the manifestations of the internal echogenic intensity of the masseter muscles were different depending on the locations. But there was no statistically significance. CONCLUSION: Changes of muscles thickness with contraction and internal echogenic intensity with locations showed great disparity within the masseter muscles, which will be diagnostic criteria for pathophysiologic and anatomic changes of masseter muscles.
Contracts ; Dentition ; Female ; Humans ; Male ; Masseter Muscle ; Muscles ; Young Adult

PURPOSE: To assess the diagnostic accuracy and value in an imaging technique field through the comparison of cone beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular canal and impacted third molars. MATERIALS AND METHODS: Participants consisted of 100 patients offered the images through cone beam computed tomography and panoramic radiography. PSR-9000(TM) Dental CT system (Asahi Roentgen Ind. Co., Ltd, Japan) was used as the unit of cone beam computed tomography. CE-II (Asahi Roentgen Ind. Co., Ltd, Japan) and Pro Max (Planmeca Oy, Finland) were used as the unit of panoramic radiography. The images obtained through panoramic radiography were classified into 3 types according to the distance between mandibular canal and root of mandibular third molar. And they were classified into 4 types according to the proximity of radiographic feature. The images obtained through cone beam computed tomography based on the classification above were classified into 4 types according to the location between the mandibular canal and the root and were analyzed. And they were classified into buccal, inferior, lingual, and between roots, according to the location between mandibular canal and root. The data were statistically analyzed and estimated by chi-square-test. RESULTS: 1. There was no statistical significance according to 3 types (type l, type ll, type lll) through CBCT. 2. The results of 4 types (type A, type B, type C, type D) through CBCT were as high prevalence of CBCT 1 in type A, CBCT 2 in type B, CBCT 3 in type C, and CBCT1 in type D and those of which showed statistical significance (P value=0.03). 3. The results according to location between mandibular canal and root through CBCT recorded each 49, 25, 17, 9 as buccal, inferior, lingual, between roots. CONCLUSION: When estimating the mandibular canal and the roots through the panoramic radiography, it could be difficult to drive the views of which this estimation was considerable. Thus it is required to have an accurate diagnostic approaching through CBCT that could estimate the location between mandibular canal and roots.
Cone-Beam Computed Tomography ; Humans ; Mandibular Nerve ; Molar, Third ; Prevalence ; Radiography, Panoramic

PURPOSE: To compare and evaluate the diagnostic ability of cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). MATERIALS AND METHODS: CBCT and MRI of 46 TMJs of 23 patients with TMJ disorders were evaluated. They were divided into 3 groups according to the position of the articular disc of the TMJ at closed mouth position and the reduction of the disc during open mouth position on MRI : no disc displacement group (NDD), disc displacement with reduction group (DDR), and disc displacement without reduction group (DDWR). With PACS viewing softwares, position of mandibular condyle in the articular fossa, osseous change of mandibular condyle, shape of articular fossa, and mediolateral and anteroposterior dimensions of mandibular condyle were evaluated on CBCT and MRI. Each value was tested statistically. RESULTS: The position of mandibular condyle in the articular fossa were concentric in the NDD, DDR, and DDWR of CBCT and NDD of MRI. However, condyle was positioned posteriorly in DDR and DDWR of MRI. Flattening, sclerosis and osteophyte of the mandibular condyle were much more apparent on DDR of CBCT than MRI. And the erosion of the condyle was much more apparent on DDWR of MRI than CBCT. Box and Sigmoid types of articular fossa were found most frequently in DDR of MRI. Flattened type was found most frequently in DDR of CBCT and deformed type was found most frequently in DDWR of CBCT. No significant difference in mediolateral and anteroposterior dimensions were shown on CBCT and MRI. CONCLUSION: Since MRI and CBCT has unique diagnostic imaging ability, both modalities should be used together to supplement each other to evaluate TMJ.
Colon, Sigmoid ; Cone-Beam Computed Tomography ; Diagnostic Imaging ; Displacement (Psychology) ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Mandibular Condyle ; Mouth ; Osteophyte ; Sclerosis ; Temporomandibular Joint ; Temporomandibular Joint Disorders

PURPOSE: To estimate the shape of root and pulp canal using a dental cone beam computed tomography (CBCT) and to evaluate the accuracy of imaging reformation. MATERIALS AND METHODS: CBCT images were obtained with incisors, premolars, and molars as the destination by using PSR 9000NTM Dental CT system (Asahi Roentgen Ind. Co., Ltd, Kyoto, Japan) and i-CAT (Imaging Sciences International, Inc, USA) cone beam CT unit that have different kind of detector and field of view, and compared these with the shape and the size of actual root and root canal. RESULTS: When the measuring value of cone beam computed tomography concerning to each root's bucco-lingual diameter and mesio-distal diameter was compared with the value of the actual root, it reveals an error range -0.49 ~+0.63 mm at PSR900N and -0.97~+1.14 mm at i-CAT(P.0.05). It was possible to identify and measure PSR 9000NTM Dental CT system to the limit 0.48+/-0.06 mm (P.0.05) and i-CAT CBCT to the limit 0.86+/-0.09 mm (P.0.05) on estimating the size and the shape of root canal. Two kinds of CBCT images revealed the useful reproducibility to estimate the shape of root, but there was the difference to estimate the shape of root according to apparatus. The reproducibility of root shape in the image of three-dimensions at PSR 900N is low such as 0.65 mm in a case of minute root canal. CONCLUSIONS: CBCT images revealed higher accuracy of the imaging reformation for root and pulp and clinically CBCT is a useful diagnostic tool for the assessment of root and canal. However, there are different qualities of imaging reformation according to CBCT apparatus and limitation of reproducibility for minute root canals.
Bicuspid ; Cone-Beam Computed Tomography* ; Dental Pulp Cavity* ; Incisor ; Molar ; Radiography, Dental ; Tomography, X-Ray Computed ; Tooth*