Trichoadenoma is a rare tumor with differentiation towards the infundibular portion of the pilosebaceous canal. Clinically, it is a nodular growth, usually on the face and buttock. Histologically, it is characterized by numerous horn cysts lined with squamous epithelium in the dermis. In this report, we describe a 44-year-old man who developed trichoadenoma on his right shin. Anti-CD34 antibody stained spindle-shaped cells in the stroma just adjacent to the peripheral layers of keratinous cysts and solid masses of squamous epithelial cells. To our knowledge, this is the first description of an occurrence of trichoadenoma in the lower leg and the first to use immunohistochemical staining to know the CD34 staining pattern.
Adult ; Animals ; Buttocks ; Dermis ; Epithelial Cells ; Epithelium ; Horns ; Humans ; Leg

PURPOSE: To analyze the incidence and clinical course of epithelial ingrowth after laser in situ keratomileusis (LASIK) using a femtosecond laser. METHODS: We retrospectively evaluated the results of 1158 eyes of 581 patients who received LASIK with the flap created by a femtosecond laser from February 2006 to March 2009 at our institute. We investigated the incidence and clinical course of LASIK in which the flap was created by a femtosecond laser. RESULTS: Epithelial ingrowth was first detected one week after surgery in 12 (57%) of 21 eyes and within one month in 19 eyes (90%). Epithelial ingrowth was localized most commonly near the temporal and nasal flap edge in 12 eyes (57%). In two eyes (9.5%), an isolated ingrowth mass was located in the pupillary area. The development of more than 2.0 mm of epithelial ingrowth was observed in three eyes (0.25%). Among 28 eyes with loose epithelium or epithelial detachment during surgery, epithelial ingrowth was observed in six eyes (21.4%) compared with 15 (1.32%) of 1130 eyes without loose epithelium or epithelial detachment. Therefore, epithelial detachment during surgery was significantly associated with epithelial ingrowth (p = 0.00). CONCLUSIONS: In LASIK in which the flap is created by a femtosecond laser, damage to the epithelial layer increases the chances of epithelial ingrowth. Therefore, avoiding epithelial defects with a gentle maneuver is needed to reduce the chance of epithelial ingrowth during surgery.
Epithelium ; Eye ; Humans ; Incidence ; Keratomileusis, Laser In Situ ; Retrospective Studies

Acidic primer is the bonding agent which combines the conditioning and priming agent into the single solution and was originally developed for the dentin bonding system. It is less harmful to the tooth structure and more convenient to manipulate than the traditional etching procedure. The purpose of this study is to evaluate the shear bond strength of various bonding materials when the enamel is treated with acidic primer for the bracket bonding procedure. Fifty recently extracted human premolars were randomly separated into five groups : Group I using Clearfil Liner Bond 2 adhesive system to the enamel treated with acidic primer, Group II using Transbond XT adhesive system to the enamel treated with acidic primer, Group III using panavia 21 adhesive system to the enamel treated with acidic primer, Group IV using Fuji-Ortho LC adhesive system to the enamel treated with acidic primer, Group V using Transbond XT adhesive system to the enamel treated with 37% phosphoric acid. The shear bond strength was measured with Instron universal testing machine after storing in 37oC water bath for 48 hours. After debonding, the teeth and brackets were examined under scanning electron microscope (SEM) and assessed with the adhesive remnant index (ARI). The results were as follows : 1. There were no significant differences in shear bond strength between group III (8.69 +/- 2.72 MPa), group IV (9.7 +/- 3.16 MPa), and group V (10.48 +/- 2.60 Mpa) (p>0.05). 2. The shear bond strength of group III and group IV was significantly higher than that of group I (1.09 +/- 0.53 Mpa), and Group II (2.70 +/- 1.46Mpa) (p<0.05). 3. The ARI of group IV (2.1 +/- 1.1) and group V (2.9 +/- 0.3) was significantly higher than that of group I (0.2 +/- 0.4), group II (0.3 +/- 0.9) and group III (0.2 +/- 0.4) (p<0.05). 4. There were no significant difference between the ARI of group IV and group V (p>0.05). This result suggests that the combination of acidic primer and some bonding adhesive can provide sufficient shear bond strength for clinical orthodontics.
Adhesives ; Baths ; Bicuspid ; Dental Cements* ; Dental Enamel ; Dentin ; Humans ; Orthodontics ; Tooth ; Water

Otologic complaints, including otalgia, tinnitus, vertigo, and hearing loss, are known to be related to temporomandibular disorders (TMDs). There have been several hypotheses regarding the clinical correlation between otologic complaints and TMDs, based on clinical phenomena with corresponding symptoms, the close neurological relationship between otic and masticatory structures, and anatomical features of the tympanic cavity and jaw joint. Function of the tensor tympani muscle seems to be crucial to understanding TMD-related otologic symptoms. The tensor tympani inserts into the handle of the malleus and it modulates sound transduction in situations of excessive noise. This muscle is innervated by the trigeminal nerve, like the masticatory muscles. Voluntary eardrum movement by pathological tensor tympani contraction results in various otologic symptoms. Thus, co-contraction of the tensor tympani with the masticatory muscle could be a possible cause of TMD-related otologic symptoms. The tensor tympani is rather unrelated to the acoustic reflex, in which the stapedius is strongly involved. The tensor tympani seem to be controlled by proprioceptive information from the trigeminal sensory nucleus. The peripheral innervation pattern of the tensor tympani and masticatory muscles is also supposed to be interconnected. The middle ear structure, including the malleus, incus, and tensor tympani, of mammals had been adapted for acoustic function and lacks the masticatory role seen in non-mammalian jawed vertebrates. The tensor tympani in non-mammals is one of the masticatory muscles and plays a role in the modulation of sound transduction and mastication. After the functional differentiation of the mammalian middle ear, the nervous connection of the tensor tympani with other masticatory apparatus still remains. Through this oto-stomatognathic vestige, the tensor tympani seems to contract unnecessarily in some pathological conditions of the TMD in which the masticatory muscles contract excessively. We hypothesized that the phylogenic relationship between the tensor tympani and masticatory apparatus is a significant and logical reason for TMD-related otologic complaints.
Acoustics ; Ear, Middle ; Earache ; Hearing Loss ; Incus ; Jaw* ; Joints ; Logic ; Malleus ; Mammals ; Mastication ; Masticatory Muscles ; Noise ; Reflex, Acoustic ; Stapedius ; Temporomandibular Joint Disorders ; Tensor Tympani* ; Tinnitus ; Trigeminal Nerve ; Tympanic Membrane ; Vertebrates ; Vertigo

The effects of pretreatment of Co-Cr alloy, including two adhesive primers that contain either MDP or MAC-10, and silicoating on the bond. The results obtained as follows : Strength of 4-META/MMA-TBB resin were investigated using FT-IR SEM, and EDAX. in the SEM observation of surface morphologies, the sandblasted specimen exibited a very rough surface, whereas the surfaces of the two groups primed with either MDR or MAC-10 were covered with a layer of primer, and the surface morphology of the silicoated specimen remained almost the same after sandblasting. Before the thermocycling tests, the group treated with MDP demonstrated the highest mean tensile bond strength and the sandblasted group showed the lowest bond strength. After 20,000 themocyling, the mean tensile bond strength of the sandblasted group exhibited a 50% reduction in bond strength, while the other showed a 20~30% reduction. Observation of the metal-resin interface revealed that in all groups the resin permeated the rough surface formed by sandblasting thereby producing a mechnical bond between the metal and the resin, It was also found that thermocycling resulted in a gap formation at the metal-resin interface of the specimens, and the sandblasted group exhibited a larger gap width than the other groups. in fracture mode, all specimens indicated a cohesive fracture within the resin before thermocycling. However, thermocyling produced adhesive failure at the edge of the resin-metal interface in most specimens, The sandblasted group, which exhibited the lowest bond strength after thermocycling, also demonstrated the largest area of adhexive failure.
Adhesives ; Alloys*

Liposclerosis is a feature of chronic venous insufficiency. Clinically, liposclerosis is characterized by induration and variable hyperpipmention located on the skin of the leg and ankle. A 49-year-old male was presented with dark brown colored indurated plaque with the appearance of an inverted bottle on the lower leg. He had a history of stasis dermatitis on the area. The main histopathologic finding was broad septal fibrosis, where there were scattered hemosiderin, thick-walled and tortuous vessels, and fibrin deposition stained by phosphotungstic acid-hematoxyline (PTAH) stain.
Ankle ; Dermatitis* ; Fibrin ; Fibrosis ; Hemosiderin ; Humans ; Leg ; Male ; Middle Aged ; Skin ; Venous Insufficiency

Treatment of tumors on the lip often present special difficulties in selecting the appropriate modality of treatment that will provide the patient with the best cosmetic result. The complex functions and contours of the lip, the many small cosmetic subunits and the limited availability of adjacent skin make the preservation of function and appearance difficult. Five cases comprised of 4 cases of squamous cell carcinoma, 1 case of basal cell carcinoma on the lip, particulary involved in the vermilion border. Five cases of malignant tumors were removed by total excision, followed by reconstructive surgery, such as A-T advancement flap, and advancernent flap after fusiform excision with angles greater than 30o (i.e., 60o), W-plasty, bilateral opposing advancement flap. We can treat malignant tumors on the lip involved upto one half of the total length by simple excision followed by reconstructive surgery under local anesthesia without great hazards. In our experience, surgical treatment is one of the best treatments for malignant tumors.
Anesthesia, Local ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans ; Lip* ; Skin

Percutaenous transhepatic biliary drainage (PTBD) is widely used to control cholangitis, sepsis, or jaundice caused by biliary tree obstruction. The PTBD tract can be used in percutaneous biliary stone extraction in pre-or post-operative state when ERCP is failed or operation is contraindicated. We performed 16 cases of percutaneous transhepatic biliary stone removal. Locations of biliay stones are combined intrahepatic and extrahepatic in 8 cases (50%), only extrahepati in 7 cases (44%), and only intrahepatic in 1 case (6%). The number of stones was single in 6 cases and multiple in 10 cases. Over all success rate was 81% (13/16), 93% (14/15) in extrahepatic stones and 78% (7/9) in intrahepatic stones. In 5 of 6 cases, complete stone removal was impossible due to marked tortuosity of T-tube tract or peripherally located stones, complete removal of biliary stones was achieved via a new PTBD tract. No significant pre-or post-procedure complication was occured. Percutaneous removal of biliary stones via PTBD tract is an effective and safe alternative method in difficult cases in the menagement of biliary tract stones.
Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Drainage ; Jaundice ; Methods ; Sepsis

Isovolumic phase indices of right ventricular(RV) systolic function were evaluated in 9 normal control cases(Group I) and 9 patients with mitral stenosis(Group IIa) and 8 patients with mitral stenosis and aortic regurgitation(Group IIb). RV systolic pressures of all patients in Group II(n=17) were over 40mmHg RV dp/dt max, Vmax and Vpm were measured by digitizing method and V(CE10) were measured by manual tangent method. RV isovolumic contractile functional indices were greater in Group II(n=17) compared with those in Group I(n=9) : RV dp/dt max(mmHg. Sec(-1)) 347.8+/-104.4(mean+/-SD) VS 230.5+/-65.5(p<0.05), Vmax(Sec(-1)) 30.9+/-10 VS 20.1+/-5.18(p<0.05), Vpm(Sec(-1)) 22.96+/-9.63 VS 14.8+/-4.04(p<0.05) and V(CE10)(Sec(-1)) 20.4+/-7.11 VS 12.5+/-5.31(p<0.05). But no significant differences were noted between Group IIa(n=9) and Group IIb(n=8) in these indices. In all cases(n=26), significant correlations were noted between V(CE10) and Vmax(r=0.90), V(CE10) and Vpm(r=0.85). We summurized that RV contractile function is preserved in many cases with mitral stenosis and V(CE10) may be used as an convenient index for RV contractile function.
Humans ; Mitral Valve Stenosis*

BACKGROUND: Cyclosporin A (CsA), a potent immunosuppressant, has been reported to be effective in the treatment of severe atopic dermatitis (AD). OBJECTIVE: The aim of this study was to evaluate the efficacy and side-effects of CsA in Korean patients with severe AD. MATERIALS AND METHODS: 16 patients with recalcitrant AD took CsA for at least 6 weeks. Among them, 11 patients were followed up for more than 16 weeks. Initial dose was 5mg/kg/day (maximum 300 mg/day) and the dose was reduced according to their therapeutic responses. SCORAD (Scoring AD) was used to evaluate clinical efficacy of CsA. During the 1st month of therapy, the therapeutic efficacy and side-effects were evaluated every 2weeks and after 1 month, every month. We checked blood pressure and laboratory abnormalities including liver function test, blood urea nitrogen (BUN), creatinine (Cr) and urinalysis at each visit in addition to observing clinical adverse effects. RESULTS: Significant reduction of SCORAD was noted in 15 patients after 6 weeks of CsA therapy. Only one patient stopped CsA therapy because of the elevation of blood pressure. Three patients showed albuminuria, which disappeared after CsA dose reduction. CONCLUSION: CsA can be used effectively and safely in severe Korean AD patients. Albuminuria seems to be a peculiar side-effect in Korean patients.
Albuminuria ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Cyclosporine* ; Dermatitis, Atopic* ; Humans ; Liver Function Tests ; Urinalysis