This study was to investigate the various parts of the mandible related to inferior alveolar nerve conductive anesthesia in 228 dry skulls of Korean adults. Five morphological variations were observed and four measurements were undertaken. The following results were obtained. 1. The Position of coronoid notch in the anterior border of the ramus of mandible is classified into three types and percentage of each type was as follows : Type I (Coronoid notch in the middle part of the anterior border of the ramus of mandible) : 83.3% Type II (Coronoid notch in the inferior part of the anterior border of the ramus of mandible) : 12.7% Type III (No coronoid notch in the anterior border of the ramps of mandible) : 4.0% 2. The position of the lingula of mandible to the imaginary line of the molar occlusal plane is classified into three types and percentage of each type was as follows : Type I (Above the imaginary line of the mandibular molar occlusal plane) : 87.3% Type II (Coincide with the imaginary line of the mandibular molar occlusal plane) : 8.6% Type III (Below the imaginary of mandibular molar occlusal plane) : 4.3% 3. The position of the lingula of the mandible in the internal oblique line-posterior border of the ramus of mandible dimension is classified into three types and percentage of each type was as follows : Type I (Anterior part in the internal oblique line-posterior border of the ramus of mandible dimension) : 82.9% Type II (Middle part in the internal oblique line-posterior border of the ramus of mandible dimension) : 11. 4% Type III (Posterior part in the internal oblique line-posterior border of the ramus of mandible dimension) : 5.7% 4. The position of the apex of the lingula of mandible to the deepest point of the coronoid notch in the anterior border of the ramus of mandible is classified into three types and percentage of each type was as follows : Type I (Coincide with the deepest point of the coronoid notch) : 82.0% Type II (Above the deepest point of the coronoid notch) : 13.2% Type III (Below the deepest point of the coronoid notch) : 4.8% 5. The position of the apex of the lingula of mandible to the imaginary line of the mandibular molar occlusal plane is classified into three types and percentage of each type was as follows : Type I (Above the 8mm) : 65.7% Type II (Above the 5mm) : 18.6% Type III (Above the 10mm) : 15.7% 6. Angle between the line connecting the apex of the lingula of mandible-1-2 premolars in the contralateral side and median line of the mandible is classified into three types and percentage of each type was as follows : Type I (50°) : 67.2% Type II (45°) 21.4% Type III (55°) : 11.4% 7. The averages of the measurement of the various bony landmarks of the mandible related to inferior alveolar nerve conductive anesthesia were as follows : ① Distance from deepest point of the coronoid notch to internal oblique line : 9.2mm ② Distance from internal oblique line to the apex of the lingula of mandible : 11.6mm ③ Distance from deepest point of the coronoid notch to apex of the lingula of mandible : 19.7mm ④ Height of the lingula of mandible : 9.8mm
Adult ; Anesthesia* ; Architectural Accessibility ; Bicuspid ; Dental Occlusion ; Humans ; Mandible* ; Mandibular Nerve* ; Molar ; Skull

Iatrogenically developed immunosuppression-associated Kaposis sarcoma is the result of immunosuppressive therapy after an organ transplantation, particularly after a renal transplantation. Since the advent of powerful immunosuppressive agents such as cyclosporine, recently the incidence of Kaposis sarcoma has been increased. In addition to immunosuppression, other factors, such as genetic predisposition, environmental and geographic factors, and oncogenic viruses, may play a role in the pathogenesis of this tumor. Ilerein we report a case of Keposis sarcoma with multiple organ involvement of the skin, lung, small intestine and mesenteric lymph node in a renal allograft recipient who received cyclosporine and prednisolone. Reduction of the dosage of immunosuppressant for 1 month resulted in improvement of the cutaneous lesions.
Allografts* ; Cyclosporine ; Genetic Predisposition to Disease ; Geography ; Immunosuppression ; Immunosuppressive Agents ; Incidence ; Intestine, Small ; Kidney Transplantation ; Lung ; Lymph Nodes ; Oncogenic Viruses ; Organ Transplantation ; Prednisolone ; Sarcoma ; Sarcoma, Kaposi* ; Skin ; Transplants

Radiotherapy in the treatment of head and neck cancers is often used either alone or in addition to surgery. Radiation disrupts the proliferative capacity of the cancer while doing as little damage as possible to the normal tissue. Nevertheless, conventional radiotherapy of advanced head and neck tumors is frequently associated with severe oropharyngeal mucositis. The fungiform papillae are found on the dorsal surface of the anterior 2/3 of the tongue and have one taste bud which always located on the superior side. In recent years, many study have demonstrated the location of neuropeptides in the intragemmal cells of the taste buds. We used neural cell adhesion molecule (NCAM) in this study. NCAM is a membrane surface glycoprotein found in neural tissue that functions in cell -cell interactions such as adhesion and recognition and may contribute to neuronal and receptoneural synaptogenesis. However, to the best of our knowledge, there is no study about NCAM in relation to dysgeusia, especially after radiotherapy. Therefore, we studied the change of the expression of NCAM in the fungiform papilla of the young rat tongue following single dose radiation. Twenty days old 18 Sprague -Dawley rats were used. Twelve rats were irradiated with a single dose of 17 Gy gamma radiation. We sacrificed rats 1, 7, 20 days after radiation. The anterior part of tongues were removed and cut into at 30 micro gram on a cryocut. Using the free floating method, we immunostained sections. In control group, NCAM is expressed on some intragemmal cells which were located in the center of the bud and intragemmal nerve fibers. NCAM -immunoreactive (ir) perigemmal nerve fibers were rare, however basal plexus fibers and subpapillary nerve bundle showed strong immunoreactivity. One day after radiation, taste buds had no detectable changes of the expression of NCAM. However, seven days after radiation, the number of NCAM -ir intragemmal cells was reduced and the shape of ir cells was deformed. Immunoreactivity of basal plexus fibers and subpapillary nerve bundle was also decreased. The surface of the papilla was transformed into dome shape. Twenty days after radiation, overall forms of buds were recovered except a few deformed NCAM -ir intragemmal cells. NCAM was expressed in the intragemmal cells which are thought to be related with taste sensation, and we speculate that NCAM participate synaptogenesis. However, more studies using immunoelectron microscopic method are required.
Animals ; Dysgeusia ; Gamma Rays ; Head ; Immunohistochemistry ; Membrane Glycoproteins ; Membranes ; Mucositis ; Neck ; Nerve Fibers ; Neural Cell Adhesion Molecules* ; Neurons ; Neuropeptides ; Radiotherapy ; Rats* ; Sensation ; Taste Buds ; Tongue*

This is a retrospective analysis of 67 patients with histologically proven invasive carcinoma of uterine cervix treated with surgery followed by adjuvant radiotherapy at Inje University Seoul Paik Hospital between october 1983 and september 1991. Postoperative radiotherapy was carried out in patients with high risks of locoregional recurrence such as positive pelvic lymph node (38 pts), large tumor size more than 3 cm (22 pts), cervical stromal invasion more than 2/3 (46 pts), parametrial involvement (9 pts), positive resection margin (147ts), endo/myometrial extension (10 pts), and angiolymphatic invasion (13 pts). Stage IA, IB, and IIA were 2(3%), 39(58.2%), and 26(38.8%), respectively. Median follow-up period was 48 months with ranges from 13 to 115 months. All 67 patients were treated externally with standard pelvic field with radiation dose ranging from 4080 to 6120 cGy in 4~6 weeks period of time. Of these, 45 patients received intracavitary radiotherapy. The overall survival rate and disease free survival rate at 5-year were 88.0% and 82.1%, respectively. The survival rates by stage were 87.l% in IB and 88.4% in IIA. Local control rate was 86.6%(58 pts). The treatment failure was noted in 12 of 67 Patients(17.9%): locoregional failure in 7(10.4%), distant metastasis in 3(4.5%), and locoregional and distant metastasis in 2 (3%). The univariate analysis of prognostic factors disclosed endo/myometrial extension as a significant factor of survival and recurrence (70.0% vs 91.l% P< 0.05 & 30.0% vs 15.8%, respectively). The complication of postoperative radiothrapy was not significant and all patient were well tolerated. In conclusion, postoperative radiotherapy in patients with high risks of locoreginal recurrence is relatively well tolerated and it gives significantly improved survival rate especially in patients with positive lymph nodes, bulky tumor size( 3 cm), parametrial involvement, cervical stromal invasion more than 2/3, positive resection margin and angiolymphatic invasion.
Cervix Uteri ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Treatment Failure ; Uterine Cervical Neoplasms*

No abstract available.
Child* ; Humans ; Male ; Penis* ; Replantation*

From Nov. 1983 through Feb. 1986, 35 patients of uterine cervical cancer were treated by external radiation therapy and intracavitary radiation therapy using Fletcher-Sult-Delclos applicator. Age of the patients ranged from 32 to 70 years (median age:53 years). All patients had follow up from 9 to 34 months and median follow up of 20 months. 4 patients were in stage I, 25 were in stage II, 5 were in stage III and I was in stage IV. Overall regression rate was 80% and uncorrected actuarial 2 year survival rate was 88%. The incindence of rectal complications were analyzed. There was no rectal complication in the patients who received less than 7000 rad maximal rectal dose, but 2 out of 17 patients who received more than 7000rad developed moderate degree (grade 2) of rectal complication. In viewing of our results, Fletcher-Suit-Delclos applicator (3M) seemed to be an appropriate instrument for intracavitary radiation therapy in the patients of uterine cervical cancer.
Cesium* ; Follow-Up Studies ; Humans ; Radiotherapy* ; Survival Rate ; Uterine Cervical Neoplasms*

PURPOSE: To assess the value of contrast-enhanced color Doppler ultrasonography(US) in the detection of ves-sels related to hepatocellular carcinoma(HCC). MATERIALS AND METHODS: Between July 1997 and April 2000, 76 HCCs in 70 patients (50 men and 20 women; mean age, 57.8 years) were confirmed histologically or clinically. Tumor site and size at gray scale US, and afferent, intratumoral and efferent color signals at precontrast and postcontrast color Doppler US were deter-mined. Afferent signals were classified as basket or penetrating type, and intratumoral signals as spotty, linear or mixed. Efferent signals were categorized as signal to portal vein or signal to hepatic vein, and postcontrast color signal changes as focal, general or marginal spotty type. We also measured the color percentage of intra-tumoral signals as seen during precontrast and postcontrast study. RESULTS: The detection rate changed from 41(53.9%) to 60(78.9%) in cases with afferent signals, from 50(65.8%) to 64(84.2%) in those with intratumoral signals, and from 6(7.9%) to 9(11.8%) in those with efferent signals. Overall, 74(97.4%) cases showed positive findings at postcontrast color Doppler US. The most common enhancing pattern was general, occurring in 33(43.4%) cases. The color percentage of intratumoral signals increased from an average of 8.2% to 34.9%. The detection rate of intratumoral signals from tumors less than 3 cm in diameter increased from 56.8% to 100%, and that of deeply-located tumor-related signals (17 cas-es) increased from 47.1% to 94.1%. CONCLUSION: The use of contrast enhanced color Doppler US increased the detection rate of afferent, intratumoral, and efferent signals, especially that of intratumoral signals from tumors less than 3 cm in diameter and signals from deeply located tumors. In addition, the modality can aid the diagnosis of HCC by evaluating tumor dynamics.
Diagnosis ; Female ; Hepatic Veins ; Humans ; Liver Neoplasms ; Male ; Portal Vein ; Ultrasonography, Doppler, Color*

OBJECTIVE: This study was carried out to investigate the clinical availability of event related potential (ERP) P300, N100 and QEEG as biological markers in schizophrenia (SPR) patients. METHODS: The 23 SPR patients who met Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria of SPR and age and sex matched 23 normal controls (NC) were recruited. Positive and Negative Syndrome Scale (PANSS) was used to evaluate the clinical symptoms. The three electrodes (Cz, CPz, Pz) were used to measure the amplitude and latency of each ERP components. The qEEG was analyzed by the ranges of Hz: delta (1-3 Hz), theta (4-7 Hz), alpha (8-12 Hz), beta (13-30 Hz) and gamma (30-50 Hz). RESULTS:P300 amplitudes of SPR patients were reduced across Cz, CPz and Pz (F=5.81, p<0.05). There was no difference in P300 latency, N100 amplitude and N100 latency between SPR and NC. P300 amplitudes were not influenced by demographic characteristics and PANSS scores in SPR patients. The PANSS positive, negative, general subscale scores were positively correlated with N100 latency at Cz, CPz. SPR patients showed significantly decreased alpha activity (SPR vs. NC=24.44+/-6.98% vs. 29.55+/-6.74%, p<0.05) and increased gamma activity (SPR vs. NC=19.48+/-5.47% vs. 16.42+/-4.69%, p<0.05) compared with those of NC. CONCLUSION: The results suggest that the amplitude of P300 and alpha activity can be considered as a biological marker of SPR. And there is a possibility that the latency of N100 may reflect symptom severity of schizophrenia patients.
Biomarkers ; Diagnostic and Statistical Manual of Mental Disorders ; Electrodes ; Humans ; Schizophrenia

Total knee arthroplasty is a surgical treatment for end-stage osteoarthritis of the knee. Postoperative lower limb alignment is one of the factors determining the long-term prognosis after total knee arthroplasty. Navigation-assisted surgery can be used to achieve an accurate lower limb alignment. Particular situations, such as severe extra-articular deformity in the femur or tibia and retained hardware, are a good indication for navigation-assisted surgery. On the other hand, thorough preoperative planning and an understanding of each steps of surgery are necessary to perform total knee arthroplasty successfully in these special cases. In this review article, preoperative radiological measurements and surgical planning for extra-articular deformity correction will be elucidated. The surgical steps and necessary instruments for navigation-assisted total knee arthroplasty will be described in cases of extra-articular deformity or retained hardware. A literature review showed that the radiological and clinical results after total knee arthroplasty using navigation in osteoarthritis with extraarticular deformity were good. Therefore, it is essential to use navigation when performing total knee arthroplasty in patients with extraarticular deformity or retained hardware.

PURPOSE: The purpose of this study is to elucidate the clinical feature of the hasbitual patella dislocation in the skeletally immature patients and evaluate the result of modified Galeazzi procedure. MATERIAL AND METHODS: From Aug, 1997 to Jan, 2002 we operated 9 knees in 7 patients. Mean age at surgery was 13.3 years. There were 3 males with 3 knees and 4 females with 6 knees. The lateral retinaculum was released and the medial retinaculum was reefed. Patella was tenodesed with semitenidinosus tendon. The operated knees were immobilized with plaster of cast for 3 weeks and progressive range of motion exercise with hinged brace was permitted. RESULTS: Based on the clinical and radiological evaluation, there were improved results. Especially congruence angle was decreased from preoperative +72 degrees to postoperative +20 degrees. There was 1 recurrence that had increased femoral anteversion and 1 arthrofibrosis that had past history of ipsilateral thigh infection. CONCLUSION: Satisfactory clinical results were obtained with modified Galeazzi procedure for treatment of habitual patella dislocation in skeletally immature patient.
Braces ; Dislocations* ; Female ; Humans ; Knee ; Male ; Patella* ; Range of Motion, Articular ; Recurrence ; Tendons ; Thigh