PURPOSE: Cell transplantation of myelin-producing exogenous cells is being extensively explored as a means of remyelinating axons in X-linked adrenoleukodystrophy. We determined whether 3,3',5-Triiodo-L-thyronine (T3) overexpresses the ABCD2 gene in the polysialylated (PSA) form of neural cell adhesion molecule (NCAM)-positive cells and promotes cell proliferation and favors oligodendrocyte lineage differentiation. MATERIALS AND METHODS: PSA-NCAM+ cells from newborn Sprague-Dawley rats were grown for five days on uncoated dishes in defined medium with or without supplementation of basic fibroblast growth factor (bFGF) and/or T3. Then, PSA-NCAM+ spheres were prepared in single cells and transferred to polyornithine/fibronectin-coated glass coverslips for five days to determine the fate of the cells according to the supplementation of these molecules. T3 responsiveness of ABCD2 was analyzed using real-time quantitative polymerase chain reaction, the growth and fate of cells were determined using 5-bromo-2-deoxyuridine incorporation and immunocytochemistry, respectively. RESULTS: Results demonstrated that T3 induces overexpression of the ABCD2 gene in PSA-NCAM+ cells, and can enhance PSA-NCAM+ cell growth in the presence of bFGF, favoring an oligodendrocyte fate. CONCLUSION: These results may provide new insights into investigation of PSA-NCAM+ cells for therapeutic application to X-linked adrenoleukodystrophy.
ATP-Binding Cassette Transporters/*metabolism ; Adrenoleukodystrophy/genetics/*therapy ; Animals ; Animals, Newborn ; Bromodeoxyuridine ; Cell Differentiation ; Fibroblast Growth Factor 2/pharmacology ; Fibronectins/metabolism ; Immunohistochemistry ; Neural Cell Adhesion Molecules/*genetics ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Sialic Acids/metabolism ; Stem Cells ; Thyroid Hormones/*metabolism ; Triiodothyronine/pharmacology

Animals ; Apoptosis ; Bone Marrow ; Capillaries ; Carcinoma, Squamous Cell ; Cell Death ; Cell Line ; Cicatrix ; Europe ; Fibrosis ; Heterografts ; Mass Screening ; Mice ; Mice, Nude ; Mouth Neoplasms ; Necrosis ; Viscum album

BACKGROUND AND OBJECTIVES: Submandibular space might be estimated as the most common space of deep neck infection. It may, in certain cases, be treated conservatively with no need for early open surgical drainage. The purpose of this study is to review the clinical course and outcome in treatment of submandibular abscess. SUBJECTS AND METHOD: A retrospective study was peformed for 9 years on 49 cases admitted from June 1994 to January 2003 for deep neck infection limited to the submandibular space. All patients were treated with intravenous antibiotics. The conservative group was treated with antibiotics only or combination therapy with needle aspiration. The surgical group was treated with intraoral or external drainage. Contrast enhanced computed tomography (CT) imaging was conducted for all cases and had confirmed that they all had an abscess in the submandibular space. RESULTS: The mean period of hospitalization was 7.6 days, with 35 patients treated with IV antibiotics only and 3 patients with aspiration in the conservative group. On the other hand, 3 patients were treated with intraoral drainage and 8 patients with external drainage in the surgical group. One patient required tracheotomy because of severe dyspnea. There was no complication observed in any cases. CONCLUSION: SSubmandibular abscess is an infection of deep neck space and is considered as the most common infection. Conservative treatment is a good therapeutic choice in cases with localized submandibular absess.
Abscess* ; Anti-Bacterial Agents ; Drainage ; Dyspnea ; Hand ; Hospitalization ; Humans ; Neck ; Needles ; Retrospective Studies ; Tracheotomy

No abstract available.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Humans ; Lung*

PURPOSE: The purpose of this study was to assess the relative diagnostic capability of magnetic resonance angiography(MRA) and CT angiography(CTA) in the evaluation of intracranial aneurysm. MATERIALS AND METHODS: MRA and CTA were performed in 14 intracranial aneurysms (Including four which were ruptured) confirmed in the II patients involved by conventional angiography(CA). The size(in largest dimension) of the aneurysms ranged between 3 mm and 20 mm and the mean was 10.5 mm. For MRA, the 3D TOF method, with magnetization transfer suppression, wasused at 1.5T. For CTA, twenty seconds after beginning the injection of contrast media(100mL with use of a power injector at the rate of 3 mL/sec), CT scanning(30-second exposure and 60-mm length) was performed with a table speed of 2 mm/sec and a section thickness of 2mm. The resulting data were reformatted by MIP. MRA and CTA were compared with regard to the detection of aneurysms and their neck, size, shape, direction, intensity and relationship to adjacent bony structures or vessels. RESULTS: All aneurysms were clearly visualized with CTA. Inone case with a 3-mm aneurysm, however, this was not defined on MRA. Of the 13 aneurysms demonstrated by both MRA and CTA, eight were seen equally well with both modalities. CTA was considered to be superior to MRA in fivecases, either because calcification in the aneurysm wall was seen only on CTA(n = 3) or because the relationship with adjacent bony structures were seen better with CTA(n = 2). With CTA, the intensities of the aneurysm were homogeneous in all cases ; with MRA, however, the intensities of three large aneurysms were different. CONCLUSION: MRA and CTA may be useful in the evaluation of intracranial aneurysm, CTA has specific advantages over MRA inthe evaluation of large aneurysms, calcification of aneurysm wall and relationship with adjacent bony structure.
Aneurysm ; Angiography* ; Cerebral Angiography ; Intracranial Aneurysm* ; Magnetic Resonance Angiography* ; Neck

BACKGROUND AND OBJECTIVES: Whether through a posterior tympanotomy or after canal wall-down mastoidectomy, visuali-zation of the most posterior recess of the tympanic sinus is often inadequate. The purpose of this study is to assess the usefulness of endoscopic approach to tympanic sinus during chlolesteatoma surgery. MATERIALS AND METHODS: Twenty six cases that had been operated by a same surgeon were reviewed. The mean follow-up period was 12.5 months. Four cases with cholesteatoma confined to tympanic sinus had underwent tympanoplasty. Twenty-two cases had underwent canal wall-down mastoidectomy with or without ossiculoplasty. RESULTS: Two patients (7.7%) showed recurrence of cholesteatoma in tympanic sinus within 6 postoperative months. Twenty-four cases showed normal state. CT scans were performed in 14 cases before the second look operation. All free air cavities on the CT scan showed no residual cholesteatoma. CONCLUSION: The endoscopic approach to the middle ear in association with a microscope enables surgeons to eradicate the cholesteatoma at the tympanic sinus more effectively.
Cholesteatoma* ; Ear, Middle ; Endoscopy ; Follow-Up Studies ; Humans ; Recurrence ; Tomography, X-Ray Computed ; Tympanoplasty

BACKGROUND AND OBJECTIVES: As indications for tracheotomy have evolved over the decades, the trends in the pediatric tracheotomy also have changed. The purpose of this study is to review the clinical courses and outcomes in the current pediatric tracheotomy. MATERIALS AND METHOD: A retrospective study was performed on 42 pediatric patients who underwent tracheotomies at Ajou University Hospital from June, 1994 to May, 2004. Charts were reviewed with respect to indications for tracheotomy, underlying diseases, success rate in decannulation and length of support time until decannulation, complication and mortality rate. RESULTS: There were 34 (81.0%) male patients and 8 (19.0%) female patients. Ventilatory support for neurological impairment (47.6%) was the leading indication for tracheotomy, followed by upper airway obstruction (19.0%), prolonged intubation due to respiratory failure (16.7%), cervical trauma (7.1%), craniofacial abnormalities (4.8%) and vocal cord palsy (4.8%). Convulsive disorder (19.0%) and congenital neurological malformation (14.3%) were the most common underlying diseases. Decannulation was accomplished in 70.0% of children with an average of 254.5 days with tracheotomy. The length of support time until decannulation was significantly greater in the neurological impairment group than in the other group. Complications occurred in 19.0% without tracheotomy-related death. CONCLUSION: Tracheotomy is relatively safe in the pediatric population as conservative therapy and its outcomes are thought to be usually related to the underlying disease and age.
Airway Obstruction ; Child ; Craniofacial Abnormalities ; Female ; Humans ; Intubation ; Male ; Mortality ; Respiratory Insufficiency ; Retrospective Studies ; Tracheotomy* ; Vocal Cord Paralysis

With the discovery of screlostin as a pivotal player in bone metabolism, a novel medication targeting sclerostin has been introduced. Romosozumab, a humanized anti-sclerostin monoclonal antibody, is a unique approach to the treatment of osteoporosis that inhibits sclerostin, a key regulator that has the dual properties of promoting bone formation and inhibiting bone resorption. Romosozumab has been shown to be superior to conventional agents, in increasing bone mineral density and preventing osteoporotic fractures. Romosozumab may also be effective in the management of treatment-resistant osteoporosis and in the prevention of osteoporotic fractures in the very high risk population. However, further studies are necessary as there is insufficient data on its clinical efficacy and safety.

The superior gluteal artery is branched from the internal iliac artery and is located outside the pelvis through a greater sciatic notch. This anatomical characteristic makes the artery vulnerable to injury when pelvic fracture involves the sciatic notch. In the case of a superior gluteal artery injury, hemodynamic instability can occur, and appropriate evaluation and management are mandatory in the acute phase. On the other hand, if the initial detection of the injury is neglected due to a masked pattern, it can cause massive bleeding during surgery, resulting in difficult hemostasis. This paper reports an experience of a latent superior gluteal artery injury by entrapment between the fragments of a transverse acetabular fracture.

PURPOSE: High tension electrical injuries result in major tissue(eg. bones, tendons, vessels and nerves) destruction. Therefore, the management of mutilating wrist caused by electrical injuries still represents a challenge. There are various approaches to this problem including local and regional flaps as well as pedicled distant flaps and microsurgical free tissue transfer. Although it has not gained wide acceptance, because of the technically demanding dissection of the pedicle, posterior interosseous flap is now well accepted for the reconstruction of hand and wrist in hand surgery. The principal advantages of this flap are minimal donor site morbidity, minimal vascular compromise, one stage operation. This flap also offers the advantages of ideal color match and composition. In this report, we describe our experience with the reverse posterior interosseous island flap for reconstruction of mutilating wrist with main vessel injuries. METHODS: From October, 2004 to June, 2006, we treated 11 patients with soft tissue defects and main vessel injuries on the wrist that were covered with reverse posterior interosseous island flap. RESULTS: These 11 patients were all male. The ages ranged from 27 to 67 years(mean age 41.75) and the follow-up period varied from 4 to 19 months. Complete healing of the reverse posterior interosseous island flaps were observed in 11 patients(12 flaps). The majority of these flaps showed a certain degree of venous congestion, which in a flap was treated with medical leech. 1 flap has partial necrosis owing to sustained venous congestion, requiring secondary skin graft. flap size varied from 3.5x8cm to 10x12cm(mean size 6.4x8.9m). The donor site defect was closed directly in 5 flaps, and by skin graft in 7 flaps. CONCLUSION: We found that the reverse posterior interosseous island flap is reliable and very useful for reconstruction of mutilating wrist and we recommend it as first choice in coverage of soft tissue defects in the wrist with electrical arc injuries.
Follow-Up Studies ; Hand ; Humans ; Hyperemia ; Male ; Necrosis ; Skin ; Surgical Flaps ; Tendons ; Tissue Donors ; Transplants ; Wrist*