No abstract available.

The purpose of present study was to observe the radiographic finding and histologic response by Confocal Laser Scanning Microscopy(CLSM) on interface of the bone and titanium implant coated by chitosan. The tissue of rabbit tibiae to the surgical placement titanium implant coated by chitosan was examined at 3, 9 and 24 days postoperatively. The radiographic finding showed that surrounding bone density of implants was not significantly different compare with the bone on 3 and 9 days group. A large amount new bone was formed on 24 days group, the reason was osteconduction activity by chitosan. The CLSM analysis show that the surface coating by chitosan filled the gap between bone and implant on 3 days group and filled by mew born on 9 days group. On 24 days group, the bone and titanium surface was filled by lamella bone. This results indicated that this enhanced the initial stability of implant significantly and chitosan induced osseointegration around implant. CLSM allows the non-destrutive histo-tomography of bone biopsy as well as clinical practice. We conclude that CLSM allowed a good comprehension of the nature of bone-implant contact, avoiding artifacts due to the thickness of the specimen.
Artifacts ; Biopsy ; Bone Density ; Chitosan* ; Comprehension ; Microscopy, Confocal* ; Osseointegration ; Tibia ; Titanium*

BACKGROUND: An aggressive skin cancer on the nose, tends to have poorly defined clinical margins, and has a higher recurrence rate. A small tumor on the nose is usually easily treated by any of the standard methods. However, removal and reconstruction with preserved cosmesis is more laborous in a basal cell carcinoma larger than 10 mm in diameter. This is because the nose has complex contoures, unique skin color and texture, and the limited availability of mobile adjacent skin. When available Mohs micrographic surgery is the preferred treatment for these large tumors. OBJECTIVE: Our purpose was to investigate the preferred reconstruction method(especially, local flap reconstruction) by the cosmetic unit of the nose after Mohs micrographic surgery. METHODS: From March 1991 to February 1997, twenty-one patients were diagnosed with basal cell carcinoma on the nose at our department. All the tumors were removed with Mohs micrographic surgery, and then the defects were reconstructed with a primary closure, skin graft, and local flap.
Carcinoma, Basal Cell* ; Humans ; Mohs Surgery* ; Nose* ; Recurrence ; Skin ; Skin Neoplasms ; Transplants

In this study, we designed the expert system for the diagnosis of stroke. The causes of stroke in central nervous systems are very diverse, so a doctor who treats the patients with stroke must have the expert knowledge for the quick and correct diagnosis and for the adequate medical management. But the primary physician who engaged in the primary care of the patient with stroke does not have the expert knowledge for the stroke. So, we need to develop the expert system for assisting the diagnosis of stroke. Also the diagnosis system can be used as simulator for the medical students who study the neurology. In this study, we developed the diagnosis expert system that offer a pathological name provided by artificial neural networks. And we designed the inference engine and GUIs(graphical user interfaces). The artificial neural network is a system that provide a possible diagnosis of stroke. We implemented the system using Visual Basic 6.0 of Microsoft Co.
Central Nervous System ; Diagnosis* ; Expert Systems* ; Humans ; Neurology ; Primary Health Care ; Stroke* ; Students, Medical

Spontaneous intracranial epidural hematoma (EDH) due to dural metastasis of hepatocellular carcinoma is very rare. A 53-year-old male patient with hepatocellular carcinoma, who was admitted to the department of oncology, was referred to department of neurosurgery because of sudden mental deterioration to semicoma with papillary anisocoria and decerebrate rigidity after transarterial chemoembolization for hepatoma. Brain computed tomography (CT) revealed large amount of acute EDH with severe midline shifting. An emergent craniotomy and evacuation of EDH was performed. Active bleeding from middle cranial fossa floor was identified. There showed osteolytic change on the middle fossa floor with friable mass-like lesion spreading on the overlying dura suggesting metastasis. Pathological examination revealed anaplastic cells with sinusoidal arrangement which probably led to spontaneous hemorrhage and formation of EDH. As a rare cause of spontaneous EDH, dural metastasis from malignancy should be considered.
Anisocoria ; Brain ; Carcinoma, Hepatocellular ; Cranial Fossa, Middle ; Craniotomy ; Decerebrate State ; Floors and Floorcoverings ; Hematoma, Epidural, Cranial ; Hemorrhage ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neurosurgery

No abstract available.
Biopsy, Needle* ; Needles*

BACKGROUND: The rate of rise of left ventricular(LV) systolic pressure, dp/kt, and the peak ejection rate(PER) of LV may be more accurate indices for assessing LV systolic function than ejection fraction(EF). Both can be easily obtained by noninvasive methods, M-mode echo/phonocardiography and automated border detection(ABD) echocardiography, respectively. Mean dp/dt by M-mode echo/phonocardiography and PER by ABD echocardiography were compared with mean dp/dt by Doppler echocardiography. METHODS: Twenty-one adult patients who had normal sinus rhythm, mitral regurgitant signals by continuous wave Doppler echocardiography and an apical 4 chamber view of LV in which at least 75% of the endocardium was clearly visualized were selected for our study. The off-line estimation of LV end-diastolic volume (1) were performed by the method of disc, after manually tracing the endocardial border on the apical 4 chamber view and EF was calculated. M-mode echocardiography of the aortive valve and phonocardiography were simultaneously recorded on the strip chart to measure the isovolumic contraction time(dtM). A blood pressure (2) and LV end-diasolic pressure(LVEDP) was assigned 20mmHg in patients with Q wave myocardial infarction or EF< or =40% and 10mmHg in others. The mean dp/dtM during isovolumic contraction time was calculated as (aortic diastolic pressure-LVEDP)/dtM and was compared with the Doppler-derived mean rate of LV pressure rise(dp/dtDoppler) over the time period between velocities of 1 and 3m/sec on the ascending slope of the Doppler velocity spectrum. ABD system was used to measure the changes in LV volume and PER on the apical four chamber view. PER was compared with mean dp/dtDoppler. RESULTS: Mean dp/dtM positively correlated with mean dp/dtDoppler(r=0.73, p<0.001), but the limits of agreement between two methods were somewhat wide(-659-937mmHg/sec). PER also positively correlated with dp/dtDoppler and EF(r=0.73, p<0.001 ; r=0.80, p<0.001). CONCLUSIONS: Mean dp/dtM by M-mode echo/phomocardiography and PER by ABD echocardiography may be useful indices for assessing LV systolic function.
Adult ; Blood Pressure ; Echocardiography* ; Echocardiography, Doppler ; Endocardium ; Humans ; Myocardial Infarction ; Phonocardiography

BACKGROUND: The PUVA therapy of psoriasis is a very effective therapeutic modality that combines the action of light and drugs. Generally the conventional PUVA therapy based on patient's skin type is used in Korea. But there are many reported that conventional PUVA therapy is not suitable in several instances including the determination of oral 8-methoxypsoralen(8-MOP) dose, initial and incremental UVA dose and so on. OBJECTIVE: The purpose of this study is to establish a new protocol of PUVA therapy that is photomedically acceptable. METHOD: From 1997 to 2001, twenty psoriasis patients of moderate to severe grade who visited our clinic, were treated with PUVA therapy. Initial UVA dose was the same as MPD of each patient and proportion of weekly incremental UVA dose was 20% added to previous dose. All patients received PUVA therapy twice a week. The 8-MOP dose was determined by body surface area. RESULT: Total of 8 patients were skin type III, and 12 patients were skin type IV. The average of initial MPD in skin type III was 1.75J/cm2(0.5~2.5J/cm2) and skin type IV was 3.25J/cm2(2.5~4.5J/cm2). The average number of treatments to the end of therapy were 13.63(10~16) in skin type III, and 12.5(8~18) in skin type IV. The total cumulative UVA dose was 44.73J/cm2(30~68.2J/cm2) in skin type III, and 67.98J/cm2(31.6~109J/cm2) in skin type IV. CONCLUSION: The excellent effectiveness and safety of our new PUVA protocol have been demonstrated. We conclude that this PUVA protocol is a very effective, safe, and efficient method for the treatment of psoriatic patients.
Body Surface Area ; Humans ; Korea ; Methoxsalen ; Psoriasis* ; PUVA Therapy* ; Skin

Leiomyomas of the vagina are rare benign solid tumors. A leiomyoma arises frommuscle in the round ligament and appears as a firm movable tumor deep in the substanceof the labium majus, but minority of these tumors occur in vaginal wall. A case of a 39year old woman with leiomyoma of the vaginal orifice was reported with a brief review ofliterature.
Female ; Humans ; Leiomyoma* ; Round Ligament of Uterus ; Vagina

Uterine carcinosarcomas are rare and highly aggressive tumors with a poor prognosis. Due to early metastasis and disease progression, it is known to be far more aggressive than matched grade 3 endometroid endometrial carcinomas. Five-year survival for stage IV is reported to be 10% and overall survival for stage IVB is expected to be very poor. The authors report one case after experiencing long-term survival (over 5 years) for stage IVB carcinosarcoma of uterus. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed to 56 year old patient for uterine myoma. On pathology report, uterine carcinosarcoma was diagnosed and image studies were performed. With the impression of stage IVB uterine carcinosarcoma, 6 cycles of chemotherapy (ifosfamide and cisplatin) was conducted as adjuvant. Up to recently (over 5 years), she maintains good performance scale without evidence of tumor recurrence or disease progression.
Carcinosarcoma ; Disease Progression ; Endometrial Neoplasms ; Female ; Humans ; Hysterectomy ; Myoma ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Uterus