A Study of Correlation Between Mandibular Angle Fracture and the Mandibular Third Molar

PURPOSE: The aim of this study is to analyze the correlation between incidence of mandibular angle fracture and eruption state of mandibular third molar using clinical and radiographic findings. MATERIALS AND METHODS: The data were obtained from the clinical and radiographic records of 205 patients who visited the Department of Oral and Maxillofacial Surgery, Chonbuk National University Hospital for treatment of the mandibular fracture. Panoramic radiographies were taken for radiographic examination and the mandibular third molars were classified according to age, gender, position and eruption state. Data were analyzed by a chi-square statistics. RESULTS: In this study, the incidence of mandibular angle fracture had a tendency to be greater when a mandibular third molar was present(p>0.05), but there was not a statistically significant difference. Of the 255 cases with a mandibular third molar, 67 had an angle fractures. Of the 155 cases without a mandibular third molar, 138 had not angle fracture. And the incidence of mandibular angle fracture was high at class BII(by Pell & Gregory system) (p<0.05). CONCLUSION: Although there was not a statistically significant difference, mandibular third molar was more susceptible to mandibular angle fracture. When the reduction of mandibular angle fracture, it was recommended that mandibular third molar should be extracted especially in case of pericoronitis, periodontitis and other infections.

A Case Report on the Change of the Refractive Power After a Blunt Trauma

PURPOSE: To determine the pathogenesis of transient myopia after blunt eye trauma. METHODS: In one patient, the refraction of both eyes (the left eye was injured, but the right eye was not) was measured with an autorefractometer. The cycloplegic refraction was measured at the early stage of trauma and again 3 months after the blunt eye injury. The angle and depth of the anterior chamber, the ciliary body, and the choroids were examined by ultrasound biomicroscopy (UBM) over 3 months. The depth of the anterior chamber, the thickness of the lens, and the axial length were measured by A-scan ultrasonography in both eyes. During the 3 months after the injury, we made comparisons between the menifest and the cycloplegic refractions, the depths of anterior chambers, the thickness of the lenses, the axial lengths, and the UBM-determined appearances of the angles and depths of the anterior chambers, the ciliary bodies, and the choroids in both eyes. RESULTS: We suspect that the depth reduction in the anterior chamber, the increase in anterior to posterior lens diameter, and the edema in the ciliary body are all related to the change in the refractive power following the blunt trauma. CONCLUSIONS: Ultrasound biomicroscopy (UBM) and ultrasonography of the anterior segment in the eye may be helpful to diagnose and confirm changes in the refractive power that occur after trauma.

A Case Report on the Change of the Refractive Power After a Blunt Trauma

PURPOSE: To determine the pathogenesis of transient myopia after blunt eye trauma. METHODS: In one patient, the refraction of both eyes (the left eye was injured, but the right eye was not) was measured with an autorefractometer. The cycloplegic refraction was measured at the early stage of trauma and again 3 months after the blunt eye injury. The angle and depth of the anterior chamber, the ciliary body, and the choroids were examined by ultrasound biomicroscopy (UBM) over 3 months. The depth of the anterior chamber, the thickness of the lens, and the axial length were measured by A-scan ultrasonography in both eyes. During the 3 months after the injury, we made comparisons between the menifest and the cycloplegic refractions, the depths of anterior chambers, the thickness of the lenses, the axial lengths, and the UBM-determined appearances of the angles and depths of the anterior chambers, the ciliary bodies, and the choroids in both eyes. RESULTS: We suspect that the depth reduction in the anterior chamber, the increase in anterior to posterior lens diameter, and the edema in the ciliary body are all related to the change in the refractive power following the blunt trauma. CONCLUSIONS: Ultrasound biomicroscopy (UBM) and ultrasonography of the anterior segment in the eye may be helpful to diagnose and confirm changes in the refractive power that occur after trauma.

Serotonin (5-HT) Receptor Subtypes Mediate Regulation of Neuromodulin Secretion in Rat Hypothalamic Neurons

Serotonin (5-HT), the endogenous nonselective 5-HT receptor agonist, activates the inositol -1,4,5- triphosphate / calcium (InsP3/Ca2+) signaling pathway and exerts both stimulatory and inhibitory actions on cAMP production and neuromodulin secretion in rat hypothalamic neurons. Specific mRNA transcripts for 5-HT1A, 5-HT2C and 5-HT4 were identified in rat hypothalamic neurons. These experiments were supported by combined techniques such as cAMP and a Ca2+ assays in order to elucidate the associated receptors and signaling pathways. The cAMP production and neuromodulin release were profoundly inhibited during the activation of the Gi-coupled 5-HT1A receptor. Treatment with a selective agonist to activate the Gq-coupled 5-HT2C receptor stimulated InsP3 production and caused Ca2+ release from the sarcoplasmic reticulum. Selective activation of the Gs-coupled 5-HT4 receptor also stimulated cAMP production, and caused an increase in neuromodulin secretion. These findings demonstrate the ability of 5-HT receptor subtypes expressed in neurons to induce neuromodulin production. This leads to the activation of single or multiple G-proteins which regulate the InsP3/Ca2+/PLC-gamma and adenyl cyclase / cAMP signaling pathways.

Prevalence and Risk Factors for Cataracts in Persons with Type 2 Diabetes Mellitus

PURPOSE: This study was performed to quantitatively evaluate the prevalence and risk factors of cataracts in Korean patients with type 2 diabetes mellitus. METHODS: Eight hundred fifty patients (males: 342, mean age: 58.07+/-8.60 years) with diabetes who underwent ophthalmologic evaluation were studied retrospectively. Diabetic patients were classified into a cataract group and control group (i.e. a group without cataracts). Risk factors like sex, age, duration of diabetes, fasting blood sugar, HbA1c, BUN, creatinine, and total cholesterol were compared between patients with and without cataracts. RESULTS: Four hundred twenty-five patients (50.00%) had cataracts at evaluation. Females were more common in the cataract group than the control group. The mean age did not differ between the two groups. Total cholesterol, triglyceride, and LDL cholesterol levels were not different between the two groups. Duration of diabetes was significantly longer in patients in the cataract group than in the control group (13.03+/-6.96 years vs. 7.03+/-6.04 years, p<0.001). The patients in the cataract group also had higher levels of HbA1c, BUN, creatinine, and fasting blood sugar than those in the control group. Multiple regression analysis revealed that the duration of diabetes (p<0.001) was significantly correlated with the presence of cataracts. CONCLUSIONS: The duration of diabetes was the most significant risk factor for cataracts in patients with diabetes. This finding indicates that the accumulated effect of hyperglycemia is related to lens transparency in patients with diabetes.

The Effects of Glucose Concentrations on Reactive Oxygen production and Cellular Activity in Retinal Pigment Epithelial Cells

PURPOSE: To investigate the effects of glucose concentrations on formation of reactive oxygen products and cellular activity in human retinal pigment epithelial cells. METHODS: Human retinal pigment epithelial cells were cultured with high glucose (200 mg/100 ml, 300 mg/100 ml, 400 mg/100 ml) and normal glucose (100 mg/100 ml). The amounts of reactive oxygen products were assayed with dihydroethidium (DHE). Paraquat-induced cellular activity was determined by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) method. RESULTS: Reactive oxygen products of human retinal pigment epithelial cells were increased 120%, 250% and 390% in high glucose (200 mg/100 ml, 300 mg/100 ml, 400 mg/100 ml) media compared to those of normal glucose (100 mg/100 ml) media. Paraquat-induced cell toxicity was increased by high glucose concentrations. CONCLUSIONS: High glucose increased formation of reactive oxygen products in human retinal pigment epithelial cells. These results suggest that high glucose can make human retinal pigment epithelial cells more sensitive to oxidative cellular injury.

A Randomized, Phase IV, Comparison Study on the Efficacy and Safety of Tapocin(R) and Targocid(R) in Treating Infections Caused by Multi-Resistant Gram Positive Cocci

BACKGROUND: Tapocin(R) is a recently produced Teicoplanin in Korea. To evaluate its clinical usefulness, we compared clinical outcome and safety of Tapocin(R) with those of Teicoplanin (Targocid(R)) against infection caused by multi-drug resistant gram positive cocci. MATERIALS AND METHODS: Twenty-four adult patients infected with multi-drug resistant gram positive cocci were enrolled and randomized into each treatment arm after informed consents were obtained. All patients were given one of the test articles for 7 to 14 days intravenously. Clinical outcome and safety were compared between the two groups. Statistical analysis was done by Chi-square test, Student's t-test, and Fisher's exact test. RESULTS: Twenty out of 24 enrolled patients could be evaluated for clinical efficacy and safety (10 patients for each treatment arm). The baseline characteristics were not significantly different between the two groups in terms of mean age, sex ratio, underlying diseases, site of infections, and causative microorganisms. MRSA was the most common organism: 66.67% in Tarpocin(R) and 91.67% in Targocid(R) groups. Total doses of Targocid(R) and Tapocin(R) administered were 24 and 23 vials, respectively. Fever resolved in 90% of treated subjects and there were no significant differences between the two groups. Bacteriological response shows that the causative microorganisms were eradicated except for one MRSA isolate from each group. Drug fever, as a side effect, was reported from one subject in each group. CONCLUSION: Efficacy and safety of Tapocin(R) is comparable to those of Targocid(R) for the treatment of infections with multi-drug resistant gram-positive cocci.

A Randomized, Phase IV, Comparison Study on the Efficacy and Safety of Tapocin(R) and Targocid(R) in Treating Infections Caused by Multi-Resistant Gram Positive Cocci

BACKGROUND: Tapocin(R) is a recently produced Teicoplanin in Korea. To evaluate its clinical usefulness, we compared clinical outcome and safety of Tapocin(R) with those of Teicoplanin (Targocid(R)) against infection caused by multi-drug resistant gram positive cocci. MATERIALS AND METHODS: Twenty-four adult patients infected with multi-drug resistant gram positive cocci were enrolled and randomized into each treatment arm after informed consents were obtained. All patients were given one of the test articles for 7 to 14 days intravenously. Clinical outcome and safety were compared between the two groups. Statistical analysis was done by Chi-square test, Student's t-test, and Fisher's exact test. RESULTS: Twenty out of 24 enrolled patients could be evaluated for clinical efficacy and safety (10 patients for each treatment arm). The baseline characteristics were not significantly different between the two groups in terms of mean age, sex ratio, underlying diseases, site of infections, and causative microorganisms. MRSA was the most common organism: 66.67% in Tarpocin(R) and 91.67% in Targocid(R) groups. Total doses of Targocid(R) and Tapocin(R) administered were 24 and 23 vials, respectively. Fever resolved in 90% of treated subjects and there were no significant differences between the two groups. Bacteriological response shows that the causative microorganisms were eradicated except for one MRSA isolate from each group. Drug fever, as a side effect, was reported from one subject in each group. CONCLUSION: Efficacy and safety of Tapocin(R) is comparable to those of Targocid(R) for the treatment of infections with multi-drug resistant gram-positive cocci.

A Case of Endometriosis at the Site of Abdominal Scar following Cesarean Section and A Case of Parenchymal Pulmonary Endometriosis / 대한산부인과학회잡지

Abdominal wall endometriosis secondary to cesarean section is very rare condition, being reported in less than 0.5% of patients undergoing cesarean section. Moreover, parenchymal pulmonary endometriosis is a rare gynecologic problem, characterized by cyclic hemoptysis. We experienced 38 years old female patient who had had cyclically appearing painful abdominal wall mass after cesarean section pathologically proven endometriosis and 33 year-old female patient with recurrent catamenial hemoptysis localized with CT scanning, and then treated with GnRH agonist. So, we present two cases with a brief review of literatures.

A Case of Spontaneous Pneumothorax During Chemotherapy for Metastatic Choriocarcinoma / 대한산부인과학회잡지

Spontaneous pneumothorax is a rare complication of pulmonary metastatic disease, most often following chemotherapy for osteogenic sarcomas, primary lung cancer or malignant germ cell tumors. Intensive chemotherapy may theoretically increase the risk of pneumothorax in patients with manifest or occult lung metastases by inducing rapid lysis of the tumor tissue and by interfering with repair processes. We present a case of patient with spontaneous pneumothorax after the introduction of chemotherapy for metastatic choriocarcinoma and review the literature and discuss the possible pathophysiologic mechanisms.

A Case of Squamous Cell Carcinoma in Ovary Presented after Treatment of Microinvasive Cervical Cancer / 대한산부인과학회잡지

Squamous cell carcinoma of the ovary is rare. It is considered to be associated with benign cystic teratoma, Brenner tumor and ovarian endometriosis which undergo malignant degeneration in their epithelial layers. Although ovarian metastasis from advanced cervical cancer is well known, however, ovarian metastasis from microinvasive cervical cancer is extremely rare. Because there are few reports about squmaous cell carcinom of the ovary, the pathogenesis is still not well known. Recently we experienced a case of squamous cell carcinoma in ovary presenting 109 months after surgical therapy of a microinvasive cervical cancer. We report this case with a brief review of literature and possible pathogenesis.

A Case of Squamous Cell Carcinoma in Ovary Presented after Treatment of Microinvasive Cervical Cancer / 대한산부인과학회잡지

Squamous cell carcinoma of the ovary is rare. It is considered to be associated with benign cystic teratoma, Brenner tumor and ovarian endometriosis which undergo malignant degeneration in their epithelial layers. Although ovarian metastasis from advanced cervical cancer is well known, however, ovarian metastasis from microinvasive cervical cancer is extremely rare. Because there are few reports about squmaous cell carcinom of the ovary, the pathogenesis is still not well known. Recently we experienced a case of squamous cell carcinoma in ovary presenting 109 months after surgical therapy of a microinvasive cervical cancer. We report this case with a brief review of literature and possible pathogenesis.

Arthroscopic Management and Manipulation of Chronic Idiopathic Adhesive Capsulitis of the Shoulder / 대한정형외과학회잡지

PURPOSE: To describe the clinical efficacy of arthroscopic management followed by manipulation under anesthesia in chronic idiopathic adhesive capsulitis of the shoulder. MATERIALS AND METHODS: We evaluated nineteen patients who had a mean follow-up period of 3 years 1 month using the UCLA shoulder rating score. Arthroscopic management included an arthroscopic examination and debridement of the glenohumeral joint and the subacromial space, as well as the release of the rotator interval, the capsule, the glenohumeral ligaments and the inferior recess. Manipulation was performed after the arthroscopic procedures. RESULTS: Thirteen patients (68%) were completely free from pain. The forward elevation was im-proved from 97 degrees to 175 degrees, the abduction from 69 degrees to 170 degrees, the external rotation from 8 degrees to 51 degrees, and the internal rotation from the range of the buttock and the 3rd-4th lumbar spinous process to the level of the 7th-9th thoracic spinous process. The average UCLA shoulder rating score was 9 points before the operation and 34 points after the operation. CONCLUSION: Our clinical findings suggest that arthroscopic management followed by manipulation is an effective method for the treatment of chronic idiopathic adhesive capsulitis of the shoulder.

Intraoral Open Reduction of Mandibular Subcondylar Fractures using Kirschner Wire

A Case of Recurrent Cervical Cancer Responded to Paclitaxel and Carboplatin Combination / 대한부인종양콜포스코피학회잡지

We report the case of a patient with a recurrent squamous cell carcinoma of the cervix, FIGO stage IIa, that metastasized to both lung fields 5 years after primary radical hysterectomy and adjuvant pelvic irradiation. The tumor was resistant to UFT-cisplatin regimen. We used a combination of paclitaxel (175mg/m2 intravenous infusion over 3 hours) and carboplatin with a target area under the curve of 4.5 microgram-h/ml and repeated every 3 weeks. The patient well tolerated the chemotherapy with minor neurologic side effect and myelosuppression controlled by granulocyte colony-stimulating factor. The disease went into remission. Thus, the combination of paclitaxel and carboplatin may be a good combination in recurrent or advanced squamous cell carcinoma of the cervix.

Predictive Factors for Residual Neoplasia after Large Loop Excision of Transformation Zone(LLETZ) in the Treatment of Cervical Intraepithelial Neoplasia / 대한산부인과학회잡지

OBJECTIVE: Large loop excision of transformation zone(LLETZ) is gaining popularity as an alternative to other ablative or cone methods for the treatment of cervical intraepithelial neoplasia(CIN). The optimal management of CIN after LLETZ, however, remains controversial and the reliable predictors of residual disease after LLETZ have not been consistently identified. This study was performed to identify factors to predict residual disease after LLETZ. METHODS: From August 1993 to July 1995, 133 patients who received subsequent hysterectomy after LLETZ in Department of Obstetrics and Gynecology at Seoul National University Hospital were retrospectively reviewed. Residual disease was defined as positive findings of CIN or further advanced findings in hysterectomy specimen. The age of patients, the severity of disease and the status of resection margin(RM) were analyzed for predictive values of residual disease. The Chi-square test, Fisher's exact test and Student t-test were used for statistical analysis. RESULTS: The residual disease after hysterectomy was negative in 85.7%(114/133) and positive in 14.3%(19/133). Among 19 cases with positive residual disease, 3 cases were revealed to be microinvasive cervical cancer. The mean age of patients with no residual disease was 42.5 years(range; 27-71) and that of patients with residual disease was 49.1 years(range; 33-72). Nine out of 94 cases(9.6%) with negative RM and 10 out of 39 cases(25.6%) with positive RM in LLETZ had residual disease. Two out of 14 cases(14.3%) with CIN II and 17 out of 119 cases(14.3%) with CIN III in LLETZ had residual disease. The success of LLETZ which means no residual disease was influenced by the age of patients(p=0.005) and the status of resection margin of LLETZ(p=0.032). CONCLUSION: The negative resection margin in LLETZ does not always guarantee that there is no residual disease. Close preoperative workup and more aggressive treatment plan(wide conization or hysterectomy) should be considered in patients who has higher possibility of positive residual disease such as old age and positive resection margin in LLETZ.