A Case of Postcardiac Injury Syndrome Presenting as Acute Mediastinitis

A 41-year-old man sought evaluation at the emergency department for pain in the anterior chest that had been ongoing for approximately 35 hours. The electrocardiogram showed marked ST segment elevation in the precordial leads. Cardiac biomarker levels were elevated. He subsequently underwent coronary angioplasty and stenting of the left anterior descending artery using two sirolimus-eluting stents. The following day, the patient complained of severe pain in his chest and shoulders. Computed tomography (CT) of the chest showed small gas bubbles around the aortic wall and mild pericardial thickening with subtle air densities, suggesting acute mediastinitis. With an impression of postcardiac injury syndrome and acute mediastinitis, he was treated with intravenous antibiotics and oral ibuprofen. Two days later, the patient had subjective improvement and the friction rub was no longer heard.

Bony ankylosis of temporomandibular joint / 대한구강악안면방사선학회지

Ankylosis of joint is defined as limited movement due to infection, trauma, or surgical procedure. A 59-year-old female with a chief complaint of limited movements during mouth opening had a positive history of trauma to her right TMJ area about 5 years ago. From that time, progressive mouth opening limitation and intermittent pain have occurred. At the time of admission the patient showed mandibular deviation to the right side during mouth opening, with a maximum opening limited to 5 mm. On plain radiographs, right condylar enlargement and joint space reduction by newly formed bony tissues were observed. CT scans showed right condylar enlargement, cortical sclerosis, and thickening of the condyle, articular fossa and articular eminence.

Influence of threshold value of computed tomography on the accuracy of 3-dimensional medical model / 대한구강악안면방사선학회지

PURPOSE: To evaluate the influence of threshold value of computed tomography on the accuracy of rapid prototyping (RP) medical model MATERIAL AND METHODS: CT datas of a human dry skull were transferred from CT scanner via compact disk to a personal computer (PC). 3-dimensional image reconstruction on PC by V-works(TM) 3.0 (CyberMed. Inc.) software and RP models fabrication were followed. 2-RP models were produced by threshold value of 500 and 800 selected in surface rendering process. Linear measurements between arbitrary 12 anatomical landmarks on dry skull, 3-D image model, and 2-RP models were done and compared. Thus, the accuracy of 500 RP and 800RP models was respectively evaluated. RESULTS: There was mean difference (% difference) in absolute value of 2.27 mm (2.73%) between linear measurements of dry skull and 500 RP model. There was mean difference (% difference) in absolute value of 1.94 mm(2.52%) between linear measurements of dry skull and 800 RP model. CONCLUSION: Slight difference of threshold value in rendering process of 3-D modelling made a influence on the accuracy of RP medical model.

Usefulness of panoramic radiography in the diagnosis of osteoporosis / 대한구강악안면방사선학회지

PURPOSE: To assess the possibility of using panoramic indices as an indicator of jaw osteoporosis. METHODS: Mandibular cortical width (MCW), degree of mandibular alveolar bone resorption (ABR) and morphology of mandibular inferior cortex (MIC) on panoramic radiograph were used as panoramic indices. These panoramic indices were compared with bone mineral density (BMD) of lumbar (L1-L4) and femoral neck measured by dual energy X-ray absorptiometry. We also compared MCW and ABR of young men with those of postmenopausal women. RESULTS: There was a significant correlation between ABR and BMD of lumbar and femoral neck. And also significant correlation between MIC and BMD of lumbar and femoral neck. ANOVA test of BMD of lumbar and femoral neck showed significant differences according to morphologic classification of inferior cortex. There was significant difference in MCW and ABR between young men and postmenopausal women. CONCLUSION: Our results suggested that ABR and MIC on panoramic radiograph could be reliable in screening of osteoporosis.

Usefulness of panoramic radiography in the diagnosis of osteoporosis / 대한구강악안면방사선학회지

PURPOSE: To assess the possibility of using panoramic indices as an indicator of jaw osteoporosis. METHODS: Mandibular cortical width (MCW), degree of mandibular alveolar bone resorption (ABR) and morphology of mandibular inferior cortex (MIC) on panoramic radiograph were used as panoramic indices. These panoramic indices were compared with bone mineral density (BMD) of lumbar (L1-L4) and femoral neck measured by dual energy X-ray absorptiometry. We also compared MCW and ABR of young men with those of postmenopausal women. RESULTS: There was a significant correlation between ABR and BMD of lumbar and femoral neck. And also significant correlation between MIC and BMD of lumbar and femoral neck. ANOVA test of BMD of lumbar and femoral neck showed significant differences according to morphologic classification of inferior cortex. There was significant difference in MCW and ABR between young men and postmenopausal women. CONCLUSION: Our results suggested that ABR and MIC on panoramic radiograph could be reliable in screening of osteoporosis.

Rhabdomyosarcoma of masticator space / 대한구강악안면방사선학회지

A 16-year-old female was admitted to Wonkwang dental hospital with a chief complaint of painful ulceration on right buccal mucosa around mandibular 3rd molar area. Computed tomography and magnetic resonance imaging showed relative large soft tissue mass on the infratemporal fossa and masseter muscle region. By the feature of T1-weighted and T2-weighted of MR imaging, we suspected this mass as a kind of myogenic sarcoma. Histopathological and immunohistochemical studies established a definitive diagnosis of embryonal rhabdomyosarcoma. A review of the literature was also presented.

An Experimental Study of Radiographic Density of Alveolar Bone and Cortical Thickness of Mandible by Osteoporosis / 대한구강악안면방사선학회지

PURPOSE: To evaluate the effect of the systemic osteoporosis on radiographic density of alveolar bone and cortical thickness of mandible MATERIALS AND METHODS: The bone mineral density values of lumbar and femur were measured by dual-energy X-ray absorptiometry and T scores of lumbar, femur were obtained respectively. Radiographic densities of alveolar bones and panorama mandibular index(PMI, represents as cortical thickness) were analysed statistically according to age and T score variavles. RESULTS: The radiographic density of alveolar bone of maxillary molar showed significant difference by age and femur T group. That of mandibular molar showed significant difference between femur T group. Panorama mandibular index showed significant difference between age groups. CONCLUSON: The radiographic density of alvealar bones was more dependent on age femur T than lumbar T. Cortical thickness of mandible was correlated with increasing age.

A Case of Extensive polyostotic fibrous dysplasia / 대한구강악안면방사선학회지

Fibrous dysplasia is a benign disorder of bone consisting of intramedullary proliferation of fibrous tissue and irregularly distributed, poorly developed bone. The disease manifests itself in the monostotic form in which only one bone is involved and the polyostotic form in which multiple bones at different sites are affected. We reported a extensive case of polyostotic fibrous dysplasia with involvement of craniofacial bones, mandible, ribs, extremities. A 18-year-old man showed remarkable right facial swelling who had been treated on right femur 3 years ago with a bone graft for pathologic fracture and he recognized facial swelling 5 years ago. Extraoral radiograms and computed tomogram showed diffuse sclerosis with a ground glass appearance of the most calvarial bones, facial bones. The right mandibular lesion showed very expansile lesion with mottled appearance. Bone scans showed mutifocal increased uptakes in craniofacial bones, right mandible, bilaterally in ribs, humerus, femur, tibia and characteristic varus deformity of right femur (shepherd's crook defomity). This case showed exceptionally bilateral, extensive nature of bone lesion and didn't show any features of skin pigmentation and endocrine disturbances.

Acrofacial dysostosis: a case report

RADOGRAPHIC STUDY OF HEIGHT OF MANDIBULAR CANAL

Mandibular canal is an important anatomic structure for implant surgery. Many clinicians favor a panoramic procedure instead of tomographic or computed tomographic procedure for the pre-surgery because of low cost & easy manipulation. But mandibular canal will not be observable on panoramic X-ray film when bony surrounding structure of mandibular canal is not thick. In this case, we should predict the location of mandibular canal by comparing the opposite side or supposing the relative height of mandibular canal in mandibular body if other obserable methods unusable, The author takened the 261 panoramic views of healthy adults and measured the distance (alveolar process) between alveolar crest and superior border of mandibular canal, distance(basal bone) between superior border of mandibular canal and inferior cortex of mandible, respectively The obtained results were as followings. 1. 56 cases(21.4%) from 261 cases showed inevident walls of mandibular canal on X-ray films. 2. In comparing the 1st molar area and the 2nd molar area, the portions of mandibular 1st molar showed greater height of alveolar process area and the portions of mandibular 2nd molar showed greater height of basal bone area. respectively. 3. Distances from alveolar crest to inferior cortex represented 2.02-2.04 times(mental foramen), 2.47-2.52 times(2nd molar), 2.84-2.86 times(1st molar) of distance from mandibular canal to inferior cortex. 4. Usually each measurements showed non-significant differences (P>0.05) between right and left side of mandible. 5. The average length of anterior loops of mental foramens was measured about 2.285mm.