Recent development of oral and maxillofacial surgery has taken an interest in the regeneration of facial bone defects. For the reconstruction of bony defects, autogenousbone grafts have been widely used. However, there are some clinical problems ; the morbidity of donor sites, resorption of autogenous bone graft and the availability of the proper form and size. The purpose of this study is to find the proper filling materials for the bone defects. The present study was designed to evaluate the roles and regenerating capacity of maikture of freeze-dried domineralized allogenic bone and hydroxylapatite. Fifteen adult New Zealand white rabbits were used as the experimental animal, Four trephine defects were made by drilling on the parietal bone of each rabbit. The size of each defects was 8x8mm. In first group, the defect was filled with freeze-dried demineralized allogenic bone and hydroxylapatite. The defect in second group was filled with autogenous bone chip only. The third group was filled with autogenous bone chip and hydroxylapatite. The fourth group was filled with freeze-dried dimineralized allogenic bone only. The results were carefully examined grossly and micorsocopically from the 2 weeks to 12 weeks postoperatively. The following results were obtained ; 1. In the case of the graft with autogenous bone chip only, new bone formation was more active than any other groups. 2. In the case of the graft with combination of freeze-dried demineralized allogenic bone and hydroxylapatite, new bone formation was similar to the case of autogenous bone and hydroxylapatite mixture. 3. In the case of the graft with freeze-dried demineralized bone, new bone formation was observed, but less than the other groups. And the time of new bone appeared was later than the other groups. A combination of freeze-dried deminearalized allogenic bone and hydroxylapatite plays an effective role in forming new bone. The results of this study may suggest the possible usage of the mixture of freeze-dried allogenic bone and hydroxylapatite as an alternative to autogenous bone in maxillofacial orthopedic surgery.
Adult ; Animals ; Bone Regeneration* ; Durapatite* ; Facial Bones ; Humans ; Orthopedics ; Osteogenesis ; Parietal Bone ; Rabbits ; Regeneration ; Surgery, Oral ; Tissue Donors ; Transplants*

Screening mammography has been proved to be an effective tool to detect early breast cancers and to decrease mortality. However, the rate of false-negative mammograms has been reported to be still high as 10~30%. Missed breast cancers are cancers that are visible at previous mammograms only retrospectively and can be classified as three types; interval cancers, subsequent screen-detected cancers, and alternative imaging-detected cancers. In a small group, screen-detected abnormalities recalled for further evaluation may be dismissed due to false negative diagnostic assessment, leading to delays in breast cancer diagnosis. Possible causes for missing include perception errors, interpretation errors, and technical errors. Furthermore, every diagnostic examination has inherent limitations. Perception errors are often attributed to combined multiple factors; peripheral lesions, single view abnormalities, subtle findings, distracting lesions, and dense parenchyma obscuring a lesion. To decrease the false negative rate, radiologists should be alert to take additional mammograms and ultrasonography, and should try to improve the image quality and interpretation techniques comparing with the previous imaging, considering the use of computer-aided detection or double reading.
Breast ; Breast Neoplasms ; Early Detection of Cancer ; Mammography ; Mass Screening ; Retrospective Studies

PURPOSE: Breast augmentation with cohesive silicone gel implant has been popular but there remains the risk of implant rupture. We investigated the diagnosis and treatment of cohesive gel implant rupture. METHODS: Ten cases of cohesive gel implant rupture between August 2006 and August 2010 in ooo were reviewed in this study. The diagnostic role of Magnetic resonance imaging (MRI) and ultrasonography (US), and operative findings of cases were studied retrospectively. RESULTS: The mean interval from previous surgery was 14.7 months ranging from 3 to 44 months. Nine cases were visited due to abrupt changes in texture of implants and 1 case for revision of capsular contracture. Seven of 10 cases had capsular contracture, simultaneously. We diagnosed the first case by US and MRI but only US was used in the other 9 cases. US showed discontinuity of the implant membrane and multiple parallel echogenic lines within the implant interior (stepladder sign), and MRI showed the presence of multiple curvilinear low-signal-intensity lines seen within the high-signal-intensity silicone gel (linguine sign). All the ruptured gel remained in place within the capsule and did not migrate into the surrounding area. Surgeries were implant replacement in 3, replacement with capsulectomy in 6 with capsular contracture, and subpectoral conversion with capsulectomy and mastopexy in 1 case. CONCLUSION: US without MRI has asatisfactoryrole in the screening method for detection of cohesive silicone gel implant rupture in symptomatic cases. Ruptured implants were removed and replaced easily due to their highly cohesive nature.
Breast ; Breast Implants ; Contracture ; Hypogonadism ; Magnetic Resonance Imaging ; Mass Screening ; Membranes ; Mitochondrial Diseases ; Ophthalmoplegia ; Rupture ; Silicone Gels

In Asia, mammography following the injection of foreign materials into the breasts for cosmetic augmentation is frequently seen and diagnosis based on the typical radiologic findings is straightforward. We report the unusual radiologic findings in two patients with foreign body granulomas caused by injected foreign materials and discovered incidentally during screening work up. The mammographic findings were bilateral, hyperdense, spiculated masses, with occasional microcalcification, and at sonography, markedly hypoechoic, spiculated solid masses, located near the pectoralis muscle and partly extending into it, were observed. These radiologic findings mimicked malignancy.
Breast Neoplasms/radiography ; Case Report ; Cholesterol ; Diagnosis, Differential ; Esthetics ; Female ; Granuloma, Foreign-Body/etiology/*radiography/*ultrasonography ; Human ; Injections/adverse effects ; Mammography ; Middle Age ; Paraffin

This study was performed to investigate the effect of progesterone (P) on the estrogen-induced proliferation of mammotropes in cultures of normal rat pituitary cells. Dispersed pituitary cells from male rats were cultured in Dulbecco's Modified Eagle's medium containing striped 10% fetal bovine serum for 6 days. Part of cells were treated with 10(-9) M 17beta-estradiol with or without P (10(-6) M). For the simultaneous detection of mitotic cells and mam-motropes, bromodeoxyuridine (BrdU) labeling and double immunocytochemical staining for BrdU and prolactin were performed. The ratio of BrdU-labeled cells among mammotropes (BLI) was increased by 6.3-fold after 6 day treatment with estradiol, which was partly suppressed by 2.3-fold by additional P treatment. The percentage of mammotropes among pituitary cells was increased by 1.5-fold by estradiol treatment, which was suppressed by 1.1-fold after coadminis-tration of progesterone. Thus, coadmistration of progesterone could suppress the estradiol-induced effect on the BLI and the proportion of mammotropes by 75% and 80%, respectively. In addition, apoptotic ratio of mammotropes was not changed by hormone treatment. The present data demonstrated that progesterone inhibits estradiol-induced proliferation of mammotropes, which may contribute to the decrease in the proportion of mammotrope. The indirect modulatory effect of progesterone on the estradiol-induced increase in the prolactin secretion in the rat pituitary was suggested.
Animals ; Bromodeoxyuridine ; Estradiol ; Estrogens* ; Humans ; Male ; Progesterone* ; Prolactin ; Rats*

PURPOSE: To report the findings of a six-year medial oudit performed at our mammographic screening centre, comparing those findings with the follow-up data stored at our hospital and at the Korea Central Cancer Registry. MATERIALS AND METHODS: We analyzed the findings of 32,289 mammographic examinations of 25,541 women performed at our screening center between 1994 and 1999. For follow-up and outcome monitoring, the guideline of the American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS) was used. All mammograms were categorized by means of BI-RADS, and cases in categories 0, 4, and 5 were followed up through a review of our hospital information system. To determine whether any cases were false negative, we compared breast cancer patients registered in our medical record department and in the Korean Central Cancer Registry during the study period, with women whose mammograms were interpreted as normal or benign at our screening center within a year prior to cancer diagnosis. RESULTS: The mean age of women enrolled in this study was 48.6 years, ten years less than reported in the West. The recall rate was 6.2%. Among 256 women whose final assessment category was 4 or 5, breast cancer was diagnosed in 51. The cancer detection rate was 2.0/1,000 women; positive predictive value 1 (PPV1: PPV, based on abnormal findings at screening examination) was 2.5% of cases and PPV2 (PPV when biopsy or surgical consultation was recommended) was 20%. The most common mammographic finding was microcalcifications only (45%). The rate of minimal breast cancer, including invasive cancer less than 1 cm in diameter and ductal carcinoma in situ, was 72.5%. Node positivity was 27%. Sensitivity was 85.0% based on the tumor registry of our institution's medical record department, and 78.5% based on the tumor registry of the Korea Central Cancer Registry. Specificity was 99.0%. CONCLUSION: In our study, the cancer detection rate at screening mammography was 2.0/1,000 women. The rate of minimal breast cancer (72.5%) was very high but measurable sensitivity was 78.5%, somewhat lower than the ACR guideline of 85%. To improve the performance of screening mammography, appropriate interpretation of mammography and constant, follow-up and outcome monitoring are important.
Biopsy ; Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Hospital Information Systems ; Humans ; Information Systems ; Korea ; Mammography ; Mass Screening* ; Medical Audit* ; Medical Records ; Sensitivity and Specificity

We have experienced a rare case of bilateral retinoblastoma in identical twins recently. Their mother noticed that elder sister gazed upward when she fixated some object 5 days ago. On visiting here, we could find out retinoblastoma in both eyes by ophthalmoscopic examination, and younger sister had same fundus. Therefore we enucleated both eye balls of elder sister because of aggrevation of retinoblastoma. Retinoblastoma was confirmed pa thologically. We have been following up periodically younger sister.
Humans ; Mothers ; Retinoblastoma* ; Siblings ; Twins, Monozygotic*

BACKGROUND: The regular meal pattern with consistent day-to-day calorie and carbohydrate intake is one of the most important determinants of good glycemic control in diabetes. This study was aimed to investigate the meal pattern and their relationships with total energy intake, nutrients intake and glycemic and lipid profile in type 2 diabetes. METHODS: 1,084 subjects were divided according to glycemic status into three groups: the diabetes (DM), dysglycemia (DG) and normal (N). The meal frequency (MF), meal interval (MI) and daily intake of total energy, macronutrient and micronutrient were estimated with the 24 hours dietary recall from the Korean National Health and Nutrition Examination Survey (KNHANES) in 2001 and Eulji hospital. For analysis of meal pattern and it's relations with the nutrients intake, we regrouped into meal skipper (G1), non-meal skipper with unreasonable MI (G2), and non-meal skipper with reasonable MI (G3). RESULTS: 17.5% of DM, 21.8% of DG, 23.3% of N skipped at least one meal a day without significant difference across the groups. 55.9% of non-meal skipper had unreasonable MI. Meal was more regular in older age, lower educated person, employee, and female. G1 took higher fat, and more calories form snack and less micronutrient density, compared with G3 (P < 0.05). HbA1c, total cholesterol and triglyceride values were higher in G1 compared with other two groups (P < 0.05). CONCLUSION: Many type 2 diabetics had the irregular meal patterns, which was associated with poor glycemic control, lipid profiles and less micronutrient density. This suggested that another treatment strategy might be required for those who had irregular lifestyle.
Cholesterol ; Energy Intake ; Female ; Humans ; Life Style ; Meals ; Micronutrients ; Nutrition Surveys ; Snacks

PURPOSE: This paper describes a new anatomic reconstructive surgical procedure that simultaneously reconstructs the fibular collateral ligament, popliteal tendon and popliteofibular ligament using a split Achilles allograft and compares the clinical results of this new technique with the posterolateral corner sling procedure used for posterolateral instability of the knee. MATERIALS AND METHODS: Forty-six patients were treated for a posterolateral instability of the knee between 1998 and 2003. The posterolateral corner sling procedure (Group A) was performed in 25 patients and anatomic reconstructive surgery (Group B) in 21 patients. The minimum follow-up was 12 months. An arthroscopic evaluation was performed in all cases. The clinical review included the Lysholm knee scores as well as a lateral instability and tibial external rotation assessment. RESULTS: The mean Lysholm knee scores in groups A and B were 54.8 points and 54.4 points prior to surgery, and 86.9 and 93.6 points at the time of the latest follow-up, respectively (p<0.05). Tibial external rotation of 5 degrees more than the contralateral uninjured knee was noted in 12% of group A and in 5% of group B (p<0.05). Lateral instability of 5 mm greater than the contralateral knee was observed in 28% of group A and in 14% of group B (p<0.05). CONCLUSION: Anatomic reconstruction of the posterolateral corner resulted in less lateral instability and tibial external rotation than did the posterolateral corner sling procedure.
Allografts* ; Collateral Ligaments ; Follow-Up Studies ; Humans ; Knee* ; Ligaments ; Reconstructive Surgical Procedures ; Tendons

Malposition of catheter in the subdural space is a possible complication during attempted epidural anesthesia. We report here an inadvertent subdural block confirmed by the radiographic contrast materiaL Epidural anesthesia was planned for a full-term gravida and epidural catheter was inserted about 3 cm cranially at the level of L1-2. After injection of 19.5 ml local anesthetic, blood pressure was 70/50 mmHg. Fluid was rapidly infused and intravenous ephedrine 10 mg was given. After then, vital signs were well maintained and twin babies were delivered without events. Twentyfive minutes later, she complained chest tightness and became tachypneic. Ketamine 50 mg was given and endotracheal intubation was performed with ease. She obeyed command, but could not open her eyes for some duration. Self respiration returned after 110 minutes and minute ventilation was 6 liter/minute at that time. 160 minutes later, extubation was done and radiological examination was performed using contrast materiaL The cathter tip was positioned in anterior subdural space at T12 level.
Anesthesia, Epidural* ; Blood Pressure ; Catheters ; Ephedrine ; Humans ; Intubation, Intratracheal ; Ketamine ; Respiration ; Subdural Space ; Thorax ; Twins ; Ventilation ; Vital Signs