The patient with an anterior open bite has one of the most difficult orthodontic problem to correct Previous studies have yielded different conclusions as to exactly where the morphologic problems associated with vertical dysplasia- high angle cases are located. In order to identify the cephalometric features of high angle cases and highlight the measurements that characterize high angle cases, 109 pretreatment cephalograms, 35 high angle, 37 average angle, and 37 low angle cases, were analyzed and compared statistically. As the mandibular plane was steeper, the anterior facial height, especially lower anterior facial height, became greater, and the posterior facial height became smaller. All the dentoalveolar vertical dimensions, especially in upper, increased. Arid all the skeletal angular measurements increased. Especially Lower gonial angle had most positive correlation to mandibular plane angle. Upper incisor was lingually inclined, and lower incisor was labially inclined in high angle cases.
Humans ; Incisor ; Open Bite ; Vertical Dimension

BACKGROUND: Patients infected with Staphylococcus aureus related to the use of propofol have been reported. The purpose of this study was to assess and compare the growth of S. aureus in propofol, thiopental, midazolam and ketamine. METHODS: These intravenous anesthetics were inoculated with S. aureus and they were plated onto blood agar at 0, 3, 6, 21, 24 and 27 hrs. The number of colony forming units (CFU) on the plate was counted after 24 hours of incubation. RESULTS: Samples from ketamine and midazolam showed no CFU at the 3 hr and thereafter. The 21hr, thiopental exhibited no CFU. The inoculated propofol emulsion showed a significant increase in number of CFU at the 21, 24 and 27hr compared with the zero time (P<0.05). CONCLUSIONS: This study shown that propofol was the only anesthetic that provided a medium for the growth of S. aureus. Therefore when handling propofol, meticulous sterile technique is advised.
Agar ; Anesthetics ; Anesthetics, Intravenous* ; Humans ; Ketamine ; Midazolam ; Propofol ; Staphylococcus aureus* ; Staphylococcus* ; Stem Cells ; Thiopental

The clincopathologic features of microcystic adnexal carcinoma are presented. Microcystic adnexal carcinoma is a recently described, very rare neoplasm characterized by a locally aggressive growth pattern, and as far as we know, only two reports on the microcystic adnexal carcinoma have been published in the Korean literature. Recently we experienced two cases of microcystic adnexal carcimoma occurred in a 32-year-old male and 27-year-old female patient. They had 2.5 x 2.0 x 2.0 cm and 1.2 x 0.9 x 0.9 cm sized, slowly growing mass in the glabella and below the lower lip, respectively. The immunohistochemical staining for CEA antigen stains the glandular structures but not pilar structures. So we thinked that this tumor would be originated from primitive adnexal cells differentiating into both pilar and eccrine structures.
Female ; Male ; Humans

Since the first report by Drury and Szent-Gyorgyi in 1929, the inhibitory influences of adenosine on the heart have repeatedly been described by many investigators. A lot of investigations on the working mechanisms of adenosine have been focused mainly on the effects on the coronary blood flow. However, the cellular mechanisms underlyiag the inhibitory action of adenosine on the SA node are not well understood yet. Furthe-rmore, the physiological role of adenosine in the regulation of the heart beat remains still to be explored. Thus, this study was undertaken to examine the behavior of the rabbit SA node ander the influence of adenosine, and the interactions between adenosine and aminophylline on the SA node, and then to compare these results with those of acetylcholine. At the same dosage range, adenosine suppressed the sinus rate and atrial contractility even in the reserpinized preparation. The spontaneous firing rate of the SA node at 35degrees C (mean+/-SEM, n=16) was 154+/-3.3 beats/min. The parameters of action potential were: maximum diastolic potential(MDP), -73+/-1,7 mV; overshoot(OS), 9+/-1.4 mV; slope of pacemaker potential(SPP), 94+/-3.0 mV/sec. Adenosine suppressed the firing rate of the SA node in a dose-dependent manner. This inhibitory effect appeared at the concentration of 10(-4)M and was potentiated in parallel with the increase in adenosine concentration. Changes in the action potential by adenosine were dose-dependent as show by the increase of MDP and the decrease of SPP until 10(-4)M. Above this concentration, however, the amplitude of the action potential decreased markedly due to the simultaneous decrease of both MDP and OS. Dipyridamole, which is known to block the adenosine transport aross the cell membrane, definately potentiated the action of adenosine. The effects of adenosine on the SA node were inhibited by aminophylline. However, the similar effects of acetylcholine to those of adenosine were not reversed by aminophylline. These results suggest that adenosine suppressed the pacemaker activity by acting dire-ctly on the membrane of the SA node, and the effects of adenosine on SA node are sele-ctively inhibited by aminophylline.
Acetylcholine ; Action Potentials ; Adenosine ; Aminophylline ; Cell Membrane ; Dipyridamole ; Fires ; Heart ; Humans ; Membranes ; Research Personnel

BACKGROUND & OBJECTIVES: After introduction of MRI with excellent capability of diagnosis In intracerebral hemorrhage (ICH), old ICH is more readily detected in patients with ischemic stroke. However, very few studies have addressed the identification of clinical significance of mixed stroke. The aims of the study are to elucidate the incidence and the location of the coexisting ICH in non-embolic ischemic stroke. Also we tried to seek the difference of the vascular risk factors between ischemic strokes combined with and without ICH. MEHTODS: Having 222 patients with non-embolic ischemic stroke as subjects, we reviewed the clinical data and MRIs of them retrospectively. We have defined mixed stroke as ischemic stroke combined with MR evidence of coexisting old ICH. The diagnosis of old ICH was made on the basis of the following findings; T2 weighted image showing a low signal intensity lesion with or without a hyperintesity area within it, and Tl weighted image revealing a low intensity lesion in the corresponding area. The frequency of vascular risk factors in the patients with mixed stroke was compared to that of those with pure ischemic stroke. RESULTS: MRI examinations showed old coexisting ICH in 10.4% (23) of 222 non-embolic ischemic stroke patients. Of 23 patients, nineteen patients had old ICH associated with multiple lacunar infarction and others were cortical infarction. The anatomic distribution of the hemorrhage was as follows; basal ganglia and internal capsule 19(78.3%), thalamus 3(13.1%), corona radiata 1 (4.3%), cerebellum 1 (4.3%). Analyzing the vascular risk factors, no significant difference was noted between lacunar infarctions and mixed stroke. CONCLUSION: The results of the study support that lacunar infarction and hypertensive ICH are bases on similar vascular pathophysiology. Therefore, old intracerebral hemorrhage may have a similar significance as a risk factor like previous ischemic stroke and inadvertent anti-thrombotic therapy might be avoided in certain stroke subtypes, which must be defined in future study.
Basal Ganglia ; Cerebellum ; Cerebral Hemorrhage ; Diagnosis ; Hemorrhage ; Humans ; Incidence ; Infarction ; Internal Capsule ; Magnetic Resonance Imaging ; Retrospective Studies ; Risk Factors ; Stroke* ; Stroke, Lacunar ; Thalamus

BACKGROUND: A tourniquet is commonly used to achieve a bloodless field in surgery of the extremities. However, the anesthesiologist is concerned about the adverse effects of hypertension which occur during general anesthesia. In this study, we assessed the effects of lidocaine infiltration in the tourniquet site on blood pressure and heart rate during tourniquet inflation under general anesthesia. METHODS: Forty patients of ASA class I or II, scheduled for knee surgery, were randomly divided into two groups. In group 1 underwent general anesthesia and in group 2 also underwent general anesthesia and combined with 1% lidocaine infiltration in the tourniquet site. The changes of systolic and diastolic blood pressure and heart rate were measured before and after toumiquet inflation, after skin incision and 30 min after inflation. RESULTS: Comparing group 1 with group 2, there were significant increases after tourniquet inflation to 30 min after inflation in systolic and diastolic blood pressure in group 1 (p<0.05). However, there were no significant changes in heart rates in either group. CONCLUSIONS: The above results demonstrate that patients who received lidocaine infiltration in the tourniquet site showed less increase in blood pressure during tourniquet inflation.
Anesthesia, General ; Anesthetics ; Blood Pressure* ; Extremities ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Inflation, Economic ; Knee ; Lidocaine* ; Skin ; Tourniquets*

The effect of Atenolol on the blood pressure were studied in 31 cases of essential hypertension and on the effect of plasma renin activity in 8 cases. There were 8 cases of male with age 49.5(42-70) and 23 cases of female with age 49(35-71) years. 27 cases of 31 cases were untreated hypertensive patients and 4 cases were refractory to hypotensive drugs of diuretics and vasodilators. The Atenolol 50mg once-daily was given to all patients orally for 3 weeks. The blood pressure, heart rate, ECG and symptoms were checked in one week interval. In 8 cases, the plasma renin activity was measured by Dainabot Kit before and after one week medication. The results were as follows: 1. In 27 cases of untreated hypertension, the control blood pressure was 182.9/11.4mmHg in average. The blood pressure decreased in average by 18.3/11mmHg in one week, 23.7/15.9mmHg in two week and 21.5/10.5mmHg in three week. The heart rate also decreased by 7.4/min. in one week, 14.9/min. in two week and 7.8/min. in three week. These data showed considerable reduction of blood pressure and heart rate with 50mg Atenolol once-daily. 2. The basal plasma renin activity after one week medication was reduced by 46% in 8 cases and this data showed considerable reduction regardless control level of basal plasma renin activity. 3. There were considerable blood pressure reduction by adding Atenolol 50mg once-daily to diuretics and vasodilator to which patient's blood pressures were refractory. 4. There was no orthostatic hypotension or serious side effect by Atenolol medication.
Atenolol ; Blood Pressure* ; Diuretics ; Electrocardiography ; Female ; Heart Rate ; Humans ; Hypertension* ; Hypotension, Orthostatic ; Male ; Plasma* ; Renin* ; Vasodilator Agents

BACKGROUND: Postoperative nausea and vomiting (PONV) are very common side effects of laparoscopic procedures. The aim of this study was to compare the effectiveness of dexamethasone with that of ondansetron in prevention of PONV after laparoscopic cholecystectomy. METHODS: Seventy-five ASA class 1, 2 patients planned for laparoscopic cholecystectomy were assigned to receive intravenously either dexamethasone 5 mg (dexamethasone group, n = 25), ondansetron 4 mg (ondansetron group, n = 25), or normal saline 2 ml (control group, n = 25) just after induction of general anesthesia. During the maintenance, end-tidal carbon dioxide tension was controlled to maintain 35-40 mmHg and intraabdominal pressure was controlled to maintain 12 mmHg. Patient's nausea and vomiting were observed in the recovery room just after operation and 6 h, 12 h and 24 h after operation. RESULTS: Incidences of PONV were significantly lower in dexamethasone group and ondansetron group than control group. However there was no significant difference between the two antiemetic groups. CONCLUSIONS: Both of dexamethasone and ondansetron were effective for the prevention of PONV after laparoscopic cholecystectomy.
Anesthesia, General ; Carbon Dioxide ; Cholecystectomy, Laparoscopic* ; Dexamethasone* ; Humans ; Incidence ; Nausea ; Ondansetron* ; Postoperative Nausea and Vomiting* ; Recovery Room ; Vomiting

Sodium nitroprusside is reported to inhibite platelet aggregation. We studied the effects of sodium nitroprusside on platelet aggregation function were in 30 adult patients undergoing spine surgery with enflurane anesthesia. Platelet-rich plasma from patients receiving sodium nitroprusside was studied for aggregation in response to adenosine diphosphate, epinephrine and collagen. Maximum aggregation rate and maximum aggregation time were evaluated serially from the samples collected at post-induction (pre-sodium nitroprusside infusion), 30 min and 90 min after sodium niroprusside infusion. The mean maximum aggregation rate of adenosone diphosphate, epinepherine and collagen at post-induction decreased significantly 30 min and 90 min after sodium nitroprusside infusion (P 0.05),but maximum aggregation time showed no significant changes. The correlation between total sodium nitroprusside dose delivered and maximum aggregation rate of adenosine diphosphate, epinepherine and collagen were r=-0.54 (P<0.05), r=-0.706 (P<0.05) and r=-0.794 (P<0.05). In summary, in situation in which sodium nitroprusside is administered during deliberate hypotensive anesthesia, the anesthesiologist must be aware of the potential for the inhibition of platelet aggregation.
Adenosine Diphosphate ; Adult ; Anesthesia* ; Blood Platelets* ; Collagen ; Enflurane ; Epinephrine ; Humans ; Nitroprusside* ; Platelet Aggregation* ; Platelet-Rich Plasma ; Sodium* ; Spine

Small cortical infarctions can produce isolated motor paresis in the upper extremities. Several cases of isolated hand or finger paresis have been reported, but isolated shoulder weakness is extremely rare. We report here a patient who developed isolated shoulder weakness due to a small cortical infarction in the medial precentral gyrus.
Fingers ; Hand ; Humans ; Infarction* ; Paresis ; Shoulder* ; Upper Extremity