PURPOSE: The anterior vaginal wall sling (AVWS) was introduced to be a simpler and less morbid procedure than the fascial or synthetic slings. However, the long-term outcome of the AVWS has not been fully assessed. In this study, the long-term outcomes of AVWS in female stress urinary incontinence were determined. MATERIALS AND METHODS: A total of 54 patients, followed-up postoperatively for at least five years, were surveyed. The surgical outcome was evaluated by pre- and post-operative SEAPI scores, subjective satisfaction and complications. The preoperative clinical parameters were analyzed using a multivariate analysis to determine the factors influencing the success. RESULTS: After a follow-up period of at least 60 months (mean 72.3 months), 63% were cured, 24% showed improvement and 13% had unsuccessful outcomes. The multivariate analysis demonstrated no preoperative factors for the prediction of the outcome of the AVWS. In a subjective satisfaction assessment, 40.8% were extremely satisfied, 40.8% were satisfied, 9.3% felt fair, and 9.3% were dissatisfied. The short-term complications were; UTI (1 case) and operation related transfusion (1 case). The long-term complications were; de novo urge incontinence (3 cases), removal of suture material due to extra-vaginal protrusion (3 cases) and chronic pelvic pain (1 case), but there was no chronic retention. CONCLUSIONS: An AVWS has many benefits, such as low morbidity, easiness of familiarization and can be performed on patients with anatomical incontinence and internal sphincter deficiency. Nevertheless, the complete dry rate of AVWS is 63% for a follow-up of over 5-years. With regard to its long-term durability, this procedure is considered a less effective treatment modality for female stress urinary incontinence.
Female* ; Follow-Up Studies* ; Humans ; Multivariate Analysis ; Pelvic Pain ; Surgical Procedures, Operative ; Sutures ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge

A case of congenital mutilocular intrapulmonary bronchogenic cyst which was undifferentiated radiographicallyfrom congenital lobar emphysema, large pneumatocele, or tension pneumothoarax is reported. The cyst occupied about4/5 of left lung fields and displaced the mediastinal structures to right moderately and compressed the remainingleft lungs severely.
Bronchogenic Cyst ; Emphysema ; Lung

PURPOSE: Platelet Rich Plasma(PRP) application is increasing with sinus inlay bone graft, but there is few research with radiographic ananlysis on effect of PRP in maxillary sinus. The author investigated the amount of bony changes of maxillary sinus for dental implantation among the patients with maxillary inlay graft. MATERIALS AND METHODS: With 10 patients who were treated with sinus inlay autologous bone grafting combined with PRP technique, and with 5 patients who were treated with sinus inlay grafting only without PRP, the panoramic radiographys which were taken at preoperation, immediate postoperation, 3months postoperation, and 4 months postoperation(a month after dental implantation)periods were analysed. The films had been scanned, and then proceeded throughout image analysis system. The bone density of maxillary grafted sites was compared with adjacent tooth enamel density and remeasured according to density luminosity of each film. The density changes on PRP group and bone graft only group were an lysed with non-parameteric statistics method. RESULTS: In PRP combined patients group, bone density on postoperation periods was increased totally. The remarkable enhanced change of bone density was observed on 3 months postoperation period, thereafter the increasing rate was slightly reduced . In only bone graft patients group, bone density on postoperation periods was also increased compared with preoperation period, but the bone density of 4 months postoperation period was decreased compared with 3 months postoperation period. The amount of bone density on PRP group was significantly changed according to periods in contrast to bone graft only group. CONCLUSION: The bone density on PRP group was remarkably increased at 3 months postoperation compared to bone graft only group and it was seemed to be associated with more new bone formation, less grafted bone resorption at bone grafted sites with PRP.
Blood Platelets* ; Bone Density ; Bone Resorption ; Bone Transplantation ; Dental Enamel ; Dental Implantation ; Dental Implants ; Humans ; Inlays ; Maxillary Sinus ; Osteogenesis ; Platelet-Rich Plasma ; Tooth ; Transplants

Twenty-two children(4 months to 17 years old)with a clincial diagnosis of complex partial seizure(CPS) were examined with a 0.5T MRI scanner using spin-echo sequences. Eleven patients showed abnormal brain MRI findings; two had focal lesions with corresponding seizure foci on the EEG, one arising from temporal lobe(Hippocampal Formation atrophy) and the other from the frontal lobe. Nine patients showed diffuse lesions with inconsistent seizure foci on EEG. The remaining 11 patients were normal on bran MRI; two of them had normal EEG findings and the others either focal or diffuse abnormalities on EEG.
Brain* ; Child* ; Diagnosis ; Electroencephalography ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Seizures*

Severe cartilage defects and congenital anomalies affect millions of people and involve considerable medical expenses. Tissue engineering offers many advantages over conventional treatments, as therapy can be tailored to specific defects using abundant bioengineered resources. This article introduces the basic concepts of cartilage tissue engineering and reviews recent progress in the field, with a focus on craniofacial reconstruction and facial aesthetics. The basic concepts of tissue engineering consist of cells, scaffolds, and stimuli. Generally, the cartilage tissue engineering process includes the following steps: harvesting autologous chondrogenic cells, cell expansion, redifferentiation, in vitro incubation with a scaffold, and transfer to patients. Despite the promising prospects of cartilage tissue engineering, problems and challenges still exist due to certain limitations. The limited proliferation of chondrocytes and their tendency to dedifferentiate necessitate further developments in stem cell technology and chondrocyte molecular biology. Progress should be made in designing fully biocompatible scaffolds with a minimal immune response to regenerate tissue effectively.

BACKGROUND AND OBJECTIVES: Apolipoprotein E (apoE), a 34-kD plasma glycoapolipoprotein, plays a key role in lipoprotein metabolism by facilitating cellular uptake of remnants of triglyceride-rich chylomicrons and VLDL and may have other important biological functions. Various studies using apoE-knockout mice have elucidated the role of apoE in lipolysis, remnant clearance, and atherogenesis. Despite the growing evidence of the protective role exerted by apoE against atherosclerosis, the direct in vivo effects of the apoE overexpression on lipoprotein metabolism in the presence of endogenous mouse apoE are not yet fully understood. In this study, the technique of adenovirus-mediated gene transfer was employed to investigate the in vivo effect of apoE overexpression on lipid level and lipoprotein profile in mice fed on normal chow or high cholesterol diet. MATERIALS AND METHODS: Recombinant adenovirus (rAd.mApoE) containing mouse apoE cDNA driven by a cytomegalovirus promoter was generated and infused via tail vein in mice fed on normal chow or high cholesterol diet. Recombinant adenoviruses have emerged as the most efficient vectors for transient delivery of functional genes to the mammalian liver. RESULTS: rAd.mApoE in the various mouse tissues one week after injection was expressed mainly in the liver. ApoE overexpression decreased the cholesterol and triglyceride concentration in mice fed on normal chow. In mice fed on high cholesterol diet, apoE overexpression resulted in decrease in triglyceride concentration and increase in cholesterol. VLDL and LDL fraction were decreased, HDL was increased by apoE overexpression in both mice fed on normal chow and high cholesterol diet. CONCLUSION: These data suggest that overexpression of mouse apoE in mice with endogenous apoE may exert antiatherogenic effect by inducing favorable change in the lipoprotein profile, regardless of diet and consequent plasma lipid level. In the future, the studies regarding the effect of human apoE overexpression on the lipid and lipoprotein profile in mice fed on normal chow and high cholesterol diet will be helpful to understand the species differences or similarities in apoE activity.
Adenoviridae ; Animals ; Apolipoproteins E ; Apolipoproteins* ; Atherosclerosis ; Cholesterol* ; Chylomicrons ; Cytomegalovirus ; Diet* ; DNA, Complementary ; Humans ; Lipolysis ; Lipoproteins* ; Liver ; Metabolism ; Mice* ; Plasma* ; Triglycerides ; Veins

A study was made of 104cases of neonatal hyperbiliruinemia receiving blood exchange transfusion at Kwangju Christian Hospital from January 1969 to December 1975, with the following results: 1. 52 patients(50%) returned for follow-up, 9 patients(8.7%) had died, and 43 patients(41.3%) did not return. 2. Of the 52 patients returning, developmental status was studied by D.D.S.T. 43 patients(82.7%) had normal development, 8(15.4%) were retarded, and 1(1.9%) was questionable. No patients had a failing score. Most of the retarded patients had cerebral palsy, due to kernicterus. 3. There was no retardation among patients exchange-transfused at age of less than 5days, or over 8 days(except 1 pts.) , and with less than 30mg% of Pre-B.E.T. serum bilirubin level. 4. No significant difference of sex incidence was noted. 5. ABO incompatibility (57%) was predominant as the etiology and main cause of retarded development (19.4%), but the idiopathic type of hyperbilirubinemia(41.3%) was interestingly high among these B.E.T. patients. 6. Mean value and standard error of pre-B.E.T. serum bilirubin levels are as follows: Normal development group:30.80+/-1.60 Retarded development group:38.83+/-2.35 The difference of men values between both groups is very significant according to the t-test. 7. Motor disturbance was the predominant handicap in retarded patients at ages less than 3 years, and after this there was a tendency toward recovery, accompanied by mild speech disturbance. Hearing loss, especially of high pitched tone, was noted in 1 patient and confirmed by audiometry.
Audiometry ; Bilirubin ; Cerebral Palsy ; Follow-Up Studies* ; Gwangju ; Hearing Loss ; Humans ; Hyperbilirubinemia* ; Incidence ; Kernicterus ; Male

Many clinical trials have shown the effectiveness of the platelet releasate or the platelet gel on chronic wounds. However, the patient's own blood had to be aspirated and processed to make the platelet releasate or a platelet gel. The purpose of this study was to assess the effects of platelet concentrates from the blood bank for the treatment of diabetic foot ulcers. To obtain the basic data of the PDGF-BB content in platelet concentrates supplied from the blood bank, enzyme-linked immunosorbent assay quantification was performed. On average, 8.5 pg of the PDGF-BB was released per 1 million platelets. Sixteen patients with diabetic foot ulcers ranging from 1.0 to 18.0 cm2 (mean, 6.1 cm2) in size were treated. The platelet concentrates was centrifuged and the precipitantte was mixed with 1 ml of fibrinogen. The platelets and fibrinogen mixture was dispersed on to the ulcer lesions. The liquid platelet and fibrinogen mixture was then sealed using 0.3-1.0 ml of thrombin and moisture dressing was performed. The procedure was repeated every one or two weeks until wound closure. Time required for complete healing ranged from 3 to 12 weeks after treatment (mean, 7.3 weeks). Patient satisfaction was also very positive. In this study, the use of platelet concentrates from the blood bank was found to be effective in treating diabetic foot ulcers.
Bandages ; Blood Banks* ; Blood Platelets* ; Diabetic Foot* ; Enzyme-Linked Immunosorbent Assay ; Fibrinogen ; Humans ; Patient Satisfaction ; Thrombin ; Ulcer* ; Wounds and Injuries

Pseudo-kaposi's sarcoma is a vasoproliferative disorder that may resemble Kaposi's sarcoma, clinically and histologically. In most cases, it has been associated with congenital or iatrogenic arteriovenous fistula and chronic venous insuffiency. We present a 36-year-old male patient with pseudo-Kaposi's sarcoma caused by a deed vein thrombosis in the absence of any detectable underlying etiologic factors.
Adult ; Arteriovenous Fistula ; Humans ; Male ; Sarcoma ; Sarcoma, Kaposi* ; Thrombosis ; Veins ; Venous Thrombosis*

Almost always patients with multiple neurofibromatosis show cafe-au-lait macules on their skin. At times the skin macules are seen even before the appearance of the neurofibromata in childhood. The author experienced one case of neurofibromatosis in a 12-year-old boy who has no cafe-au-lait macules. Besides the clinical peculiarity of having no skin pigmentation, the histopathology of the case showed well-formed double-palisading structure, which is not common among the micro-scopical findings of neurofibromata.
Child ; Humans ; Male ; Neurofibromatoses* ; Skin ; Skin Pigmentation