The authors report a patient with a small traumatic cirsoid aneurysm of the scalp, diagnosed by duplex doppler ultrasonography. This 15-year-old boy was diagnosed as a cirsoid aneurysm by duplex doppler ultrasonogram which revealed an ovoid cystic lesion at left temporal area of scalp containing vascular flow mapping. The gross appearance showed an aneurysm with arteriovenous fistula, consisting of two feeding arteries and two draining veins. Total removal of mass was made and the histological examination revealed an aneurysm which showing irregular contour of inner surface and thickened fibrotic vascular wall without normal arterial layers. Noninvasive duplex doppler ultrasonography before surgical excision or direct puncture embolization of cirsoid aneurysms of the scalp could be recommended as an alternative management option.
Adolescent ; Aneurysm* ; Arteries ; Arteriovenous Fistula ; Humans ; Male ; Punctures ; Scalp* ; Ultrasonography ; Ultrasonography, Doppler* ; Ultrasonography, Doppler, Duplex ; Veins

Purpose: The greatest concern in the androgen replacement therapy (ART) is the possible side effects to the prostate. We evaluated the effects of ART focusing on the prostate specific antigen (PSA). Materials and Methods: From 2003 to 2006, 47 patients 44 to 75 years old (mean age 60.1) received ART. At baseline and after ART, digital rectal examination, serum testosterone and PSA measurement and transrectal ultrasonography were evaluated. Mean follow-up was 7.9 months (range 1 to 41). Patients were classified into two groups based on the initial PSA level, as PSA levels of 2.5 ng/ml or greater (group 1) (n=29) and PSA levels of less than 2.5 ng/ml (group 2) (n=18). Results: ART significantly increased serum testosterone, PSA and free PSA levels. However, prostate volume did not change significantly. When serum PSA was compared, the increase of PSA levels was greater than in high PSA group (group 1) than in group 2, although the ratio between the two groups in PSA increase was 38.3% for group 2 and 18.2% for group 1, respectively. A total of 4 patients (16.7% of group 1 and 3.4% of group 2) with a serum PSA level greater than 4 ng/ml after ART underwent a prostate biopsy but no patients were found to have prostate carcinoma. Conclusions: Rates of PSA elevation (>4 ng/ml) and prostate biopsies were higher in patients with high baseline PSA level (> or =2.5 ng/ml) than in those with PSA level less than 2.5 ng/ml who received ART. However, our findings suggest that an increased risk of prostate cancer was not associated with ART.
Biopsy ; Digital Rectal Examination ; Follow-Up Studies ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Testosterone

PURPOSE: Synuclein has been identified as an important neuroprotein for developing pathologic deposits in Alzheimer's and Parkinson's disease patients. gamma-synuclein is also known as a breast cancer-specific gene 1 thats's not found in normal breast tissues but it has been reported to be overexpressed in breast cancer, ovarian cancer and other tumors. To evaluate the availability of gamma-synuclein expression as a prognostic factor for infiltrative breast cancer, we analyzed its correlation with the clinical parameters and the HER-2/neu gene expression. METHODS: Two hundred fiffty samples of breast cancer tissues embedded in paraffin and that were obtained from the infiltrative breast cancer patients who were operated in our institution from January 1995 to December 2000 were analyzed with employing the tissue microarray technique. The expression of gamma-synuclein was studied with immunohistochemistry and with using gamma-synulcein antibodies. One hundred thirty one cases that showed favorable staining were selected and studied retrospectively. RESULTS: Fiffty five% (71/131) of the patients showed gamma-synuclein overexpression. The histopathological findings that significantly correlated with gamma-synuclein overexpression were the number of metastatic lymph nodes (p<0.01) and the cancer stage (p<0.01). Using the same tissue mircoarray, the HER-2/neu gene expression and gamma-synuclein expression also showed statistically significant correlation (p=0.04). CONCLUSION: gamma-synuclein overexpression showed significant correaltion with lymph node metastasis and cancer stage. It also showed significant relevance with the HER-2/neu gene expression, and that is already known to be a prognostic factor for breast cancer. Therefore gamma-synuclein may be a useful prognostic factor for infiltrative breast cancer and further studies on the its correlation with survival, local recurrence, and distant metastasis should be conducted
Antibodies ; Breast Neoplasms* ; Breast* ; gamma-Synuclein* ; Gene Expression ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Ovarian Neoplasms ; Paraffin ; Parkinson Disease ; Recurrence ; Retrospective Studies ; Synucleins

PURPOSE: The aim of this study was to determine if preoperative temporary discontinuation of antiplatelet medication (aspirin, clopidogrel, or cilostazol) is a safe procedure that does not increase early postoperative bleeding and allogenic blood transfusion after a total knee arthroplasty. MATERIALS AND METHODS: A retrospective analysis was conducted among consecutive patients who underwent navigation assisted primary total knee arthroplasty performed by a single surgeon, from January 2013 to December 2016. A total of 369 patients enrolled in this study were divided into two groups, 271 patients with no history of antiplatelet therapy and 98 patients who underwent 7 days of temporary withdrawal of antiplatelet therapy. Comparative analysis between the two groups, on the variation of hemoglobin and hematocrit during the first and second postoperative days, was conducted to determine the amount of early postoperative bleeding and the frequency of allogenic blood transfusion during hospitalization. RESULTS: The variation of hemoglobin, hematocrit during the first and second postoperative days and the frequency of allogenic blood transfusion between no history of antiplatelet medication and discontinuation antiplatelet medication before 7 days from surgery were similar in both groups. Of the 369 patients, 149 patients received a blood transfusion during their hospitalization. Compared to patients who did not receive a blood transfusion, those who did received blood transfusion were significantly older in age, smaller in height, lighter in weight, and showed significantly lower preoperative hemoglobin and hematocrit values. No statistically significant differences in sex, preoperative American Society of Anesthesiologists scores, and the history of antiplatelet medication until 7 days prior to surgery were observed between the two groups according to blood transfusion. CONCLUSION: Compared to patients with no history of antiplatelet medication, the temporary discontinuation of antiplatelet medication 7 days prior to surgery in patients undergoing antiplatelet medication did not increase the amount of postoperative bleeding or the need for allogenic blood transfusion.
Arthroplasty, Replacement, Knee ; Blood Transfusion ; Hematocrit ; Hemorrhage ; Hospitalization ; Humans ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Chronic sinusitis is a common disease in otolaryngology, but its pathologic mechanism has not been clearly known. Also, the evaluation method for the severity of chronic sinusitis is not established. The aim of this study was to analyze possible factors associated with the correlation between the radiological and pathological severity of chronic sinusitis. In addition, we assessed the profiles of inflammatory cells in the sinus mucosa and peripheral blood eosinophils in relation to the overall pathologic grades and OMU CT findings. SUBJECTS AND METHOD: Fifty specimens of pathologic sinus mucosa, obtained during endoscopic sinus surgery were stained with hematoxylin and eosin. Total inflammatory cells, plasma cells, neutrophils, lymphocytes and eosinophils were quantified. The preoperative OMU CT scans were scored by the staging system of Lund-Mackay. Also, the preoperative percentage of eosinophils in peripheral white blood cells were obtained with the complete blood count with differentiation. RESULTS: The count of total inflammatory cells, lymphocytes and eosinophils infiltrated in the diseased sinus mucosa correlated significantly with the severity of the pathologic grades and OMU CT scores. In addition, the CT scores assessed by Lund-Mackay system correlated significantly with the severity of the pathologic grades. CONCLUSION: The important indicators of the severity of the chronic inflammation in chronic sinusitis were OMU CT scores, overall pathologic grades, and total inflammatory cells, lymphocytes and eosinophils infiltrated in sinus mucosa.
Blood Cell Count ; Eosine Yellowish-(YS) ; Eosinophils ; Hematoxylin ; Inflammation* ; Leukocytes ; Lymphocytes ; Mucous Membrane ; Neutrophils ; Otolaryngology ; Plasma Cells ; Sinusitis* ; Tomography, X-Ray Computed

BACKGROUND: Stomach cancer is the most common cancer in Korea. Lifelong health management program recommends that males over 40 years and women over 50 years should undergo stomach cancer screening by endoscopy or upper gastrointestinal series every two years. The importance of re-screening of stomach cancer in a high risk group is emphasized. METHODS: A telephone questionnaire was done one year after to 123 patients over 40 years old considered as a high risk group with either chronic atropic gastritis, intestinal metaplasia, gastric ulcer, gastric adenoma among 804 subjects who had undergone anendoscopic examination from February 2002 to June 2003 at a university hospital health promotion center. RESULTS: The number of patients who responded were 109. The average recognition rate of high risk group was 53.2%. The rate of recognition of high risk group was lower in good subjective health estimation group and in less educated group, in old age group, and in chronic atrophic gastritis and intestinal metaplasia group. The rate of not receiving re-screening after 1 year was 48 (44.0%). Re-screening rate in patients with intestinal metaplasia (35.3%) and chronic atropic gastritis (39.1%) compared to gastric ulcer (77.8%) and gastric polyp (90.0%), in those not recognizing themselves as high risk group, in low education group, in old age, was lower. CONCLUSION: In patients with chronic atropic gastritis and intestinal metaplasia, in those not recognizing themselves as high risk group, in old age and in good subjective health state. We need to educate the importance for regular screening of stomach cancer more intensively.
Adenoma ; Education ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Health Promotion ; Humans ; Korea ; Male ; Mass Screening* ; Metaplasia ; Polyps ; Stomach Neoplasms* ; Stomach Ulcer ; Telephone ; Surveys and Questionnaires

PURPOSE: The aim of this study was to evaluate the effect of cyclic loading and screw retightening on reverse torque value (RTV) in external and internal type implants. MATERIALS AND METHODS: Cement-retained abutments were connected with 30 Ncm torque to external and internal type implants. Experimental groups were classified according to implant connection type and retightening/loading protocol. In groups with no retightening, RTV was evaluated after cyclic loading for 100,000 cycles. In groups with retightening, RTV was measured after 3, 10, 100 cycles as well as every 20,000 cycles until 100,000 cycles of loading. RESULTS: Every group showed decreased RTV after cyclic loading. Before and after cyclic loading, external type implants had significantly higher RTVs than internal type implants. In external type implants, retightening did not affect the decrease in RTV. In contrast, retightening 5 times and retightening after 10 cycles of dynamic loading was effective for maintaining RTV in internal type implants. CONCLUSION: Retightening of screws is more effective in internal type implants than external type implants. Retightening of screws is recommended in the early stage of functional loading.
Torque*

Teeth wear and extrusion of antagonist are commonly observed in deep bite patient having severe vertical and horizontal overlap. These problems cause collapse of occlusal plane and abnormal anterior guidance. Without restoring harmonious occlusion, loss of multiple teeth and decreased masticatory function could not be prevented. To resolve problems associated with deep bite, multidisciplinary treatment including oral surgical, orthodontic and prosthetic treatment should be performed. This clinical report describes the results of increasing occlusal vertical dimension with a full-mouth restoration procedure. The treatment procedures include extraoral and intraoral examination, diagnosis, treatment planning, diagnostic wax-up, segmental osteotomy, orthodontic intrusion and prosthodontic rehabilitation. Full mouth rehabilitation with increasing occlusal vertical dimension can solve esthetic and functional problems.
Dental Occlusion ; Diagnosis ; Humans ; Methods ; Mouth Rehabilitation* ; Osteotomy* ; Overbite* ; Prosthodontics ; Rehabilitation ; Tooth ; Vertical Dimension

PURPOSE: The purpose of this study was to compare the findings on high-resolution CT (HRCT) of the chest with those on video-assisted thoracoscopy for the detection of bullae in patients who had undergone an operation for spontaneous pneumothorax, and we also wished to evaluate the relationship between the characteristics of bullae on HRCT and development of spontaneous pneumothorax. MATERIALS AND METHODS: Fifty patients with spontaneous pneumothorax who had undergone both HRCT of the chest and video-assisted thoracoscopic surgery were included in the study. Spontaneous pneumothoraces were classified as either primary or secondary pneumothorax, and as initial or recurrent pneumothorax. The HRCT scans were obtained with 1 mm slice thickness and a 5 mm scan interval. Two radiologists retrospectively compared the HRCT findings of the chest with those findings on video-assisted thoracoscopy for the detection of bullae, and they evaluated the value of HRCT for diagnosing bullae. In addition, we assessed the size and number of bullae in these patients, and we also evaluated the relationship between those findings of bullae and the development of spontaneous pneumothorax. RESULTS: Bullae were detected in 40 patients by using video-assisted thoracoscopy, and HRCT showed bullae in 38 of these patients. Bullae were not identified with video-assisted thoracoscopy in the remaining ten patients, and among these ten patients, bullae were not demonstrated by HRCT in eight of them. Therefore, the sensitivity and specificity of HRCT for the detection of bullae were 95% (38/40) and 80% (8/10), respectively. The average size of the bullae of the affected hemithorax and the contralateral un-affected hemithorax was 1.97 cm+/-2.30 and 1.24 cm+/-1.46, respectively. Pneumothorax was more frequently observed in the hemithorax with larger bullae (p<0.05). The average numerical grade of the bullae (3.38+/-1.60) was higher in the affected hemithorax than in the contralateral un-affected hemithorax (2.96+/-1.86), but there was no statistically significant difference between both groups of hemithoraces (p>0.05). The average size of bullae in patients with secondary pneumothorax and those bullae of patients with primary pneumothorax was 4.44 cm+/-4.06 and 1.42 cm+/-1.26, respectively. The bullae were significantly larger in the patients with secondary pneumothorax than in those patients with primary pneumothorax (p<0.05). Although the average numerical grade of bullae was higher in the patients with secondary pneumothorax (4.00+/-1.58) than in those patients with primary pneumothorax (3.24+/-1.61), the difference between two groups was not statistically significant (p>0.05). CONCLUSION:HRCT of the chest would be a useful modality for detecting the bullae of those patients with spontaneous pneumothorax. The development of spontaneous pneumothorax is associated with the size of bullae rather than the number of bullae.
Humans ; Pneumothorax* ; Retrospective Studies ; Sensitivity and Specificity ; Thoracic Surgery, Video-Assisted ; Thoracoscopy* ; Thorax

PURPOSE: The purpose of this study was to assess the potential benefit of a 5-hydroxytryptamine receptor antagonist, sarpogrelate-based triple antiplatelet therapy (TAPT) in comparison with dual antiplatelet therapy (DAPT) in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). MATERIALS AND METHODS: 119 patients of STEMI were retrospectively assessed. All patients received aspirin and clopidogrel per standard of care. Among them, 53 patients received an additional loading dose of sarpogrelate and a maintenance dose for 6 months post-PCI (TAPT group), while others did not (DAPT group). RESULTS: The rates of complete ST-segment resolution at 30 minutes post-PCI and post-procedural thrombolysis in myocardial infarction flow were not significantly different between the two groups (52.8% vs. 48.5%, p=0.200; 92.5% vs. 89.4%, p=0.080). In addition, no significant differences were observed between the two groups with regard to 30-day and 12-month clinical outcomes (cardiac death, myocardial infarction, stent thrombosis, target vessel revascularization, and severe bleeding). Meanwhile, improvement in left ventricular (LV) systolic function was observed in the TAPT group [ΔLV ejection fraction (LVEF)=17.1±9.4%, p<0.001; Δglobal longitudinal strain (GLS)=−9.4±4.2% , p<0.001] at 6 months, whereas it was not in the DAPT group (ΔLVEF= 8.8±6.5%, p=0.090; ΔGLS=−4.6±3.4%, p=0.106). In multivariate analyses, TAPT was an independent predictor for LV functional recovery (odds ratio, 2.61; 95% confidence interval, 1.16–5.87; p=0.003). CONCLUSION: Sarpogrelate-based TAPT improved LV systolic function at 6 months in STEMI patients undergoing primary PCI.
Aspirin ; Humans ; Multivariate Analysis ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Retrospective Studies* ; Serotonin ; Standard of Care ; Stents ; Thrombosis ; Ventricular Function, Left