Crohns disease is a granulomatous isease of the gastrointetin 1 tract, especially terminal ileum, but may involve the lip, mouth, anus, skin, liver and bone. The skin is a common site of extraintestinal involvement in Crohns disease, with the perianil, perineal, and peristomal areas most frequently affected. Vulvar involvement, however, is an uncommon extraintestinal manifestantion of Crohns disease. We report a case of a 16-year-old girl with Crohns disease of the vulva and perianal region. A histopathologic study of the descending colon and vulvar skin showed noncaseating granulomatous reactions composed of lymphocytes, epithelioidell and giant cells. We were able to make the diagnosis of Crohns disease of the vulvar and the patient was treated with prednisolone and metronidazole.
Adolescent ; Anal Canal ; Colon, Descending ; Crohn Disease* ; Diagnosis ; Female ; Giant Cells ; Humans ; Ileum ; Lip ; Liver ; Lymphocytes ; Metronidazole ; Mouth ; Prednisolone ; Skin ; Vulva*

We present a case of malignant melanoma associated wi h itiligo in the 49 year-old female patient. Skin lesions showed that centrally located dark black nodile surrounded with brownish colored plaque on the upper half and depigmented patch on the lower half on the left upper thigh and depigmented patch on the right forehead. In western countries, patients with melanoma have been obscrved to develop vitiligo or depigmented spots on the skin, while in korea, rarely observed. We reports that malignant melanoma associated with vitiligo.
Female ; Forehead ; Humans ; Korea ; Melanoma* ; Middle Aged ; Skin ; Thigh ; Vitiligo*

This study examined the disinfection conditions (exposure time, 0–30 min; exposure temperature, 4℃–65℃) of hypochlorous acid water (HOCl) in automobile disinfection equipment. The study tested poliovirus type 1 (PV1), low pathogenic avian influenza virus (AIV, H9N2), and foot and mouth disease virus (FMDV, O type). As a result, the PV1 and FMD viruses were inactivated easily (virus titer 4 log value) by HOCl (> 100 ppm) but the AIV required higher exposure temperatures (> 55℃). In conclusion, the exposure temperature and time are important factors in deactivating AIV and FMDV.

This study examined the disinfection conditions (exposure time, 0–30 min; exposure temperature, 4℃–65℃) of hypochlorous acid water (HOCl) in automobile disinfection equipment. The study tested poliovirus type 1 (PV1), low pathogenic avian influenza virus (AIV, H9N2), and foot and mouth disease virus (FMDV, O type). As a result, the PV1 and FMD viruses were inactivated easily (virus titer 4 log value) by HOCl (> 100 ppm) but the AIV required higher exposure temperatures (> 55℃). In conclusion, the exposure temperature and time are important factors in deactivating AIV and FMDV.
Animals ; Automobiles ; Disinfection ; Foot-and-Mouth Disease Virus ; Foot-and-Mouth Disease ; Hypochlorous Acid ; Influenza in Birds ; Poliovirus ; Water

The complications and sequelae after the mandibular surgery are related to inferior alveolar neurovascular bundles, which pass through the mandibular canal. The knowledge of their positions would decrease the risk of mandibular surgery dramatically and would be used for the development of the new surgical techniques. This study was undertaken to clarify the anatomical position of mandibular canal for the mandibular surgery. Forty four mandibules (23 males and 21 females average 66.5 years) obtained from the collection of Hanyang medical college were studied. The location of mandibular canal in the sections between premolars and molars were measured. The obtained results were as follows; At first, the mandibular canal lay lingual to the distal part of the body of the mandible. It then ran anteriorly and to the buccal part of the mandible between the first and the second premolars. In the sections between premolars and molars, the distance between the mandibular canal and the lower border of mandibular body was 8.9+/-1.9 mm at the position of the first molar, the distance between the deepest point of the alveolar socket and the mandibular canal was 9.5+/-3.5 mm at the second molar, which was the narrowest point. The results of this study would be useful to decrease the risk of the mandibular surgery and to develop the new techniques for mandibul surgery in the field of the dentistry and maxillofacial surgery.
Bicuspid ; Dentistry ; Female ; Humans ; Male ; Mandible* ; Molar ; Surgery, Oral

STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate the natural history of conservatively treated lumbar degenerative kyphosis (LDK). SUMMARY OF LITERATURE REVIEW: The correlations between the clinical and radiologic parameters of general adult spinal deformity (ASD) are widely known. However, in LDK, dynamic sagittal imbalance is present during ambulation, meaning that its pathogenesis and natural history are different and not widely recognized compared to those of other forms of ASD, resulting in many controversies regarding treatment. To elucidate the natural history of LDK, we analyzed the clinical and radiologic outcomes of patients, comparing their first and final follow-up visits, and evaluated correlations among clinical and radiologic parameters. MATERIALS AND METHODS: From June 2006 to January 2014, 31 patients diagnosed with LDK who underwent conservative treatment were studied. The mean age of the patients was 72.5 years, and the mean follow-up period was 59.2 months. Clinical and radiologic evaluations were conducted on the first and final follow-up visits. Clinical evaluations were done using a visual analog scale and the Oswestry disability index, and radiologic evaluations were performed using spinal and pelvic parameters over a follow-up period of at least 24 months. RESULTS: Patients who were diagnosed with LDK and underwent conservative treatment showed no significant differences in their clinical outcomes between the first and final follow-up. Some radiologic parameters significantly progressed. There were no significant differences between clinical and radiologic parameters at the initial and final follow-up visits. CONCLUSIONS: During the follow-up period of patients diagnosed with LDK, some radiologic parameters progressed. However, the progress of LDK and the clinical symptoms reported by the patients did not significantly change. Decisions regarding the treatment of LDK should not be made according to radiologic parameters showing the degree of deformity, but by carefully determining the patients' clinical symptoms and disability level.
Adult ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis* ; Natural History* ; Retrospective Studies ; Visual Analog Scale ; Walking

PURPOSE: To perform comparative analysis between the results of internal fixation and hemiarthroplasty in unstable intertrochanteric fracture of osteoporotic bone. MATERIALS AND METHODS: From February 2003 to February 2006, 36 patients treated surgically for unstable intertrochanteric fractures were evaluated. The patient's age was older than 70 year old; the T-score of preoperative bone mineral density (BMD) was lower than -3.0; they were followed up for more than 1 year. The patient were divided into two groups. One group was treated with dynamic hip screw or proximal femoral nail (Group A, 23 cases), and the other group was treated with bipolar hemiarthroplasty (Group B, 13 cases). The two groups were compared in terms of hip joint function using Clawson classification and radiologically. RESULTS: Nonunion and fixation failure happened in 6 cases (26%) of gruop A. However, all patients in group B showed stable maintenance of implant. Recovery of hip joint function was found in 13 cases (43%) of group A, whereas 12 cases (93%) of group B recovered. CONCLUSION: Nonunion and failure of fixation happened more frequently in internal fixation than bipolar hemiarthroplasty, and the postoperative hip joint function was better in bipolar hemiarthroplasty than internal fixation. Therefore, bipolar hemiarthroplasty might be better operative treatment for unstable intertrochanteric fracture of osteoporotic bone.
Bone Density ; Classification ; Hemiarthroplasty* ; Hip ; Hip Fractures ; Hip Joint ; Humans ; Osteoporosis

Recently, with the increasing interests in the endoscopic nasal surgery, it is essential for practitioners to have detailed knowledges of the anatomical structures for the successful surgery. This study was undertaken to provide morphological information of the nasal turbinates as anatomical reference during endoscopic nasal surgery. A total of 43 adult cadaver heads were bisected midsagitally and evaluated morphometrically. The results were as follows: The highest nasal turbinatee were observed in 66.7% of the case. After removal of the mucosa, the distances from the akanthion to the anterior end of superior, middle, inferior nasal turbinate were 46.75 mm, 38.23 mm, 18.51 mm respectively. The distances from the akanthion to the posterior end of superior, middle, inferior nasal turbinate were 55.11 mm, 54.72 mm, 50.26 mm respectively. The lengths of the superior, middle, inferior nasal turbinate were 22.20 mm, 40.14 mm, 40.97 mm respectively. The detailed measurements of the nasal turbinates performed in this study may provide useful anatomical landmarks for the endonasal endoscopic surgery.
Adult ; Cadaver ; Head ; Humans ; Mucous Membrane ; Nasal Surgical Procedures ; Turbinates*

OBJECTIVES: The purpose of this study was to assess the effect of sagittal spino-pelvic alignment on the clinical symptoms of thoracolumbar kyphosis (TLK; T10-L2 Cobb's angle >20°) in osteoporotic patients.SUMMARY OF LITERATURE REVIEW: Few studies have investigated the clinical symptoms and radiological features of TLK caused by degenerative changes. There is also controversy over whether clinical symptoms will deteriorate in patients with TLK or which treatment should be chosen according to the degree of TLK. MATERIALS AND METHODS: From May 2005 to May 2016, we reviewed 75 patients who were diagnosed with TLK (T10-L2 Cobb's angle >20°) and osteoporosis. Patients were excluded from the study if they had neurological symptoms, underlying spinal disorders, or unstable vertebral fractures. Fifty patients with TLK due to an osteoporotic vertebral compression fracture (group F) and 25 patients with senile TLK (group S) were assessed by clinical symptoms and radiological parameters. Thoracolumbar kyphosis angle and sagittal vertical axis (SVA) were also analyzed. Clinical symptoms were assessed using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: There were no significant differences in clinical symptoms (VAS, ODI) and radiological parameters between groups F and S, or according to the degree of TLK(20°–30°, 30°–40°, >40°). Clinical symptoms were significantly more severe in patients with sagittal imbalance (SVA >5 cm) than in those with sagittal balance. CONCLUSIONS Sagittal imbalance is a more important factor affecting clinical symptoms than the cause or the degree of TLK. Therefore, sagittal imbalance should be considered in the management of TLK in osteoporotic patients.

STUDY DESIGN: Retrospective study. OBJECTIVES: The purpose of this study was to assess the effect of sagittal spino-pelvic alignment on the clinical symptoms of thoracolumbar kyphosis (TLK; T10-L2 Cobb's angle >20°) in osteoporotic patients. SUMMARY OF LITERATURE REVIEW: Few studies have investigated the clinical symptoms and radiological features of TLK caused by degenerative changes. There is also controversy over whether clinical symptoms will deteriorate in patients with TLK or which treatment should be chosen according to the degree of TLK. MATERIALS AND METHODS: From May 2005 to May 2016, we reviewed 75 patients who were diagnosed with TLK (T10-L2 Cobb's angle >20°) and osteoporosis. Patients were excluded from the study if they had neurological symptoms, underlying spinal disorders, or unstable vertebral fractures. Fifty patients with TLK due to an osteoporotic vertebral compression fracture (group F) and 25 patients with senile TLK (group S) were assessed by clinical symptoms and radiological parameters. Thoracolumbar kyphosis angle and sagittal vertical axis (SVA) were also analyzed. Clinical symptoms were assessed using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: There were no significant differences in clinical symptoms (VAS, ODI) and radiological parameters between groups F and S, or according to the degree of TLK(20°–30°, 30°–40°, >40°). Clinical symptoms were significantly more severe in patients with sagittal imbalance (SVA >5 cm) than in those with sagittal balance. CONCLUSIONS: Sagittal imbalance is a more important factor affecting clinical symptoms than the cause or the degree of TLK. Therefore, sagittal imbalance should be considered in the management of TLK in osteoporotic patients.
Fractures, Compression ; Humans ; Kyphosis ; Osteoporosis ; Retrospective Studies