Sacral pressure sores have been treated by a variety of surgical methods. complete treatment needs wide excision and coverage with healthy tissue which has constant and sufficient blood supply. Use of gluteus maximus muscle flap with or without overlying skin is a revolutionary method because of the reliability of blood supply. However, it is technically a little bit complicated, and future reconstruction for recurrent decubitus is especially limited in paraplegic patients. The development of gluteal perforator-based flap with para-sacral perforator introduce a new treatment modality for the sacral pressure sores. Total 10 cases of sacral pressure sores were treated with gluteal perforator-based flap. There were minimal postoperative complications except wound dehiscence in one case. This flap has a many advantage of no transection or sacrifice of the gluteus maximus muscle, elevation time for the flap is short, reliable blood flow of the perforator, large rotation arc and no post-operative hindrance to walking in patients who are not paraplegic. The disadvantages of this perforator-based flaps are the anatomical variation in the location of perforators and the need for technically careful dissection.
Humans ; Postoperative Complications ; Pressure Ulcer* ; Skin ; Walking ; Wounds and Injuries

No abstract available.
Animals ; Ischemia* ; Muscle, Skeletal* ; Rats* ; Reperfusion*

PURPOSE: The aim of this study is to reveal the detailed clinical features of diarrhea- associated benign infantile convulsion. METHODS: We studied 34 patients with diarrhea-associated benign infantile convulsion between March 2000 and February 2004. RESULTS: There were 34 patients with diarrhea-associated benign infantile convulsion : 19 boys and 15 girls. The age of the disease onset ranged from 3 to 34(mean; 18.7+/-6.6) months. The incidence was high from November to March. The types of the seizures were generalized tonic-clonic or generalized tonic in 32(94%) of 34 episodes, while the seizure types changed during episodes for 2 patients. The durations of seizures were from 3 sec to 10 min. 2 or more seizures occurred in 22(64.7%) episodes. A family history of febrile or afebrile convulsions was noted in 3 patients. There were no abnormalities in serum biochemistry tests. 12 out of 22 patients showed positive rotavirus antigen tests. Interictal EEG's were normal in 26 out of 30 episodes. CT or MRI demonstrated no neuroradiological abnormalities in 13 out of 14 patients. 4 patients experienced recurrence of diarrhea-associated benign infantile convulsion, but none had more than 2 episodes. Epilepsy developed in none of the patients during the follow-up period. CONCLUSION: Diarrhea-associated benign infantile convulsion is characterized by a cluster of seizures. A continous or intermittent antiepileptic treatment is not required because recurrence or later development of epilepsy is rare. Appropriate treatment for a cluster of seizures will be the subject of future studies.
Biochemistry ; Diarrhea ; Epilepsy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Infant ; Magnetic Resonance Imaging ; Recurrence ; Rotavirus ; Seizures*

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.
Acetazolamide* ; Arteriovenous Malformations* ; Brain* ; Humans ; Perfusion* ; Prognosis* ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Animals ; Antibodies, Neutralizing* ; Immunization* ; Mice*

PURPOSE: To evaluate position of the mandibular condyle within articular fossa in an asymptomatic population radiographically by a cone beam computed tomography. MATERIALS AND METHODS: Cone beam computed tomography of 60 temporomandibular joints was performed on 15 males and 15 females with no history of any temporomandibular disorders, or any other orthodontic or prosthodontic treatments. Position of mandibular condyle within articular fossa at centric occlusion was evaluated. A statistical evaluation was done using a SPSS. RESULTS: In the sagittal views, mandibular condyle within articular fossa was posteriorly located at medial and central sections. In the coronal views, mandibular condyle within articular fossa was laterally located at central section. Mandibular condyles in the right and left sides were showed asymmetric positional relationship at medial,central, and lateral sections. CONCLUSION: Mandibular condyle within articular fossa in an asymptomatic population was observed nonconcentric position in the sagittal and coronal views.
Cone-Beam Computed Tomography* ; Female ; Humans ; Male ; Mandibular Condyle* ; Prosthodontics ; Temporomandibular Joint ; Temporomandibular Joint Disorders

PURPOSE: To assess the internal echo intensity and morphological variability of masseter muscles on ultrasonography and to establish diagnostic criterion of estimation. MATERIALS AND METHODS: Participants consisted of 50 young adults (male 25, female 25) without pathologic conditions and with full natural dentitions. Sonographic examinations were done with real time ultrasound equipment as Logiq 500 (GE Medical Systems, Seoul, Korea) at 3 parts according to lines paralleling with ala-tragus line as reference line. The thickness and area of masseter muscles according to reference line in cross-sectional images were measured at rest and at maximum contraction. The visibility and width of the internal echogenic intensity of the masseter muscles were also assessed and the muscle appearance was classified into 4 types. Data were statistically analyzed by paired t-test and chi-square-test. RESULTS: 1. When comparing the thickness and area of masseter muscles concerning with gender, there was few significant difference between right and left sides, however, there were significant differences between males and females except for the greatest thickness of left side. 2. The changes of the greatest thickness and the area between rest and maximum contraction showed that the part of the least thickness manifested more increase at maximum contraction. 3. Each part the manifestations of the internal echogenic intensity of the masseter muscles were different depending on the locations. But there was no statistically significance. CONCLUSION: Changes of muscles thickness with contraction and internal echogenic intensity with locations showed great disparity within the masseter muscles, which will be diagnostic criteria for pathophysiologic and anatomic changes of masseter muscles.
Contracts ; Dentition ; Female ; Humans ; Male ; Masseter Muscle ; Muscles ; Young Adult

PURPOSE: To observe and evaluate the effects of Simvastatin-induced osteogenesis on the wound healing of defective bone. MATERIALS AND METHODS: 64 defective bones were created in the parietal bone of 32 New Zealand White rabbits. The defects were grafted with collagen matrix carriers mixed with Simvastatin solution in the experimental group of 16 rabbits and with collagen matrix carriers mixed with water in the controlled group. The rabbits were terminated at an interval of 3, 5, 7, and 9 days, 2, 4, 6, and 8 weeks after the formation of defective bone. The wound healing was evaluated by soft X-ray radiography. The tissues within defective bones were evaluated through the analysis of flow cytometry for the manifestation of Runx2 and Osteocalcin, and observed histopathologically by using H-E stain and Masson-Trichrome stain. RESULTS: 1. In the experimental group, flow cytometry revealed more manifestation of Runx2 at 5, 7, and 9 days and Osteocalcin at 2 weeks than in the controlled groups, but there was few difference in comparison with the controlled group. 2. In the experimental group, flow cytometry revealed considerably more cells and erythrocytes at 5, 7, and 9 days in comparison with the controlled group. 3. In the experimental group, soft x-ray radiography revealed the extended formation of trabeculation at 2, 4, 6, and 8 weeks. 4. histopathological features of the experimental group showed more fibroblasts and newly formed vessels at 5 and 7 days, and the formation of osteoid tissues at 9 days, and the newly formed trabeculations at 4 and 6 weeks. CONCLUSION: As the induced osteogenesis by Simvastatin, there was few contrast of the manifestation between Runx2 and Osteocalcin based on the differentiation of osteoblasts. But it was considered that the more formation of cells and erythrocytes depending on newly formed vessels in the experimental group obviously had an effect on the bone regeneration.
Collagen ; Erythrocytes ; Fibroblasts ; Flow Cytometry ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Parietal Bone ; Rabbits ; Simvastatin ; Transplants ; Water ; Wound Healing

TS-1 is an oral anti-cancer agent for gastric cancer with a high response rate and low toxicity. We report a case of long-term drug retention of TS-1 causing interstitial lung disease (ILD) as a fatal adverse reaction. A 65-year-old woman underwent a total gastrectomy with pathologic confirmation of gastric adenocarcinoma. She received 6 cycles of TS-1 and low-dose cisplatin for post-operative adjuvant chemotherapy followed by single-agent maintenance therapy with TS-1. After 8 months, the patient complained of a productive cough with sputum and mild dyspnea. A pulmonary evaluation revealed diffuse ILD in the lung fields, bilaterally. In spite of discontinuing chemotherapy and the administration of corticosteroids, the pulmonary symptoms did not improve, and the patient died of pulmonary failure. TS-1-induced ILD can be caused by long-term drug retention that alters the lung parenchyma irreversibly, the outcome of which can be life-threatening. Pulmonary evaluation for early detection of disease is recommended.
Adenocarcinoma ; Adrenal Cortex Hormones ; Aged ; Chemotherapy, Adjuvant ; Cisplatin ; Cough ; Dyspnea ; Early Diagnosis ; Female ; Gastrectomy ; Humans ; Lung ; Lung Diseases, Interstitial ; Retention (Psychology) ; Silicates ; Sputum ; Stomach Neoplasms ; Titanium

PURPOSE: To observe direct effect of irradiation on cariogenic Streptooccus mutans. MATERIALS AND METHODS: S. mutans GS5 was exposed to irradiation with a single absorbed dose of 10, 20, 30, and 40 Gy. Viability and changes in antibiotic sensitivity, morphology, transcription of virulence factors, and protein profile of bacterium after irradiation were examined by pour plate, disc diffusion method, transmission electron microscopy, RT-PCR, and SDS-PAGE, respectively. RESULTS: After irradiation with 10 and 20 Gy, viability of S. mutans was reduced. Further increase in irradiation dose, however, did not affect the viability of the remaining cells of S. mutans. Irradiated S. mutans was found to have become sensitive to antibiotics. In particular, the bacterium irradiated with 40 Gy increased its susceptibility to cefotaxime, penicillin, and tetracycline. Under the transmission electron microscope, number of morphologically abnormal cells was increased as the irradiation dose was increased. S. mutans irradiated with 10 Gy revealed a change in the cell wall and cell membrane. As irradiation dose was increased, a higher number of cells showed thickened cell wall and cell membrane and lysis, and appearance of ghost cells was noticeable. In RT-PCR, no difference was detected in expression of gtfB and spaP between cells with and without irradiation of 40 Gy. In SDSPAGE, proteins with higher molecular masses were gradually diminished as irradiation dose was increased. CONCLUSION: These results suggest that irradiation affects the cell integrity of S. mutans, as observed by SDSPAGE, and as manifested by the change in cell morphology, antibiotic sensitivity, and eventually viability of the bacterium.
Anti-Bacterial Agents ; Cefotaxime ; Cell Membrane ; Cell Wall ; Dental Caries ; Diffusion ; Electrophoresis, Polyacrylamide Gel ; Microscopy, Electron, Transmission ; Penicillins ; Radiotherapy ; Streptococcus mutans* ; Streptococcus* ; Tetracycline ; Virulence Factors ; Xerostomia