OBJECTIVE: We studied the effects of the age factor in pregnant women who are over the age of 35 on pregnancy, parturition and verified its usefulness in the future managements of the old aged pregnancy. METHODS: Out of 2,526 mothers who delivered in Dongguk university hospital from April 2000 to June 2003, we selected 183 mothers who aged more than 35 years as a study group, and 150 mothers aged between 25 and 29 years as a control group. We then statistically evaluated and analyzed the two groups. RESULTS: Study group consumed up to 7.24%. Placenta previa, male birth delivery, abnormal presentation, low birth weight, iron deficiency anemia and preterm labor was noted more in the study group. Likewise, preterm delivery, pregnancy induced hypertension and cesarean section rates were significantly high in the study group. CONCLUSION: Pregnancy in old age is currently a rising trend. Whlie they might have the tendency to show prenatal complications, neonatal complication and difficult decision making in delivery method, early detection and treatment of presumable complications by adequate antenatal care and appropriate selection of delivery method can reduce the section rates and obtain relatively successful pregnancy outcome.
Age Factors ; Anemia, Iron-Deficiency ; Cesarean Section ; Decision Making ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Mothers ; Obstetric Labor, Premature ; Parturition ; Placenta Previa ; Pregnancy Outcome ; Pregnancy* ; Pregnant Women*

Primitive neuroectodermal tumor (PNET), which belongs to the Ewing's sarcoma (ES) family of tumors, is mainly seen in children and young adults. PNETs are extremely rare in the maxilla. Here, we report a case of PNET of the left maxillary sinus in an elderly male. Magnetic resonance imaging (MRI) revealed a slightly enhanced solid mass occupying the left maxillary sinus and infiltrating into the retroantral space. A partial maxillectomy was performed. Despite postoperative chemotherapy, follow-up computed tomography (CT) and MRI revealed a nodal metastasis in the submandibular space. Neck dissection was performed. However, the patient died 10 months after the second surgery because of distant metastasis to the liver. MRI and CT were particularly useful in detecting the extent of the tumor, recurrence, and metastasis. Further, a literature review of the previously reported PNET cases of the maxilla was carried out. In this paper, we also discuss the current approach for the diagnosis and management of these tumors.
Aged* ; Child ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Liver ; Magnetic Resonance Imaging ; Male ; Maxilla ; Maxillary Sinus* ; Neck Dissection ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive* ; Recurrence ; Sarcoma, Ewing ; Young Adult

BACKGROUND: Matrix metalloproteinases (MMPs) can degrade a wide range of extracellular matrix components. The degradation of microvascular basal lamina by MMPs may be, in part, responsible for the hemorrhagic transformation, brain edema, and accentuation of ischemic injury in cerebral ischemia. Although MMP-2 and MMP-9 were reported to increase in cerebral ischemia, the temporal patterns of their increase are uncertain. METHODS: By using gelatin zymography, we investigated the activity of MMP-2 and MMP-9 in 10 micrometer frozen sections of ischemic and non-ischemic hemispheres in spontaneous hypertensive rats (SHRs) after variable time of reperfusion following 2 hours of middle cerebral artery occlusion (MCA:O). Adjacent 2mm-thick slices were stained with 2,3,5-triphenyltetrazolium chloride (TTC) solution to define the area of ischemic damage. RESULTS: The infarcted zone could be visualized well by TTC staining after 3 hours of reperfusion. MMP-2 was observed in all samples examined, while MMP-9 was observed only in the ischemic hemispheres. In the ischemic hemispheres when comparing with non-ischemic sides, MMP-9 was increased in all groups undergoing MCA:O, as early as in 2 hours of MCA:O group, while MMP-2 was increased only after 6 days in the reperfusion group. MMP-2 and MMP-9 activities per unit volume of infarction increased during the reperfusion period and were highest after 6 days. CONCLUSIONS MMP-9 increased early after MCA:O in the SHR and both MMP-2 and MMP-9 increased during the reperfusion period. These findings highlight the early potential role of MMP-9 in cerebral ischemia. (J Korean Neurol Assoc 19(3):278~284, 2001)
Animals ; Basement Membrane ; Brain Edema ; Brain Ischemia ; Extracellular Matrix ; Frozen Sections ; Gelatin ; Infarction ; Infarction, Middle Cerebral Artery* ; Matrix Metalloproteinases* ; Middle Cerebral Artery* ; Rats ; Reperfusion

PURPOSE : To investigate the incidence and prevalence of C-shaped root canal using computed tomographic images of head and neck in Korean population. MATERIALS AND METHODS : Regardless of each examination purpose, randomly selected 268 examples which have serial axial computed tomographic images with 8 normal molars in maxilla and mandible were selected and investigated. Defined C-shaped root canal and we could get 82 proper image examples in view of this definition. These were detected and investigated of incidence and prevalence of C-shaped root canal. RESULTS : C-shaped root canals were found in 82 examples among 268 (30.6%) and 147 teeth. They were only found on molar area, and the highest incidence was 37.41% of left mandibular second molars, and the lowest was 2.04% of right maxillary second molars. On prevalence of tooth position, mandibular second molar was the highest, 65% of C-shaped root canal teeth and maxillary second molar was 6% the lowest. CONCLUSION : 31% of randomly selected CT images no considering check-up reason have C-shaped root canals. The C-shaped root canals of mandibular second molar are found most frequently and they are also detectable on maxilla. On Korean population, C-shaped root canals are one of conditions that have to concern with dental treatment for it appears at a high prevalence relatively.
Dental Pulp Cavity ; Head ; Incidence ; Mandible ; Maxilla ; Molar ; Neck ; Prevalence ; Tooth

A 60-year-old female, who complained of delayed healing and swelling after extraction of left lower second molar during chemotherapy, visited our department. She had a history of a resection surgery of breast cancer and postoperative radiotherapy. The conventional radiographs showed diffuse permeative bone destruction in posterior mandibular body, which gave the first radiologic impression of osteonecrosis associated with radiotherapy or chemotherapy. And bone metastasis from the breast cancer was also considered in the differential diagnosis. On the enhanced computed tomography (ECT) the posterior mandibular body was occupied by a large expansile lesion showing central low attenuation with peripheral rim enhancement. Magnetic resonance images revealed that the low attenuated area on ECT did not show as high signal intensity as water on T2 weighted image and indicated solid component of a tumor. The final diagnosis was central squamous cell carcinoma. We present the diagnostic imaging features of the patient with special emphasis on the differential diagnosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Squamous Cell ; Diagnosis* ; Diagnosis, Differential ; Diagnostic Imaging ; Drug Therapy* ; Female ; Humans ; Middle Aged ; Molar ; Neoplasm Metastasis ; Osteonecrosis ; Radiography ; Radiotherapy* ; Water

PURPOSE: The purpose of this study was to develop a system for the measurement and simulation of the TMJ movement and to analyze the mandibular movement quantitatively. MATERIALS AND METHODS: We devised patient-specific splints and a registration body for the TMJ movement tracking. The mandibular movements of the 12 subjects with facial deformity and 3 controls were obtained by using an optical tracking system and the patient-specific splints. The mandibular part was manually segmented from the CT volume data of a patient. Three-dimensional surface models of the maxilla and the mandible were constructed using the segmented data. The continuous movement of the mandible with respect to the maxilla could be simulated by applying the recorded positions sequentially. Trajectories of the selected reference points were calculated during simulation and analyzed. RESULTS: The selected points were the most superior point of bilateral condyle, lower incisor point, and pogonion. There were significant differences (P<0.05) between control group and pre-surgical group in the maximum displacement of left superior condyle, lower incisor, and pogonion in vertical direction. Differences in the maximum lengths of the right and the left condyle were 0.59+/-0.30 mm in pre-surgical group and 2.69+/-2.63 mm in control group, which showed a significant difference (P<0.005). The maximum of differences between lengths of the right and the left calculated during one cycle also showed a significant difference between two groups (P<0.05). CONCLUSION: Significant differences in mandibular movements between the groups implies that facial deformity have an effect on the movement asymmetry of the mandible.
Congenital Abnormalities ; Displacement (Psychology) ; Humans ; Incisor ; Mandible ; Maxilla ; Splints ; Temporomandibular Joint ; Track and Field

Acquired facial lipoatrophy is a rare disease with an unclear etiology and pathological pathway. The distinct causative factors of this disease have been not elucidated, but it is suspected to be associated with immune systemrelated diseases, most notably AIDS. Although the management of facial lipoatrophy is very important for patients’ social life and mental health, no treatment framework has been developed due to the unknown nature of the disease manifestation. The present case report was designed to provide sequential imaging to visualize the disease progression. The clinical backgrounds of the patients are also introduced, helping characterize this disease entity more clearly for maxillofacial specialists.

PURPOSE: Underlying bone sclerosis is frequently observed in clinical settings when oral squamous cell carcinoma (OSCC) invades the jaw bone. The aim of this study was to assess the prevalence and characteristics of underlying bone sclerosis in patients with OSCC. MATERIALS AND METHODS: We retrospectively reviewed the computed tomographic (CT) images of 131 patients who underwent mandibulectomy between January 2012 and December 2015 to treat OSCC. The presence, degree, and extent of underlying bone sclerosis were assessed on CT images and correlated with the following imaging patterns of bone invasion: cortical invasion, medullary invasion with a smooth margin, and medullary invasion with an irregular margin. The chi-square test was used to determine the relationships between the variables. RESULTS: The prevalence of underlying bone sclerosis on CT images was 70.1% (47 of 67). The prevalence was 85.7% (42 of 49) in patients with medullary invasion, but it was 27.8% (5 of 18) in patients with only cortical invasion, indicating a significant increase in the prevalence of underlying bone sclerosis in patients with medullary invasion (P < .05). Aggressive patterns of bone invasion were associated with increases in the degree and extent of the underlying bone sclerosis (P < .05). CONCLUSION: More than two-thirds of OSCC cases with bone invasion showed underlying bone sclerosis. On CT images, reactive sclerosis in the remaining margin of the alveolar bone should not be used as the primary means to differentiate periodontal inflammatory lesions from those resulting from OSCC.
Carcinoma, Squamous Cell* ; Epithelial Cells* ; Humans ; Jaw ; Mandible ; Prevalence ; Retrospective Studies* ; Sclerosis* ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study was to evaluate the effect of the kV on fractal dimension of trabecular bone in digital radiographs. MATERIALS AND METHODS: 16 bone cores were obtained from patients who had taken partial resection of tibia due to accidents. Each bone core along with an aluminum step wedge was radiographed with an occlusal film at 0.08 sec and with the constant film-focus distance (32 cm). All radiographs were acquired at 60, 75, and 90 kV. A rectangular ROI was drawn at medial part, distal part, and the bone defect area of each bone core image according to each kV. The directional fractal dimension was measured using Fourier Transform spectrum, and the anisotropy was obtained using directional fractal dimension. The values were compared by the repeated measures ANOVA. RESULTS: The fractal dimensions increased along with kV increase (p<0.05). The anisotropy measurements did not show statistically significant difference according to kV change. The fractal dimensions of the bone defect areas of the bone cores have low values contrast to the non-defect areas of the bone cores. The anisotropy measurements of the bone defect areas were lower than those of the non-defect areas of the bone cores, but not statistically significant. CONCLUSION: Fractal analysis can notice a difference of a change of voltage of x-ray tube and bone defect or not. And anisotropy of a trabecular bone is coherent even with change of the voltage of x-ray tube or defecting off a part of bone.
Aluminum ; Anisotropy* ; Fourier Analysis ; Fractals* ; Humans ; Tibia

PURPOSE: The research was performed to predict the three dimensional relationship between the impacted mesiodens and the maxillary central incisors and the proximity with the anatomic structures by comparing their panoramic images with the CT images. MATERIALS AND METHODS: Among the patients visiting Seoul National University Dental Hospital from April 2003 to July 2007, those with mesiodens were selected (154 mesiodens of 120 patients). The numbers, shapes, orientation and positional relationship of mesiodens with maxillary central incisors were investigated in the panoramic images. The proximity with the anatomical structures and complications were investigated in the CT images as well. RESULTS: The sex ratio (M : F) was 2.28 : 1 and the mean number of mesiodens per one patient was 1.28. Conical shape was 84.4% and inverted orientation was 51.9%. There were more cases of anatomical structures encroachment, especially on the nasal floor and nasopalatine duct, when the mesiodens was not superimposed with the central incisor. There were, however, many cases of the nasopalatine duct encroachment when the mesiodens was superimpoised with the apical 1/3 of central incisor (52.6%). Delayed eruption (55.6%), crown rotation (66.7%) and crown resorption (100%) were observed when the mesiodens was superimposed with the crown of the central incisor. CONCLUSION: It is possible to predict three dimensional relationship between the impacted mesiodens and the maxillary central incisors in the panoramic images, but more details should be confirmed by the CT images when necessary.
Crowns ; Diagnostic Imaging ; Floors and Floorcoverings ; Humans ; Incisor ; Orientation ; Sex Ratio ; Tooth, Impacted