PURPOSE: Cerebral contusion is often associated with delayed edema, ischemia, demyelination, and secondary impairment in the neurological function. Early prediction of the outcome for patients with diverse critical illnesses has long been a concern of intensive care unit physicians. Recently, the systemic release of host-derived inflammatory mediators has been used for prognosis assessment in patients with multiple infections, burn injury, and systemic infection. Experimental investigations have revealed the importance of free radicals and calcium currents in cellular damage. Also experimental injuries have caused an early production of cytokines. This study was undertaken to analyze the production of interleukin-6 in the brain and in plasma following a brain contusion. METHODS: Sixty male Sprague-Dawley (SD) rats, each weighing 300-350 g were used in an experimental group following brain contusion, and 18 SD rats were used as a control group following a sham operation. Intracerebral IL-6 and plasma IL-6 were measured by using the ELISA method with a rat IL-6 kit at 3, 6, 24, 48, and 72 hours after the brain contusion. After contusion, the brains were fixed by perfusion via the carotid artery with 40% formaldehyde, glacial acetic acid, and 100% ethanol (1:1:8) at a flow rate of 25 ml/min and stained with hematoxylin and eosin for histologic examination. RESULTS: Brain IL-6 levels increased to reach a maximum of 160.23 pg/ml, at 6 hour after brain trauma. Plasma IL-6 levels increased to 70.02 pg/ml at 3 hour following brain contusion. CONCLUSION: The elevated brain IL-6 level in the injured rat does not seem to reflect a systemic inflammation. Although plasma IL-6 is detected in the sham-operated and the traumatized rats, the levels are too low to account for the increase observed in the brain cortex. This finding shows that the increase in brain IL-6 is related to the dynamics of brain contusion.
Acetic Acid ; Animals ; Brain Injuries* ; Brain* ; Burns ; Calcium ; Carotid Arteries ; Contusions ; Critical Illness ; Cytokines ; Demyelinating Diseases ; Edema ; Enzyme-Linked Immunosorbent Assay ; Eosine Yellowish-(YS) ; Ethanol ; Formaldehyde ; Free Radicals ; Hematoxylin ; Humans ; Inflammation ; Intensive Care Units ; Interleukin-6* ; Ischemia ; Male ; Perfusion ; Plasma ; Prognosis ; Rats* ; Rats, Sprague-Dawley

PURPOSE: The purpose of this study was to compare the fracture strength of the zirconia monolithic all-ceramic crowns according to the thickness (0.5mm, 0.8mm, 1.1mm) and metal-ceramic crowns (1.0mm, 1.5mm). MATERIAL AND METHOD: Twelve crowns for each of 3 zirconia crown groups were fabricated using CAD/CAM system (Kavo, Germany) and twelve crowns for each of 2 metal-ceramic crown groups were made by the conventional method. All crowns were luted to the metal dies using resin cement. Half of the specimens were exposed to thermocycling (5-55degrees C, 1 Hz) and cyclic loading (300,000 cycles, 50N). Subsequently, all crowns were mounted on the testing jig in a universal testing machine. The load was directed at the center of crown with perpendicular to the long axis of each specimen until catastrophic failure occurred. Analysis of variance and Tukey multiple comparison test (P<.05) were used for statistical analysis of all groups, and paired t-test (P<.05) was followed for statistical comparison between each groups'fracture load before and after cyclic loading. RESULTS: 1. The fracture strength of the zirconia monolithic crowns and the metal-ceramic crown increased as thickness increased (P<.05). 2. The cyclic loading and thermocycling significantly decreased the fracture strength of the zirconia monolithic crowns (P<.05). 3. The standard deviation of fracture strength of the zirconia monolithic crowns was very low. CONCLUSION: The fracture strength of the zirconia monolithic crowns for the posterior area tends to be higher with thickness increased and 0.8mm or over in thickness is recommended to have similar or over the fracture strength of metal-ceramic crowns.
Axis, Cervical Vertebra ; Crowns* ; Resin Cements

Purpose: To evaluate whether vascular uptake on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) during the clinically inactive state of Takayasu arteritis (TAK) is associated with disease relapse. Materials and Methods: Patients with TAK who underwent 18F-FDG PET/CT during the clinically inactive state of the disease between 2006 and 2019 were included. Clinically inactive disease was defined as a status not fulfilling the National Institutes of Health (NIH) criteria for active disease in TAK. Relapse was defined as recurrence of clinically active disease after a clinically inactive period, requiring change in the treatment regimen. Vascular uptake on 18F-FDG PET/CT was assessed using target/background ratio (TBR), calculated as arterial maximum standardized uptake value (SUV)/mean SUV in venous blood pool. Multivariable Cox regression analysis was performed to identify factors associated with relapse. Results: A total of 33 patients with clinically inactive TAK were included. During a median observation period of 4.5 (0.9–8.1) years, relapse occurred in 9 (27.3%) patients at median 1.3 (0.7–6.9) years. Notably, TBR [1.5 (1.3–1.8) vs. 1.3 (1.1–1.4), p=0.044] was significantly higher in patients who relapsed than in those who did not. On multivariable Cox regression analysis, the presence of NIH criterion 2 [adjusted hazard ratio (HR): 7.044 (1.424–34.855), p=0.017] and TBR [adjusted HR: 11.533 (1.053–126.282), p=0.045] were significantly associated with an increased risk of relapse. Conclusion Vascular uptake on 18F-FDG PET/CT and the presence of NIH criterion 2 are associated with future relapse in patients with clinically inactive TAK.

Purpose: To evaluate whether vascular uptake on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) during the clinically inactive state of Takayasu arteritis (TAK) is associated with disease relapse. Materials and Methods: Patients with TAK who underwent 18F-FDG PET/CT during the clinically inactive state of the disease between 2006 and 2019 were included. Clinically inactive disease was defined as a status not fulfilling the National Institutes of Health (NIH) criteria for active disease in TAK. Relapse was defined as recurrence of clinically active disease after a clinically inactive period, requiring change in the treatment regimen. Vascular uptake on 18F-FDG PET/CT was assessed using target/background ratio (TBR), calculated as arterial maximum standardized uptake value (SUV)/mean SUV in venous blood pool. Multivariable Cox regression analysis was performed to identify factors associated with relapse. Results: A total of 33 patients with clinically inactive TAK were included. During a median observation period of 4.5 (0.9–8.1) years, relapse occurred in 9 (27.3%) patients at median 1.3 (0.7–6.9) years. Notably, TBR [1.5 (1.3–1.8) vs. 1.3 (1.1–1.4), p=0.044] was significantly higher in patients who relapsed than in those who did not. On multivariable Cox regression analysis, the presence of NIH criterion 2 [adjusted hazard ratio (HR): 7.044 (1.424–34.855), p=0.017] and TBR [adjusted HR: 11.533 (1.053–126.282), p=0.045] were significantly associated with an increased risk of relapse. Conclusion Vascular uptake on 18F-FDG PET/CT and the presence of NIH criterion 2 are associated with future relapse in patients with clinically inactive TAK.

Mucormycosis is an opportunistic fungal infection caused by the mucorales, which consist of the Rhizophus, Absidia, Mortierella, and Mucor. The diverse clinical forms of mucormycosis can be categorized as rhinocerebral, pulmonary, disseminated, gastrointestinal, cutaneous and miscellaneous. Although it can cause disease in healthy people, it most commonly affects patients who are diabetic or immunosup-pressed. Rarely, mucormycosis develops confined to the subcutaneous tissue. We experienced a case of cutaneous mucormycosis developed in a well-controlled diabetic patient who had previously injected foreign material on her face for an aesthetic purpose at the behest of an unlicensed physician. The patient had tissue necrosis and purulent discharge on her left cheek. Following histologic examination, we diagnosed the condition as cutaneous mucormycosis and treated it by wide excision combined with amphotericin B therapy. The disease was cured without any significant sequelae within 6 months of follow up. Cutaneous mucormycosis is rarely reported but it can cause facial deformity due to tissue necrosis, so that early diagnosis and appropriate treatment are important. Currently, foreign material injection for aesthetic purposes is still performed by unlicensed physicians. We present a case report concluding that one should consider the possibility of fungal infection in skin lesion in diabetic or other immunosup-pressed patients. We also emphasize the seriousness of illegal injection of foreign material.
Absidia ; Amphotericin B ; Cheek ; Congenital Abnormalities ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortierella ; Mucor ; Mucorales ; Mucormycosis* ; Necrosis ; Paraffin* ; Skin ; Subcutaneous Tissue

In analyzing the postoperative results or evaluating the velopharyngeal incompetence after palatoplasty, speech evaluation is the inevitable factor. However, a standardized method for evaluating the speech problem in Korean cleft palate patients has not been available until now. So, the authors tried to establish a method of speech evaluation which is simple, economic and applicable to young patients, and to make a scoring method of the speech results in cleft palate patients based on the 'hypernasality diagnosing tool for cleft palate patient (OK Ran Jung)' which is commonly used by domestic speech therapists. The authors adopted the 'hypernasality diagnosing tool for cleft palate patients (OK Ran Jung)' male and female of children and adults, each consisting of 10 patients and make them speak according to the items about hypernasality and misarticulation evaluation, and record the results. We also calcuted the degree of the formants of the vowels (/a/, /o/, /u/)using sound spectrography. We examined the interjudge and intrajudge reliance of speech evaluation among the 10 inverstigators, revised the evaluation tool, devised the scoring method according to the above results, and compared the scoring results with those of sound spectrography to prove the reliance of our speech evaluation tool. With the scoring method, the authors could estimate the degree of hypemasality and misarticulation in cleft palate patients with evidence of reliability based on point-to-point agreement in two items. In comparing the results of our scoring method with the formant of vowels using sound spectrography, staistical significance existed except /u/F2 and that meant that our scoring method was reliable. We suggest that this simple, economic and reliable method of speech evaluation in cleft palate patients can create the basis for speech evaluation in patients of cleft palate and velopharyngeal incompetence under circumstances in which the results of various speech treatments are evaluated in comparison to various methods of speech evaluation.
Adult ; Articulation Disorders ; Child ; Cleft Palate* ; Female ; Humans ; Male ; Research Design ; Sound Spectrography ; Velopharyngeal Insufficiency

Many methods of correcting secondary cleft lip nose deformity have been introduced, but a single best method that can be uniformly adjusted for all cases does not exist. Since it is difficult to make the nostril of the cleft side symmetric with that of normal side, the authors tried to formulate the basis for correction of unilateral secondary cleft lip nose deformity according to the varying amounts of deformed nostril. We then adopted 4 different methods of correcting the soft tissue and nostril deformity in 63 patients from 1996 to 1998 and surveyed the results. Our principles were as follows: 1) Alar rim incision was done in cases of different-shaped cleft-side nostrils with nearly the same measured area in comparison to the normal side. 2) When deformity of the alar-columellar web was severe, we performed modified Z-plasty. 3) When the nostril of the cleft-side nostril was smaller than the normal side with slight asymmetry, reverse W-plasty was done. 4) We adopted a reverse-U incision when there was a discrepancy in height with moderate asymmetry compared with the normal nostril. After dissection, repositioning of alar cartilage was done by same method in each case. A nasal stent was kept in position for at least 6 months postoperatively in almost all cases. After follow-up of 6 to 24 months, we concluded that our choice was correct in selecting the optimal operative method, considering the characteristics of deformity of the cleft side nostril in an effort to make it symmetric with that of the normal side.
Cartilage ; Cleft Lip* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Nose* ; Stents

The search for the ideal augmentation material of facial soft tissues has been an ongoing effort for many years. Injectable soft tissue substitutes provide an affordable, non-surgical alternative for correcting contour defects in facial skin. A safe and effective material for this purpose should respect certain characteristics that it should be biocompatible, non-antigenic, nonpyrogenic, noninflammatory, noninflammatoy, nontoxic, easy to use, stable after injection, non-migratory, long-lasting but reabsorbable, natural looking and not too expensive. Although many biomaterials are currently on the market, none meets all the above criteria. The recent development of hyaluronic acid gels(Restylane ) for dermal implantation is therefore particularly interesting in treating the aging face. Restylane is produced in cultures of Equine streptococci by fermentation in presence of sugar, the hyaluronic acid chains are then chemically stabilized through permanent epoxidic cross-links that the manufacturer reports to alter only about 1% of the hyaluronan molecular network. The resulting viscoelastic transparnet gel, suitable for intradermal infection, has a concentration of 20 mg/ml, is delivered in disposable syringes (0.7 ml) ready for use, using a 30 gauge needles. The twenty-one patients in thirty area were treated with facial intradermal implantation of hyaluronic acid gel for augmentation therapy of wrinkles and folds for recoutouring. The results were evaluated in all patients by subjective judgment by the physician and the patients. This study provides a clinical evaluation of safety and efficacy of a cross-linked stabilized non-animal hyaluronic acid gel to determine its characteristics, advantages, disadvantages, and side-effects in Korean. We concluded that Restylane implantation was soft, easy to use and long lasting effective materials in augmentation therapy of soft tissue of face.
Aging ; Biocompatible Materials ; Fermentation ; Humans ; Hyaluronic Acid ; Judgment ; Needles ; Skin ; Syringes

Augmentation mammoplasty can be done in various manners according to the way of approach. the type of implant or implatation site depending on the status and demand of the patients or the operator's preferrence. In reviewing the many published reports about augmentation mammoplasty, they compare their surgical outcomes with mixed factors, so it is difficult to compare the results of mammoplasty simply with one factor under the same conditions. We think that analyzing the surgical results with one consistent method enables to compare and decide the influencing effect of one factor within it in augmentation mammoplasty. We could find the fact that the Korean women who wanted augmentation mammoplasty had same physical characteristics and demands, so developed the standardized method of augmentation mammoplasty among those debatable data for the purpose of increasing the patients' satisfaction, decreasing the complications, and shortening the operation time. The method we adopted was placing the implant through transaxillary subpectoral approach and using the endoscope auxiliarily in additional dissection and hemostasis. We employed saline-filled implants of round, textured type with the size ranging fro 125cc to 175cc and overinflated them by 10 to 30% beyond its original volume. After irrigation of the dissected pocket, we placed the suction drainage system into the subpectoral pocket. We educated the patients to massage their breasts right after removal of the drain. During the period of follow-up (from 6 months to 24 months), most of the patients were satisfied with their operative results. Though we experienced one case of capsular contracture, one case of malposition of the implant, and three cases of scar contracture on axillar incision site, as a whole, we could minimize the complications associated with augmentation mammoplasty. We present our postoperative results with the conclusion that our standardized method of augmentation mammoplasty can bring results of high satisfaction rate, minimal complication, predictability of postoperative results, shortening of operation time when applied consistently to the Korean patients whose physical characteristics are similar. We also hope that stanadardized method can be used to compare the influencing effect of many factors in the case of changing one factor within the standardized in the future follow up period.
Breast ; Cicatrix ; Contracture ; Endoscopes ; Female ; Follow-Up Studies ; Hemostasis ; Hope ; Humans ; Mammaplasty* ; Massage ; Suction

Hair takes a great role in featuring man's appearance and absence of hair can causes troubles in physical and psychological aspects. Many efforts have been made to treat male pattern baldness, including medical therapy and surgical correction, but there is not a definite and eternal method of treatment. Even though the diagnosis of male pattern baldness can be made with its characteristic clinical manifestations, histopathological study must be done for definite diagnosis. Author obtained biopsy material from the frontal progressive baldness area and the occipital non-baldness area with punch biopsy in 20 patients who were diagnosed to be Type II and III male pattern baldness according to the Norwood classification. A comparative study was done in the basis of histopathology using serial vertical section of the biopsy materia with the aid of light microscope and the results are as follows : 1. The average number of total hair in the frontal area was on third than that of occipital area and the number of anagen hair was less in the frontal area. The number of telogen hair in the frontal area was seven times more than that of occipital area. 2. The thickness of epidermis and dermis in the frontal area was thinner than that of occipital area. 3. The infiltration of inflammatory cells in the periadnexal field like blood vessels, hair follicles, sebaceous glands, eccrine glands was more prominent in the frontal area than in the occipatal area. 4. Perifollicular fibrosis and hypertrophy of arrector pilli muscle were more remarkable in the frontal area compared with that of occipital area. 5. There was no difference between the frontal and occipiral area in the number of lobules of sebaceous glands.
Alopecia* ; Biopsy ; Blood Vessels ; Classification ; Dermis ; Diagnosis ; Eccrine Glands ; Epidermis ; Fibrosis ; Hair ; Hair Follicle ; Humans ; Hypertrophy ; Male* ; Sebaceous Glands