This study was done to recognize the importance of errors in measurements of cephalometric radiograph and to find the anatomical structures those need special care to select as a reference points through the detection of the systematic errors and estimation of random errors. For this purose, 100 cephalometric radiographs were prepared by usual manner and 61 reference points, and 130 measurement variables were established. Measurement errors were detected and estimated by the comparison of the 25 randomly-selected samples for repeated measurements with the main sample. The following results were obtained: 1. In comparison of the repeated measurements, there were statistical significant differences in 24 variables which were 18.4% of 130 total variables. 2. The frequency of the difference in identification of the reference points between the repeated measurements was very high in the root apex of upper incisor(as), the most posterior wall of maxilla(tu), soft tissue nasion(n'), soft tissue frontal eminence(ft), and adl in airway. 3. After correction of reference points marking until the level of below 59,6 significance, the range of random errors were from 0.67 to 1.71 degree or mm. 4. The variable shown the largest random error was the intenncisal angle(ILs-lLi). 5. Measurement errors were mainly caused by the lack of precision in anatomic definitions and obscure radiographic image. From the above results, the author could find the high possibility of errors in cephalometric measurements and from this point, we should include error analysis in all the studies concerning measurments. In is essential to have a concept of error analysis not only for the investigator but also for a reader of other articles.
Activities of Daily Living ; Humans ; Research Personnel

No abstract available.
Ganglion Cysts* ; Paralysis* ; Peroneal Nerve*

PURPOSE: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. METHODS: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. RESULTS: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. CONCLUSION: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.
Airway Obstruction ; Ambulatory Care Facilities ; Brain ; Cleft Palate ; Dandy-Walker Syndrome ; Female ; Follow-Up Studies ; Fourth Ventricle ; Humans ; Hydrocephalus ; Live Birth ; Magnetic Resonance Imaging ; Necrosis ; Palate, Hard ; Pediatrics ; Physical Examination ; Physical Therapists ; Respiration ; Uvula

PURPOSE: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. METHODS: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. RESULTS: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. CONCLUSION: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.
Airway Obstruction ; Ambulatory Care Facilities ; Brain ; Cleft Palate ; Dandy-Walker Syndrome ; Female ; Follow-Up Studies ; Fourth Ventricle ; Humans ; Hydrocephalus ; Live Birth ; Magnetic Resonance Imaging ; Necrosis ; Palate, Hard ; Pediatrics ; Physical Examination ; Physical Therapists ; Respiration ; Uvula

The authors diagnosed femoral component fracture after total knee arthroplasty (TKA) using an anterior-posterior glide mobile-bearing system in a 78-year-old female patient who visited with severe pain and flexion limitations in the left knee and performed revision TKA. The fracture of the femoral component after TKA is a rare complication, and various factors cause the fracture of the femoral component. This case is reported along with a literature review.

The hemodynamic effects of thyroid hormones which is well established, affect myocardial contractility, heart rate, and myocardial oxygen consumption. The alterations in thyroid function test are frequently seen in patients with nonthyroidal illness and often correlate with the severity of the illness and the prognosis. In this study, thyroid hormone changes were investigated in 20 patients who received cardiopulmonary bypass(CPB). All patients showed a state of biochemical euthyroidism preoperatively. The results were as follows : 1. Serum triiodothyronine(T3) reached to its nadir(30.05+/-17.5ng/dl, p<0.001) at 10 minutes after the start of CPB and remained low(p<0.05) throughout the study period. 2. Serum thyroxine(T4) concentration slightly decreased after CPB, but maintained within normal range. 3. Serum free thyroxine(fT4) concentration slightly increased after CPB, but maintained within normal range. 4. Serum thyroid stimulating hormone(TSH) concentration increased 10 minute after CPB, reached to its nadir(3.37+/-0.81uIU/ml, p<0.001) at 2 hours after CPB. After then, serum TSH concentration decreased and reached its normal levels at 24 hours after CPB. 5. The patients whose postoperative recovery was uneventful(Group 1) had higher serum T3 levels than those who had postoperative complications(Group 2)(p<0.05). Group 1 showed elevating patterns of serum T3 in the fourth day after operation, whereas group 2 did not show such an elevating pattern. These findings are similar to the euthyroid sick syndrome seen in severely ill patients and indicate that patients undergoing open heart surgery have suppression of the pituitary-thyroid axis.
Axis, Cervical Vertebra ; Euthyroid Sick Syndromes ; Heart* ; Hemodynamics ; Humans ; Myocardial Contraction ; Oxygen Consumption ; Prognosis ; Reference Values ; Thoracic Surgery* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Hormones

We have determined and analyzed the full-length cDNA sequence of a coxsackievirus B3 (CVB3) Korean isolate (CVB3-Korea/97) which has been known as a general human pathogen. The whole genome contains 7,400 nucleotides and has a single large open reading frame with 6,555 nucleotides that encodes a potential polyprotein precursor of 2,185 amino acids. The genome also contains a 5' non-coding region (NCR) of 741 bases and a 3' NCR of 104 bases followed by poly(A) tail. Sequence homologies of nucleotides and deduced amino acids between the CVB3-Korea/97 strain and the prototype (Nancy strain) were 81.7% and 91.5%, respectively. The genes encoding the functional proteins including viral protease and RNA dependent RNA polymerase showed higher homology than those encoding the structural proteins. We have further analyzed the sequences of 5' NCR, VP1 and VP2 of CVB3-Korea/97, which are known as cardiovirulent determining factors at the nucleotide and amino acid levels. Although the CVB 3-Korea/97 strain was isolated from an aseptic meningitis patient without cardiomyopathy, its 234th nucleotide and 165th amino acid were uracil and Asn as same as those of other cardiovirulent strains one. However, the 155th amino acid of VR1, which closely associated with cardiovirulence, was replaced with Arg155 by single nucleoptide substitution from A2916 to T2916. Moreover, additional amino acid substitutions were observed in the flanking region of Asp155. Taken together, aminoacid(s) substitution in VP1 may play a critical role in determining cardiovirulence of the CVB3-Korea/97 strain rather than individual nucleotide replacements in the 5' NCR and/or an amino acid substitution in VP2.
Amino Acid Substitution ; Amino Acids ; Cardiomyopathies ; Clone Cells* ; Cloning, Organism* ; DNA, Complementary* ; Genome ; Humans ; Korea* ; Meningitis, Aseptic ; Nucleotides ; Open Reading Frames ; RNA Replicase ; RNA, Messenger ; Sequence Analysis* ; Sequence Homology ; Uracil

BACKGROUND: To investigate the epidemiology of aseptic meningitis in Korea, we have isolated and characterized enteroviruses isolated from patients with acute meningitis from 1993 to 1998. METHODS: Stool and/or cerebrospinal fluid (CSF) samples from patients with aseptic meningitis were inoculated onto enterovirus-susceptible cell lines. The virus propagation was examined by the presence of cytopathic effects and each viral isolate was further characterized using a neutralization test. RESULTS: Out of 1,127 specimens, 197 enteroviral isolates were obtained mostly from stool samples (82.8 %) of children aged zero to ten years. At least 15 serotypes of enteroviruses, including echoviruses (EV) 3, 6, 7, 9, 25 and 30, coxsackieviruses (CV) B1~B6, and vaccine-derived polioviruses (PV) had circulated during the previous 6 years. The major serotypes that caused outbreaks of aseptic meningitis, were EV30 in 1997 and EV6 in 1998. Although the incidence of virus isolation peaked during summer, we had isolated enteroviruses all the year round in 1998. CONCLUSION: Since 1993, we had confirmed 197 cases of enteroviral meningitis. Outbreaks of aseptic meningitis were mainly caused by EVs, with peaks during the summer months. Our data emphasize that the nationwide surveillance of aseptic meningitis should be expanded and maintained throughout the year.
Cell Line ; Cerebrospinal Fluid ; Child ; Disease Outbreaks ; Enterovirus B, Human ; Enterovirus* ; Epidemiologic Studies* ; Epidemiology ; Humans ; Incidence ; Korea* ; Meningitis ; Meningitis, Aseptic* ; Neutralization Tests ; Poliovirus

BACKGROUND: To investigate the epidemiology of aseptic meningitis in Korea, we have isolated and characterized enteroviruses isolated from patients with acute meningitis from 1993 to 1998. METHODS: Stool and/or cerebrospinal fluid (CSF) samples from patients with aseptic meningitis were inoculated onto enterovirus-susceptible cell lines. The virus propagation was examined by the presence of cytopathic effects and each viral isolate was further characterized using a neutralization test. RESULTS: Out of 1,127 specimens, 197 enteroviral isolates were obtained mostly from stool samples (82.8 %) of children aged zero to ten years. At least 15 serotypes of enteroviruses, including echoviruses (EV) 3, 6, 7, 9, 25 and 30, coxsackieviruses (CV) B1~B6, and vaccine-derived polioviruses (PV) had circulated during the previous 6 years. The major serotypes that caused outbreaks of aseptic meningitis, were EV30 in 1997 and EV6 in 1998. Although the incidence of virus isolation peaked during summer, we had isolated enteroviruses all the year round in 1998. CONCLUSION: Since 1993, we had confirmed 197 cases of enteroviral meningitis. Outbreaks of aseptic meningitis were mainly caused by EVs, with peaks during the summer months. Our data emphasize that the nationwide surveillance of aseptic meningitis should be expanded and maintained throughout the year.
Cell Line ; Cerebrospinal Fluid ; Child ; Disease Outbreaks ; Enterovirus B, Human ; Enterovirus* ; Epidemiologic Studies* ; Epidemiology ; Humans ; Incidence ; Korea* ; Meningitis ; Meningitis, Aseptic* ; Neutralization Tests ; Poliovirus