PURPOSE: This study aimed to identify the range of normal facial asymmetry using three-dimensional CT and to develop a simple method of diagnosis of facial asymmetry. MATERIALS AND METHODS: Twenty eight adults with normal occlusion (16 males and 12 females; mean age 24 years and 1 month) were selected, whose faces were assessed to be symmetric by an orthodontist. Three-dimensional reconstructions were obtained utilizing spiral CT scans and an oral and maxillofacial radiologist evaluated nineteen anatomic landmarks in three-dimensional coordinates. Facial asymmetry index of each landmark was caluculated. RESULTS: The range of normal facial asymmetry of each landmark was identified using mean and standard deviation of facial asymmetry index. CONCLUSION: The range of normal facial asymmetry identified in this study may be used as a diagnostic standard for facial asymmetry analysis.
Adult ; Anatomic Landmarks ; Diagnosis ; Facial Asymmetry* ; Female ; Humans ; Male ; Tomography, Spiral Computed

PURPOSE: This study was aimed to compare skin entrance dose of digital radiography with that of film radiography and to show the dose reduction achievement with digital systems at 11 dental schools in Korea. MATERIALS AND METHODS: Forty six intraoral radiographic systems in 11 dental schools were included in this study. Digital sensors were used in 33 systems and film was used in 13 systems. Researchers and the volunteer visited 11 dental schools in Korea. Researchers asked the radiologic technician (s) at each school to set the exposure parameters and aiming the x-ray tube for the periapical view of the mandibular molar of the volunteer. The skin entrance doses were measured at the same exposure parameters and distance by the technician for each system with a dosimeter (Multi-O-Meter : Unfors instruments, Billdal, Sweden). RESULTS: The median dose was 491.2micronGy for digital radiography and 1, 205.0 microGy for film radiography. The skin entrance dose in digital radiography was significantly lower than that of film radiography (p< 0.05). CONCLUSIONS: Fifty-nine percent skin entrance dose reduction with digital periapical radiography was achieved over the film radiography in Korean dental schools.
Humans ; Korea ; Molar ; Radiographic Image Enhancement ; Radiography* ; Schools, Dental* ; Skin* ; Volunteers

PURPOSE: The most common cause of failure after Steindler flexorplasty has been known insufficient power of the transferred muscles. We develop "effective muscle index" which is calculated from the actual strength of each muscle to predict postoperative flexion power of the elbow for preventing the failure of the surgery. MATERIALS AND METHODS: We reviewed 10 patients who received Steindler flexorplasty from Aug. 1983 to Jan. 1997. We calculated "effective muscle index" with power of each transferred muscle, tension fraction2) by Brand, 1981, correction index of the magnitude of transferring muscle and correlated the "effective muscle index" with postoperative elbow flexion power. RESULTS: Excluding 4 out of total 10 patients who had grade 1 or 2 power of biceps and brachialis, "effective muscle index" has borderline significance with the postoperative flexion power of the elbow (p=0.123) . CONCLUSION: The authors concluded that the "effective muscle index" is maybe considered as a useful index for predicting the postoperative flexion power of the elbow after Steindler flexorplasty.
Elbow* ; Humans ; Muscles

PURPOSE: To evaluate the safety and efficacy of CT-guided celiac plexus block (CPB) using an anterior approach, and to determine the role of CT in this procedure. MATERIALS AND METHODS: CPB was attempted in 15 patients (10 men and 5 women; mean age, 62.3 years) with intractable upper abdominal pain due to terminal malignancy of the pancreas, liver, bowel, and kidney. To permit an anterior approach, patients lied supine on the CT scan table during the procedure. One or two 21-guage needles were placed just anterior to the diaphragmatic crus at or between the levels of the celiac and superior mesenteric arteries and 10-40 ml of 99.9% alcohol was injected. Pain relief following the procedure was assessed and pain was graded on a visual analogue scale (VAS) from 0 to 10. RESULTS: There were no technical failures and no neurologic or hemorrhagic complications. Abdominal pain during alcohol injection occurred in all patients, and transient hypotension in three. One patient with recurrent cancer of the pancreatic head died of sepsis five days after the procedure; the cause of sepsis was difficult to determine, but there was thought to be a biliary source of infection. Two days after block, 13 of 15 procedures (86.7%) had produced at least partial pain relief ; in 12 patients, relief was good. With CT guidance, more directed positioning of the needle is possible, allowing alcohol to be deposited in specific ganglion areas. CONCLUSION: CT-guided celiac plexus block using an anterior approach was an easy and effective way of reducing intractable upper abdominal pain due to terminal malignancies. CT guidance allowed precise needle placement and a safer procedure.
Abdominal Pain ; Anesthesia ; Celiac Plexus* ; Ethanol* ; Female ; Ganglion Cysts ; Head ; Humans ; Hypotension ; Kidney ; Liver ; Male ; Mesenteric Artery, Superior ; Needles ; Pancreas ; Sepsis ; Tomography, X-Ray Computed

Uterine torsion, which most often occurs during pregnancy, is rare. Torsion of a nongravid uterus is extremely rare and is associated with pelvic adhesions, uterine leiomyomas, or uterine anomalies. We experienced a case of uterine torsion, with a huge subserosal leiomyoma and multiple intramural leiomyomas, in a postmenopausal woman, one that showed the most extreme degree of rotation among the known cases of uterine torsion. Necrosis of the uterus and both adnexae was observed. A total abdominal hysterectomy with a bilateral salpingo-oophorectomy was performed. We present this case with a brief review of the relevant literature.
Female ; Humans ; Hysterectomy ; Leiomyoma ; Necrosis ; Postmenopause ; Pregnancy ; Urogenital Abnormalities ; Uterus

This study examined salivary flow and salivary pH and the prevalence and levels of cariogenic bacteria in the saliva of oncological patients and healthy controls. Quantitative real-time polymerase chain reaction was used to assess the levels of microbes including Streptococcus mutans, Streptococcus sobrinus, Lactobacillus salivarius, and Lactobacillus acidophilus in the saliva of 41 patients with a solid tumor (SO), 30 patients with a hematologic malignancy (HE), and 40 healthy controls. Salivary flow and pH were lower in oncological patients than in controls. The frequencies of all four cariogenic bacteria were highest in the SO group. S. mutans and L. salivarius were the most commonly detected in all three study groups. Mean numbers of S. sobrinus and L. salivarius in the SO group were significantly higher than in controls (p<0.05). There were no significant differences between patients and controls with respect to mean numbers of S. mutans and L. acidophilus in saliva. However, the proportions of S. mutans, S. sobrinus, and L. salivarius versus total bacteria in the SO group were significantly higher than in controls. Within patients, both mean numbers and the proportions of S. mutans and S. sobrinus were significantly different (p<0.05). In summary, significant differences were found in salivary pH values and the levels of S. mutans, S. sobrinus, and L. salivarius between SO patients and healthy controls.
Bacteria ; Hematologic Neoplasms ; Humans ; Hydrogen-Ion Concentration ; Lactobacillus ; Lactobacillus acidophilus ; Prevalence ; Real-Time Polymerase Chain Reaction ; Saliva ; Streptococcus ; Streptococcus mutans ; Streptococcus sobrinus

OBJECTIVE: The purpose of this study was to evaluate the risk of cesarean section in nulliparous women who undergone induction at postterm pregnancy. METHODS: The retrospective study was conducted from March, 1997 to March, 2005 by reviewing 331 nulliparous patients more than 41 weeks' gestation delivered after induction at our Hospital. The evaluated variables to assess the risk of cesarean section were maternal age, body mass index (BMI), gestational age (GA), Bishop scores (BS), fetal body weight (FBW), fetal head circumference (FHC) and fetal sex. t-test and x2-test were used to compare these categorical variables. RESULTS: The study included 331 nulliparous singleton pregnant women undergoing elective induction for postterm pregnancy: 127 (38.4%) delivered babies by cesarean section due to induction failure, progression failure and fetal distress, whereas 204 (61.6%) delivered vaginally. The mean maternal ages were 27.59+/-2.57 in cesarean delivery group and 26.99+/-2.61 in vaginal delivery group. The average values of BMI at postterm in cesarean and vaginal delivery groups were 26.70+/-2.82 and 25.75+/-2.67 kg/m2. GA was 41.36+/-0.27 weeks in cesarean delivery group, whereas 41.20+/-0.19 weeks in vaginal delivery group. The average FBW and FHC were 3460.31+/-358.22 g and 34.59+/-1.18 cm in cesarean delivery group, compared to 3363.95+/-361.22 g and 34.03+/-1.34 cm in vaginal delivery group. CONCLUSION: The BMI, FBW and FHC have linked to the risk of cesarean delivery in nulliparous women who underwent elective induction. Thus, these information would provide the useful tools to assess the risk of cesarean section in postterm nulliparous patients for planning an induction.
Body Mass Index ; Cesarean Section* ; Female ; Fetal Distress ; Fetal Weight ; Gestational Age ; Head ; Humans ; Maternal Age ; Pregnancy ; Pregnancy* ; Pregnant Women ; Retrospective Studies

BACKGROUND: Wear cannot be completely prevented after total hip arthroplasty. If severe polyethylene (PE) liner wear develops, the so-called catastrophic failure occurs and metallosis develops. We postulated that longevity of the new implant may be affected after revision surgery for metallosis following a catastrophic failure of a PE liner due to the substantial amount of PE wear particles and infiltration of the metal particles in this catastrophic condition. METHODS: Twenty-three hips of 23 patients were identified because they showed metallosis during revision total hip arthroplasties performed in Seoul National University Hospital between January 1996 and August 2004. They were followed for at least 6.5 years after the index revision total hip arthroplasty. The clinical and radiological results of revision total hip arthroplasties in these patients were evaluated. RESULTS: The median Harris hip score increased from 60 points before revision total hip arthroplasties to 90 points at the final follow-up. Osteolysis was detected at an average of 9.3 years after revision total hip arthroplasties in 13 hips and acetabular cup loosening at average 9.8 years after revision total hip arthroplasties in 9 hips. With radiographic evidence of osteolysis and loosening as the end points, the 15-year survival rates were 28.2% and 56.0%, respectively. CONCLUSIONS: The survival rate of revision total hip arthroplasty in patients with metallosis following a catastrophic failure of a PE liner was low.
Adolescent ; Adult ; *Arthroplasty, Replacement, Hip ; Biocompatible Materials ; Female ; Hip Joint/radiography/surgery ; Hip Prosthesis/*adverse effects ; Humans ; Joint Diseases/radiography/*surgery ; Male ; Metals/adverse effects ; Metals, Heavy/*poisoning ; Middle Aged ; Osteolysis/etiology/surgery ; Poisoning/etiology/*surgery ; Polyethylene/adverse effects ; Prosthesis Design ; *Prosthesis Failure/etiology ; Reoperation ; Young Adult

PURPOSE: This study was performed to investigate the interobserver agreement on the detection of carotid artery calcifications on panoramic radiographs. MATERIALS AND METHODS: This study consisted of panoramic radiographs acquired from 634 male patients of the age of 50 years or older. Having excluded carotids of no diagnostic quality, 1008 carotids from the panoramic radiographs of the patients were interpreted by two oral and maxillofacial radiologists independently for the presence of carotid artery calcifications. Statistical analysis was used to calculate the interobserver agreement. RESULTS: Interobserver agreement was obtained for 932 carotids (92.4%). Inconsistent interpretation of 76 carotids (7.5%) between the two observers was found. Cohen's kappa value was 0.688 (p<0.001). CONCLUSION: The probability of a match between the two observers was substantially high.
Atherosclerosis ; Carotid Arteries* ; Diagnosis* ; Humans ; Male ; Radiography, Panoramic

The aims of this study were to investigate serum hepatitis B virus (HBV) DNA levels at different clinical stages in patients with chronic HBV infection, and to determine the serum HBV DNA level that discriminated HBeAg-negative chronic hepatitis B(CHB) cases from inactive HBsAg carriers. In all, 222 patients, encompassing 68 HBeAg-positive CHB patients (HBeAg-positive, ALT-elevation), 89 HBeAg-negative CHB patients (HBeAg-negative, ALT-elevation), and 65 inactive HBsAg carriers (HBeAg-negative, ALT-normal), were tested. The ALT levels had been tested more than twice during the previous six months, and the serum HBV DNA levels were quantified by a polymerase chain reaction-based assay. The serum HBV DNA levels of the HBeAg-negative patients were significantly lower than those of the HBeAg-positive patients (median 2.7 x 10(4) vs. 1.6 x 10(8) copies/mL; p=0.000). In addition, the HBV DNA levels of the HBeAg-negative CHB patients were significantly higher than those of the inactive HBsAg carriers (median 2.2 x 10(5) vs. 3.2 x 10(3) copies/ mL; p=0.000). The optimal HBV DNA level for discriminating HBeAg-negative CHB cases from inactive HBsAg carriers was 2.0 x 10(4) copies/mL. The serum HBV DNA levels were lower than the cutoff value in 72.3% (47/65) of the inactive HBsAg carriers, and in 31.5% (28/89) of the HBeAg-negative CHB patients. The serum HBV DNA levels differed significantly between these two groups. However, the levels in the two groups overlapped extensively, preventing the definition of a differentiation cut-off value.
Adolescent ; Adult ; Aged ; Child ; DNA/chemistry ; DNA, Viral/*genetics ; False Positive Reactions ; Female ; Hepatitis B/metabolism/*pathology ; Hepatitis B Virus/*metabolism ; Human ; Liver/metabolism ; Male ; Middle Aged ; Polymerase Chain Reaction ; ROC Curve