Numerous surgical procedures have been advocated to correct the facial deformity in patients with hemifacial microsomia, including chondrocostal grafts, mandibular osteotomies combined with bone grafts, and maxillary osteotomies done at an early age after permanent dentition is completed. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth. Furthermore, these procedures often require intermaxillary fixation, blood transfusions and sometimes tracheostomies. Lengthening of the mandible by gradual distraction, according to the method of Ilizarov, opens new perspectives for interceptive therapy. Laboratory and clinical studies have shown that mandibular distraction is an effective and powerful reconstructive surgical technique. Lengthening of the mandible by gradual distraction was performed on five patients of hemifacial microsomia and one patient of Goldenhar syndrome using unidirectional or bidirectional extraoral device and intraoral device. In two patinets, simultaneous mandibular and maxillary distraction was performed with incomplete Le Fort I osteotomy. The amount of mandibular bone lengthening ranged from 8 to 21 mm, the patinets were maintained in fixation for an average of 12 weeks to allow ossification. There was no severe perioperative complication and the length of clinical follow-up ranged from 3 to 17 months. The skeletal change resulting from directional bone lengthening could be seen best by comparing the pre-and postoperative 3-D CT scans. There was also the potential for improvement in neuromuscular function (functional matrix), attendant growth and development of the affected jaw. Mandibular distraction is a simple procedure with minimal morbity and complications, so the results to date indicated that the technique can be applied to the correction of hemifacial microsomia. The development of new devices should permit multidirectional mandibular distraction and craniofacial distraction to allow early reconstruction of cranio-maxillofacial malformations. Distraction osteogenesis for reconstruction of the mandible in this subest of young patients was a safe and effective technique for improving the craniofacial skeletal form and appearance, with minimal associated morbidity.
Blood Transfusion ; Bone Lengthening ; Congenital Abnormalities ; Dentition, Permanent ; Follow-Up Studies ; Goldenhar Syndrome* ; Growth and Development ; Humans ; Jaw ; Mandible ; Mandibular Osteotomy ; Maxillary Osteotomy ; Osteogenesis, Distraction ; Osteotomy ; Tomography, X-Ray Computed ; Tracheostomy ; Transplants

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Acute coronary closure occurs 2-10% during the procedure of PTCA, 50-80% of those events are in the catheterization room. The causes of acute coronary closure are mainly due to dissection, thrombosis or spasm. We recently experienced a case of acute left main coronary artery closure due to guiding catheter induced embolization in the 56 year-old female, unstable angina patient complicated by diabetes mellitus and chronic renal failure. The patient received cardiopulmonary resuscitation shortly after acute closure because of cardiac arrest. During the resuscitation, we performed PTCA at the site of acute closure. The blood pressure maintained normaly after successful recanalization. And then we inserted IABP(intraaortic balloon pump) balloon and did PTCA of original stenosis sites. The patient removed IABP 24 hours later and discharged a month later without complication.
Angina, Unstable ; Blood Pressure ; Cardiopulmonary Resuscitation* ; Catheterization ; Catheters* ; Constriction, Pathologic ; Coronary Vessels ; Diabetes Mellitus ; Female ; Heart Arrest ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Resuscitation ; Spasm ; Thrombosis

Lung cancer is one of the most prevalent cancers and it has the highest mortality of all forms of cancers. Although surgery, chemotherapy and radiotherapy are routinely used for the treatment of lung cancer treatment, little progress has been made in the treatment of this condition over the past 20 years. The histological subtype of squamous cell carcinoma (SCC) accounts for approximately 30% of all lung cancer patients. Spontaneous regression of non-small-cell lung cancer (NSCL) is an extremely rare phenomenon. Spontaneous regression of cancer (SR) is defined as a complete or partial, temporary or permanent disappearance of all or at least some the relevant parameters of soundly diagnosed malignant disease without any medical treatment or with treatment that is considered inadequate to produce the resulting regression.
Carcinoma, Squamous Cell ; Humans ; Lung ; Lung Neoplasms

OBJECTIVE: To investigate the relationship between removable dentures and swallowing and describe risks. METHODS: Twenty-four patients with removable dentures who were referred for videofluoroscopic swallowing study (VFSS) were enrolled. We evaluated the change of swallowing function using VFSS before and after the removal of the removable denture. The masticatory performance by Kazunori's method, sensation of oral cavity by Christian's method, underlying disease, and National Institutes of Health Stroke Scale for level of consciousness were collected. Functional dysphagia scales, including the oral transit time (OTT), pharyngeal transit time (PTT), percentage of oral residue, percentage of pharyngeal residue, oropharyngeal swallow efficiency (OPSE), and presence of aspiration were measured. RESULTS: Four patients dropped out and 20 patients were analyzed (stroke, 13 patients; pneumonia, 3 patients; and others, 4 patients). The mean age was 73.3+/-11.4 years. There were significant differences before and after the removal of the denture for the OTT. OTT was significantly less after the removal of the denture (8.87 vs. 4.38 seconds, p=0.01). OPSE increased remarkably after the removal of the denture, but without significance (18.24%/sec vs. 25.26%/sec, p=0.05). The OTT and OPSE, while donning a removable denture, were correlated with the masticatory performance (OTT, p=0.04; OPSE, p=0.003) and sensation of oral cavity (OTT, p=0.006; OPSE, p=0.007). CONCLUSION: A removable denture may have negative effects on swallowing, especially OTT and OPSE. These affects may be caused by impaired sensation of the oral cavity or masticatory performance induced by the removable denture.
Consciousness ; Deglutition ; Deglutition Disorders ; Denture, Partial, Removable ; Dentures ; Humans ; Hypesthesia ; Mouth ; National Institutes of Health (U.S.) ; Pneumonia ; Sensation ; Stroke ; Weights and Measures

PURPOSE: Complete septal extension grafts have been widely used in rhinoplasty for effective projection of the short retruded columella in Asian patients. Autologous septal cartilages and porous high-density polyethylene sheets are frequently used as septal extension grafts. This study was conducted to compare the postoperative results of porous polyethylene sheets and septal cartilages used for correction of unilateral cleft lip nasal deformities by using photogrammetric analysis. METHODS: This study investigated a total of 49 patients with cleft lip nasal deformities who underwent corrective surgery, and were followed up for at least 6 months. Septal cartilages were used in 39 patients, and porous polyethylene sheets were used in 10 patients. In all patients, through the open rhinoplasty, complete septal extension grafts were sutured to the caudal margin of the septal cartilage, and the alar cartilage was sutured with suspension. The cleft side alar cartilage was overcorrected by approximately 3 - 5 mm. Postoperative outcomes were evaluated by using photogrammetric analysis. Five indices and 4 angles were measured on their photographs taken before and after the surgery. In patients with unilateral cleft lip nasal deformities, symmetry was also evaluated by means of columellar length index. RESULTS: The postoperative values obtained in photogrammetric analysis showed improvements in comparison with the preoperative ones. The polyethylene group produced more improved outcomes than the septal cartilage group but also resulted in more complications at the same time. CONCLUSION: The results of this study indicates that complete septal extension grafts are efficient for the correction of unilateral cleft lip nasal deformities. However, since postoperative complications occur more frequently in the polyethylene group than in the septal cartilage group, caution is advised in using porous high-density polyethylene sheets in patients with cleft lip nasal deformities.
Asian Continental Ancestry Group ; Cartilage ; Cleft Lip ; Congenital Abnormalities ; Humans ; Nasal Cartilages ; Polyethylene ; Postoperative Complications ; Rhinoplasty ; Succinates ; Transplants

OBJECTIVES: The purpose of this study was to find risk factors that are associated with complications of cerebral infarction in patients with atrial fibrillation (AF) and to discover useful association rules among these factors. METHODS: The risk factors with respect to cerebral infarction were selected using logistic regression analysis with the Wald's forward selection approach. The rules to identify the complications of cerebral infarction were obtained by using the association rule mining (ARM) approach. RESULTS: We observed that 4 independent factors, namely, age, hypertension, initial electrocardiographic rhythm, and initial echocardiographic left atrial dimension (LAD), were strong predictors of cerebral infarction in patients with AF. After the application of ARM, we obtained 4 useful rules to identify complications of cerebral infarction: age (>63 years) and hypertension (Yes) and initial ECG rhythm (AF) and initial Echo LAD (>4.06 cm); age (>63 years) and hypertension (Yes) and initial Echo LAD (>4.06 cm); hypertension (Yes) and initial ECG rhythm (AF) and initial Echo LAD (>4.06 cm); age (>63 years) and hypertension (Yes) and initial ECG rhythm (AF). CONCLUSIONS: Among the induced rules, 3 factors (the initial ECG rhythm [i.e., AF], initial Echo LAD, and age) were strongly associated with each other.
Arm ; Association Learning ; Atrial Fibrillation ; Cerebral Infarction ; Data Mining ; Electrocardiography ; Humans ; Hypertension ; Logistic Models ; Mining ; Risk Factors

Codonopsis lanceolata, which is predominantly found in Korea and East Asia, has attracted considerable scientific attention due to its long-standing use in traditional medicine. However, despite both its roots and stems being utilized as functional food and medicinal resources, there has been limited phytochemical investigation into its aerial parts. Therefore, the aim of this study is to isolate compounds present in the aerial parts of C. lanceolata. Through repeated chromatography, two alkaloids (1 and 2), seven flavones (3-9), and three isoflavones (10-12) and one type of phenylpropanoid (13) and polyacetylene (14) were isolated from a 70% ethanol extract of C. lanceolata. The structure of each compound was determined through the analysis of spectroscopic data ( 1 H and 13 C NMR), and by comparing them with previous research results. Among the isolates, the presence of methyl 2-formyl-5-(methoxymethyl)-1H-pyrrole-1-butanoate (1), chrysoeriol 5-O-β-D-glucopyranoside (3), apigenin-5-O-β-D-glucopyranoside (5), and 3′-O-methylorobol 7-O-β-D-glucopyranoside (12) were reported for the first time in plants belonging to the Campanula family in this study. In addition, the current study marked the isolation of luteolin 4′-O-β-D-glucopyranoside (4) from C. lanceolata for the first time.

OBJECTIVE: The purpose of this study was to investigate the isolation and characterization of multipotent human periodontal ligament (PDL) stem cells and to assess their ability to differentiate into bone, cartilage, and adipose tissue. METHODS: PDL stem cells were isolated from 7 extracted human premolar teeth. Human PDL cells were expanded in culture, stained using anti-CD29, -CD34, -CD44, and -STRO-1 antibodies, and sorted by fluorescent activated cell sorting (FACS). Gingival fibroblasts (GFs) served as a positive control. PDL stem cells and GFs were cultured using standard conditions conducive for osteogenic, chondrogenic, or adipogenic differentiation. RESULTS: An average of 152.8 +/- 27.6 colony-forming units was present at day 7 in cultures of PDL stem cells. At day 4, PDL stem cells exhibited a significant increase in proliferation (p < 0.05), reaching nearly double the proliferation rate of GFs. About 5.6 +/- 4.5% of cells in human PDL tissues were strongly STRO-1-positive. In osteogenic cultures, calcium nodules were observed by day 21 in PDL stem cells, which showed more intense calcium staining than GF cultures. In adipogenic cultures, both cell populations showed positive Oil Red O staining by day 21. Additionally, in chondrogenic cultures, PDL stem cells expressed collagen type II by day 21. CONCLUSIONS: The PDL contains multipotent stem cells that have the potential to differentiate into osteoblasts, chondrocytes, and adipocytes. This adult PDL stem cell population can be utilized as potential sources of PDL in tissue engineering applications.
Adipocytes ; Adult ; Antibodies ; Azo Compounds ; Bicuspid ; Calcium ; Cartilage ; Chondrocytes ; Collagen Type II ; Durapatite ; Fibroblasts ; Humans ; Mesenchymal Stromal Cells ; Multipotent Stem Cells ; Osteoblasts ; Periodontal Ligament ; Periodontics ; Stem Cells ; Tissue Engineering ; Tooth

Surfactant replacement therapy in neonates with respiratory distress syndrome (RDS) has been introduced in our country since May 1990. The purpose of this study was to assess the effect and short-term outcome of surfactant replacement for neonatal RDS using collective data of uncontrolled trials from different hospitals in Korea. For the period May 1990 to Dec. 1991, a total of 68 RDS neonates were treated with a reconstituted bovine surfactant (Surfactant-TA) at 17 hospitals. Data on 60 neonates were collected from 16 hospitals and were analyzed in this study. In order to examine the factors that might influence the mortality, we performed a stepwise discriminant analysis. RDS was diagnosed according to accepted clinical and radiographic criteria at each hospital. The mean gestational age of 60 neonates was 31+/-3 weeks (1 SD, range, 24~40 wk) and the mean birth weight was 1549+/-566 grams (range, 590~3300 gm). Surfactant treatment resulted in a significant improvement in ventilatory requirement during the subsequent clinical course. However, there were large variations in the instillation procedure (single vs repeated instillations), dose of surfactant, and respirator settings after surfactant treatment. The neonatal mortality was 40% in this group. When the effect of surfactant treatment was compared between survival and death group, the magnitude of improvement was significantly less in death group than that in survival group. Factors affecting the neonatal mortality include a poor response to surfactant, sepsis and/or DIC, decreasing gestational age and weight, acidosis before treatment and air-leaks. We conclude that treatment with Surfactant-TA has an impact on the clinical course of RDS. To optimize the effects of surfactant therapy, the following refinement will be needed: better initial stabilization with respect to blood pressure, blood gases and pH, instillation techniquse including pre-and post-surfactant ventilation, weaning guidelines, dose, dose schedule, as well as timing of treatment, management of infection, and prevention of severe birth asphyxia.
Acidosis ; Appointments and Schedules ; Asphyxia ; Birth Weight ; Blood Pressure ; Dacarbazine ; Gases ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant Mortality ; Infant, Newborn* ; Korea ; Mortality ; Parturition ; Sepsis ; Ventilation ; Ventilators, Mechanical ; Weaning