Cone-beam computed tomography analysis of transverse dental compensation in patients with skeletal Class III malocclusion and facial asymmetry / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to analyze the transverse dental compensation in reference to the maxillary and mandibular basal bones using cone-beam computed tomography (CBCT) and evaluate the correlations between transverse dental compensation and skeletal asymmetry variables in patients with skeletal Class III malocclusion and facial asymmetry. METHODS: Thirty patients with skeletal Class I (control group; 15 men, 15 women) and 30 patients with skeletal Class III with menton deviation (asymmetry group; 16 men, 14 women) were included. Skeletal and dental measurements were acquired from reconstructed CBCT images using OnDemand3D 1.0 software. All measurements were compared between groups and between the deviated and nondeviated sides of the asymmetry group. Correlation coefficients for the association between skeletal and dental measurements were calculated. RESULTS: Differences in the ramus inclination (p < 0.001), maxillary canine and first molar inclinations (p < 0.001), and distances from the canine and first molar cusp tips to the midmaxillary or midmandibular planes (p < 0.01) between the right and left sides were significantly greater in the asymmetry group than in the control group. In the asymmetry group, the ramus inclination difference (p < 0.05) and mandibular canting (p < 0.05) were correlated with the amount of menton deviation. In addition, dental measurements were positively correlated with the amount of menton deviation (p < 0.05). CONCLUSIONS: Transverse dental compensation was correlated with the maxillary and mandibular asymmetry patterns. These results would be helpful in understanding the pattern of transverse dental compensation and planning surgical procedure for patients with skeletal Class III malocclusion and facial asymmetry.

Evaluation of the relationship between upper incisor exposure and cephalometric variables in Korean young adults / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to classify Korean young adults into 3 groups on the basis of upper incisor exposure rates (UIERs) and to compare the skeletal, dental, and soft tissue variables. METHODS: Samples were obtained from 127 students at the College of Dentistry, Wonkwang University in South Korea. Facial photographs of frontal posed smiles and lateral cephalograms of the subjects were taken. The subjects were divided into 3 groups on the basis of UIERs and 20 measurements were compared among the 3 groups. The correlations between the variables were determined. RESULTS: Male and female subjects showed significant differences in the group distribution. Male subjects showed higher frequencies of low smiles, and female subjects showed higher frequencies of high smiles. The vertical height of the anterior alveolar process of the maxilla directly correlated with the UIER. However, the UIER showed no significant correlation with the vertical height of the anterior basal bone or the inclination of the upper incisor axis. In female subjects, the upper central incisor clinical crown length showed an inverse correlation with the UIER. However, this variable showed no significant correlation with the UIER in male subjects. CONCLUSIONS: The UIER was directly correlated with the levator muscle activity of the upper lip and inversely correlated with the upper lip thickness, yet there was no correlation between the UIER and upper lip length at rest.

16 Cases of Anti-obesity Drug Intoxication Experienced in 4 Emergency Departments

PURPOSE: In Korea, few studies have examined the acute toxicity of anti-obesity drugs. The purpose of this study is to analyze the general characteristics and clinical aspect of acute anti-obesity drug intoxication. METHODS: We retrospectively investigated patients admitted to the emergency department after anti-obesity drug intoxication between March, 2004 and February, 2012. The medical records of these patients were reviewed for demographic data, toxicologic history, time elapsed to presentation, clinical symptoms and signs, treatment, and outcome. RESULTS: There were a total of 18 anti-obesity intoxication cases during the study period; of 16 which were included in our study. The purchasing route of the anti-obesity drug was mainly through a doctor's prescription (68.8%), however, some were obtained through the internet and the pharmacies. The mean time to The most commonly ingested anti-obesity drug was sibutramine (31.3%) and many of the cases (62.5%) were multi-drug ingestions. The most common clinical manifestations were gastrointestinal symptoms (94%), but, CNS symptoms (75%) and cardiovascular symptoms (75%) were almost equally present. 13 patients (81%) were discharged after clearance of toxic symptoms and signs with a mean observational period of 7.0 hours. 3 patients were admitted for observation and treatment; of which 1 patient died due to fatal complications. CONCLUSION: Most anti-obesity intoxications show mild toxicity and a nonfatal clinical course. However, the recent trend toward prescribing psychostimulant anti-obesity medication, which can be fatal after an acute overdose, calls physicians' attention to treating of anti-obesity intoxications.

Comparative Study between the Conventional Method and Small Skin Incision Method for Simple Decompression of Cubital Tunnel Syndrome / 대한신경손상학회지

OBJECTIVE: The purpose of this study is to review the results of two surgical methods of simple decompression for treatment of cubital tunnel syndrome. METHODS: Surgical procedure of simple decompression of the ulnar nerve using the conventional method requires a relatively long incision of 6-8 cm. Later with accumulating experience, we performed simple decompression using a skin incision of 2 cm or less. Between November 2005 and July 2010, simple decompression using the conventional method was performed in 10 elbows (Group 1), and simple decompression using the small skin incision method was performed in 10 elbows (Group 2). The surgical outcome was evaluated and the two groups were compared using a modified Bishop scoring system. We also compared the operation time and hospital stay between the two groups. RESULTS: There were no significant differences in the outcomes between the two groups using the modified Bishop scoring system (p>0.05). Also, there were no significant differences in the postoperative electrodiagnostic study results between the two groups (p>0.05). However, the operation time and hospital stay were significantly shorter in Group 2 (p<0.01). CONCLUSION: Both the methods can be recommended for the treatment of cubital tunnel syndrome due to their advantages including simplicity and safety of the method. However, the small skin incision method is superior to the conventional method due to the shorter operation time and hospital stay.

Single Incision Percutaneous Pedicle Screw Fixation for Transforaminal Lumbar Interbody Fusion

OBJECTIVE: Percutaneous pedicle screw fixation (PPSF) offers some of the advantages of minimally invasive surgery. However, an additional skin incision is necessary in order to gain these advantages. The author recently performed a modified PPSF through a single skin incision and it yielded good results. Here, we report the single incision percutaneous pedicle screw fixation (SIPPSF). METHODS: The medical records of 51 patients who underwent single segment transforaminal lumbar interbody fusion (TLIF) with pedicle screw fixation (PSF) between December 2009 and December 2011 were reviewed. The patients were divided into 3 groups according to the PSF technique used; conventional group (Group C), SIPPSF (Group S) and PPSF through multiple skin incisions (Group M). Operation time, estimated blood loss (EBL) and pain intensity before and after the operation using a numeric rating scale (NRS) were evaluated. RESULTS: The number of patients in Group S, Group C and Group M was 25, 17 and 9, respectively. The NRS demonstrated a reduction in pain intensity in all the patients, and there were no differences in NRS scoring between the three groups. Group S showed a reduction in the EBL compared to Group C (p=0.001) and a reduction in the operation time compared to Group M(p=0.003). CONCLUSION: The author supposes that the type of skin incision does not correlate significantly with the clinical results of TLIF with PPSF. However, it can be considered that SIPPSF offers the advantage of avoiding an additional paramedian skin incision.

Single Incision Percutaneous Pedicle Screw Fixation for Transforaminal Lumbar Interbody Fusion

OBJECTIVE: Percutaneous pedicle screw fixation (PPSF) offers some of the advantages of minimally invasive surgery. However, an additional skin incision is necessary in order to gain these advantages. The author recently performed a modified PPSF through a single skin incision and it yielded good results. Here, we report the single incision percutaneous pedicle screw fixation (SIPPSF). METHODS: The medical records of 51 patients who underwent single segment transforaminal lumbar interbody fusion (TLIF) with pedicle screw fixation (PSF) between December 2009 and December 2011 were reviewed. The patients were divided into 3 groups according to the PSF technique used; conventional group (Group C), SIPPSF (Group S) and PPSF through multiple skin incisions (Group M). Operation time, estimated blood loss (EBL) and pain intensity before and after the operation using a numeric rating scale (NRS) were evaluated. RESULTS: The number of patients in Group S, Group C and Group M was 25, 17 and 9, respectively. The NRS demonstrated a reduction in pain intensity in all the patients, and there were no differences in NRS scoring between the three groups. Group S showed a reduction in the EBL compared to Group C (p=0.001) and a reduction in the operation time compared to Group M(p=0.003). CONCLUSION: The author supposes that the type of skin incision does not correlate significantly with the clinical results of TLIF with PPSF. However, it can be considered that SIPPSF offers the advantage of avoiding an additional paramedian skin incision.

Rapid Spontaneous Reduction of a Huge Intracerebral Hematoma

Rapid reduction of a large acute subdural hematoma has been frequently reported. In my knowledge, however, it was rarely reported that rapid spontaneous reduction occurred in large volume of spontaneous intracerebral hematoma (sICH). We describe a patient with a rapid spontaneous decrease in the volume of a large hematoma. A 73-year-old man presented semi-comatose mentality. Initial brain computed tomography (CT) revealed the huge sICH. An emergency operation was planned, but was not performed due to the refusal of patient's family. Therefore, we decided to treat with conservative therapy. However, follow-up brain CT 16 hours after initial scan showed a remarkable reduction of previous sICH. The mechanism involving the spontaneous rapid decrease of the hematoma is presumed to occur through redistribution in brain atrophy, compression effect from the increased intracranial pressure and dilution through a wash out by the cerebrospinal fluid.