We present two cases of cerebral paragonimiasis in a 23-year-old Korean army soldier and in a 18-year-old Korean girl, respectively. The diagnosis was made on the basis of clinical, laboratory and x-ray findings, and was confirmed by the histopathological examination of the excised cyst. P.W. skin test showed positive reaction, whereas C.S. test negative. X-ray study on skull revealed multiple globulated round cystic formations in occipital region. Two months after surgical removal of cysts, visual field were not improved. Pertinent literatures are reviewed.
Adolescent ; Adult ; Blindness* ; Choroid* ; Coloboma* ; Diagnosis ; Female ; Hemianopsia* ; Heredity ; Humans ; Iris* ; Membranes ; Military Personnel ; Optic Nerve* ; Paragonimiasis* ; Skin Tests ; Skull ; Visual Fields ; Young Adult

Carotid angiography is a most important diagnostic procedure for investigation of intracranial lesions and for understanding the cerebral circulation. Of the cerebral arteries, only the posterior cerebral artery is, both functionally and anatomically, a border artery between the carotid and vertebral circulatory systems, so it is more important for an understanding of the cerebral circulation. Early in the development of the fetal circulation, the posterior cerebral artery arises from the internal carotid artery(carotid segment), with the connection to the basilar artery(basilar segment) developing later. In many cases, however, it derives its supply from both systems simultaneously. Angiographic demonstration of the posterior cerebral artery is influenced by certain pressure factors of the intracranial cavity and other technical factors, for example, site of puncture, needle size, injection time and force used and position of the head, ect. Here the author has analysed the factors of age, sex, puncture site and right of left side and a degree of hydrocephalus. Carotid angiography has been performed for definite indication, hence, no cerebral angiography has been performed on any entirely asymptomatic subject. The normal controls used in this investigation consist of angiographies done in subjects with symptoms but no evidence of vascular lesions or other abnormality. The author found a high incidence of the posterior cerebral arteries demonstrated in hydrocephalus, in spite of increased pressure and changed courses of the cerebral arteries. So, the cerebral arteriograms of normal cases are compared with those of hydrocephalic subjects and the chances of demonstrating the posterior cerebral artery in both groups are analysed. Engeset A.(1948), Saltzman(1959), Yasargil & Krayenbuhl(1964) and others reported the demonstration of the posterior cerebral artery but report of a relationship of the artery with hydrocephalus was not found. This study comprises 2,350 conventional carotid angiographies carried out from 1968 to 1973 in the neurosurgery department of Severance Hospital, Seoul, Korea. Out of these 2,350 angiographies, 1,288 were normal and 160 were indicative of hydrocephalus. The incidence of angiographic demonstration of the posterior cerebral artery in normal Koreans is 34.2% and in hydrocephalus, 45.6%. This is a higher incidence than is reported in the literature concerning conventional carotid angiography. The number of cases where the posterior communicating artery alone was filled was so small that there was no point in separating them according to age and sex, etc. Generally the hydrocephalic group showed a higher incidence of the posterior cerebral and posterior communicating arteries than the normal group. In all cases, the effect of sex difference is not significant but the effect of age is. The posterior cerebral artery was more visible in the younger groups and occurred most frequently in the youngest group, while the incidence dropped slightly in the higher age groups, in both normal and hydrocephalus groups. Filling of the posterior cerebral arteries in subjects aged 10-30 is markedly more frequent than in the 40-60 age range in both the normal and hydrocephalus groups. The posterior cerebral artery was demonstrated in 148 out of 384(38.6%) internal carotid arteriograms and in 292 out of 904(32.3%) common carotid arteriograms. This difference is highly significant and is similar to the results of Saltzman(1959). No significance of the right or left side difference could be found. The increasing tendency of the filling of the posterior cerebral artery in the more severe forms of hydrocephalus compared with the milder types was noted. In this report, the statistical significance was evaluated by means of the z-test.
Angiography ; Arteries* ; Cerebral Angiography ; Cerebral Arteries ; Head ; Humans ; Hydrocephalus* ; Incidence ; Korea ; Needles ; Neurosurgery ; Posterior Cerebral Artery ; Punctures ; Seoul ; Sex Characteristics

The face and notably the lips are important structures not only of aestheticvalue but also for expression, vibrancy and vitality. Sometimes we are encountered with the functional and aesthtetic lip problems especially in the patients with mandibular prognathism, such as excessive vermilion exposure, lip incompetence and hyperactivity of mentalis muscle. The etiologic factors are usually related to excessive anterior facial height, secondary to the abnormal development of perioral muscle, salivary gland and the swelling of lymphatic gland. Sometimes orthognathic surgery (mandibular setback osteotomy) alone is not accepted regarding to aesthetic value, there is likely to be a corresponding interest in adjunctive procedures such as genioplasty and soft tissue procedures. This article urges the incorporation of reduction cheiloplasty. It is a relatively minor procedure that can be easily reproducible and yields excellent, predictatable results with few complications. We treated two patients who have excessive vermilion exposure and marked abnormal lip eversion using reduction cheiloplasty combined with mandibular setback osteotomy, followed by improved facial harmony and patients were pleased.
Genioplasty ; Humans ; Lip ; Orthognathic Surgery ; Osteotomy* ; Prognathism ; Salivary Glands

STATEMENT OF PROBLEM: Macroscopic and especially microscopic properties of implant surfaces play a major role in the osseous healing of dental implants. Dental implants with modified surfaces have shown stronger osseointegration than implants which are only turned (machined). Advanced surface modification techniques such as anodic oxidation and Ca-P application have been developed to achieve faster and stronger bonding between the host bone and the implant. PURPOSE: The purpose of this study was to investigate the effect of surface treatment of titanium dental implant on implant stability after insertion using the rabbit tibia model. MATERIAL AND METHODS: Three test groups were prepared: sandblasted, large-grit and acid-etched (SLA) implants, anodic oxidized implants, and anodized implants with Ca-P immersion. The turned implants served as control. Twenty rabbits received 80 implants in the tibia. Resonance frequencies were measured at the time of implant insertion, 2 weeks and 4 weeks of healing. Removal torque values (RTV) were measured 2 and 4 weeks after insertion. RESULTS: The implant stability quotient (ISQ) values of implants for resonance frequency analysis (RFA) increased significantly (P < .05) during 2 weeks of healing period although there were no significant differences among the test and control groups (P > .05). The test and control implants also showed significantly higher ISQ values during 4 weeks of healing period (P < .05). No significant differences, however, were found among all the groups. All the groups showed no significant differences in ISQ values between 2 and 4 weeks after implant insertion (P > .05). The SLA, anodized and Ca-P immersed implants showed higher RTVs at 2 and 4 weeks of healing than the machined one (P < .05). However, there was no significant difference among the experimental groups. CONCLUSION: The surface-modified implants appear to provide superior implant stability to the turned one. Under the limitation of this study, however, we suggest that neither anodic oxidation nor Ca-P immersion techniques have any advantage over the conventional SLA technique with respect to implant stability.
Dental Implants ; Imidazoles ; Immersion ; Nitro Compounds ; Osseointegration ; Rabbits ; Tibia ; Titanium ; Torque

In 1921, Dandy discussed the clinical diagnosis and treatment of hydrocephalus secondary to occlusion of the foramina of Magendie and Luschka. In 194, Walker reported a case of congenital atresia of the outlets of the fourth ventricle treated surgically. Since a detailed study of this disease entity by Benda in 1954, the condition has commonly been known by the term, the Dandy-Walker syndrome. In 1968, Raimondi and et al refered this condition as the Dandy-Walker cyst. There is considerable discussion as to the nature of the fundamental embryologic error in this condition, but Denda suggested that atresia of developing fourth ventricular foramina was only a part of the syndrome and not its cause, because in some cases reported, the foramina were found to be patent. These patients. Show characteristic clinical symptoms, signs and radiological findings and should suggest the correct diagnosis. This syndrome was one of the first cause of hydrocephalus to be treated successfully by surgery. We are reporting one case of this cyst encountered recently at Yonsei University Medical Center.
Academic Medical Centers ; Dandy-Walker Syndrome* ; Diagnosis ; Fourth Ventricle ; Humans ; Hydrocephalus

In 1921, Dandy discussed the clinical diagnosis and treatment of hydrocephalus secondary to occlusion of the foramina of Magendie and Luschka. In 194, Walker reported a case of congenital atresia of the outlets of the fourth ventricle treated surgically. Since a detailed study of this disease entity by Benda in 1954, the condition has commonly been known by the term, the Dandy-Walker syndrome. In 1968, Raimondi and et al refered this condition as the Dandy-Walker cyst. There is considerable discussion as to the nature of the fundamental embryologic error in this condition, but Denda suggested that atresia of developing fourth ventricular foramina was only a part of the syndrome and not its cause, because in some cases reported, the foramina were found to be patent. These patients. Show characteristic clinical symptoms, signs and radiological findings and should suggest the correct diagnosis. This syndrome was one of the first cause of hydrocephalus to be treated successfully by surgery. We are reporting one case of this cyst encountered recently at Yonsei University Medical Center.
Academic Medical Centers ; Dandy-Walker Syndrome* ; Diagnosis ; Fourth Ventricle ; Humans ; Hydrocephalus

Malignant melanoma of the spinal cord is a rare tumor 3,8,9,12 The melanomas that originate in the meninges bear a general structural resemblance to those arising elsewhere, but it is questionable whether they ever metastasis outside the central nervous system7. If can be also argued that the primary central nervous system melanoma could actually be a metastasis from an occult primary site in the skin, esophagus, rectum or other sites6. We are reporting a case of malignant melanoma involving the cervical spinal meninges and hard palate.
Central Nervous System ; Esophagus ; Melanoma* ; Meninges ; Neoplasm Metastasis ; Palate, Hard ; Rectum ; Skin ; Spinal Cord*

BACKGROUND: We described a surgical method for osteosynthesis and reported the resultant strength after application of a PHILOS plate through the anterolateral approach for the treatment of fractures of the distal humerus. METHODS: Between February 2010 and March 2012, open reduction and internal fixation operations with the PHILOS plate for treatment of fracture of the distal humerus were performed on a total of nine patients (five men, four women). The mean age was 40.8 years (range, 24-50 years), and the average follow-up period was 9.1 months (range, 6-15 months). Clinical evaluations were performed 6 months after the operation. Clinical assessment included determination of the range of motion of the elbow, the Mayo and Oxford elbow scores, and any postoperative complications. RESULTS: Fracture union was noted in all patients, with an average period of 12.4 weeks. The average Mayo elbow and Oxford elbow scores were 87.2 (of a total of 100) and 43.3 (of a total of 48), respectively. For the postoperative range of motion of the elbow, all patients showed complete recovery to the preoperative range of motion. No other conditions, such as neurolepsis, plate breakage, or rotational deformity, were observed. CONCLUSIONS: Open reduction and internal fixation of distal humerus fractures with a PHILOS plating system via anterolateral approach can be effective. A high rate of union with good outcomes can be assumed.
Congenital Abnormalities ; Elbow ; Follow-Up Studies ; Fracture Fixation ; Humans ; Humeral Fractures ; Humerus* ; Male ; Postoperative Complications ; Range of Motion, Articular

BACKGROUND: Morphine has a direct action on morphine receptors in the brain and spinal cord. Intrathecally administered L-NAME, a nitric oxide synthase inhibitor, is known to have an antinociceptive effect on formalin-induced pain in animal studies. Efficacy of intrathecally administered ketorolac, a cyclooxygenase inhibitor, is somewhat controversial. The interactions of intrathecally administered morphine, ketorolac and L-NAME on formalin-induced nociception was studied. METHODS: Male Sprague-Dawley rats were implanted with chronic lumbar intrathecal catheters and were tested for paw flinch by a formalin injection. Drugs were intrathecally administered 15 min before the formalin injection, and biphasic painful behaviors were observed. We obtained the ED50 for each agent (ketorolac, L-NAME and morphine). ED50 fractions (1, 1/2 and 1/4) of drug combinations of L-NAME-ketorolac, morphine-L-NAME and ketorolac-morphine were administered. The ED50 of each combined drug was established and isobolographic analysis of the drug interactions was carried out. RESULTS: Intrathecal administration of ketorolac, L-NAME and morphine produced a dose-dependent suppression of pain behaviors in phase 2. ED50 values were 297.04micro gram for ketorolac, 207.46micro gram for L-NAME and 0.17micro gram for morphine in phase 2. Isobolographic analysis showed that the combination of intrathecal morphine and L-NAME synergistically reduced pain behaviors in phase 2. CONCLUSIONS: Intrathecally administered morphine, L-NAME and ketorolac produced a dose-dependent decrease in the number of paw flinches in both phase 1 and phase 2 on the formalin test. Morphine with L-NAME showed synergistic analgesic effects on formalin-induced pain in phase 2.
Animals ; Brain ; Catheters ; Drug Combinations ; Drug Interactions ; Formaldehyde ; Humans ; Ketorolac* ; Male ; Morphine* ; NG-Nitroarginine Methyl Ester* ; Nitric Oxide Synthase ; Nociception ; Pain Measurement ; Prostaglandin-Endoperoxide Synthases ; Rats* ; Rats, Sprague-Dawley ; Receptors, Opioid, mu ; Spinal Cord

STATEMENT OF PROBLEM: Recently Yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) has been introduced due to superior flexural strength and fracture toughness compared to other dental ceramic systems. Although zirconia has outstanding mechanical properties, the phenomenon of decrease in the life-time of zirconia resulted from degradation in flexural strength after low temperature aging has been reported. PURPOSE: The objective of this study was to investigate degradation of flexural strength of Y-TZP ceramics after various low temperature aging treatments and to evaluate the phase stability and micro-structural change after aging by using X-ray diffraction analysis and a scanning electron microscope (SEM). MATERIAL AND METHODS: Y-TZP blocks of Vita In-Ceram YZ (Vita Zahnfabrik, Bad Sackingen, Germany) were prepared in 40 mm (length) x 4 mm (width) x 3 mm (height) samples. Specimens were artificially aged in distilled water by heat-treatment at a temperature of 75, 100, 125, 150, 175, 200, and 225degrees C for 10 hours, in order to induce the phase transformation at the surface. To measure the mechanical property, the specimens were subjected to a four-point bending test using a universal testing machine (Instron model 3365; Instron, Canton, Mass, USA). In addition, X-ray diffraction analysis (DMAX 2500; Rigaku, Tokyo, Japan) and SEM (Hitachi s4700; Jeol Ltd, Tokyo, Japan) were performed to estimate the phase transformation. The statistical analysis was done using SAS 9.1.3 (SAS institute, USA). The flexural strength data of the experimental groups were analyzed by one-way analysis of variance and to detect statistically significant differences (alpha= .05). RESULTS: The mean flexural strength of sintered Vita In-Ceram YZ without autoclaving was 798 MPa. When applied aging temperature at below 125degrees C for 10 hours, the flexural strength of Vita In-Ceram YZ increased up to 1,161 MPa. However, at above 150degrees C, the flexural strength started to decrease. Although low temperature aging caused the tetragonal-to-monoclinic phase transformation related to temperature, the minimum flexural strength was above 700 MPa. CONCLUSION: The monoclinic phase started to appear after aging treatment above 100degrees C. With the higher aging temperature, the fraction of monoclinic phase increased. The ratio of monoclinic/tetragonal + monoclinic phase reached a plateau value, circa 75% above 175degrees C. The point of monoclinic concentration at which the flexural strength begins to decrease was between 12% and 54%.
Aged ; Aging ; Aluminum Oxide ; Ceramics ; Collodion ; Dental Porcelain ; Electrons ; Humans ; Phenothiazines ; Tokyo ; Water ; X-Ray Diffraction ; Yttrium ; Zirconium