Osteopetrosis is an uncommon hereditary bone disorder whose prominent radiologic feature characterized by increased bone density. The authors reported a 7-year-old male patient who referred from local dental clinic for dental problems such as early exfoliation of deciduous teeth(#54,73,83) and delayed eruption of permanent teeth(#31,41,36,46). The patient appeared as a poorly developed. Dental X-ray films showed early exfoliation of deciduous teeth, delayed eruption of permanent teeth, and rampant caries. Lateral view of skull demonstrated increased opacity of calvarium, facial bones, and skull base. Generally the skeletal density is greatly increased throughout all bones. Facial CT showed poor development of paranasal sinuses and mastoid air cells. No hematopoietic and neurologic complications such as anemia, thrombocytopenia, blindness and deafness were found. Also mental retardation was not found. The final diagnosis of this case was a osteopetrosis tarda. Sometimes patient with osteopetrosis tarda may be developed dental problems prior to severe systemic symptoms. The dentist can be the first clinician to see the patient. It is very important for the dentist to have the knowledge of the osteopetrosis and to care the patient's dental problems to prevent complication such as osteomyelitis of jaws.
Anemia ; Blindness ; Bone Density ; Child ; Deafness ; Dental Clinics ; Dentists ; Diagnosis ; Facial Bones ; Growth Disorders ; Humans ; Intellectual Disability ; Jaw ; Male ; Mastoid ; Osteomyelitis ; Osteopetrosis* ; Paranasal Sinuses ; Skull ; Skull Base ; Thrombocytopenia ; Tooth ; Tooth Eruption ; Tooth, Deciduous ; X-Ray Film

A 35-year-old man was referred to the department of Oral and maxillofacial surgery of Chonnam university hospital for the chief complaint of asymptomatic swelling on the buccal vestibule of upper right canine area. Radiographs revealed that the upper right canine was impacted and there was a well-circumscribed pericoronal radiolucency related with the canine. Multiple radiopaque foci were scattered in the radiolucent lesion, and the roots of the lateral incisor and the first premolar related to the lesion showed external resorption. The radiographic features of this lesion were typical of adenomatoid odontogenic tumor, but considering the sex and age of the patient, the tentative diagnosis was made as calcifying odontogenic cyst. Microscopically this lesion was diagnosed as calcifying odontogenic cyst. Because calcifying odontogenic cyst has no pathognomonic feature of radiographs, to consider radiographic features with clinical findings is necessary in order to establish more correct diagnosis.
Adult ; Bicuspid ; Cuspid* ; Diagnosis ; Humans ; Incisor ; Jeollanam-do ; Odontogenic Cyst, Calcifying* ; Odontogenic Tumors ; Surgery, Oral

PURPOSE: Colonoscopy is one of the most effective diagnostic and therapeutic tools for colorectal diseases. We aim to propose a master-slave robotic colonoscopy that is controllable in remote site using conventional colonoscopy. MATERIALS AND METHODS: The master and slave robot were developed to use conventional flexible colonoscopy. The robotic colonoscopic procedure was performed using a colonoscope training model by one expert endoscopist and two unexperienced engineers. To provide the haptic sensation, the insertion force and the rotating torque were measured and sent to the master robot. RESULTS: A slave robot was developed to hold the colonoscopy and its knob, and perform insertion, rotation, and two tilting motions of colonoscope. A master robot was designed to teach motions of the slave robot. These measured force and torque were scaled down by one tenth to provide the operator with some reflection force and torque at the haptic device. The haptic sensation and feedback system was successful and helpful to feel the constrained force or torque in colon. The insertion time using robotic system decreased with repeated procedures. CONCLUSION: This work proposed a robotic approach for colonoscopy using haptic feedback algorithm, and this robotic device would effectively perform colonoscopy with reduced burden and comparable safety for patients in remote site.
*Algorithms ; Colonoscopes ; Colonoscopy/instrumentation/*methods ; Equipment Design ; *Feedback ; Humans ; Robotics/*methods ; Torque

No abstract available.
Anesthetics* ; Brain* ; Humans ; Infant, Newborn*

Segmental fractures of the clavicle are very rare. Therefore, to date, there has not been a clear, standardized method of management of segmental clavicle fractures. Herein, two patients with a segmental fracture are described: One patient was treated conservatively, while another patient was treated operatively. Both patients showed excellent results. We discuss the various management options with a literature review.
Clavicle* ; Humans ; Methods*

BACKGROUND AND OBJECTIVES: Mucosal melanoma comprises 1.3% of all malignant melanomas and mainly occurs at the oropharynx and the sinonasal cavity in the head and neck area. Five year survival rate is about 10-46%. We aimed to investigate the clinical features and treatment outcomes of 38 patients with sinonasal malignant melanoma (SNMM). SUBJECTS AND METHOD: A retrospective review of medical records was carried out on 38 patients who were diagnosed as SNMM between August 1995 and December 2012. Clinical features were evaluated and tumors were staged according to the TNM staging system. The Kaplan-Meier method was used to assess survival in the cohort. RESULTS: The 38 patients consisted of 18 males and 20 females, ranging in age from 36 to 91 years, with a median age of 59 years at diagnosis. Common symptoms were nasal obstruction and epistaxis, and mean symptom duration to diagnosis was 2.0 months. The main treatment modalities were surgery only (n=18) or surgery plus adjuvant radiotherapy (n=9). Distant metastases were detected in 15 patients (39.5%) at 8 months after initial therapy. Overall 5-year survival rate was 45.6%. There was no significant difference in survival rate between patients who underwent surgery only and those who had surgery with postoperative radiation (p=0.359). CONCLUSION: Sinonasal mucosal melanoma is a highly recurrent tumor (80% recurrence rate) with poor prognosis (5-year survival rate; 46%). As radiation treatment and/or chemotherapy are not so effective for the recurrent tumor, early detection and surgical resection are mandatory at present. New treatment modality should be developed to improve the survival rate.
Cohort Studies ; Diagnosis ; Drug Therapy ; Epistaxis ; Female ; Head ; Humans ; Male ; Medical Records ; Melanoma* ; Nasal Obstruction ; Neck ; Neoplasm Metastasis ; Neoplasm Staging ; Oropharynx ; Prognosis ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies* ; Survival Rate

PURPOSE: To report the clinical results from surgical treatment for clavicle shaft fracture by percutaneous intramedullary fixation with Steinmann pins. MATERIALS AND METHODS: Between January 2004 and June 2014, the medical records of 135 patients who underwent percutaneous intramedullary fixation with Steinmann pins were reviewed. The mean follow-up periods were 15 months. The functional results were evaluated with The Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant score. The clinical results were evaluated with the shortened length of the clavicle, length of surgical wound, operation time and Kang's criteria. RESULTS: The mean bone union period was 11.6 weeks (8–16 weeks). The mean DASH score was 11.8. The mean Constant score was 91.2. The mean shortened length of the clavicle was less than 20 mm. The mean length of surgical wound was 1.2 cm (0.7–1.5 cm). The mean operation time was 18 minutes (10–35 minutes). Using Kang's criteria, 131 out of 135 patients (97.0%) showed good results. Complications included were 3 pin migrations and 2 non-unions. CONCLUSION: Percutaneous intramedullary fixation with Steinmann pins showed good results for treating clavicle shaft fracture.
Arm ; Clavicle* ; Follow-Up Studies ; Hand ; Humans ; Medical Records ; Shoulder ; Wounds and Injuries

OBJECTIVE: To identify the thickness of gastrocnemius muscles (GCM) in normal children and children with spastic cerebral palsy using ultrasonography and to determine the influencing factors in order to increase the accuracy of intramuscular injection of botulinum toxin A. METHOD: Fifty-six children with spastic cerebral palsy (Group A) with no fixed contractures or operation history were involved in this study and they were compared with normal children (Group B). Children lay prone and one examiner measured the thickness of medial and lateral GCM using ultrasonography. Relationship between GCM thickness and clinical variables (age, height, weight, body mass index (BMI), calf circumference, Gross Motor Function Classification System (GMFCS) level, spasticity, number of botulinum toxin injections) were determined with Pearson's correlation. RESULTS: The thickness of medial and lateral GCM were 78.06+/-14.66 mm, 66.90+/-12.23 mm respectively, in Group A, and 103.44+/-12.04 mm, 79.95+/-9.76 mm respectively, in Group B. Medial GCM were thicker than lateral GCM in both groups. The age, height, weight, BMI, calf circumference and the thickness of GCM were higher in Group B. In group A, weight, BMI, calf circumference showed positive correlations with the thickness of medial GCM and GMFCS showed negative correlation with the thickness of medial GCM. CONCLUSION: To increase the accuracy of intramuscular injection of botulinum toxin A, we should keep in mind that the thickness of GCM may be influenced by several factors. Further controlled study including larger group is needed.
Body Weight ; Botulinum Toxins ; Cerebral Palsy ; Child ; Contracture ; Humans ; Injections, Intramuscular ; Muscle Spasticity ; Muscle, Skeletal ; Muscles

PURPOSE: The aim of this study was to assess the size and extrusion of the meniscus in young and non-traumatic knees, especially in Korean males. MATERIALS AND METHODS: The participants (n=91 knees, 77 patients) were consecutive patients observed at an orthopedic outpatient clinic who had another problem unrelated to the knee joint. The patients were excluded from the study if they had a history of trauma and pain on the knee joint. The patients received a magnetic resonance imaging (MRI) scan on the knee joint. The size, extrusion, and extrusion ratio of the meniscus on an MRI scan were evaluated. RESULTS: The mean age of the participants was 21.6±1.1 years (range, 19–24 years). The mean size of the medial meniscus on the coronal plane was 9.0±1.1 mm (range, 7.1–11.9 mm). The extent of extrusion on the coronal plane was 2.0±1.0 mm (range, 0–4.4 mm). The extrusion ratio (extruded size/total size×100) of the medial meniscus on the coronal plane was 22.7%±11.5% (range, 0%–53.7%). The extent of extrusion on the sagittal plane was 1.6±1.1 mm (range, 0–4.0 mm). The extrusion ratio (extruded size/total×100) of the medial meniscus on the sagittal plane was 18.0%±11.9% (range, 0%–40.7%). The incidence of medial meniscal extrusion on the coronal and sagittal plane are 92.3% and 80.2%, respectively. The mean size of lateral meniscus on the coronal plane was 11.1±3.4 mm (range, 7.3–22.9 mm). The extent of extrusion on the sagittal plane was 0.5±0.7 mm (range, 0–2.5 mm). The extrusion ratio of the lateral meniscus on the sagittal plane was 4.0%±6.7% (range, 0%–26.3%). The incidence of lateral meniscal extrusion on the coronal plane was 34.1%. No extrusion of the lateral meniscus was observed on the sagittal plane. CONCLUSION: In young and non-traumatic knees, the extrusion of meniscus was common, especially medial meniscus than lateral meniscus.
Ambulatory Care Facilities ; Humans ; Incidence ; Knee Joint ; Knee* ; Magnetic Resonance Imaging* ; Male ; Menisci, Tibial ; Orthopedics

PURPOSE: Early diagnosis and management of therapeutic interventions are very important in chest trauma. Conventional chest X-rays (CXR) and computed tomography (CT) are the diagnostic tools that can be quickly implemented for chest trauma patients in the emergency department. In this study, the usefulness of the CT as a diagnostic measurement was examined by analyzing the ability to detect thoracic injuries in trauma patients who had visited the emergency department and undergone CXR and CT. METHODS: This study involved 84 patients who had visited the emergency department due to chest trauma and who had undergone both CXR and CT during their diagnostic process. The patients' characteristics and early vital signs were examined through a retrospective analysis of their medical records, and the CXR and the CT saved in the Picture Archiving Communication System (PACS) were examined by a radiologist and an emergency physician to verify whether or not a lesion was present. RESULTS: Pneumothoraxes, hemothoraxes, pneumomediastina, pulmonary lacerations, rib fractures, vertebral fractures, chest wall contusions, and subcutaneous emphysema were prevalently found in a statistically meaningful way (p<0.05) on the CT. Even though their statistical significance couldn't be verified, other disorders, including aortic injury, were more prevalently found by CT than by CXR. CONCLUSION: CT implemented for chest trauma patients visiting the emergency department allowed disorders that couldn't be found on CXR to be verified, which helped us to could accurately evaluate patients.
Contusions ; Early Diagnosis ; Emergencies ; Hemothorax ; Humans ; Lacerations ; Medical Records ; Pneumothorax ; Retrospective Studies ; Rib Fractures ; Subcutaneous Emphysema ; Thoracic Injuries ; Thoracic Wall ; Thorax ; Tomography, X-Ray ; Vital Signs