BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

A 6-day-old female infant had generalized superficial pustules which evolved into pigmented maucles, many of which had a peripheral collarvtte of scale. Histopsthologic stadies showed intracormeal aggregates of neutrophils. The appearance of the lesions and histopathologic finding fitted transient neonal pustular melanosis.
Female ; Humans ; Infant ; Melanosis* ; Neutrophils

No abstract available.
Multiple Organ Failure* ; Sepsis*

The characteristics of modern society's trauma is a propensity for multiple and severe trauma, specially, the fatal damage accompanied by facial bone fracture. We observed the malocclusion owing to delayed prompt treatment If the fractured fragments is crushed severely, it is difficult to make them positioned into the normal anatomical states and to fix them tightly. Post-traumatic malocclusion is usually caused by a delay in treatment and inadequate anatomic reduction. Inadequately treated facial bone fractures result in facial disfiguring and functional impairment of mastication and speech.We performed 27 cases of correction of post-traumatic malocclusion between April 1994 and June 1996. We used various operative techniques such as anterior segmental osteotomy, Le Fort osteotomy, maxillary segmental osteotomy and mandibular sagittal split osteotomy. If the malocclusion was due to disarrangement segmental osteotomy. If that malocclusion was attributed to a malpositioned skeletal bone, we take maxillary segmental osteotomy or mandibular sagittal split osteotomy. We acquired the desirable occlusion first followed by a fixation between the mandible and maxillary skeletal bones with the bite block. The aim in the correction of malocclusion was to create a harmony of centric relation and centric occlusion. After operation, intermaxillary fixation with bite block have many advantages in the treatment of malocclusion.
Centric Relation ; Facial Bones ; Malocclusion* ; Mandible ; Mastication ; Maxillary Osteotomy ; Osteotomy ; Osteotomy, Le Fort

Evaluation of a fever of unknown origin (FUO) is complex. Recently, PET scanning has been approved for screening in FUO evaluation. We treated three cases of FUO associated with increased FDG uptake in the bone marrow of the femur and tibia on the fusion PET/CT; all three had the same pattern of uptake. Bone marrow biopsies revealed mature lymphocyte and histiocyte infiltration and myxoid changes in one case, and cortical bone involvement in another case. The cases were all young females who had fever with neutropenia and relative lymphocytosis that lasted for several weeks and then remitted spontaneously. Even though the results of the studies were not diagnostic, the unique uptake pattern on PET/CT and the histology might be related to the cause of the illness and should be studied further to assess the association with classic FUO.
Biopsy ; Bone Marrow ; Female ; Femur ; Fever ; Fever of Unknown Origin ; Histiocytes ; Humans ; Lymphocytes ; Lymphocytosis ; Mass Screening ; Neutropenia ; Positron-Emission Tomography ; Tibia

PURPOSE: In young male patients who suffered several kinds of trauma with subsequent suspicious reflex sympathetic dystrophy syndrome, we performed three-phasic bone scan in order to investigate its usefulness. MATERIALS AND METHODS: Patients with narrow range of age (21-25. mean 22.8+/-1.3, all male) were included with suspicious reflex sympathetic dystrophy syndrome of 12 feet and 5 hands. Only one was bilateral feet case and 16 were ipsilateral (Rt:13, Lt:3). The etiologic traumas were 4 fractures, 4 sprains, 3 blunt trauma, 2 cellulitis, 1 tendon tear, 1 crush injury, 1 overexercise, and 1 unknown. Radiologically 3 showed osteoporotic changes. Three-phasic bone scans were performed 21.2+/-7.3wks after trauma. RESULTS: According to symptom complex, confirmatory reflex sympathetic dystrophy syndrome 4 cases and suspicious 13 were analyzed. All confirmatory cases (100%) showed increased uptake at delay phase with periarticular accentuation. Of confirmatory 4 cases, 2 showed increased uptake in all three phases (perfusion: P, blood pool: B, and delay: D), and other 2 revealed decreased P but, both increased B and D. Of suspicious 13 cases, 9(69.2%) had increased D (4 periarticular and 5 focal), 2 decreased D, and 2 symmetric D. In 12 foot cases, so-called weight bearing patterns - increased contralateral sole at P and B - were revealed in 7(58.3%). CONCLUSION: Diffuse periarticular increased uptake at delay phase of three-phasic bone scan was a compatible finding to reflex sympathetic dystrophy syndrome in young male patients whose symptom complex strongly designated post traumatic reflex sympathetic dystrophy syndrome.
Cellulitis ; Foot ; Hand ; Humans ; Male* ; Reflex Sympathetic Dystrophy* ; Reflex* ; Sprains and Strains ; Tendons ; Weight-Bearing

No abstract available.
Multiple Organ Failure* ; Sepsis*

Mandibular prognathism was defined by Johe Hunter as follows : 'The lower jaw projecting too far forwards so that the foreteeth pass before those of upper jaw, therefore disfigurement and malocclusion are the two of facial main characteristics.' Mandibular ramus osteotomy by vertical osteotomy or sagittal splitting osteotomy recently has come into more common use. Although preoperative and postoperative orthdontic management is indispensable in surgery of this type, we occasionally encounter patients who are intolerant to a long duration of orthodontic treatment and intermaxillary fixation. We describe surgical refinement accomplishing mandibular anterior segmental osteotomy, recession genioplasty by horizontal osteotomies and decortication of the anterior portion of the bony bar for a minor degree of mandibular prognathism. In results, the amount of setback is limited to 4 to 5mm, no intermaxillary fixation is required and no orthodontic treatment, in this operation, is needed. This procedure can obtain a rapid aesthetic improvement. We used this preocedure in 8 patients (3 males and 5 females) with a mild mandibular prognathism. No major complications occurred throughout the follow-up period except transient paresthesia of the mental nerves, otherwise all patients were satisfied with the result.
Follow-Up Studies ; Genioplasty* ; Humans ; Jaw ; Male ; Malocclusion ; Osteotomy* ; Paresthesia ; Prognathism*

The inverted nipple presents many problems including both cosmetic and functional aspects and impairment in breast feeding. the histopathologic characters of inverted nipple are that inverted nipple has less fibromuscular tissue than normal nipple and has short lactiferous duct and dense fibrous tissue. Many surgical and non-surgical techniques have been designed for correction of the inverted nipple. But most of these techniques have produced unsatisfactory problems. especially undesirable recurrence is most important problem. We experienced 19 inverted nipples in 12 patients between March 1995 and January 1998. We combined modified Teimourian method, purse-string suture and Z-plasty. and had good result for 3weeks to 30months follow up. This method was effective for correction of the inverted nipple with low recurrence rate and simple techniques.
Breast Feeding ; Follow-Up Studies ; Humans ; Nipples* ; Recurrence ; Sutures