The authors experienced two cases of cervical epidural AVM resembling that of tumor. It is the purpose of this report to point out by means of two cases the problem involved in establishing the diagnosis. To our knowledge, our two cases of cervical epidural AVM is the first report in Korea.
Diagnosis ; Korea

No abstract available.
Gonadotropin-Releasing Hormone*

No abstract available.
Cyclosporine*

The use of alginate impression materials today is prevalent because of its efficiency and simplicity in clinical settings. Unfortunately, the simplicity of the procedure tends to lull the dentist into a sense of well-being, and lead him into using careless or sloppy technique. Alginate impression materials are used to fabricate diagnostic and preliminary casts, and the final cast. Incorrect use of this material is known to affect the accuracy of the final prosthesis. The purpose of this study was to compare the effect of different mixing methods of alginate impression material and tray adhesive on the accuracy of the stone cast produced by each method. A total of 30 stone casts were produced by using 3 different types of mixing methods (10 stone cast for each mixing method, respectively) The first method utilized an automatic-mixing machine to mix alginate while the second method was carried out manually, strictly following manufacturer's instructions. The third method also involved manual mixing, but did not follow the manufacturer's instructions and was done in a random fashion. Also, 20 additional stone casts were produced by using alginate with or without tray adhesives were included in the study to evaluate effects of tray adhesives on the accuracy of alginate impression. 10 stone casts were produced by adding tray adhesives to the interior surface of the impression tray prior to taking the impression. The other 10 excluded this step. A total of 50 stone casts were analyzed by the three-dimensional measuring machine to measure and compare the dimensional changes of the impression material of each group. The results are as follows. 1. No significant difference was found between the automatic mixing group and the manually-mixing group(p>0.05). 2. For the group that followed manufacturer's instructions, less dimensional changes were recorded than the group that didn't in measuring distance d4(p<0.05) 3. The group that used tray adhesives showed less dimensional changes(p<0.05). The findings revealed that mechanical methods of mixing alginate impression materials had little influence on dimensional changes. However, it is proven that following manufacturers instructions in alginate impression taking is an important step in acquiring accurate impressions and tray adhesives may play an important role in enhancing the results.
Adhesives* ; Dentists ; Humans ; Prostheses and Implants

No abstract available.
Fibrin Tissue Adhesive ; Fibrin ; Surgery, Oral

PURPOSE: To assess how accurately computed tomography (CY) can demonstrate the abnormal findings which are believed to cause the clinical signs and symptoms of hearing loss (HL), vertigo and facial paralysis (FP) in patients with temporal bone trauma. MATERIALS AND METHODS: The authors studied CT scans of 39 ears in 35 patients with temporal bone trauma. CT scans were performed with 1-115 mm slice thickness and table incrementation. Both axial and coronal scans were obtained in 32 patients and in three patients only axial scans were obtained. We analyzed CT with special reference to the structural abnormalities of the external auditory canal, middle ear cavity, bony labyrinth, and facial nerve canal, and correlated these findings with the actual clinical signs and symptoms. As to hearing loss, we evaluated 32 ears in which pure tone audiometry or brainstem evoked response audiometry had been performed. RESULTS: With respect to the specific types of HL, CT accurately showed the abnormalities in 84% (16/19) in conductive HL, 100% (2/2) in sensorineural HL, and 25% (2/8) for mixed HL. When we categorized HL simply as conductive and sensorineural, assuming that mixed be the result of combined conductive and sensorineural HL, CT demonstrated the abnormalities in 89% (24/27) for conductive HL and 50% (5/10) for sensorineural HL. Concerning vertigo and FP, CT demonstrated abonormalities in 67%(4/6), and 29% (4/14), respectively. CONCLUSION: Except for conductive HL, CT seems to have a variable degree of limitation for the demonstration of the structural abnormalities resulting sensorineural HL, vertigo or facial paralysis. It is imperative to correlate the CT findings with the signs and symptoms in those clinical settings.
Audiometry ; Audiometry, Evoked Response ; Brain Stem ; Ear ; Ear Canal ; Ear, Inner ; Ear, Middle ; Facial Nerve ; Facial Paralysis ; Hearing Loss ; Humans ; Temporal Bone* ; Tomography, X-Ray Computed ; Vertigo

Subfalcial herniation secondary to a unilateral supratentorial space occupying lesion is frequently seen on the brain CT scan, however, the development of distal anterior cerebral artery infarction following compression of the terminal branches of the pericallosal artery against the falx during the period of subfalcial herniation is uncommon. For the last three years, we have experienced three cases of distal anterior cerebral artery infarction caused by subfalcial herniation on the brain CT scan. All patitnts had acute subdural hematomas resulting in subfalcial herniation on the first CT scan and subsequently developed focal infarctions in the ipsilateral paracentral lobule. The patients did not improve clinically and died several days after operation. The development of such infarction may reflect severe cerebral injury and portend a poor clinical outcome.
Anterior Cerebral Artery* ; Arteries ; Brain ; Hematoma, Subdural, Acute ; Humans ; Infarction* ; Infarction, Anterior Cerebral Artery ; Tomography, X-Ray Computed

The superficial sural artery flap is supplied by the superficial sural artery that accompanies the sural nerve. The superficial sural artery connects distally with a peroneal artery septocutaneous perforator via a suprafascial network of vessels that permits the flap to be raised on its distal pedicle. We treated 10 patients who showed soft tissue defect of the lower third of the leg, around the ankle and the hindfoot with this flap. The causes of the soft tissue defect were trauma in 6 cases, pressure sore in 2 cases, squamous cell carcinoma in 1 case and osteomyelitis in 1 case. The sites of the soft tissue defect were the lower third of the leg in 5 cases, around the ankle in 2 cases and the hindfoot in 3 cases. The size of the soft tissue defect was from 5x6 cm to 8xl2 cm. All 10 flaps survived. Two flaps showed slight venous congestion which cleared in a few days. The time for flap dissection was 15 minutes in average. The results of our cases show that the distally based superficial sural artery flap is useful for the soft tissue coverage of the lower third of the leg, around the ankle and the hindfoot. The advantages of the flap are that the blood supply is reliable, elevation is easy and quick, the major arteries are not sacrificed and the donor site morbidity is negligible.
Ankle ; Arteries* ; Carcinoma, Squamous Cell ; Humans ; Hyperemia ; Leg ; Lower Extremity ; Osteomyelitis ; Pressure Ulcer ; Sural Nerve ; Tissue Donors

Earlier work suggested that Ginseng saponin had an effect on osteoblast and other cells, but there has been no report on saponin effects on chondrocyte. The purpose of this study was to investigate the effect of saponin on cultured human chondrocyte. The chondrocyte was isolated from human articular cartilage of knee joint during notchplasty of ACL reconstructive procedure using collagenase, and cultured in standard medium and serum free deficient medium, with addition of saponin(0(control), 10, 20, 50 microgram/ml concentration). DNA, RNA synthesis of chondrocyte was estimated on 36 hours and 5 days of culture by measuring of thymidine and uridine uptake. Human collagen type I and II synthesis was estimated by reverse transcriptation-polymerase chain reaction on 36 hours of culture. Low dose saponin was found to enhance DNA, RNA, and collagen synthesis of chondrocytes which were cultured with a deficient medium in comparison to the controls. It promoted cell proliferation of the osteoblasts cultured with a deficient medium in comparison to the controls. But, high dose saponin was found to diminish the synthesis of DNA, RNA and collagen. In summary, the results showed that the saponin increased proliferation and differentiation of the chondrocyte cultured in deficient medium. Therefore saponin seemed to act as a physiologic stimulant on human chondrocyte. But further study should be done.
Cartilage, Articular ; Cell Proliferation ; Chondrocytes* ; Collagen ; Collagen Type I ; Collagenases ; DNA ; Humans* ; Knee Joint ; Osteoblasts ; Panax* ; RNA ; Saponins* ; Thymidine ; Uridine

PURPOSE: Ventriculoperitoneal (VP) shunt insertion is an important treatment modality in children with hydrocephalus. VP shunt infection is a major complication and an important factor that determines the surgery outcome. This 15-year study was performed to evaluate the epidemiology of VP shunt infections in pediatric patients treated at our center. METHODS: A retrospective review of medical records was performed in patients 18 years old or younger who underwent VP shunt insertion surgery from April 1995 to June 2010. RESULTS: Three hundred twenty-seven VP shunt surgeries were performed in a total of 190 pediatric patients (83 females, 107 males). The median age of the patients was 2.4 years (range, 0.02-17.9 years). Having a malignant brain tumor was the most frequent cause for VP shunt insertion. The shunt infection rate was 6.7% (22/327) per 100 operations and 9.5% (18/190) per 100 patients, and the incidence rate was 0.45 infection cases per 100 shunt operations-year. The most common pathogen was coagulase-negative staphylococcus (n=7) followed by methicillin resistant Staphylococcus aureus (n=1). Ten cases were treated with vancomycin and beta-lactam antibiotic (cephalosporin or carbapenem) combination therapy and 7 cases were treated with vancomycin monotherapy. The median duration of antibiotic treatment was 26 days (range, 7 to 58 days). Surgical intervention was performed in 18 cases (18/22, 81.8%). CONCLUSION: Epidemiologic information regarding VP shunt infections in pediatric patients is valuable that will help guide proper antibiotic management. Additional studies on the risk factors for developing VP shunt infections are also warranted.
Brain Neoplasms ; Child ; Epidemiologic Studies ; Female ; Humans ; Hydrocephalus ; Incidence ; Medical Records ; Methicillin Resistance ; Retrospective Studies ; Risk Factors ; Staphylococcus ; Staphylococcus aureus ; Vancomycin ; Ventriculoperitoneal Shunt