Skull base surgery has developed through the evolution of imaging, anatomic research, surgical approach and reconstructive techiques. The basic disciplines of approaching skull base lesions are to provide direct vision, minimize brain retraction, allow excellent exposure and minimal blood loss. Although many advantages listed above are reported, objective long-term follow up results about post-operative complications of this procedures were not introduced. This study was designed to review the complications of skull base approach that we experienced 43 cases by a team approach with neurosurgery-supraorbital rim osteotomy, orbitozygomatic osteotomy, orbitozygom aticoglen-oidotomy, orbitozygomaticoglenoidocondylotomy, and transfrontonasomaxillary osteotomy-through objective evalutation criteria. The result of this study demonstrated that the type of complications were consisted with perioperative infection (5 cases), subdural empyema (1 case), CSF leakage(1 case), hematoma (1 case), meningitis (3 cases), ophthalmic nerve injury (1 case),facial nerve injury (2 cases), T-M joint problem ( 2 cases), & enophthalmos ( 2cases). In conclusion, after performing the different skull base approaches, we analyzed several complications of the above procedures. We analyzed with the purpose of preventing complications in the next skull base approach.
Brain ; Empyema, Subdural ; Enophthalmos ; Follow-Up Studies* ; Hematoma ; Joints ; Meningitis ; Ophthalmic Nerve ; Osteotomy ; Skull Base* ; Skull*

No abstract available.
Constriction* ; Heart Ventricles* ; Pulmonary Artery* ; Rabbits*

BACKGROUND: The wound healing process is impaired or delayed in aged patients. The development of a new wound healing model is needed. Nerve growth factor (NGF) plays a special role in wound healing because NGF is expressed only in proliferating tissues such as wounds. OBJECTIVE: The aim of our study was to develop a wound healing model using a 3-dimensional culture system, raft culture, by comparing the level of NGF expression according to the wound stage after an artificial wound was made to the raft samples. We tried to specifically localize the site of NGF expression both in mRNA and protein level. METHODS: Raft culture using normal human keratinocytes was done and a 2 mm slit wound was made in the center of the raft samples. Raft samples of no wound, 4 d, 7 d, and 9 d after wounding were prepared. In situ RT-PCR and immunohistochemistry were performed to detect and localize NGF expression after making wounds and the addition of substance P (SP). RESULTS: We failed to localize NGF mRNA expression in raft samples by in situ RT-PCR. Immunohistochemistry showed NGF staining throughout the epidermis although a little more dense staining was found in the basal layer. NGF(+) cells tended to increase until 7 d after wounding, but there were no significant differences according to the wounding days. There was `a tendency that the SP(+) group showed more NGF(+) cells than the SP(-) group, but there were no statistical differences. CONCLUSION: We think that our in vitro raft wound model using NGF expression could be used, at least in part, as an objective indicator for wound healing. In our raft model lacking nerve, NGF may not be suitable for representing wound healing process because this model can not reflect the interaction between the skin and the nervous system. Expression of growth factors or cytokines other than NGF need to be applied to our raft culture system.
Cytokines ; Epidermis ; Humans ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Keratinocytes ; Nerve Growth Factor ; Nervous System ; RNA, Messenger ; Skin ; Substance P ; Wound Healing* ; Wounds and Injuries*

BACKGROUND: Recently, the incidence of acute myocardial infaction has been gradually increasing as prolongation of life spans and improvements of diet and life styles in Korea. The rate of mortality and sudden death is higher than other diseases. The purpose of this study is to evaluate factors which can affect on the mortality of AMI during initial 24 hrs. METHODS: A retrospective clinical study was done on 364 consecutive patients with AMI who had been presented to Keimyung University Dong-sang Medical Center from January 1990 to May 1997(M:F ratio=254:110). The subjects were divided two groups. The Group I was patients who had expired during the initial 24hrs period of AMI(47 patients, 13%), the Group II was patients who had survived(317 patients, 87%). We compared clinical features, EKG, laboratory results in both groups and tried to analyse the vulnarable factors. RESULTS: The results were as follows; 1) The mean age in Group I (64.4 yearly) was older than in Group II(61.3 yearly) and female gender was also higher in Group I. The mean systolic/diastolic blood pressures of the Group I(103/61mmHg) were lower than those of the Group II(123/75mmHg). 2) The chest pain and mental change were noted more frequently in Group I than in Group II and the dyspnea was less frequent in Group I than Group II. 3) The higher grades of Killip classification was significantly more frequent in Group I than in Group II. 4) The mean onset to drug time for thrombolytics in Group I and Group II were 14.1 hrs and 6.6 hrs. 5) The mortality rate of the Group I and the Group II were respectively 13%, 6.6%. The most common causes of death were cardiogenic shock and ventricular arrhythmia. CONCLUSION: The mortality rate of initial 24 hrs of onset as form of sudden death was higher than post-24hrs group(66.2%). The factors for the higher mortality group were old age and female gender, and they were unstable in vital signs, higher Killip classifications. Therefore, these groups demand more rapid and aggressive approach than the other groups.
Arrhythmias, Cardiac ; Cause of Death ; Chest Pain ; Classification ; Death, Sudden ; Diet ; Dyspnea ; Electrocardiography ; Female ; Humans ; Incidence ; Korea ; Life Style ; Life Support Care ; Mortality* ; Myocardial Infarction* ; Retrospective Studies ; Risk Factors* ; Shock, Cardiogenic ; Vital Signs

Generalized granuloma annulare is a rare skin disease presenting generalized eruption with a distinctive histologic picture. The age of onset of generalized granuloma annulare differs from that of localized granuloma annulare. Most of the patients with generalized granuloma annulare were in the fifth to seventh decades and cases of generalized granuloma annulare in infancy or in early childhood have been rarely reported. We herein report two cases of generalized granuloma annulare in 45- and 18-month-old boys, who is the youngest patient yet reported in the Korean literature. The histopathologic findings were compatible with granuloma annulare and all lesions completely involuted in two months after administration of topical or systemic corticosteroids.
Adrenal Cortex Hormones ; Age of Onset ; Granuloma Annulare* ; Granuloma* ; Humans ; Infant ; Skin Diseases

An epidemiological investigation was conducted on Metagonimus yokogawai infection in Hadong Gun (County), Gyeongsang Nam Do, Korea, and following findings were obtained. Overall prevalence rate of Metagonimus yokogawai infection was 29.1 percent from a total of 1,163 inhabitants examined. By area of river and stream, Seomjin-gang R.: 9.5 percent (out of 95 inhabitants examined) in Jeondo Ri in the lower river, 19.9 percent (156) at Dugog Ri near Hadong town, and 90.8 percent (65) in Tab Ri of Hwagae Myeon where Hwagae-cheon Stream joins; Hwagae-Cheon Stream: 42.2 percent (45) in Yonggang Ri of the middle stream and 27.5 percent (72) in Daeseong Ri of the upper stream; Hoengcheon-gang R.: 54.7 percent (161) in Gojeol Ri of the lower river, 40.6 percent (128) in Hoengcheon Ri of the middle stream, and 5.4 percent (93) in Jungi Ri of the upper stream, and 43.8 percent (89) in Uge Ri located along a tributary of the Hoengcheon-gang R. and 4.0 percent (101) in Jangam Ri which is located about 4 km away from the river; Deogcheon-gang R.: 18.5 percent (54) in Munam Ri; Gwangog-cheon Stream: 2.8 percent (107) in Gwangog Ri. The difference in prevalence rate of the infection by area was correlated with the opportunity and amount of raw eating of sweetfish by the inhabitants in the respective areas. By age and sex, the overall prevalence rate increased from young age group and reached a peak at 20-29 age group and then the rate decreased gradually. In high endemic areas, however, a peak level of the rate lasted up to 40-49 age group in male. On the other hand, in low endemic areas, the rate was significantly lower in female, though moderate level of the infection was seen in male. The overall prevalence rate was higher in male than in female and the difference was greater in middle age groups. The most significant mode of infection by the inhabitants was the raw eating of sweetfish which commonly harbour metacercariae of M. yokogawai during summer through autumn. Besides, it was noted that the infection can be acquired through contamination with the metacercariae on food of various side-dish and kitchen utensils as well as on hands of a cook when such fish are prepared or handled. The inhabitants usually begin to acquire infection from early June of a year when fishing of sweetfish opens and acquire infection more frequently in July and August when fish are caught more productively and favored for raw consumption by inhabitants. From September, sweetfish are no more favored for raw consumption and accordingly are dried and cooked in this season. The infection in the sweetfish Plecoglossus altivelis as the second intermediate host was first observed from May with low level of infection and the intensity of infection in a fish rapidly increased until reaching a peak in October when sweetfish season normally ends. The first intermediate host snail of M. yokogawai in this area was Semisulcospira coreana (Martens) which is widely distributed in the streams and rivers in this locality.
parasitology-helminth-trematoda ; Metagonimus yokogawai ; metacercaria ; Plecoglossus altivelis ; epidemiology

Fracture healing in the hand is not an isolated goal. The functional end result is of paramount importance. When the correct techniques are used, miniplate fixation for metacarpal and phalangeal fractures of the hand provides rigid internal fixation, stabilizes the skeleton, preserves the gliding tissue, and therefore allowing immediate active range of motion exercise as well as minimizing joint and tendon complications. The authors have reviewed 39 patients, 52 cases of metacarpal and phalangeal fractures of the hand which were treated with miniplate in the department of orthopaedic surgery, Chang Ang Gil hospital from Sep. 1989 to Feb. 1993. The following results were obtained. 1. Miniplate fixation, in terms of fracture reduction and maintenance, allows on accurate anatomic reduction with rigid fixation which in turn affords on early mobilization without loss of reduction alignment. 2. The roentgenographic union was obtained within 15.1 weeks in average. The mean total acitve motion at the fractured finger was 230°. The complication rate was 11.5%. 3. In the treatment of metacarpal and phalangeal fractures of the hand, especially fractures of metacarpal bones, fixation with miniplate is considered to be an useful method in terms of getting fracture union and good range of motion with relative low complication rates.
Early Ambulation ; Fingers ; Fracture Healing ; Hand ; Humans ; Joints ; Metacarpal Bones ; Methods ; Range of Motion, Articular ; Skeleton ; Tendons

Posterior segment injuries due to non-penetrating ocular trauma have protean ocular manifestations. Vision may be unaffected or completely lost according to the injured area. Although most cases require no specific treatment, early accurate diagnosis and appropriate prophylactic treatment will prevent some patients from late visual loss. We analyzed retrospectively 36 eyes of 36 patients with non-penetrating posterior segment trauma who had visited our clinic from August, 1994 to February, 1997. Thirty two of the patients(88.8%) were male and the peak age group was in the third decade. Thirteen of the patients(21%) had Berlin`s edema, which was one of the most common findings seen in the posterior segment. The most common anterior segment finding associated with non-penetrating ocular trauma was hyphema(20%). The most common cause of non-penetrating trauma was violence(first, foot)(38.8%). Final visual acuity was better in eyes without the lesion involving the macula.
Diagnosis ; Edema ; Humans ; Male ; Retrospective Studies ; Visual Acuity

PURPOSE: To treat limbal stem cell deficiency, we investigated the epithelial characteristics in rabbits with total limbal stem cell deficiency (LSCD) after reconstruction with autologous limbal corneal epithelial cells in vivo expanded on amniotic membrane. METHODS: The right eyes of 10 rabbits were rendered total LSCD, as verified by impression cytology. In the left eyes of 10 rabbits, in vivo limbal corneal epithelial cells culture was achieved. In group A (n=4), we evaluated the characteristics of the cultured limbal corneal epithelial cells and in group B (n=6) we evaluated the characteristics of the transplanted limbal corneal epithelial cells at postoperative 1, 2, and 4 weeks. RESULTS: Successful epithelial growth was observed on amniotic membrane in all eyes of group A. Transplanted epithelial cells were well remained in five eyes of group B. The epithelial cells of group A and B were confirmed with corneal specificity by immunohistochemical staining (AK-2, AE-5). CONCLUSIONS: The corneal surface with unilateral total LSCD can be successfully reconstructed by transplantation with autologous limbal corneal epithelial cells in vivo expanded on amniotic membrane.
Amnion ; Epithelial Cells* ; Rabbits ; Sensitivity and Specificity ; Stem Cells*

Lawsonia intracellularis is not culturable with a standard bacteriologic culture. One step PCR assay as a clinical diagnostic method was developed for the rapid detection of porcine proliferative enteritis (PPE) caused by L. intracellularis. Primers were designed based on the p78 DNA clone of L. intracellularis. The one step PCR resulted in the formation of a specific 210-bp DNA product derived from L. intracellularis. The nonspecific amplification product was not detected with swine genomic DNA or other bacterial strains causing similar symptoms to L. intracellularis infection. The one step PCR was as sensitive as 100 pg of L. intracellularis genomic DNA. We applied this method to field specimens diagnosed as PPE by macroscopic observation. Of 17 mucosal scraping specimens, 16(94%) were identified as positive to PPE and 15(88%) of 17 feces specimens. These results suggest that the one step PCR can be used as a rapid diagnostic method for L. intracellularis infection.
Animals ; Base Sequence ; DNA Primers ; Desulfovibrionaceae Infections/diagnosis/*veterinary ; Ileum/microbiology/pathology ; Intestinal Mucosa/microbiology/pathology ; Lawsonia Bacteria/genetics/*isolation & purification ; Polymerase Chain Reaction/*methods ; Reproducibility of Results ; Sensitivity and Specificity ; Swine ; Swine Diseases/*diagnosis/microbiology