Chronic cavities of the dorsum of the foot often have bare bone and are unsuitable for free skin grafting. Local Flaps are often impossible because of surrounding scar tissue and dead space. A simple method is presented; it consists of the excision of the lesion, filling the cavity by a two staged random-pattern de-epithelialised turn over flap, and skin graft.
Cicatrix ; Foot ; Methods ; Skin ; Skin Transplantation ; Transplants

Recently autogenous nerve graft was usually used for segmental defect of peripheal nerve injury. In case of inappropriate size or amount of donor nerve graft, there were many studies included nerve regeneration with special nerve conduit material. To compare the result of autogenous nerve graft with that of silicone tubing method in segmental defect of sciatic nerve, the experiments were carried out on adult rats with autogenous nerve graft on the left side and silicone tubing on the right side. The results were as follows; 1. Myelinated nerve fibers were larger in silicone tubing method than autogenous nerve graft at postop. 4 weeks. 2. There was no difference in nerve regeneration in both groups at postop. 12 weeks. 3. Some atrophic changes were showed in denervated muscles in both groups at postop. 4 weeks. Skeletal muscle changes between the two groups were meagre. 4. Perineural adhension was rare in silicone tubing group in contrast to autogenous nerve graft group. 5. Nerve Conduction Velocity was similar between autogenous nerve graft and silicone tubing method after 4 weeks postoperatively. In conclusion, this study suggests that silicone tubing can be useful method to repair the large nerve gaps and has a potential clinical utilization in large segmental nerve defect.
Adult ; Animals ; Autografts ; Humans ; Methods ; Muscle, Skeletal ; Muscles ; Nerve Fibers, Myelinated ; Nerve Regeneration ; Neural Conduction ; Rats ; Sciatic Nerve ; Silicon ; Silicones ; Tissue Donors ; Transplants

PURPOSE: It is known that 50% to 68% of women with stress urinary incontinence (SUI) have sexual function impairment and avoid sexual intercourse. Reports of sexual function after SUI surgery vary, with reports of both improved function and deteriorated function. The goal of this study was to evaluate the impact of midurethral sling procedures on the sexual function of women suffering from SUI preoperatively and 36 months postoperatively. MATERIALS AND METHODS: Among 75 patients who were diagnosed with SUI and underwent the midurethral procedure, 47 patients who answered the Korean version of the Female Sexual Function Index (FSFI) Questionnaire were analyzed prospectively. The retropubic route (RPR) was used in 26 patients, whereas the transobturator route (TOR) was used in 21 patients. Fifteen patients underwent concomitant posterior colporrhaphy. The FSFI was completed before surgery and 36 months after surgery. RESULTS: The patients' mean age was 44.9 years (range, 30-59 years) and their mean parity was 2.8 (range, 0-6). There were no significant differences in the individual FSFI domain scores between before surgery and 36 months (36.8+/-4.57) after surgery. There were no significant differences in sexual satisfaction between the patients with concomitant posterior colporrhaphy and patients with the midurethral sling procedure only. There were no significant differences in domain score between the TOR and the RPR, but patients experienced less pain after the RPR than after the TOR. CONCLUSION: There was no significant change in overall sexual function in women undergoing the midurethral sling procedure. Attention must be paid when performing the TOR procedure because it can cause pain during intercourse.
Coitus ; Female ; Follow-Up Studies ; Humans ; Parity ; Prospective Studies ; Sexuality ; Stress, Psychological ; Suburethral Slings ; Urinary Incontinence ; Urologic Surgical Procedures

PURPOSE: The association of age, sex and renal parenchymal damage (RPD) in vesicoureteral reflux (VUR) is well known. We compared various factors between infants and children in a cohort of patients with primary VUR. MATERIALS AND METHODS: Medical records of 147 patients diagnosed as VUR between 1997 and 2010 were reviewed. Of these children 91 (61.9%) were boys and 56 (38.1%) were girls. 99 (67.3%) of the 147 patients were younger (Group 1), and 48 (32.7%) were older than 1 year (Group 2). The impact of patient's gender and age as well as VUR grade on RPD were analyzed in each patient. The Fisher's exact test and chi square test was done with SPSS ver. 12.0 (SPSS Inc., Chicago, IL, USA). RESULTS: VUR was unilateral in 88 patients (59.9%) and bilateral in 59 patients (40.1%). Abnormal renal scan was found in 78 (37.7%) renal units. The incidence of VUR was significantly higher in male in group 1 (p<0.01) and in female in group 2 (p<0.01). The incidence of abnormal renal scan was significantly higher in intermediate and high grade VUR comparing low grade VUR in group 1 (p=0.042). In both group, abnormal renal scan didn't show any difference between male and female statistically (p>0.05). CONCLUSIONS: Our data showed that VUR in infant was significantly higher in male than in female, whereas VUR in children was significantly higher in female. This may be due to that characteristic of a population where neonatal circumcision is not a common procedure in infant and urinary tract infections are more common in female children. Further study may be needed to identify gender difference in RPD in infant with high grade reflux.
Chi-Square Distribution ; Chicago ; Child ; Circumcision, Male ; Cohort Studies ; Female ; Humans ; Incidence ; Infant ; Male ; Medical Records ; Urinary Tract Infections ; Vesico-Ureteral Reflux

PURPOSE: Many pediatric urologists still favor using prophylactic antibiotics to treat children with vesicoureteral reflux (VUR). However, breakthrough infection sometimes occurs, leading to significant increases in morbidity as a result of renal scarring. Therefore, we tested whether abnormal renal scan and other factors are predictive of breakthrough infection using univariate analyses. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 163 consecutive children who were diagnosed with vesicoureteral reflux between November 1997 and June 2010. Clinical parameters for the statistical analysis included form of presentation, gender, age, VUR grade, laterality, presence of intrarenal reflux, class of antibiotic drug, and presence of abnormal renal scan by Dimercapto-succinic acid. Clinical parameters used for prognostic factors were established by univariate analyses. Fisher's exact test and unpaired t-test were done using SPSS software [SPSS ver. 12.0 (SPSS Inc., Chicago, IL, USA)]. RESULTS: Breakthrough infection developed in 61 children (48.0%). A total of 58 children (45.7%) had abnormal renal scans. Time to development of breakthrough infection was significantly longer in girls (9.0+/-8.2 months) than in boys (5.8+/-4.8 months, p<0.05). On univariate analysis, though statistically not significant, the most predictive factor of breakthrough infection was abnormal renal scan (p=0.062). In patients with abnormal renal scans, breakthrough infection was not associated with mode of presentation, gender, grade or prophylactic antibiotics. However, there was a significant difference between patients younger than 1 year and those 1 year old or older. Mean+/-SD age at diagnosis of VUR in patients with breakthrough infection (1.14+/-3.14) was significantly younger than in those without breakthrough infection (5.05+/-3.31, p=0.009). There was also a significant difference between patients with bilateral or unilateral reflux (p=0.028). CONCLUSION: Our data showed that abnormal renal scan was the most predictive factor of breakthrough infection and demonstrated statistical significance in patients under the age of 1 year. Parents and physicians should remain aware that these patients are at high risk of breakthrough urinary tract infection, which may potentially lead to renal damage.
Anti-Bacterial Agents/*therapeutic use ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Urinary Tract Infections/*drug therapy/etiology ; Vesico-Ureteral Reflux/complications/*drug therapy/*microbiology

The recent advances in human pluripotent stem cells (hPSCs) enable to precisely edit the desired bases in hPSCs to be used for the establishment of isogenic disease models and autologous ex vivo cell therapy. The knock-in approach based on the homologous directed repair with Cas9 endonuclease, causing DNA double-strand breaks (DSBs), produces not only insertion and deletion (indel) mutations but also deleterious large deletions. On the contrary, due to the lack of Cas9 endonuclease activity, base editors (BEs) such as adenine base editor (ABE) and cytosine base editor (CBE) allow precise base substitution by conjugated deaminase activity, free from DSB formation. Despite the limitation of BEs in transition substitution, precise base editing by BEs with no massive off-targets is suggested to be a prospective alternative in hPSCs for clinical applications. Considering the unique cellular characteristics of hPSCs, a few points should be considered. Herein, we describe an updated and optimized protocol for base editing in hPSCs. We also describe an improved methodology for CBE-based C to T substitutions, which are generally lower than A to G substitutions in hPSCs.

STATE OF PROBLEM: Zirconia all-ceramic restoration fabricated with CAM system is on an increasing trend in dentistry. However, evaluation of the marginal and internal fits of zirconia bridge seldomly have been reported. PURPOSE: This study was to evaluate the fit of margin and internal surface in posterior 3-unit zirconia bridge framework fabricated with CAM system(DeguDent, Germany). MATERIAL AND METHOD: Preparations of secondary premolar and secondary molar on artificial resin model were performed for fabrication of 3-unit posterior bridge framework. Fits of 5 zirconia bridge framework were compared with 5 precious ceramo-metal alloy framework(V-GnathosPlus, Metalor, Switzerland), and prepared margins were designed to chamfer and shoulder finishing line. Each framework was cemented to epoxy resin model with reinforced glass ionomer(FujiCEM, GC Co., Japan), embedded in acrylic resin and sectioned in two planes, mesiodistal and buccolingual. Samples were divided into six pieces by sectioning and had two pieces of each surface(i.e. mesial, distal, buccal and lingual surface) per abutment, so there were eight measuring points in each abutment. External gap was measured at the margin and internal gaps were measured at the margin, axial and occlusal surface. Gaps were observed under the measuring microscope(Compact measuring microscope STM5; Olympus, Japan) at a magnification of * 100. T-test were used to determine the statistic significance of the different gaps between zirconia and metal framework. RESULTS AND CONCLUSION: 1. External and internal marginal gaps of zirconia and metal framework were in clinically acceptable range. External marginal gaps were not different significantly between zirconia(81.9 micrometer) and metal(81.3 micrometer) framework and internal marginal gaps of zirconia(44.6 micrometer) were smaller than those of metal framework(58.6 micrometer). 2. Internal axial gaps of zirconia framework(96.7 micrometer) were larger than those of metal framework(78.1 micrometer) significantly and adversely, internal occlusal gaps of zirconia framework(89.4 micrometer) were smaller than those of metal framework(104.9 micrometer) significantly. 3. There were no significant differences in external and internal marginal gaps between chamfer and shoulder finish line when zirconia frameworks were fabricated.
Alloys ; Bicuspid ; Dentistry ; Glass ; Molar ; Shoulder

While anomalies of the pancreaticobiliary system are not uncommon, drainage of the common bile duct into the bulb of the duodenum has rarely been reported. The awareness of ectopic drainage of the CBD is stressed to prevent surgical damage and improve medical management in this area. We reported one case of anomalous drainage of the CBD and pancreatic duct associated with nonvisible gallbladder or agenesis of gallbladder and cystic duct diagnosed by ERCP, ultrasonography and upper abdominal CT.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Cystic Duct ; Drainage* ; Duodenum ; Gallbladder ; Pancreatic Ducts* ; Tomography, X-Ray Computed ; Ultrasonography

While anomalies of the pancreaticobiliary system are not uncommon, drainage of the common bile duct into the bulb of the duodenum has rarely been reported. The awareness of ectopic drainage of the CBD is stressed to prevent surgical damage and improve medical management in this area. We reported one case of anomalous drainage of the CBD and pancreatic duct associated with nonvisible gallbladder or agenesis of gallbladder and cystic duct diagnosed by ERCP, ultrasonography and upper abdominal CT.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Cystic Duct ; Drainage* ; Duodenum ; Gallbladder ; Pancreatic Ducts* ; Tomography, X-Ray Computed ; Ultrasonography

Recently, through the development of CAD/CAM technology, it is also being used for fabricating dentures. Compared to conventional methods, when digital dentures are fabricated, the fabrication process is facilitated, and the number of visits to hospitals is reduced and errors are reduced. In this case, the vertical dimension was increased using a CAD program in a patient who needed vertical dimension recovery due to the use of old dentures, and the final denture was fabricated using a monolithic disc through the milling method. The centric relation was recorded using existing dentures, and using the information from the intraoral scan and the existing denture model scan, a trial denture was fabricated and delivered to the patient to evaluate the midline and occlusion. Based on the evaluation of the trial denture, the final denture was fabricated using a milling method and a monolithic disc, and the final denture showed satisfactory results functionally and aesthetically.