During the last 10 years, we have experienced 169 cases of congenital melanocytic nevi of the face at Seoul National University Children's Hospital. In these patients, various modalities of treatment have been used, including excision, staged excision, skin graft, local flap, and composite graft. Dermabrasion, electrocoagulation, and laser therapy were excluded because these were not definitive treatments. We reviewed over 169 cases based on the involved on the aesthetic units of the face and the length of the defect perpendicular to wrinkle lines. We have attempted to create a stadard for the selection of the appropriate treatment modality. Cases which involved orbital unit(38 cases), cheek(30 cases), and parotid-masseteric unit(18 cases) were analysed statistically. To avoid the statistical error, units of sufficient number of cases and involving only one unit were included. In each unit, we used Receiver Operator Characteristic Method to identify the turning points of the length of the defect perpendicular RSTL which decided the treatment modality. And we used t-test to show the statistical difference between the lengths of the defect perpendicular to RTSL in each modality. The turning point were 0.9-1.0 cm between excision/staged excision, 2.0 cm between staged excision/FTSG, in orbital unit, 1.3 cm between excision/staged excision in cheek unit, 1.6-1.9 cm between excision/staged excision in parotid-masseteric unit. And it was identified by ANOVA test and t-test that the above groups were statistically different. Till now, the treatment modality of the congenital melanocytic nevus was based on the experiences of the surgeon. But now, we have presented the stadard of the treatment according to the size in each aesthetic unit. Therefore we can choose the approproate treatment modality among the severals in accordance with the standards.
Cheek ; Child* ; Dermabrasion ; Electrocoagulation ; Humans ; Laser Therapy ; Nevus, Pigmented* ; Orbit ; Seoul ; Skin ; Transplants

The authors performed percutaneous antegrade pyelography guided by ultrasound on 33 patients, from J une 1982 to October 1984, at the department of radiology, Busan National University Hospital. The results obtained were as follows: 1. Of the 31 cases,17 cases (5 1.5%) were female and 16 cases (48.5 %)were male,and age distribution was nearly even, but most prevalent age group was third decade. 2. Comparing intravenous pyelographic findings with ultrasonographic findings, pyelographically non. visualized kidney 15 cases (45 .5%) were hydronephrosis 12 cases, multiple cysts 2 cases, and intrarenal cystic mass 1 case, ultrasonographically. Pyelographically hydronephrosis 9 cases (27.3%) were all hydronephrosis, ultrasonographically. Intrarenal mass 5 cases (15.2%) were all intrarenal cystic mass, NVK with air in kidney 1 case (3.0%) was air in perirenal space, partial NVK 1 case (3.0%) was per. irenal fluid , suprarenal mass 1 case (3 .0%) was suprarenal intrarenal and huge perirenal cystic masses, ultraso nograp h ically. 3. On technical reliability of antegrade pyelography under ultrasound gUide, 31 cases (93 .9%) could be done fluid aspiration and visualization, and 2 cases (6.1 %) could be only done fluid aspiration but failed visualization . 31 successful cases were visualization of collecting systems 23 cases, visualization of cyst 6 cases, i!nd visualization of perirenal space 2 cases. 2 partial successful cases were perirenal injection 1 case and parenchymal injection 1 case. 4. On fluid aspiration, 22 cases (66.7%) were clear, but 11 cases (33.3%) were not clear, which were pus 7 cases, turbid urine 2 cases, bloody urine 1 case, and bloody pus and air 1 case. 5. Comparing ultrasonographic findings with antegrade pyelographic findings, ultrasonographically hydronephrosis 21 cases revealed obstruction in 16 cases, antegrade pyelographically, which were consisted of ureteral stricture 14 cases, ureteral stone 1 case, and ureteral mass 1 case, non-obstruction in 4 cases, which were consisted of pyonephrosis 2 cases, posterior urethral valve 1 case, and megaureter 1 case, and other 1 case was visualization failure. Ultrasonographically intrarenal cystic mass 6 cases were simple renal cyst 4 cases, and infected renal cyst 2 cases, antegrade pyelographically. Multiple cysts 2 cases were lobulated huge renal cyst 1 case, and visualization failure 1 case, which was multi.cystic kidney. Air in perirenal space 1 case was emphysematous pyelone. phritis, suprarenal cystic mass 1 case was complete duplication with ectopic ureteral orifice, perirenal fluid 1 case due to kidney fracture was perirenal fluid , and intrarenal and perirenal cystic mass was per irenal abscess, antegrade pyelographically. 6. On ana lysis of anteg rade pyelography result as next diagnostic step of ultrasound, 31 successful cases were 27 conclusive diagnostic cases (87.1%), and 4 heplful diagnostic cases (12.9%) with percutaneous antegrade pyelography guided by ultrasound . 7. Antegrade pyelography provides significant diagnostic information on the nature of the obstructive lesion and can be performed as an adjunct to retrograde study or as an alterative to a pyelogram. 8. Ultrasonographic examination could be performed easiJy in diagnosis of renal and perirenal diseases as non.invasive method without risk of radiation hazard , and was not influenced by renal function. 9. Ultrasound is considered a most advantageous aid to the performance of antegrade pyelography and has yie lded valuab le diagnostic information in patients with obstructive hydronephrosis.
Abscess ; Age Distribution ; Busan ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Hydronephrosis ; Kidney ; Methods ; Pyonephrosis ; Suppuration ; Ultrasonography ; United Nations ; Ureter ; Urography

No abstract available.
Osteomyelitis*

An 84-year-old woman had an ovoid shallow ulcer with an elevated, indurated, pigmented border on the left cheek. Histological examination revealed a moderately differentiated squamous cell carcinoma and a solar keratosis with abundant melanocytes and melanin pigment. Ultrastructurally, the keratinocytes contained numerous melanosomes in their cytoplasms and the melanocytes in the squamous cell carcinoma and the solar keratosis had mature melanosomes.
Aged, 80 and over ; Carcinoma, Squamous Cell* ; Cheek ; Cytoplasm ; Epithelial Cells* ; Female ; Humans ; Keratinocytes ; Keratosis ; Melanins ; Melanocytes ; Melanosomes ; Ulcer

Skin graft has been widely used for facial skin reconstruction. Inguinal area is the common donor site for full-thickness skin graft of various area. Especially for facial skin graft, retroauricular area or upper eyelid skin has been used as a donor site. But these donor sites have some limitations as perfect ones in terms of size, color and texture when applied onto facial area. Even retroauricular skin shows color and texture differences from normal facial skin after it is grafted. Authors performed expansion of the skin of preauricular area or forehead where minimal scars would come out after final operation. We harvested this expanded skin and performed skin graft following excision of nevus, poor scar, or hemangioma in face.We achieved satisfactory results in terms of color and texture by applying this method in 11 clinical cases; 4 cases of hemangioma, 4 nevus, and 3 cases of traumatic scar. Donor site scars were clinically inspicuous in all these 11 cases.
Cicatrix ; Eyelids ; Forehead* ; Hemangioma ; Humans ; Nevus ; Skin* ; Tissue Donors ; Transplants*

PURPOSE: The purpose of this study was to describe the use pattern of alternative therapies in middle aged women. METHOD: The subjects of this study were 530 women from 40 to 64 years of age. The data of this study was patients' records. The data was gathered from April 1st, 2004 to June 30th, 2004. Data was analyzed statistically by using the SPSS/WIN 10.0 program. RESULT: It was shown that 63.5% of the subjects have utilized one or more types of alternative therapy. The most common type of alternative therapy was dietary and nutritional therapy 38.3%, and the place of use was the home 64.1%. The most common reason was a recommendation by friends. The degree of satisfaction after the use of alternative therapy was 95.2%. Among users of alternative therapies, the most frequent responses to each question were as follows; Motive of Use- "for health maintenance and promotion." (62.7%) In the relation ship between general characteristics and utilization of alternative therapy, religion (x2=12.33, p=.02), exercise (x2=8.21, p=004), and health status (x2=14.95, p=.005) showed a significant statistical difference. CONCLUSION: We found that middle aged women used alternative therapies more frequently than other populations. Therefore, it is suggested that medical doctors or nurses verify the true effects or side-effects from the most therapies or nurses verify the true effects or side-effects from the most common complementary or alternative therapies through experiments.
Complementary Therapies ; Female ; Friends ; Humans ; Middle Aged ; Ships

In postmenopausal osteoporosis, estrogen deficiency leads to unbalance of bone metabolism, decreased bone formation and increased bone resorption, and the result is reduced bone mineral density (BMD) and bone stiffness. The processes of bone formation and resorption involves the expression of integrins in anchoragedependent cells, such as osteoblast and osteoclast. The osteoporosis-induced rats frequently demonstrated the loss of trabecular bone volume in the tibia, vertebra and mandible due to estrogen depletion. However, in maxilla, study has been rare because of its anatomical limits. So the objective of this study was to investigate bony change and property of integrin expression in maxilla of osteoporosis-induced rats. 12-week-old female Sprague-Dawley rats were bilaterally ovariectomized (OVX). At 1, 2, 3, 4, 8 and 12 weeks, control and OVX group rats were sacrificed respectively. BMD of maxilla of the rats was measured using dual-energy X-ray absorptiometry (DEXA). And then the histopathologic observation, histomorphometric analysis and immunohistochemistry with CD44, alpha2 integrin, alpha5 integrin, alpha6 integrin, alphav integrin and beta3 integrin were done. BMD of alveolar bone in maxilla was decreased with significance statistically after OVX 4 weeks and was decreased 18.15% at OVX 12 weeks group compared to control group. From OVX 4 to 12 weeks, the thickness of periodontal ligament space was decreased, the number of osteoclast and the size of marrow stroma were increased than control group. By histomorphometric analysis, the size of marrow stroma of alveolar bone in maxilla was increased 86.42% at OVX 12 weeks group compared to control group. CD44 was widely expressed throughout the odontoblast, cementoblast, dental pulp, preiodontal ligament, osteocyte, osteoclast and perivascular tissue at control group, and CD44 immunoreactivity was increased the odontoblast, osteoblast and osteoclast at OVX groups. alpha2 integrin was expressed the odontoblast and osteoblast at control group, but alpha2 integrin immunoreactivity was decreased the osteoblast at OVX 12 weeks group. alpha5 integrin was expressed the cementoblast, osteoblast and osteoclast at control group, and alpha5 integrin immunoreactivity was decreased the osteoblast and was increased the osteoclast from OVX 4 weeks group. alpha6 integrin was weakly expressed the odontoblast, cementoblast, osteoblast and osteoclast at control group, and alpha6 integrin immunoreactivity was weakly increased the osteoclast from OVX 4 weeks. alphav integrin was expressed the odontoblast and osteoclast at control group, and alphav integrin immunoreactivity was strongly increased the osteoclast from OVX 4 weeks. beta3 integrin was expressed the osteocyte and osteoclast at control group, and beta3 integrin immunoreactivity was strongly increased the osteoclast from OVX 4 weeks. From these results, alveolar bone in maxilla of OVX rats was decreased BMD gradually. Moreover, alpha2 and alpha5 integrin expression of osteoblast was decreased, and alpha5, alphav and beta3 integrin expression of osteoclast was increased in OVX rats. Thus, this study indicates that consideration of reduced BMD is necessary in dental procedure of postmenopausal women.
Absorptiometry, Photon ; Animals ; Bone Density* ; Bone Marrow ; Bone Resorption ; Dental Cementum ; Dental Pulp ; Estrogens ; Female ; Humans ; Immunohistochemistry ; Integrin alpha2 ; Integrin alpha5 ; Integrin alpha6 ; Integrin alphaV ; Integrin beta3 ; Integrins ; Ligaments ; Mandible ; Maxilla* ; Metabolism ; Odontoblasts ; Osteoblasts ; Osteoclasts ; Osteocytes ; Osteogenesis ; Osteoporosis, Postmenopausal ; Ovariectomy* ; Periodontal Ligament ; Rats* ; Rats, Sprague-Dawley ; Spine ; Tibia

Wear of polyethylene liner and osteolysis appear to be topical problems after long-term follow-up in total hip arthroplasty(THA). Age and activity of patients, manufacturing procedure of polyethylene liner, thickness of the liner, position of acetabular cup, and material of artificial femoral head have of effects on the degree of wear. In addition, conformity, congruency and micromotion between liner and metal cup are likely to be related to the wear. The purpose of this study is 1) to determine the stress caused by contact between metal and polyethylene components, 2) to evaluate the effects of conformity, congruency, and fixation between metal and polyethylene components, on contact stress in acetabular cups and 3) to identify the design parameters of the commercial acetabular cup within the constraints imposed by the overall functional requirements of total joint replacement. The specimens applied to six different commercial cups made in five companies. The methods was performed on dynamic test and static test to rely on load conditions, estimated the gap between the components through LM. The results showed H-G II cup had the most excellent congruency because of the narrowest interval between two components.
Acetabulum ; Head ; Hip ; Humans ; Joints ; Osteolysis ; Polyethylene*

Choledochocele is a kind of choledochal cyst and represents a prolapse or herniation of the intramural segment of the distal common bile duct into the duodenal lumen. It is rare congenital anomaly and, easlily overlooked due to non-specific clinical symptoms, signs, and non-characteristic radiologic features. The cause of choledochocele remains uncertain and it was suggested that thete are two distinct types in the pathogenesis of it, i.e., congenital and acquired. Recently, many cases of choledochocele were reported, which diagnosed by ERCP and safely treated with endoscopic unroofing and EST followed by continued observation as well as interval ERCP and/or endoscopic ultrasonography. We present here four cases of symptomaatic choledochoceles that had been managcd by end- oscopic therapy and continucd observation.
Biliary Tract* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Endosonography ; Pancreas* ; Prolapse

BACKGROUND: Fascioliasis is a zoonotic helminthiasis by fasciola species and is occasionally complicated by liver abscess, and the treatment of choice is oral bithionol, which is not available in Korea. Most clinical reports showed that praziquantel given at usual dosage (75 mg/kg for 1day) failed to cure Fasciola hepatica infections, however, it has not been investigated whether long-term praziquantel (70 mg/kg/d for 7 days) would be effective. We evaluated the effectiveness of long term praziquantel therapy in patients with Fasiola liver abscess. METHOD: Three patients who were diagnosed as liver abscess by F. hepatica were included in the current study. The diagnostic criteria for inclusion were 1) eosinophilia, 2) positive serologic test for F. hepatica antigen, 3) characteristic findings on CT scan and 4) demonstration of aggregates of eosinophils on ultrasonography-guided aspirates of the abscess. Praziquantel was given orally to patients at the daily dose of 70-84mg/kg for 7 days. The effectiveness was assessed by the normalization of eosinophil count at the end of 3 months and the disappearance of abscess cavity on ultrasonography or CT scan one year after treatment. RESULTS: Blood eosinophil count decreased less than 500/mm3 in all patients within 2 to 3 months. The liver abscesses reduced in size by 90% in 5 months in one patient and disappeared within a year in two patients. No major adverse effects were observed. CONCLUSION: We conclude that 7-day praziquantel therapy may be effective and safe in the treatment of liver abscess caused by F. hepatica.
Abscess ; Bithionol ; Eosinophilia ; Eosinophils ; Fasciola hepatica ; Fasciola* ; Fascioliasis ; Helminthiasis ; Humans ; Korea ; Liver Abscess* ; Liver* ; Praziquantel* ; Ranunculaceae ; Serologic Tests ; Tomography, X-Ray Computed ; Ultrasonography