BACKGROUND AND OBJECTIVES: Overcorrection is defined as obvious deviation of the septum to the opposite direction after septoplasty and it is not infrequently developed in young patients. We investigated the rate of its incidence, especially in relation to age. MATERIALS AND METHODS: We retrospectively studied 1,124 patients undergoing septoplasty operation for septal deviation between 1994 and 1999. The operations and postoperative observation were performed by a single surgeon. We reviewed the medical records for age, sex, symptoms, combined operations, direction of deviation before and after septoplasty. RESULTS: Out of 1,124 patients, 22 (2.0%) had their septum overcorrected after septoplasty and 21 (95%) complained of nasal obstruction of the newly deviated side. The incidence of overcorrection was 7.3% (16/218) in teens, 1.7% (5/294) in twenties, 0.4% (1/250) in thirties, and 0% in older ages. The incidence in teens and early twenties was 5%. Patients of teenagers revealed significantly higher incidence as compared to other age groups (p<0.05). CONCLUSION: Overcorrected septum as a complication of septoplasty develops at the incidence rate of 5% in patients of teens and early twenties. Authors suggest that the depth of cross-hatching incision on the cartilage should be superficial or half-thickness to avoid overcorrection in young patients. And the possibility of overcorrection or revision septoplasty should be informed preoperatively.
Adolescent ; Cartilage ; Humans ; Incidence ; Medical Records ; Nasal Obstruction ; Retrospective Studies

Severe dental attrition causes pathological changes of the tooth, collapsed occlusion, and functional and aesthetic complications and can also result in a decrease in occlusal vertical dimension. Before increasing the vertical dimension with full-mouth rehabilitation, it is important to determine the amount of vertical dimension through accurate diagnosis. In this case, a 77 year old elderly male patient on anticoagulant medication with generalized attrition and fracture of teeth was treated with full-mouth rehabilitation in order to recover vertical dimension and aesthetics. Accurate clinical and radiographic examination, diagnostic, wax-up, and occlusal vertical dimension evaluation were step by step performed considering pre-medical history and old age. Patient adaptability was evaluated using an occlusal splint and interim restoration. After 3 months of stabilization with interim restoration, definitive prostheses were fabricated. Satisfactory functional and esthetic outcomes are observed after 6 months of follow up.
Aged ; Dentition ; Diagnosis ; Esthetics ; Follow-Up Studies ; Humans ; Male ; Mouth Rehabilitation ; Mouth ; Occlusal Splints ; Prostheses and Implants ; Rehabilitation ; Tooth ; Tooth Attrition ; Vertical Dimension

OBJECTIVES: Aluminum step wedge (ASW) equivalent radiodensity (eRD) has been used to quantify restorative material's radiodensity. The aim of this study was to evaluate the effects of image acquisition control (IAC) of a digital X-ray system on the radiodensity quantification under different exposure time settings. MATERIALS AND METHODS: Three 1-mm thick restorative material samples with various opacities were prepared. Samples were radiographed alongside an ASW using one of three digital radiographic modes (linear mapping (L), nonlinear mapping (N), and nonlinear mapping and automatic exposure control activated (E)) under 3 exposure time settings (underexposure, normal-exposure, and overexposure). The ASW eRD of restorative materials, attenuation coefficients and contrasts of ASW, and the correlation coefficient of linear relationship between logarithms of gray-scale value and thicknesses of ASW were compared under 9 conditions. RESULTS: The ASW eRD measurements of restorative materials by three digital radiographic modes were statistically different (p = 0.049) but clinically similar. The relationship between logarithms of background corrected grey scale value and thickness of ASW was highly linear but attenuation coefficients and contrasts varied significantly among 3 radiographic modes. Varying exposure times did not affect ASW eRD significantly. CONCLUSIONS: Even though different digital radiographic modes induced large variation on attenuation of coefficient and contrast of ASW, E mode improved diagnostic quality of the image significantly under the under-exposure condition by improving contrasts, while maintaining ASW eRDs of restorative materials similar. Under the condition of this study, underexposure time may be acceptable clinically with digital X-ray system using automatic gain control that reduces radiation exposure for patient.
Aluminum ; Humans ; Radiographic Image Enhancement

BACKGROUND: In firefighters, smoking management is important because they are exposed to various harmful substances in their occupational environment. Accurate surveys of smoking status are essential to control tobacco use. The main disadvantage of self-report questionnaires, which are commonly used for investigating smoking status, is the possibility that the subjects' response are invalid. If the validity of firefighters' answers on smoking questionnaires is not adequate, different methods will be needed for investigating smoking status in firefighters. METHODS: This study was conducted on 445 male firefighters from 9 fire stations in Daegu (the city in South Korea) who visited a medical institution for medical checkup in 2016. The urine cotinine test strip (DCT-102; CLIAwaived Inc., cut-off value = 200 ng/mL) was used to classify the actual smoking status and to assess the validity of self-reported smoking status on questionnaires. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the smoking questionnaires were analyzed. Subjects testing positive in the urine cotinine test (assumed the actual current smokers) were selected. The frequency at which actual current smokers were misclassified as current non-smokers by the questionnaire was calculated. Subjects' characteristics were analyzed for possible association with any discrepancy between self-reported smoking status and urine cotinine test results. RESULTS: The smoking rates among firefighters surveyed using the smoking questionnaire and the urine cotinine test were 22.47% and 51.24%, respectively. Of the all subjects, 29.66% (n = 132) were misclassified. The sensitivity of the smoking questionnaire was 42.98%, the specificity was 99.08%, the PPV was 98.00%, and the NPV was 62.32%. In the 228 subjects classified as current actual smokers by the urine cotinine test, 57.02% (n = 130) were misclassified on the questionnaire. The misclassification rate increased with age. The degree of misclassification also increased when subjects had a history of disease. CONCLUSIONS In present study, the validity of the smoking questionnaire for firefighters was not suitable for investigating smoking status due to low sensitivity. To increase the validity of smoking status monitoring in firefighters, consideration of the various factors like survey environment, subjects' characteristics, and occupational factors is needed.

BACKGROUND: In firefighters, smoking management is important because they are exposed to various harmful substances in their occupational environment. Accurate surveys of smoking status are essential to control tobacco use. The main disadvantage of self-report questionnaires, which are commonly used for investigating smoking status, is the possibility that the subjects' response are invalid. If the validity of firefighters' answers on smoking questionnaires is not adequate, different methods will be needed for investigating smoking status in firefighters. METHODS: This study was conducted on 445 male firefighters from 9 fire stations in Daegu (the city in South Korea) who visited a medical institution for medical checkup in 2016. The urine cotinine test strip (DCT-102; CLIAwaived Inc., cut-off value = 200 ng/mL) was used to classify the actual smoking status and to assess the validity of self-reported smoking status on questionnaires. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the smoking questionnaires were analyzed. Subjects testing positive in the urine cotinine test (assumed the actual current smokers) were selected. The frequency at which actual current smokers were misclassified as current non-smokers by the questionnaire was calculated. Subjects' characteristics were analyzed for possible association with any discrepancy between self-reported smoking status and urine cotinine test results. RESULTS: The smoking rates among firefighters surveyed using the smoking questionnaire and the urine cotinine test were 22.47% and 51.24%, respectively. Of the all subjects, 29.66% (n = 132) were misclassified. The sensitivity of the smoking questionnaire was 42.98%, the specificity was 99.08%, the PPV was 98.00%, and the NPV was 62.32%. In the 228 subjects classified as current actual smokers by the urine cotinine test, 57.02% (n = 130) were misclassified on the questionnaire. The misclassification rate increased with age. The degree of misclassification also increased when subjects had a history of disease. CONCLUSIONS In present study, the validity of the smoking questionnaire for firefighters was not suitable for investigating smoking status due to low sensitivity. To increase the validity of smoking status monitoring in firefighters, consideration of the various factors like survey environment, subjects' characteristics, and occupational factors is needed.

Intramedullary spinal cord metastases occurring from any malignant tumor are usually accompanied by frequent metastases in the intracranium. The clinical features of this disease have been described as the rapid progression of neurologic deficit that can lead to complete paraplegia. In this case, the authors treated a 76-year-old woman, who was diagnosed with an intramedullary spinal cord metastasis arising from a small cell lung cancer without an invasion of the brain, with decompressive surgery and posterior instrumentation. The patient suffered from weakness of her legs, walking difficulties, and urinary and fecal incontinence. Her preoperative neurologic symptoms were improved significantly after surgery. The patient did not want to have further treatment for the primary cancer, and she died from pneumonia caused by aggravation of the underlying disease 3 months after surgery. We report this rare case, which was diagnosed as a metastasis of a small cell lung cancer postoperatively, with a review of the relevant literature.
Aged ; Brain ; Fecal Incontinence ; Female ; Humans ; Leg ; Neoplasm Metastasis ; Neurologic Manifestations ; Paraplegia ; Pneumonia ; Small Cell Lung Carcinoma ; Spinal Cord ; Walking

BACKGROUND AND OBJECTIVES: Organizing hematoma of the maxillary sinus can be developed by organizing procedure of hematoma in the unaerated maxillary sinus. To our knowledge, this is the second article describing organizing hematoma in the maxillary sinus. We experienced 7 cases recently, and aimed to describe clinical features, radiologic characteristics, and pathological findings. MATERIALS AND METHODS: Seven patients were diagnosed as organizing hematoma pathologically. We reviewed computed tomography (CT) and medical records to find out clinical features of organizing hematoma of the maxillary sinus. Of seven patients, five were male and two were female. Their mean age was 49 years. RESULTS: All patients had a history of frequent epistaxis without bleeding tendency. They also complained of nasal obstruction, hyposmia, headache, and cheek swelling. Rhinoscopy revealed obliterated nasal cavity due to bulging lateral wall. CT scans showed soft-tissue densities expanding the maxillary sinus with the minimal contrast enhancement. Destruction of the bony wall was observed in two patients. Endoscopic sinus surgery, Caldwell-Luc's operation, and Denker's operation were applied for the treatment singly or in combination, and resulted in successful outcome. CONCLUSION: Organizing hematoma should be included in the differential diagnosis when patients have frequent epistaxis and expansile lesion in the maxillary sinus.
Cheek ; Diagnosis, Differential ; Epistaxis ; Female ; Headache ; Hematoma* ; Hemorrhage ; Humans ; Male ; Maxillary Sinus* ; Medical Records ; Nasal Cavity ; Nasal Obstruction ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Anaplastic carcinoma of thyroid gland is a lethal entity: few patients live more than 12 months following the diagnosis. We retrospectively reviewed the experience with this entity at our institute with respect to prognostic factors influencing survival. MATERIALS AND METHODS: Thirteen cases of anaplastic carcinoma of thyroid gland diagonsed from 1995 to 2000 were analyzed retrospectively. The median age at presentation was 66.2 years; the male/female ratio was 1.17:1: and the most common symptom was a rapidly enlarging neck mass. RESULTS: All but one patient died within one year of diagnosis. Tumor size of less than 7 cm and complete resection of tumor were significant prognostic factors. Patients who had operation with or without radiotherapy and/or chemotherapy survived significantly longer than other patients. Median survival duration was 74 days. CONCLUSION: This study showed that complete resection and multimodal treatment for tumor of size less than 7 cm resulted in prolonged survival for a subgroup of patients with anaplastic thyroid carcinoma.
Carcinoma* ; Combined Modality Therapy ; Diagnosis ; Drug Therapy ; Humans ; Neck ; Radiotherapy ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms

BACKGROUND AND OBJECTIVES: We carried out an acoustic analysis to investigate the phonatory characteristics of patients undergoing short-term endotracheal intubation with or without thyroidectomy, and who had no nerve injury. MATERIALS AND METHODS: The patients were divided into two groups, one undergoing thyroidectomy (39 cases) and the other not undergoing thyroidectomy (25 cases). All patients of the thyroidectomy group had undergone thyroidectomy using general anesthesia with endotracheal intubation. All patients of the other group had undergone chronic ear surgery with the same anesthetic method and duration. For the evaluation of voice, preoperative and postoperative acoustic analyses were done. RESULTS: On the acoustic analysis of thyroidectomy group, jitter, shimmer and the vocal range were significantly increased at one day after thyroidectomy. But one month after thyroidectomy, these changes return to statistically insignificant increments, except for shimmer and the vocal range. These acoustical changes were not related to the extent of surgery between total thyroidectomy and hemithyroidectomy. In comparison with acoustical changes after short-term endotracheal intubation, the change of jitter and shimmer of thyroidectomy group did differ significantly. CONCLUSION: Voice alteration after thyroidectomy without nerve injury may be associated with the disturbance of the prelaryngeal musculature. This voice changes emphasize the importance of the extralaryngeal skeleton for pitch control and early intensive speech therapy, especially in patients who need their voice professionally.
Acoustics* ; Anesthesia, General ; Ear ; Humans ; Intubation, Intratracheal* ; Skeleton ; Speech Therapy ; Thyroidectomy* ; Voice

BACKGROUND AND OBJECTIVES: Supraglottic laryngectomy is a well established technique for the treatment of appropriate carcinoma of supraglottic larynx. The purpose of this study was to determine factors that may contribute to postoperative aspiration related to deglutition problem following supraglottic laryngectomy. MATERIALS AND METHOD: A retrospective analysis of medical records of 19 patients who consecutively underwent supraglottic laryngectomy was undertaken. Contribution of the following factors was investigated: age, T stage, pack-years of smoking, and parameters of pulmonary function test. The authors used a computerized acoustic analysis program (CSL-MDVP) to measure fundamental frequency, jitter, shimmer, and noise to harmonics ratio. RESULTS: Eleven patients had no problem, 5 patients had clinically insignificant problem, and 3 patients had moderate problem in postoperative 6 months. A greater number of pack-years of smoking and decreasing FEV1/FVC were significantly correlated with poor outcome with regards to postoperative aspiration and deglutition problem. No statistically significant difference was seen between patients with supraglottic laryngectomy and the control group. CONCLUSION: This study showed that less than 60% FEV1/FVC signifies a greater risk for postoperative aspiration.
Acoustics ; Deglutition ; Forced Expiratory Volume ; Humans ; Laryngectomy* ; Larynx ; Medical Records ; Noise ; Respiratory Function Tests ; Retrospective Studies ; Smoke ; Smoking ; Vital Capacity ; Voice