Immunohistochemical study was performed for CEA staining patterns and PCNA indices. And the relationship between immunohistochemical findings and well-known clinical prognostic factors on the purpose of the clinical usefulness was evaluated. In forty seven cases of surgically removed colorectal carcinomas, the results were as follows; CEA staining patterns were apical (17 cases) and cytoplasmic (30 cases) type. Carcinomas with cyto plasmic pattern for CEA revealed more advanced Dukes' stage and more undifferentiated type and higher incidence of lymph node metastasis and were correlated with increased serum CEA levels. But PCNA indices showed no correlation with the Dukes' stage, histologic grade and CEA staining patterns. The cytoplasmic pattern of CEA immunohistochemistry may be a useful marker suggesting more aggressive biologic behavior of the colorectal carcinomas.
Colorectal Neoplasms* ; Cytoplasm ; Immunohistochemistry ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen*

Plummer-Vinson syndrome is a clinical entity characterized by dysphagia, iron deficiency anemia, cheilosis, glossitis, and cervical esophageal web, especially in middle aged women. Recently, the authors experienced a case of Plummer-Vinson syndrome. A 53-year-old female was admitted due to intermittent solid food dysphagia for 18 months. She had a 2 years history of iron deficiency anemia. On admission glossitis, fissures at the angle of the mouth, spoon nails, and iron deficiency anemia were noted. Esophagogram and esophagoscopic examination revealed thin walled concentric web at upper esophagus. Esophageal web was succefully teared by endoscopic balloon dilatation with subseguant improvement of dysphagia. Skin manifestations as well as anemia were markedly improved after oral iron replacement therapy.
Anemia ; Anemia, Iron-Deficiency ; Deglutition Disorders ; Dilatation ; Esophagus ; Female ; Glossitis ; Humans ; Iron ; Middle Aged ; Mouth ; Plummer-Vinson Syndrome* ; Skin Manifestations ; Tears

OBJECTIVES: Hemodynamic measurements of chronic portal hypertension were done to study the mechanisms that maintain high portal pressure despite well developed collateral circulations. METHODS: A prehepatic portal hypertensive rat model was produced by partial portal vein ligation. Cardiac output, organ blood flow and porto-systemic shunt were measured by radioisotope labeled microsphere methods, and vascular resistance was calculated by standard equation. RESULTS: There was a significant reduction in the weight of the liver and increase in the weight of the spleen in the portal stenotic rats. Porto-systemic shunting, representing development of the collateral circulations, was 96.7+/-0.6% in the portal stenosis group compared with 0.9+/-0.2% in the control group (p<0.01). Portal pressure was significantly increased in the portal stenosis group compared with the control group(12.8+/-1.4 vs. 6.5+/-0.6mmHg; p<0.01). Mean arterial pressure was significantly decreased in portal stenosis group compared with control group(101.4+/-2.5 vs, 129.9+/-3.9mmHg; p<0.01). In the portal stenosis group, cardiac output(135.7+/-8.0 vs. 111.0+/-4.2ml/min; p<0.01) and splanchnic organ blood flow (28.97+/-2.03 vs. 17.90+/-1.27ml/min, p<0.01) were significantly increased, with concomitant decrease in total peripheral vascular resistance(58.0+/-3.3 vs. 88.2+/-4.8 dyne sec/cm5 X 105; p<0.01) and splanchnic vascular resistance(2.54+/-0.20 vs. 5.47+/-0.33 dyne sec/cm5 X 105; p<0.01), However, the portal venous resistance was not significantly different in both groups of rats (3.57+/-0.31 vs. 3.03+/-0.38 dyne sec/cm5 X 105; p>0.05). CONCLUSION: The hemodynamic results of this study indicate that hyperdynamic status of systemic and splanchnic circulation was present in chronic portal hypertension and that the primary factor contributing to the persistently elevated portal venous pressure was the markedly increased portal venous inflow.
Animals ; Arterial Pressure ; Cardiac Output ; Collateral Circulation ; Constriction, Pathologic ; Hemodynamics* ; Hypertension, Portal ; Ligation ; Liver ; Microspheres ; Models, Animal* ; Portal Pressure ; Portal Vein* ; Rats* ; Splanchnic Circulation ; Spleen ; Vascular Resistance

The orbitozygomatic area occupies a key anatomic position in midface, is prone to injury, and plays a prominent role in facial aesthetics. So the facial appearance including orbital shape can be altered by complications of orbitozygomatic fractures. Most possible initial complications include blindness, hyphema, retinal detatchment, and paralysis or entrapment of extraocular muscles. Long term sequelaes include infraorbital nerve dysfunction, loss of malar projection, enophthalmos, and dystopia. Accurate anatomic reduction and rigid fixation is essential for management of orbitozygomatic fractures to minimize those late sequelaes. Conventional fixation devices to fix displaced fracture of facial bone are interosseous wire and miniplate. But interosseous wirings are unstable for primary bone healing and time consuming. Miniplates have great deal in rigid fixation but their high profile and palpability are the main complaints in many patients, especially in orbital rim area. In this article, we reviewed the 30 cases of zygomamaxilla complex fractures with orbital rim fracture fixed with microplates, and discussed the stability of microplate and superiorities in final aesthetics result. The use of microplates in these area permits enough stability of fracture segment with ease of procedures and superiorities in final results without any palpability.
Blindness ; Enophthalmos ; Esthetics ; Facial Bones ; Humans ; Hyphema ; Muscles ; Orbit* ; Paralysis ; Retinaldehyde

The recent development of microsurgical tissue transfer has enabled any defect in any area to be reconstructed with free flaps. However, the need for a more functional and thinner flap has been raised due to bullkiness of the flap and donorsite morbidity. For better functional and aesthetic results, various perforator flaps excluding muscles or adjacent subcutaneous tissue have been recently reported. We report 44 cases of perforating artery pedicled flaps from April 1995 to August 1998, including 21 cases of anterolateral thigh flap, 12 cases of gluteal artery perforator flap, 4 cases of posterior interosseous flap, and 7 cases of paraumbilical perforator flap for various soft tissue defects. Even though marginal necrosis of flap occurred in 9 cases, complete healing without significant problem was possible. The advantages of perforator flaps are as follows: 1. It is possible to obtain a relatively thin fasciocutaneous flap, but still with sufficient volume 2. Donor site morbidity was reduced without damage of main artery. 3. In spite of diverse vascular pattern of the perforator, the location of perforating arteries can be Detected with relative ease and mapped preoperatively with an ultrasound Doppler. The need of meticulous and tedious dissection could be a sole disadvantage of these flaps. This report describes the clinical experience with a perforator-based flap, anticpating applications of many other types of perforator flap in the future.
Arteries* ; Free Tissue Flaps ; Humans ; Muscles ; Necrosis ; Perforator Flap ; Subcutaneous Tissue ; Surgical Flaps* ; Thigh ; Tissue Donors ; Ultrasonography

Zygomatic arch fracture is one of the most commonly seen facial bone fractures and there have been many methods of reduction designed so far. However, for a simple fracture, the Gillies temporal approach is most commonly used because of the easy reducibility, and also because the depressed fracture can be approached without a facial incision. The Gillies temporal approach starts in the temporal area, between the temporalis muscle and deep temporal fascia. We have developed a new route which starts in the postauricular hair margin area and then reaches to the periosteum of the temporal bone. An elevator is then inserted to penetrate the periosteum and subperiosteal dissection is performed toward the zygomatic process of the temporal bone. At the origin of the zygomatic process, the route of dissection changes to the posterior aspect of the zygomatic arch using a curved palate elevator or the authors' modified Langenbeck elevator. This method of approach has been used in 6 cases of zygomatic arch fracture with good results and we report this method along with written reports.
Elevators and Escalators ; Facial Bones ; Fascia ; Hair ; Palate ; Periosteum ; Temporal Bone ; Zygoma*

Eating ; Female ; Hospitals, General ; Humans ; Male ; Mandible ; Mandibular Fractures ; Respiration ; Tooth ; Violence

Purpose: This study aimed to comprehensively evaluate the factors influencing the oral health-related quality of life (OHRQoL) of community-dwelling older adults living alone, using data from the ninth Korean Longitudinal Study of Aging (KLoSA). Methods: A secondary analysis of the ninth KLoSA dataset from 2022 was conducted. The study sample comprised 1,038 community-dwelling older adults living alone. The dependent variable of this study was OHRQoL, while the independent variables included socio-demographic, oral health-related, general health-related, and health behavior-related characteristics. Factors influencing OHRQoL were assessed using a complex samples general linear model with the Bonferroni correction in IBM SPSS/Win 26.0. Results: The average OHRQoL score was 37.47±0.35 out of 60. The factors influencing the OHRQoL of community-dwelling older adults living alone included age (≥85 years) (t=-3.03, p=.003), wearing dentures (t=-2.11, p=.035), difficulty in daily activities due to vision impairment (t=-2.26, p=.024), difficulty in daily activities due to hearing impairment (t=-2.21, p=.028), and depression (t=-8.38, p<.001). Conclusion Based on our findings, to improve the OHRQoL of community-dwelling older adults living alone, it is necessary to consider psychological factors, such as depression, when developing ongoing oral health-management programs aimed at improving OHRQoL. Additional considerations include effective management of dentures and addressing difficulties in daily activities due to vision and hearing impairments.

Purpose: This study aimed to comprehensively evaluate the factors influencing the oral health-related quality of life (OHRQoL) of community-dwelling older adults living alone, using data from the ninth Korean Longitudinal Study of Aging (KLoSA). Methods: A secondary analysis of the ninth KLoSA dataset from 2022 was conducted. The study sample comprised 1,038 community-dwelling older adults living alone. The dependent variable of this study was OHRQoL, while the independent variables included socio-demographic, oral health-related, general health-related, and health behavior-related characteristics. Factors influencing OHRQoL were assessed using a complex samples general linear model with the Bonferroni correction in IBM SPSS/Win 26.0. Results: The average OHRQoL score was 37.47±0.35 out of 60. The factors influencing the OHRQoL of community-dwelling older adults living alone included age (≥85 years) (t=-3.03, p=.003), wearing dentures (t=-2.11, p=.035), difficulty in daily activities due to vision impairment (t=-2.26, p=.024), difficulty in daily activities due to hearing impairment (t=-2.21, p=.028), and depression (t=-8.38, p<.001). Conclusion Based on our findings, to improve the OHRQoL of community-dwelling older adults living alone, it is necessary to consider psychological factors, such as depression, when developing ongoing oral health-management programs aimed at improving OHRQoL. Additional considerations include effective management of dentures and addressing difficulties in daily activities due to vision and hearing impairments.

Purpose: This study aimed to comprehensively evaluate the factors influencing the oral health-related quality of life (OHRQoL) of community-dwelling older adults living alone, using data from the ninth Korean Longitudinal Study of Aging (KLoSA). Methods: A secondary analysis of the ninth KLoSA dataset from 2022 was conducted. The study sample comprised 1,038 community-dwelling older adults living alone. The dependent variable of this study was OHRQoL, while the independent variables included socio-demographic, oral health-related, general health-related, and health behavior-related characteristics. Factors influencing OHRQoL were assessed using a complex samples general linear model with the Bonferroni correction in IBM SPSS/Win 26.0. Results: The average OHRQoL score was 37.47±0.35 out of 60. The factors influencing the OHRQoL of community-dwelling older adults living alone included age (≥85 years) (t=-3.03, p=.003), wearing dentures (t=-2.11, p=.035), difficulty in daily activities due to vision impairment (t=-2.26, p=.024), difficulty in daily activities due to hearing impairment (t=-2.21, p=.028), and depression (t=-8.38, p<.001). Conclusion Based on our findings, to improve the OHRQoL of community-dwelling older adults living alone, it is necessary to consider psychological factors, such as depression, when developing ongoing oral health-management programs aimed at improving OHRQoL. Additional considerations include effective management of dentures and addressing difficulties in daily activities due to vision and hearing impairments.