Nontyphoidal Salmonella are gram negative bacilli organism, which may induce systemic infection such as febrile enteritis, bacteremia, and osteomyelitis. Main route of infection is known as food but also possible through reptile, amphibian, and fish raised as pets in the house. There is no known cases report of Salmonella infection through pets in Korea and also rare in the overseas. We report 2 patients who visited Severance children's hospital with chief complaint of fever and diagnosed as nontyphoidal salmonellosis. Each case had a history of raising turtle or tropical fish with possibility of Salmonella infection through these pets. Increasing incidence of raising pet reptile and fish lately, contact precaution and proper prevention and control of Salmonella infection of these pets especially in children under 5 years old are necessary due to higher risk of serious complications of salmonellosis.
Amphibians ; Bacteremia ; Child ; Enteritis ; Fever ; Fishes ; Humans ; Incidence ; Korea ; Osteomyelitis ; Reptiles ; Salmonella ; Salmonella Infections ; Turtles

Traditional adipose tissue transplantation has unpredictable viability and poor absorption rates. Recent studies have reported that treatment with platelet-rich plasma (PRP), adipose-derived stem cells (ASCs), and stromal vascular fraction (SVF) are related to increased survival of grafted adipose tissue. This study was the first simultaneous comparison of graft survival in combination with PRP, ASCs, and SVF. Adipose tissues were mixed with each other, injected subcutaneously into the back of nude mice, and evaluated at 4, 8, and 12 weeks. Human adipocytes were grossly maintained in the ASCs and SVF mixtures. Survival of the adipose tissues with PRP was observed at 4 weeks and with SVF at 8 and 12 weeks. At 12 weeks, volume reduction in the ASCs and SVF mixtures were 36.9% and 32.1%, respectively, which were significantly different from that of the control group without adjuvant treatment, 51.0%. Neovascular structures were rarely observed in any of the groups. Our results suggest that the technique of adding ASCs or SVF to transplanted adipose tissue might be more effective than the conventional grafting method. An autologous adipose tissue graft in combination with ASCs or SVF may potentially contribute to stabilization of engraftment.
Adipocytes/*transplantation ; Adipose Tissue/cytology/*transplantation ; Adult ; Animals ; Female ; *Graft Survival ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; *Platelet-Rich Plasma ; Stem Cells ; Stromal Cells/*transplantation ; Transplantation, Heterologous

PURPOSE: Un-healing and centrally located defect on back area, it is sometimes a challenge for the reconstructive surgeon. Although skin grafts are considered as the first choice for reconstruction of large skin defect on the back region, it is not always helpful but vascularized flaps provide a superior functional and aesthetic outcome. The present study was designed to investigate the clinical anatomy of the lumbar artery perforator flap to reconstruct back ulcer. MATERIALS AND METHODS: Clinical anatomy study was undertaken using computed tomographic angiographic analysis. We identified the courses of lumbar arteries and its perforators, measured pedicle length by layers. The location of the perforator vessel was charted against anatomical landmarks. RESULTS: The pedicle lengths of the third and fourth lumbar artery perforator reached a mean of 27.8 mm and 37.1 mm respectively from superficial fascia to deep fascia. The fourth perforator was more laterally located than the third perforator and less than 1 cm above the iliac crest. A case in which the fourth lumbar artery perforator was used as flap pedicle is described. CONCLUSION: For the reconstruction of central defect on the back area, the lumbar artery perforator flap coverage may be a good alternative option. Computed tomographic angiography can easily identify the course and location of lumbar artery perforators and can be helpful to elevate the flap successfully.
Angiography* ; Arteries* ; Fascia ; Perforator Flap* ; Skin ; Subcutaneous Tissue ; Transplants ; Ulcer* ; Wound Closure Techniques

Anesthesia, General ; Anesthesia, Inhalation ; Busan ; Female ; Granuloma ; Hoarseness ; Humans ; Incidence ; Intubation ; Intubation, Intratracheal ; Laryngeal Mucosa ; Larynx ; Male ; Orthognathic Surgery ; Retrospective Studies ; Surgery, Oral

PURPOSE: A number of flap for nipple reconstruction have been well described in the literature. However, most of these techniques do not permit the reconstruction of a projecting nipple and all are hampered to some extent by long-term loss of nipple projection. The objective of this study is to evaluate the long-term result and clinical efficacy of nipple reconstruction using skate flap technique after breast reconstruction. METHODS: A retrospective chart review was carried out on 23 patients who underwent 25 nipple reconstructions. In those patients with greater than 10 mm nipple projection, reconstruction with skate flap and full-thickness skin graft and/or tattooing was performed. Maintenance of nipple projection was then carefully assessed over one-year follow-up. The following factors were analyzed: type of breast reconstruction, type of areola reconstruction, follow-up period, decrease in nipple projection, complication, and whether secondary nipple reconstruction was necessary and/or performed. RESULTS: Breast reconstructions were performed in 17 patients with free transverse rectus abdominis musculocutaneous flap, 3 patients with extended latissimus dorsi musculocutaneous flap, and 3 patients with expander and implant. The mean follow-up after nipple reconstruction was 17 months. Mean loss of projection were 17.0 +/- 13.99%, 25.0 +/- 12.70%, 30.0 +/- 12.57% and 30.8 +/- 12.49% at 3, 6, 9 months and over one year, respectively. The greatest decrease in projection was noted in the first 3 months following surgery. CONCLUSION: These results indicated that nipple reconstruction with skate flap showed about 70 percent of the projection achieved over one year postoperation. Therefore, the skate flap may be a reliable method of nipple reconstruction in those patients with greater than 10 mm nipple projection.
Breast ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Nipples ; Rectus Abdominis ; Retrospective Studies ; Skin ; Tattooing ; Transplants

An 8-year-old girl diagnosed with dilated cardiomyopathy and Russell-Silver syndrome was admitted to our pediatric intensive care unit due to low cardiac output and multiple-organ dysfunction. The patient was placed on the heart transplant waiting list and extracorporeal membrane oxygenation was performed as a bridge to transplantation. After 17 days, heart transplantation was performed. The donor was a 46-year-old female (weight, 50 kg; height, 150 cm). The donor:recipient weight ratio was 3.37:1. Because the dimension and volume of the recipient's thoracic cage were insufficient, the sternum could not be closed. Nine days after transplantation, the patient underwent delayed sternal closure. To obtain adequate space, we left the sternum 4.5 cm apart from each margin using four transverse titanium plates. A transverse rectus abdominis musculocutaneous flap was chosen to cover the wound. Due to the shortage of donors, a size-mismatched pediatric heart transplantation is sometimes unavoidable. Closure of the opened sternum of a transplant recipient can be challenging. Sternal reconstruction after an extremely oversized heart transplantation with transverse titanium plate fixation and a musculocutaneous flap can effectively achieve sternal closure and stability.
Cardiac Output, Low ; Cardiomyopathy, Dilated ; Child ; Extracorporeal Membrane Oxygenation ; Female ; Heart ; Heart Transplantation* ; Humans ; Intensive Care Units ; Middle Aged ; Myocutaneous Flap* ; Rectus Abdominis* ; Silver-Russell Syndrome ; Sternum ; Thoracic Wall* ; Tissue Donors ; Titanium ; Transplantation ; Waiting Lists ; Wounds and Injuries

PURPOSE: Since the hand elevation test was first introduced by Ahn in 2001, it has been one of most performing provocative test for diagnosing carpal tunnel syndrome. Although many studies have been published on the hand elevation test, there are no study that can explain why false-negative results of hand elevation test appears in carpal tunnel syndrome patients diagnosed by electromyography (EMG) findings. Therefore we searched out whether hand elevation test is related with EMG severity. MATERIALS AND METHODS: We made a retrospective study of 654 bilateral carpal tunnel syndrome patients. Among them 134 were studied which had different hand elevation test results on each hands. The paired samples t-test was used to compare the EMG severity of each group. The relationships between hand elevation test and EMG severity were examined using Pearson-product correlations. Comparing whether the frequency of false negative hand elevation were different between both hands, and whether the severity of EMG depends on which side of hand is, was evaluated with Mann-Whitney U-test. RESULTS: Severity of EMG in positive group was moderate to severe on average, whereas mild to moderate on negative group, with significant difference statistically (p<0.001). Correlation between the hand elevation test results and EMG severity also showed significance statistically (p<0.001). CONCLUSION: Mild severity of EMG was found out to be the factor affecting the false results. However, EMG severity and hand elevation test shows a meaningful correlation, supporting the value of hand elevation test.
Carpal Tunnel Syndrome* ; Electromyography* ; Hand* ; Humans ; Retrospective Studies

BACKGROUND: Free fibular flap is one of the most useful methods in the hard tissue reconstruction of the maxilla-mandible. Free fibular flap presents some advantages in which the reconstruction of both soft and hard tissues can be done at the same time. It also provides a safe and successful bone graft for the reconstruction, along with a low rate of complications. Despite these advantages and the rarity of a postoperative complication, particularly in oral and maxillofacial surgery procedures, a prolonged operation might exhibit some complications related with rhabdomyolysis. We experienced the rare event of rhabdomyolysis after oral cancer surgery. CASE PRESENTATION: In this article, we report the case of a patient who developed rhabdomyolysis after undergoing free fibular flap surgery. CONCLUSIONS: Despite the advantages of the free fibular flap operation, clinicians must be aware of the risk of complications because there are multiple factors that could result in rhabdomyolysis, such as duration of operation, position of the subject, and pre-existing conditions of diabetes and hypertension. Once the diagnosis of rhabdomyolysis is confirmed, a prompt treatment plan should be made and applied as soon as possible. This will increase the chance of a full recovery for the patient who is exhibiting symptoms of rhabdomyolysis.
Diagnosis ; Humans ; Hypertension ; Mandibular Reconstruction ; Mouth Neoplasms ; Postoperative Complications ; Preexisting Condition Coverage ; Renal Insufficiency ; Rhabdomyolysis ; Surgery, Oral ; Transplants

Objectives: The purpose of this study was to evaluate risk factors and symptoms in cemento-osseous dysplasia (COD) patients. Materials and Methods: In this study, 62 patients who were diagnosed histologically with COD were investigated from 2010 to 2020 at the author’s institution. We compared clinical and radiological characteristics of symptomatic and asymptomatic patients. The factors were sex, age, lesion size, site, radiologic stage of lesion, apical involvement, sign of infection, and history of tooth extraction. Statistical analysis was performed using Fisher’s exact test and the chi-square test. Results: COD was more prevalent in female patients. With the exception of three cases, all were focal COD. The majority of patients presented with symptoms when the lesion was smaller than 1.5 cm in size. Symptoms were observed when the apex of the tooth was included in the lesion or there was a local infection around the lesion. The history of tooth extraction and previous endodontic treatment were evaluated, and history was not a significant predictor for the onset of symptoms. Conclusion In this study, risk factors associated with symptomatic patients were size of lesion, apical involvement, and local infection.

Untreated adult or elderly cleft lip and palate patients are rarely seen, but studies on delayed primary palatal closure have been performed in the less developed Asian and African countries, where access to medical care is difficult. A 64-year-old woman visited our clinic with untreated cleft palate with a 40×20-mm-wide defect in the medial palate. Two-flap palatoplasty under general anesthesia was performed to close the cleft palate. After 1 month, the result was favorable without any complications including oronasal fistula. Cleft palate primary repair in an elderly patient is rare and has some surgical problems that are associated with a wide range of defects, but good results can be obtained if surgery is performed well with appropriate considerations.