18F-NaF PET/CT for the evaluation of temporomandibular joint disorder.

AIM: To investigate the usefulness of a quantitative parameter (maximum standardised uptake value [SUVmax]) of 18F-sodium fluoride (NaF) positron-emission tomography (PET)/computed tomography (CT) for the evaluation of temporomandibular joint (TMJ) disorder (TMD). MATERIALS AND METHODS: Seventy-six TMD patients (male: female=14:62, age=40.3±17.1 years, bilateral: unilateral=40:36) with 152 TMJs were enrolled. The 18F-NaF PET/CT parameter (SUVmax) was compared with the presence of TMJ arthralgia (arthralgic=86, non-arthralgic=66) and clinical subtypes based on the Research Diagnostic Criteria for TMD Axis I (TMD osteoarthritis=49, non-TMD osteoarthritis=67, and asymptomatic TMJ=36). Splint therapy was applied to 48 patients for 6 months without considering 18F-NaF PET/CT findings. Post-splint therapy 18F-NaF PET/CT was performed in 32 patients and clinical responses to the therapy were classified into improvement (n=33), no change (n=10), or aggravation (n=7) for 50 TMJs excluding asymptomatic TMJs (n=14). RESULTS: SUVmax was significantly greater in arthralgic TMJs than in non-arthralgic TMJs (6.62±3.56 versus 4.32±1.53, p<0.0001). SUVmax was also significantly greater in TMD osteoarthritis (6.75±3.85) than in non-TMD osteoarthritis (5.21±2.70) and asymptomatic TMJs (4.86±1.99; p=0.0386). After splint therapy, SUVmax was significantly increased in aggravated TMJs (from 7.80±3.72 to 11.00±5.74, p=0.0156), whereas no significant change in SUVmax was observed in improved (from 6.16±2.68 to 6.09±2.60, p=0.4915) and unchanged (from 6.46±4.19 to 6.77±4.32, p=0.3223) TMJs. CONCLUSIONS: 18F-NaF PET/CT is a useful imaging tool for TMD evaluation because SUVmax showed a fair diagnostic performance for arthralgic TMJ and TMD osteoarthritis, and a correlation with the therapeutic response.

Dacryolith after a Le Fort I fracture: case report.

A dacryolith is a rare finding and can be considered as a complication of a Le Fort I fracture. A case of dacryolith and nasolacrimal duct obstruction after surgery for a Le Fort I fracture is described, and the reasons for and prevention of this condition are discussed.

Gait analysis of donor leg after free fibular flap transfer.

The purpose of this study was to demonstrate gait disturbance after fibular flap transfer using preoperative and postoperative gait analysis. The gait performance of 20 patients was assessed at the Laboratory for Biomechanics, Seoul National University Hospital. Kinematic and kinetic data were collected simultaneously while walking on a 25-m walkway. One month postoperatively, a significant (p<0.05) decrease in the time-distance parameter as well as a significant (p<0.05) decrease in the peak plantarflexion and dynamic range was seen. Only peak plantarflexion in swing was significantly (p<0.05) decreased until 3 months postoperatively. On the basis of the gait analysis results, it was concluded that normalization of the patients' gaits would be expected within 3 months after the operation. There were no permanent pathological changes in the donor site.

Long-term follow up on recurrence of 305 ameloblastoma cases.

The aim of this study was to determine the appropriate treatment for ameloblastoma by considering the factors associated with recurrence, and to make a quantitative prediction of the risk factors for recurrence. Data on age and gender distribution, location of the tumour, histopathological findings, treatment method, and whether or not patients had a preoperative biopsy confirmation report were collected in 305 cases (239 patients; M: 139, F: 100) of ameloblastoma diagnosed and treated in 1985-2002. After initial statistical evaluation (chi(2)-test and Fisher's exact test), logistic regression analysis was performed to check relative significance and predict recurrence. The disease-free survival function curves of the patients with or without recurrence were obtained by the Kaplan-Meier method and compared using univariate regression analysis. The correlation between recurrence and the treatment method or histopathological type was significant. The differences between the 'conservative' and 'resection with bone margin' and between the 'conservative' and 'segmental resection or maxillectomy' groups in terms of disease-free survival were highly significant. The difference between the 'resection with bone margin' and 'segmental resection or maxillectomy' groups was not significant. A resection with safety margin is the best method to treat most proven ameloblastomas, and conservative treatment is reasonable for patients in their first decade or with unicystic or plexiform ameloblastoma.

Correlation of proliferative markers (Ki-67 and PCNA) with survival and lymph node metastasis in oral squamous cell carcinoma: a clinical and histopathological analysis of 113 patients.

The purposes of this study were to examine the correlations between proliferation markers and survival rate in oral squamous cell carcinoma (OSCC) patients, and to evaluate the efficacy of proliferation markers in predicting lymph node metastasis. The patients' age, gender, T score, clinical stage, PCNA and Ki-67 index were analysed. Univariate analysis showed that T score had a significant influence on survival, and stage 4 group had a significantly lower survival rate. Lymph node metastasis was also a significant predictor of survival. Using a cut-off point of 25%, those patients with lower Ki-67 scores had survival advantage over those with higher Ki-67 scores. PCNA did not show any differences in survival with a cut-off point of 50%. Ki-67 and PCNA were significantly higher in the primary tumours associated with lymph node metastasis (pN+) than in those without lymph node metastasis (pN0). Multivariate analysis showed that clinical stage and Ki-67 were independent prognostic factors for survival in OSCC patients. From this result, it can be postulated that the cancer staging based on the TNM stage was a powerful prognostic variable and Ki-67 had a significant effect on the cumulative survival rate.

Effectiveness of bone scans in the diagnosis of osteoarthritis of the temporomandibular joint.

OBJECTIVE: The objective of this study was to evaluate the usefulness of bone scan procedures for the diagnosis of temporomandibular joint (TMJ) osteoarthritis. METHODS: From February 2009 to June 2009, 22 patients (4 males and 18 females) from Seoul National University Bundang Hospital, Republic of Korea, were diagnosed with TMJ disorder. They were examined by clinical examination, plain radiograph and bone scan and were categorized into three groups: normal, internal derangement and osteoarthritis. TMJ uptake ratios and asymmetrical indices were calculated. RESULTS: There were no significant differences in uptake ratios associated with pain and bone change. However, significant results were obtained when comparing uptake ratios between the osteoarthritis and non-osteoarthritis groups. CONCLUSION: It was concluded from this study that bone scans may help to diagnose osteoarthritis when increased uptake ratios are observed.

Physical mapping and microsynteny of Brassica rapa ssp. pekinensis genome corresponding to a 222 kbp gene-rich region of Arabidopsis chromosome 4 and partially duplicated on chromosome 5.

We constructed a bacterial artificial chromosome (BAC) library, designated as KBrH, from high molecular weight genomic DNA of Brassica rapa ssp. pekinensis (Chinese cabbage). This library, which was constructed using HindIII-cleaved genomic DNA, consists of 56,592 clones with average insert size of 115 kbp. Using a partially duplicated DNA sequence of Arabidopsis, represented by 19 and 9 predicted genes on chromosome 4 and 5, respectively, and BAC clones from the KBrH library, we studied conservation and microsynteny corresponding to the Arabidopsis regions in B. rapa ssp. pekinensis. The BAC contigs assembled according to the Arabidopsis homoeologues revealed triplication and rearrangements in the Chinese cabbage. In general, collinearity of genes in the paralogous segments was maintained, but gene contents were highly variable with interstitial losses. We also used representative BAC clones, from the assembled contigs, as probes and hybridized them on mitotic (metaphase) and/or meiotic (leptotene/pachytene/metaphase I) chromosomes of Chinese cabbage using bicolor fluorescence in situ hybridization. The hybridization pattern physically identified the paralogous segments of the Arabidopsis homoeologues on B. rapa ssp. pekinensis chromosomes. The homoeologous segments corresponding to chromosome 4 of Arabidopsis were located on chromosomes 2, 8 and 7, whereas those of chromosome 5 were present on chromosomes 6, 1 and 4 of B. rapa ssp. pekinensis.