Primary pulmonary hypertension is a rar, incurable, and progressive clinical entity. When associated with pregnancy, the prognosis of primary pulmonary hypertension is worsened with maternal mortality rates of at least 50%. The patient was a 29-year-old mother in her 2nd pregnancy, with previous uncomplicated gestation, 5 years ago. She had been well until the 28th week of present gestation when she was admitted because of increasing dyspnea on exertion. She was a housewife with no remarkable family and past histories. We have experienced a patient with primary pulmonary hypertension in pregnancy. She was treated with an oral calcium-channel blocker and low-molecular-weight heparin and was delivered vaginally with good maternal and fetal outcome. So we report a case of primary pulmonary hypertension associated with pregnancy and review literature.
Adult ; Dyspnea ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Pulmonary* ; Maternal Mortality ; Mothers ; Pregnancy* ; Prognosis

Hypertrophic pachymeningitis is a rare disorder, with idiopathic, tuberculosis, syphilis and sarcoidosis being the most commonly considered etiology. We experienced a case of hypertrophic pachymeningitis caused by tuberculosis a 34-year old female. She had complained of consistent headache and diplopia for 20 days. The characteristic finding on magnetic resonance imaging was marked thickening of the unilateral cerebellar tentorium with gadolinium-DTPA enhancement. There was no significant changes on adjacent brain parenchyma. Histologic investigation of the left cerebellar tentorium disclosed chronic granulomatous inflammation with central caseous necrosis. The patient was successfully managed with anti-tuberculosis drugs.
Adult ; Brain ; Diplopia ; Female ; Headache ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Meningitis* ; Necrosis ; Sarcoidosis ; Syphilis ; Tuberculosis*

Hypertrophic pachymeningitis is a rare disorder, with idiopathic, tuberculosis, syphilis and sarcoidosis being the most commonly considered etiology. We experienced a case of hypertrophic pachymeningitis caused by tuberculosis a 34-year old female. She had complained of consistent headache and diplopia for 20 days. The characteristic finding on magnetic resonance imaging was marked thickening of the unilateral cerebellar tentorium with gadolinium-DTPA enhancement. There was no significant changes on adjacent brain parenchyma. Histologic investigation of the left cerebellar tentorium disclosed chronic granulomatous inflammation with central caseous necrosis. The patient was successfully managed with anti-tuberculosis drugs.
Adult ; Brain ; Diplopia ; Female ; Headache ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Meningitis* ; Necrosis ; Sarcoidosis ; Syphilis ; Tuberculosis*

Functional paraganglioma of the mediastinum is an uncommon tumor of the paraganglion system that causes symptoms and signs of episodic catecholamine release. It has not been reported in Korea. We experienced a case of a 17 years old man with a history of diaphoresis and paroxysmal hypertension refractory to therapy since 14 years old. Urinary execretion of catecholamine and its metabolites were elevated. Computed tomography(CT) scan revealed high density mass located on the posterior mediastinum in the area of the right fifth intercostal space. At thoracotomy, a 3X3X4cm sized lesion was resected and confirmed as a paraganglioma.
Adolescent ; Humans ; Hypertension* ; Korea ; Mediastinum* ; Paraganglioma* ; Pheochromocytoma ; Thoracotomy

Since the non-metric traits of the human teeth are various according to the genetic or environmental factors, these dental traits are significantly used in distinguishing the different racial groups. The purpose of this study was to evaluate the non-metric dental traits of Koreans among the various races on the viewpoints of the physical anthropology. The materials of this study were conducted with incisors, canine, and molars collected from 168 Korean cadavers and the upper and lower dental models of 160 Koreans. We evaluated the 15 criteria of the non-metric dental traits of Korean teeth. The results were as follows. 1. Most of the Koreans' maxillary incisors were revealed to the shovel-shaped incisor, whereas, none of the mandibular incisors showed the shoveling. The double shoveling of the maxillary central incisors and the lateral incisors were observed in 31.2%, 7.6%, respectively. The presence of the shoveling of Korean maxillary incisors was the most compared to the other racial groups. 2. The peg lateralis were only seen in the maxillary lateral incisor by 10.2%. 3. It showed a relatively low rate in the presence of the distal accessory ridge of the canine and it was more commonly seen in the maxillary canine than in the manibular canine. 4. It was most common that the maxillary molar had 4 cusps (maxillary 1st molar: 96%, maxillary 2nd molar: 81.7%). On the other hand, mandibular 1st molars having 5 cusps were most common in 81.1% and mandibular 2nd molar having 4 cusps was most common in 52%. 5. The cusp-groove patterns of the maxillary molar occlusal surface were classified into 4 categories. Among these categories, "4" patterns were most in the maxillary 1st molars and "4-" patterns were most in the mandibular 2nd molars. 6. Carabelli's trait was mostly observed in the maxillary 1st molar and "high cone patterns" among the Carabelli's traits were shown in 9.9% Korean males. The presence of the Carabelli's trait was much lower than the Caucasian. 7. The cusp-groove patterns of the mandibular molar were classified into 4 categories. The presences of "Y5" pattern (45.6%) and "+5" pattern (51.6%) were equally observed in the mandibular 1st molars, while the "+" patterns ("+4" pattern : 46.3%, "+5" pattern : 40.0%) were most in the mandibular 2nd molars. From these results, the presence of "Y5" patterns in the Korean mandibular molars were lower, but it had a tendency that presence of "+5"patterns was higher than the other races. 8. The cases in which "cusp 6" was observed in the mandibular 1st molar and 2nd molar were 5.3%, 5.1%, respectively. And the presences of "cusp 7" were observed in the mandibular 1st molar and 2nd molar by 7.5%, 4.1%, respectively.
Anthropology, Physical ; Cadaver ; Continental Population Groups ; Dental Models ; Hand ; Humans ; Incisor ; Male ; Molar ; Tooth

Mandible is the biggest and the hardest facial bone and its shape is found well-remained in the fossil and forensic research area. Therefore it is of significance in physical anthropology and it has been used to distinguish the different ethnic groups as well as the sex. The researchers took 102 mandibles in Korean of the known sex and examined the physical anthropologic characteristics that exist among the Korean males and females as well as the different ethnic groups. Through examining 13 criteria that include the shape of the chin and the shape of mental spine the following results were achieved. Out of the 13 non-metric criteria of the examined mandibles, Concerning the sexual dimorphism, the most distinguished criteria was the contour of the mandibular lower border. In males, 68.1% showed the "rocker form", on the other hand in females, the "straight form" was more general (82.0%). In addition, the shape also differed in mental region. In males the shape of the chin was bilobate or square form generally (91.7%), while females' mandible wasn't bilobate form, but square (53.6%) and pointed form (46.4%). Beside this, there was no differences between the male and female. We compared in presence of mylohyoid canal in Korean with the other ethnic groups by non-metric traits. The mylohyoid canal was relatively low by 5% among the Asians including the Koreans and relatively high by 10.0% among the Whites and over 15.0% among the Blacks.
African Continental Ancestry Group ; Anthropology, Physical ; Asian Continental Ancestry Group ; Chin ; Ethnic Groups ; Facial Bones ; Female ; Fossils ; Hand ; Humans ; Male ; Mandible* ; Sex Differentiation ; Spine

OBJECTIVES: To manage a patient's blood pressure and recovery, and to reduce unnecessary hospital visits after heart surgery, we developed and established a telecare service. METHODS: We established and test-operated the system that enabled biometric data to be measured and monitored at home, and directed connections to the video consultation with monitoring personnel and medical staff when abnormal symptoms were detected. RESULTS: As a result of using the telecare service with patients discharged from the hospital after undergoing heart surgery, the patients were mostly satisfied with the service and use of the equipment, and some patients wanted to actually receive the service continuously along with a device which could be more easily used. CONCLUSIONS: Telecare services are greatly needed for patients discharged after heart surgery for a certain period of time. A model should be developed which provides devices necessary for each disease in package form and customizes the content and services in one package.
Blood Pressure ; Heart Diseases ; Humans ; Medical Staff ; Personal Health Services ; Remote Consultation ; Self Care ; Telemedicine ; Thoracic Surgery

It has been known that the medial pterygoid muscle influences the mandibular functions related to mandibular movements. In addition, the muscle bundle of the medial pterygoid muscle influences the stability of a complete denture. Therefore, the topography of this muscle is clinically important. However, researches on the clinical anatomy related to the insertion area, and innervation, of this muscle were rare. Therefore, authors investigated the morphological and topographic characteristics of the medial pterygoid muscle by dissection of 31 Korean cadavers. The following are the results:The middle portion of the medial pterygoid muscle was the longest with the length of 59.4 degrees +/-7.1mm, and upper one third of the total length of the muscle was composed of tendon. When comparing the morphology of the insertion area of the medial pterygoid muscle and the masseter muscle in the mandibular angle region, there was no difference of the length of the insertion from the gonion to the superior margin of the insertion on the ramus. However, the length from gonion to the anterior margin of the insertion on the ramus in the masseter case was twice as long as the medial pterygoid muscle case. Insertion of the medial pterygoid was morphologically classified into six groups based on the insertion pattern and the mylohyoid groove. Type V, which the muscle fibers in the insertion of the medial pterygoid muscle were divided and did not invade the mylohyoid groove, were found the most (26.6%). Most of pterygoid branch of trigeminal nerve entered the medial pterygoid muscle through the posterior one third area or the posterior marginal area. The average length between hamulus and the region where the pterygoid branch of mandibular nerve entered the medial pterygoid muscle was 10.1mm. In conclusion, the anatomical relationship between the medial pterygoid muscle and the surrounding structures will be able to provide useful data for clinical applications.
Cadaver ; Denture, Complete ; Mandible ; Mandibular Nerve ; Masseter Muscle ; Pterygoid Muscles* ; Tendons ; Trigeminal Nerve

The anatomical description and the relationship between the root apex and the inferior wall of sinus are critical in diagnoses and surgeries of the sinus pathoses, and in dental implantation. So, identification of the proximity between the root apex and the inferior wall of sinus and the clarification of cortical thickness of inferior wall of sinus are indicated the topography of spreading dental infection into the maxillary sinus. Therefore, anatomical knowledge of the topography between the root apex and the inferior wall maxillary sinus are important in the diagnosis and treatment planning of the dental implantation, endodontic procedures, and orthodontic treatment. The purposes of this study were to clarify the morphological and clinical characteristics of the maxillary sinus, especially the inferior wall of sinus in Korean, and to identify the relationship between the inferior wall of maxillary sinus and the roots of maxillary teeth. 24 sides of maxillae of the hemi -sectioned Korean heads were used in this study. All specimens were taken DentaScan reformatted cross -sectional images were taken for the radiographic evaluation of the maxillary teeth and inferior wall of maxillary sinus. All specimens were decalcificated and thenp were sectioned coronally. On the sectioned specimen, 21 metric items were measured using the image analyzing system. The results were as follows: 1. The distance between the each root apex and the inferior wall of maxillary sinus were measured. In the 2nd molar area the distance from the root apex to the inferior wall of sinus was the shortest and the longest in the 1st premolar area. 2. The thickness of the cortical plate of the inferior wall of maxillary sinus was thinnest in the 1st premolar area, whereas, the thickest in the 2nd premolar area. 3. The vertical relationship between the inferior wall and the roots of the maxillary molars was classified into 5 types. Type I (the inferior wall of sinus was located above the level connecting the buccal and lingual root apices) was predominant (54.5% in the 1st molar area, 52.4% in the 2nd molar area). 4. The horizontal relationship between the inferior wall of sinus and root apex were classified into 3 types. Type 2 (the alveolar recess of the inferior wall of sinus was located between the buccal and lingual roots) was predominant (80% in the 1st and 2nd molar area). Taken all together, this study demonstrated various anatomical characteristics and relationships between the maxillary sinus and their surrounding structures. Recognition of these findings may have an impact on the clinical management of patients.
Asian Continental Ancestry Group ; Bicuspid ; Dental Implantation ; Dental Implants ; Diagnosis ; Head ; Humans ; Maxilla ; Maxillary Sinus* ; Molar ; Tooth

The anatomical description and the relationship between the root apex and the inferior wall of sinus are critical in diagnoses and surgeries of the sinus pathoses, and in dental implantation. So, identification of the proximity between the root apex and the inferior wall of sinus and the clarification of cortical thickness of inferior wall of sinus are indicated the topography of spreading dental infection into the maxillary sinus. Therefore, anatomical knowledge of the topography between the root apex and the inferior wall maxillary sinus are important in the diagnosis and treatment planning of the dental implantation, endodontic procedures, and orthodontic treatment. The purposes of this study were 1) to clarify the morphological and clinical characteristics of the maxillary sinus, especially the inferior wall of sinus in Korean, 2) to identify the relationship between the inferior wall of maxillary sinus and the roots of maxillary teeth, and 3) to evaluate the degree of accuracy of DentaScan reformatted images of the maxillary sinus. 33 sides of maxillae of the hemi -sectioned Korean heads were used in this study. All specimens were taken periapical radiographs, computed tomography and DentaScan reformatted cross -sectional images were taken for the radiographic evaluation of the maxillary teeth and inferior wall of maxillary sinus. From the CT images, 3 -dimentional reconstructive images of maxillary sinuses were made using the V -works TM 3.0 program. All specimens were decalcificated and then were sectioned coronally. On the sectioned specimen, 21 metric items were measured using the image analyzing system. The results were as follows: 1. In 6 categories of maxillary sinus according to their lateral aspects and shapes of the inferior walls, flat (54.5%) and round (21.2%) inferior wall of maxillary sinus were prominent. In 58.4%, the anterior limit of maxillary sinus was located in the 1st premolar area and the posterior limit was in the 3rd molar and maxillary tuberosity area (93.9%). The lowest level of the maxillary sinus was in the 1st molar and 2nd molar area. 2. From the 3 -dimentional reconstructive images of maxillary sinus, the maximum anteroposterior length of sinus was 39.3 +/-4.2 mm, the maximum height was 37.1 +/-5.6 mm, and the maximum width was 32.6 +/-6.5 mm. And the average volume of sinus was 15.1 +/-6.2 ml. All measurements were larger in male than female. Taken all together, this study demonstrated various anatomical characteristics and relationships between the maxillary sinus and their surrounding structures. Recognition of these findings may have an impact on the clinical management of patients.
Asian Continental Ancestry Group ; Bicuspid ; Dental Implantation ; Dental Implants ; Diagnosis ; Female ; Head ; Humans ; Male ; Maxilla ; Maxillary Sinus* ; Molar ; Tooth