No abstract available.
Dentures* ; Mucous Membrane*

Because deep forehead wrinkle is considered of concept against beauty, many considerations and trials to solve the problem has been done. Furthermore severely exaggerated forehead wrinkle that is accentuated with upward gaze, especially of younger persons is tremendous handicap socially and psychologically. In the persons with blepharoptosis, forehead wrinkle is created because of the compensatory action of frontalis muscle for the additional lift of inferiorly malpositioned upper eyelid. We experienced twenty three patients from February 1993 to April 1996. the average age of the patients was 22.5 years (range 15 to 34 years). There were 4 unilateral and 19 bilateral cases. Preoperative measurement of ptotic amount, levator function by Berke's method, and Margin limbal distance (MLD) were 2.1mm, 10.2mm, and 2.2mm respectively. And postoperative measurement of there were not ptotic, 14.2, and 6.2mm. We followed up 18 months in the mean. Most of the patients were corresponding to mild and borderline ptosis. We operated all the patients under the local anesthesia, which enable us to use the adjustable suture technique and overcome the pitfall of formular prediction. Simultaneously at the end of the procedure, double eyelid operations were done in the cases of oriental eye lid. As a results, correction of blepharoptosis, repositioning of abnormally elevated eyebrow, disappearance of forehead wrinkle, improvement of vision, and acquisition of adequate eyelid functionally and aesthetically were possible. On the other hand, we confronted 7 cases of mild complication. These were as follows ; transient lagophthalmost (4 cases), overcorrection(1 cases), unfercorrection(1 case), and asymmetry(1 case). Lagophthalmos was improved spontaneously after several months. We achieved satisfactory result using levator shortening without significant side effects and complications. This method is of great worth for the spontaneous resolution of the forehead wrinkle with undertectable blepharoptosis.
Anesthesia, Local ; Beauty ; Blepharoptosis ; Eyebrows ; Eyelids ; Forehead ; Hand ; Humans ; Suture Techniques

Neurofibromatosis is a syndrome of multiple neurofibromas, abnormal skin pigmentation and certain bony abnormalities. Sometimes the growth of plexiform neurofibromatosis on the face or trunk is centripetal and usually involves the mediastinum and skull base. However, it is very rare that neurofibromatosis involves the trigeminal ganglion. Its encroachment around the foramina of the skull base may induce facial palsy or conductive hearing loss. The guiding principle in the treatment of generalized neurofibromatosis is a radical excision with preservation of vital structures and an immediate reconstruction of the bony skeleton and soft tissue defect. The authors experienced 4 cases of neurofibromatosis involving the trigeminal ganglion. All had trigeminal symptoms for 3 to 4 years. These were severe headache and intractable trigeminal neuralgia. Tumors in all 4 cases were spread in the centripetal type from extracranial neurofibromatosis. The facial nerve was affected in 4 cases. Malignat Schwannoma occurred in 1 case. Accurate diagnosis and assessments were necessary with CT, MRI art oomputer-aided simulation design. Intraoperative bleeding was minimal with hypotensive anesthesia. Surgical approach to the middle cranial fossa involved temporary removal of the zygomatic arch and TMJ disarticulation with downward traction of the mandible. Satisfactory results have been obtained far 3 to 7 years(mean 5 years) follow-up.
Anesthesia ; Cranial Fossa, Middle ; Diagnosis ; Disarticulation ; Facial Nerve ; Facial Paralysis ; Follow-Up Studies ; Headache ; Hearing Loss, Conductive ; Hemorrhage ; Magnetic Resonance Imaging ; Mandible ; Mediastinum ; Neurilemmoma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Skeleton ; Skin Pigmentation ; Skull Base ; Temporomandibular Joint ; Traction ; Trigeminal Ganglion* ; Trigeminal Neuralgia ; Zygoma

To fill the large bone defect after bone and soft tissue tumor resection, there are several options such as tumor prosthesis, bone cement with intramedullary nail, autogenous bone graft and allograft. We had used isotrophic autogenous bone graft by using the heat-treated bone removed from tumor site. We analyzed the periods for junctional union and regeneration of autoclaved or low-heat treated groups, and compared these two methods to know which method is better for reconstruction of the bone defect after tumor resection. From Jan. 1987 to Sept. 1993, twelve patients took heat-treated autogenous bone graft: 6 auto- claved, and 6 low heat-treated. Each group had 10 places of junction sites between host and grafted bone. The tumors were 2 cases of osteosarcoma, 3 parosteal osteosarcoma, 2 Ewing's sarcoma, 2 malignant soft tissue tumors, 1 giant cell tumor, and 2 metastases from thyroid cancer and synovial sarcoma. The graft sites were 4 in humerus, 4 pelvis and 4 femur. Two cases showed marginal surgical margin and others wide surgical margin. Here we compare4 the difference between autoclaved group(120℃, 2 atm., 20 min) and low heat-treated group(65℃, 30 min. in water) on the aspect of complications and period to achieve junctional union to host bone. Average follow-up period was 25.3(11 to 88) months. Graft related complications in autoclaved group were bone resorption(2 sites), fracture of grafted bone(2). For low heat-treated group there was no such complication. Nonunion occurred in 3 sites for autoclaved group and 1 for low heat-treated group. Average period for junctional union was 7.3 months(5 to 10 months) for autoclaved group and 6.1 months(5 to 9 months) for low heat-treated group. With these results, heat treated bone autograft may have several advantages such as easy accessi- bility, low cost and anatomical reconstruction of the bone defect. The low heat-treated autogenous bone graft may have more advantages than that of the autoclaved one, and this method may be ratio- nalized to fill the large bone defect made by tumor resection.
Allografts ; Autografts ; Femur ; Follow-Up Studies ; Giant Cell Tumors ; Hot Temperature ; Humans ; Humerus ; Methods ; Neoplasm Metastasis ; Osteosarcoma ; Pelvis ; Prostheses and Implants ; Regeneration ; Sarcoma, Ewing ; Sarcoma, Synovial ; Thyroid Neoplasms ; Transplants

In the rat brain stem, the nerves innervating sublingual gland was studied with submandibular gland together. Cholera Toxin B subunit (CTB), neural tracer, is not yet used to study the sublingual gland. The purpose of this study is to investigate the origin of neurons and afferent fibers projecting to sublingual gland by means of retrograde transport of CTB. CTB was injected into the sublingual gland. In the rat brain stem, neurons were labeled with CTB in superior salivatory nucleus (SSN), inferior salivatory nucleus (ISN), facial nucleus and their afferent fibers in nucleus tractus solitarius. At the rostal level of SSN, the labeled cells were found in lateral aspect of pontine reticular formation. At the level of facial nerve that transverse the dorsal part of the spinal trigeminal tract, the labeled cells of SSN extended in the area of facial nerve fibers. Labeled cells were also seen at the level of internal genu of facial nerve. In ISN at the level of facial nerve that traverse the dorsal part of the spinal trigeminal tract, the labeled cells were seen in the anterolateral direction of lateral aspect of reticular formation. In the facial nucleus, the labeled cells were confined in central part of facial nucleus. The labeled nerve fibers in nucleus tractus solitarius were seen in the level at which the medial border of the nucleus tractus solitarius meets the 4th ventricle.
Animals ; Brain Stem* ; Brain* ; Cholera Toxin* ; Cholera* ; Facial Nerve ; Immunohistochemistry ; Nerve Fibers ; Neurons ; Rats* ; Reticular Formation ; Solitary Nucleus ; Sublingual Gland* ; Submandibular Gland

Our understanding of the functions of neutral sphingomyelinase (N-SMase) signaling has advanced over the past decade. In this review, we focus on the roles and regulation of N-SMase 1, N-SMase 2, N-SMase 3, an enzyme that generates the bioactive lipid ceramide through the hydrolysis of the membrane lipid sphingomyelin. A large body of work has now implicated N-SMase 2 in a diverse set of cellular functions, physiological processes, and disease pathologies. We focus on different aspects of this enzyme's regulation from transcriptional, post-translational, and biochemical. Furthermore, we expected N-SMase involvement in cellular processes including inflammatory signaling, cell growth, apoptosis, and tumor necrosis factor which in turn play important roles in pathologies such as cancer metastasis, variable disease, and other organ system disorders. Lastly, we examine avenues where targeted N-SMase inhibition may be clinically beneficial in disease scenarios.
Apoptosis ; Breast Neoplasms* ; Hydrolysis ; Membranes ; Neoplasm Metastasis ; Pathology ; Physiological Processes ; Sphingomyelin Phosphodiesterase* ; Tumor Necrosis Factor-alpha

In malignant bone and soft tissue tumors, lung is the most predilection site of metastasis and multiple pulmonary metastases is a poor prognostic factor. Aggressive treatment of pulmonary metastases may offer a chance of long term survival in selected patients whose primary tumors were controlled. We wanted to know the feasibility of pulmonary metastasectomy, whether it can prolong the survival. From Apr. 1989 to Dec. 1993, pulmonary metastasectomies were carried out for 20 patients, and followed up to Sept. 1994, with average follow-up period of 18.7(2-65) months. The primary malignant tumors were 8 in bone and 12 in soft tissues. Mean age was 27.5(12-70) years. Fifteen cases showed late metastasis after control of primary tumor(late metastasis group), and 5 cases showed pulmonary metastasis at first visit(initial stage III group). As a control we analyzed the survival of 24 cases of no treatment after pulmonary metastasis from bone or soft tissue sarcoma, during the same period of investigation. At final follow-up, in late metastasis group, 4 cases were in no evidence of disease (NED), 4 alive with disease (AWD) and 7 dead of disease (DOD). Tumor free interval (TFI) of NED and AWD was averaged 30 months, and for DOD 9.8 months. Five among 11 cases (45%) of multiple lung metastases and 3 among 4 cases (75%) of single metastasis were alive. In initial stage III group, 1 case was in NED, 1 AWD and 3 DOD. For late metastasis group, Kaplan-Meier's 5-year estimated survival rate from the first metastasectomy was 37.4%. The median survival period of 15 cases was 44 months. For initial stage III group, Kaplan-Meier's 9 months estimated survival rate was 40%. Median survival period was 8 months. Twenty four cases of no treatment cases died within 14 months from diagnosis of pulmonary metastasis. Their median survival period was 6 months. Pulmonary metastasectomy appears to prolong survival and occupies an important mode of treatment for late pulmonary metastases in malignant bone and soft tissue tumor patients. In the cases of initial stage III, more cases and follow up period are needed to have a conclusion.
Diagnosis ; Follow-Up Studies ; Humans ; Lung ; Metastasectomy ; Neoplasm Metastasis ; Sarcoma ; Survival Rate

OBJECTIVE: New Zealand White Rabbits were utilized to determine whether fetal insulin-like growth factor-1 (IGF-1) expression in small intestine is altered in response to maternal enodotoxin administration. STUDY DESIGN: Six pregnant rabbits were intramuscularly injected with lipopolysaccharide of E. coli (serotype 055:B5) 30 microgram/kg, whereas normal saline 0.3 mL/kg were injected to the other six pregnant rabbits on gestational day 25 and 26. Fetuses were harvested on gestational day 27 and were identified as favored (Fav) or runt (Runt) depending on the location in the uterus. Fetal weight and small intestinal length were recorded. Three parts of small intestine (proximal, middle and distal) were collected. Reverse transcription polymerase chain reaction (RT-PCR) was used to measure IGF-1/beta-actin mRNA densitometric band ratios. Statistical analysis was performed using paired Student's t-test and Pearson correlation test. RESULTS: The ratio of mRNA IGF-1/beta-actin was lower in endotoxin group (0.80+/-0.24, n=24) than control group (1.13+/-0.31, n=24, P<0.05). Fetal weights were decreased with endotoxin group (24.7+/-8.59 gm) compared to control group (28.5+/-4.35 gm, p<0.05). Fav fetuses (1.09+/-0.42, n=12) showed increased expression of IGF-1 mRNA in the small intestine than Runt fetuses (0.84+/-0.35, n=12) in control group. In endotoxin group, there was no statistically significant difference in expression of IGF-1 mRNA between Fav (0.82+/-0.31, n=12) and Runt (0.79+/-0.43, n=12) group. Lengths of small intestine showed no statistically significant difference between control and endotoxin group, and Fav and Runt (p>0.05). CONCLUSION: In our study, maternal endotoxin administration suppressed IGF-1 production in small intestine of fetal rabbit. Endotoxin in maternal serum might be transferred to fetus through placenta and decreased production of mRNA of IGF-1 in small intestine. Further studies are warranted to investigate the correlation between intrauterine growth retardation and maternal gram negative bacterial infection.
Bacterial Infections ; Fetal Growth Retardation ; Fetal Weight ; Fetus* ; Insulin-Like Growth Factor I ; Intestine, Small* ; Placenta ; Polymerase Chain Reaction ; Rabbits ; Reverse Transcription ; RNA, Messenger ; Uterus

The systematic study of products from bacteria and fungi has led to the development of two immunosuppressive drugs, cyclosporin A and FK 506 (tacrolimus) which are useful to suppress adaptive immune responses to the grafted tissue. However, they affect all immune responses indiscriminately and are both toxic to kidneys and other organs. To facilitate the development of immunosuppressor to block the T cell receptor (TcR)-mediated signaling cascade specifically, a novel Jurkat T cell transfectants, JK NFAT-SEAP were generated in which the expression of the secreted alkaline phosphatase (SEAP) is driven by the multiple NFAT binding sites plus minimal IL-2 promoter. Upon stimulation with ionomycin or anti-TcR mAb OKT3 in the presence of PMA, these transfectants secreted high level of SEAP into the medium, which was conveniently analyzed by SEAP analysis. The secretion of SEAP was effectively inhibited by cyclosporin A or FK 506 at the concentration of [10 ' ug/ml], [10 ug/ml] respectively. JK NFAT-SEAP transfectants will provide two major advantages for the development of a novel immunosuppressor. First, analysis of SEAP secreted into the culture medium by SEAP analysis enables us to test a large number of samples within a short period of time. Second, Usage of IL-2 promoter for the expression of SEAP makes us identify bioproducts to target specifically on TcR-mediated signaling pathway.
Alkaline Phosphatase ; Bacteria ; Binding Sites ; Cell Line* ; Cyclosporine ; Fungi ; Interleukin-2 ; Ionomycin ; Kidney ; Mass Screening* ; Muromonab-CD3 ; Receptors, Antigen, T-Cell ; T-Lymphocytes* ; Tacrolimus ; Transplants

Heteratopic or ectopic pancreas is found in 0.5% to 13% autopsy series and also found one in approximately every 500 operations in abdominal surgery. The mast common sites are stomach (esp, greater curvature of the antrum), duodenum and proximal jejunum. Many ar most of these lesions do not cause clinical symptoms and the symptoms with heterotopie pancreas are nonspecific. When it produces complication(hemorrhage, pancreatitis, pyloric or CBD obstruction, pseudocyst, cancer etc.), the symytoms depend on the site of lesion, the size of mass, and the primary pathologic processes occurring within the heterotopic pancreatic tissue. Gaetrofiberoscopy revealed a small round, submucosal projection with a central niche or umblication, but this characteristic umbilication is not always present. The lesions are frequently confused with polyp, leiomyoma, intramural neoplasm, gastric ulcer and early gastric cancer, The tumors are predominantly intramural masses; 75 percent are submuicosal and the others are either intrsmuscular or subserosal. We have recently experienced a case of heterotopic pancreas on the antrum of greater curvature of stomach in 54-year-old man, who visited our hospital for melena. Gastrofiberoscopy revealed a 2 x 2 cm sized submucosal mass without bleeding focus and local excision was performed. Histologic finding showed a pancreatic acini within the gastric poper muscle layer.
Autopsy ; Duodenum ; Hemorrhage ; Humans ; Jejunum ; Leiomyoma ; Melena ; Middle Aged ; Pancreas* ; Pancreatitis ; Pathologic Processes ; Polyps ; Stomach ; Stomach Neoplasms ; Ulcer