STATEMENT OF PROBLEM: Proper proximal contact is important for maintaining and stabilizing the dental arch. However, the proximal contact strength (PCS) is not a constant value and can be affected by a variety of factors. PURPOSE: This study examined the influences of postural changes on the posterior PCS. MATERIAL AND METHODS: Twelve adults with a normal occlusion and had not undergone prosthetic treatment or proximal restoration were participated in this study. A metal strip was inserted into the proximal surface and removed at a constant velocity. The contact strength was measured in every contact point between canine to second molar in both arches. The PCSs were obtained initially in the upright position, secondly in the supine position and finally in the upright position again. All measurements were repeated after a 2 hour period. Statistical analysis was carried out using the Friedman test (P < .05). RESULTS: Generally, a decrease in PCS occurred when the posture was changed from the initial upright to supine position, while it increased when the posture was changed from the supine to upright position. A significant change was observed in all areas except for between the canine-first premolar in the maxilla and between the first molarsecond molar in the mandible areas. CONCLUSION: The posterior PCS, which dentists generally believe to be a static feature of occlusion, is affected significantly by posture.
Adult ; Bicuspid ; Dental Arch ; Dentists ; Humans ; Mandible ; Maxilla ; Molar ; Posture ; Supine Position

We retrospectively analyzed the Magnetic Resonance (MR) imaging findings in 41 cases of histologically proved malignant tumors of oral cariey. The diagnostic value of MR imaging in detection and delineation of the lesions was assessed. The value of MRI was compared with that of Computed Tomography (CT) in 14 patients. Thirty-four cases of 41 malignant tumors were squamous cell carcinomas. Adenoic cystic carcinomas (2 cases), malignant melanomas (2 cases), non-Hodgkin lymphomas (2 cases) and mucoepidermoid carcinoma(1 cases) were also included in this study. Most of the lesions were isointense or slightly hyperintense to muscle on T1 weighted images and showed variable degrees of high signal intensity on T2 weighted images. Two cases of malignant melanomas showed characteristic hyperintensity on T1 weighted images. T2 weighted image was better in detection and delineation of tumor in most of the cases. In 6 cases, Gd-DTPA-enhanced T1 weighted image was better than T2 weighted image. T2 weighted image was useful for the evaluation of deep tissue infiltration and T1 weighted image was useful for the evaluation of bone invasion and superficial tissue plane invasion. The lesion was detected only by MR in 3 cases of 14 in which CT was also performed. MR imaging was more sensitive in the evalustion of bone marrow involvement. MR imaging is very useful modality in evaluating oral cavity malignany and is superior to CT in delineation of the as well as in the evaluation of mandible invasion.
Bone Marrow ; Carcinoma, Squamous Cell ; Humans ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging* ; Mandible ; Melanoma ; Mouth* ; Retrospective Studies

PURPOSE: We retrospectively performed this study to evaluate the characteristic findings of maxillomandibular ameloblastomas on CT and MR imaging. MATERIAS AND METHODS: We reviewed histologically proved 12 cases of ameloblastomas, of which 7 cases were postoperative recurrent tumors. one of twelve cases was presumed ameloblastic carcinoma. Eleven cases were examined with CT and 3 cases with MR. RESULTS: The types were solid in 4, unicystic in 4, and mixed in the rest 4. CT and MRI of 11 ameloblastomas showed concentric expansile mass(n=11), cortical bone thinning and focal bone destruction by the tumors(n=9), well-margined, expansile destruction of surrounding sturctures(n=9), focal bulging of the tumors(n=6) and focal poorly-marginated invasion of tissue planes(n=4). Ameloblastic carcinoma showed ill defined irregular margin, aggressive invasion of surrounding structures and hematogeneous lung metastasis. Unerupted teeth or mural nodules were found in unicystic ameloblastomas. All three tumors examined by MRI showed isointensity to muscle on T1 weighted images and slight hyperintensity on T2 weighted images. The wall, septa and solid portions of the tumors were strongly enhanced on MR imaging. There was no difference in CT or MR finding between primary and recurrent tumors. CONCLUSION: Ameloblastomas showed solid, cystic or mixed pattern, and commonly well marginated expansile contour with local aggressiveness. Presence of mural nodules on CT in unicystic ameloblastoma with unerupted tooth was helpful in distinguishing ameloblastoma from dentigerous cyst.
Abdominal Pain ; Ameloblastoma* ; Ameloblasts ; Body Temperature ; Catheters ; Dentigerous Cyst ; Ethanol* ; Follow-Up Studies* ; Humans ; Kidney ; Liver ; Lung ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Recurrence ; Retreatment ; Retrospective Studies ; Sleep Stages ; Tooth, Unerupted ; Ultrasonography

No abstract available.
Animals ; Clone Cells* ; Cloning, Organism* ; DNA, Complementary* ; Leptin* ; Rats* ; Receptors, Leptin*

PURPOSE: The purpose of this study is to describe the anglographic findings of collateral vessels in cervicofacial vascular lesions with previously ligated carotid arteries and to evaluate the extent of anglographic assessmant needed before embolization. MATERIALS AND METHODS: We retrospectively reviewed 10 cervicofacial vascular lesions with previously ligated carotid artery, which were 6 cases of arteriovenous malformation, 2 cases of carotid cavernous fistula, 1 case of hemangioma and 1 case of arteriovenous realformation with carotid cavernous fistula. The previously ligated arteries are proximal external carotid artery (n=5), branches of external carotid artery (n=2) and common carotid artery (n=3). Common carotid artery or internal carotid artery (n=9), vertebral artery (n=5), ipsilateral external carotid artery (n=4), contralateral external carotid artery (n=5), costocervical trunk (n=2), thyrocervical trunk (n=2) were assessed by conventional angiography. Angiography of both carotid and vertebral arteries was performed in 5 cases. RESULTS: The collateral vascular channels were inferolateral trunk of internal carotid artery (n=8), vertebral artery (n=5), contralateral external carotid artery (n=5), ipsilateral external carotid artery (n=4), deep cervical artery (n=2) and ascending cervical artery (n=l). Embolizations were performed in 9 cases with operative cannulation(n=4), embolization via collateral branches of ipsilateral external carotid artery (n=l), embolization via collateral branches of contralateral external carotid artery (n=3) and balloon occulusion via direct puncture (n=l). CONCLUSION: The collateral channels in cervicofacial vascular lesions with previouly ligated carotid artery were inferolateral trunk of internal carotid artery, contralateral or ipsilateral external carotid artery, vertebral artery, deep cervical artery and ascending cervical artery on angiography. Complete anglographic assessment of possible collateral channels is mandatory for the effective and safe embolization.
Angiography ; Arteries ; Arteriovenous Malformations ; Carotid Arteries* ; Carotid Artery, Common ; Carotid Artery, External ; Carotid Artery, Internal ; Fistula ; Hemangioma ; Punctures ; Retrospective Studies ; Vertebral Artery

PURPOSE: To evaluate the degree of contrast enhancement of intracranial tumors on delayed (6-8min.) MR imaging after administration of Gd-DTPA. MATERIALS AND METHODS: Both immediate and delayed post-contrast MR imagings were studied prospectively in 35 patients. with brain tumors (11 gliomas, 6 meningiomas, 4 neurinomas, 5 parencymal metastases, 5 hemangioblastoma, 4 others) at either 0.5 T or 2.0 T unit. After precontrast TI-, proton-density, and T2-weighted spin echo images were obtained, each patient underwent Tl-weighted imaging immediately following infusion of 0.1 mmol/Kg of Gd-DTPA. Subsequently, the second postcontrast Tl-weighted images were obtained with no additional injection of the contrast media. Time-interval between the postcontrast immediate and the delayed images was approximately 6-8 minutes. Degree of contrast enhancement of the lesions was assessed both visually and quantitatively. For quantitative study, contrast enhancement ratio(CER) of tumors was calculated in both immediate and delayed post-contrast images. RESULTS: There was stronger visual enhancement in 7 of 11 cases with gliomas and 3 of 5 cases with parenchymal metastasis on delayed images when compared with immediate images, whereas all 10 cases of extraaxial tumors(meningiomas and neurinomas) showed decreased enhancement on delayed images. Quantitatively, mean CERs of gliomas and metastases were higher on delayed study than on immediate study by 20. 5% and 49.2%, respectively. Extraaxial tumors showed decrease of CER on delayed study by 19.7% as compared with that of immediate study. Hemangioblastomas showed visually poor enhancement on delayed image in 4 cases and equal enhancement on both immediate and delayed images in remaining one case, and quantitatively demonstrated decrease of CER on delayed study by 15.4%. CONCLUSION: Since there was more conspicuous contrast enhancement in many intraaxial tumors such as gliomas and metastases on 6-8 minutes delayed post-contrast MR study, the delayed post-contrast study may be needed in some intraaxial tumors for their characterization, and may also be helpful for the differential diagnosis between intraaxial and extraaxial tumors.
Brain Neoplasms* ; Brain* ; Contrast Media ; Diagnosis, Differential ; Gadolinium DTPA ; Glioma ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging* ; Meningioma ; Neoplasm Metastasis ; Neurilemmoma ; Prospective Studies

PURPOSE: We investigated reproducibility and repeatability of average macular thickness and volume measurements in normal eyes with Cirrus HD OCT (optical coherence tomography). METHODS: Fifty normal eyes from twenty-five subjects without medical and ocular histories were included. Macular cube 512 x 128 combination scanning using the Cirrus HD OCT was performed for a total of three times on the same visit by an experienced technician. Then other two technicians performed one more macular scanning respectively. Within-results, the intraclass correlation coefficient (ICC) was calculated for each parameter studied to evaluate repeatability and reproducibility. The correlation between macular measurements and demographic variables (age, gender, and spherical equivalent) were also investigated. RESULTS: The ICCs for intraoperator reproducibility were 0.99 on the average macular thickness and 0.96 on the macular volume. And the ICCs for interoperator repeatability were found to be 0.98 and 0.96, respectively. The ICCs for measurements of nine regional retinal thickness also were higher than 0.90. The retinal thickness was correlated with age, gender and refractive error. However, neither age nor refractive error affected to reproducibility and repeatability. CONCLUSIONS: The retinal thickness and macular volume measurements using Cirrus HD OCT in healthy volunteers showed excellent reproducibility and repeatability. Therefore, Cirrus HD OCT has been recognized as an useful tool for diagnosis and mornitoring of variable maculopathies.
Eye ; Refractive Errors ; Retinaldehyde

PURPOSE: Subacute necrotizing myelopathy(SNM) is a rare non-tumorous disease of spinal cord characterized by subacute clinical course of progressive neurological deterioration. We report MR findings of a patient with pathologically proved SNM. MATERIALS AND METHODS: 1 case of pathologically proved subacute necrotizing myelopathy. RESULTS: The patient was a 56-year-old man with progressive motor weakness and sensory loss of the lower extremities, and urinary and fecal incontinence for 11 months. Spine MRI revealed diffuse enlargement of the thoracic spinal cord from T2 to T7 level. Signal intensity of the expanded spinal cord was isointense relative to normal cord on T1 -weighted image and hyperintense on proton-density and T2-weighted images. On contrast enhanced T1-weighted image, there was diffuse homogeneous enhancement in the expanded cord lesion. CONCLUSION: MR demonstration of stable persistence of spinal cord lesion or atrophy over months or years with clinical findings of radual progressive neurologic deterioration may be helpful in the diagnosis of SN M(1 ).
Atrophy ; Diagnosis ; Fecal Incontinence ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Spinal Cord ; Spinal Cord Diseases* ; Spine

No abstract available.
Wernicke Encephalopathy*

BACKGROUND: Escherichia coli and Klebsiella pneumoniae resistant to 3rd generation cephalosporin have been reported with increasing frequency in tertiary-care hospital in Korea. MicroScan Neg Combo Panel Type 21 (Type 21) contains a 1 microgram/mL cepfodoxime (POD) in addition to other screen wells containing ceftazidime, cefotaxime, ceftriaxone, and aztreonam, which are designed for detecting extended-spectrum beta-lactamase (ESBL)-producing E. coli and Klebsiella species. We evaluated the Type 21 panel for its ability to detect ESBL. METHODS: From November to December in 1998, 496 E. coli and 326 K. pneumoniae strains isolated from clinical specimens were tested with Type 21 panel The isolates flagged as ESBL producers by the panel were confirmed by the double disk synergy test (DDS). To evaluate the specificity of POD, n-lactamases of 54 E, coli and 20 K. pneumoniae strains that were flagged by, POD only from January to May 1999 were analyzed by isoelectric focusing(IEF). RESULTS: 75/496(15%) E. coli and 68/326(21%) K. pneumoniae were flagged as ESBL producers by Type 21 panel. Of those, 94 isolates including 38/75 (51%) of E. coli and 56/68 (82%) of K. pneumoniae were positive for DDS. Among the 94 ESBL producers, all were detected by POD, 84% by cefotaxime, 85% by ceftazidime, 84% by ceftriaxone, and 86% by aztreonam. The 74 strains that were flagged as ESBL producers by POD screen well only were mostly DDS-negative, cefoxitin- resistant and showed beta-lactamases with pls of 5.4 and 7.6 or no band, which could be interpreted as the presence of TEM-1 or SHV-1 type beta-lactamases and/or basal AmpC beta-lactamases, not ESBL. CONCLUSION: MicroScan Neg Combo Panel Type 21 was able to detect a greater number of ESBL producers by inclusion of POD in its screening well. However, the specificity of POD was compromised by flagging a significant number of DDS negative strains. We conclude that the isolates with reduced susceptibility to 3rd generation cephalosporins as well as POD can be reported as ESBL-producers and those resistant to POD only should be confirmed by DDS.
Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftazidime ; Ceftriaxone ; Cephalosporins ; Escherichia coli ; Klebsiella ; Klebsiella pneumoniae ; Korea ; Mass Screening ; Pneumonia ; Sensitivity and Specificity