The lack of sufficient oral mucosa available for intra-oral reconstruction has been dealt with by the use of skin or oral mucosa grafts harvested from donor sites but grafts requires more than one surgical procedures and could cause donor site morbidity. Many investigators have attempted to increase available soft tissue by tissue engineered skin or oral mucosa replacements for clinical applications. But, reconstructed mucosa by several methods have low physical properties such as rolling and contraction. The aims of this study were to develope an in vitro experimental model that maintains an epithelial-mesenchymal interaction by organotypic raft culture, and to characterize biologic properties of three-dimensionally cultured oral mucosa embedded with Polydioxanone mesh by histological and immunohistochemical analysis. The results were as follows; 1. Oral mucosa reconstructed by three-dimensional organotypic culture revealed similar morphologic characteristics to equvalent normal oral mucosa in the point that they show stratification and differentiation. 2. The expression of cytokeratin 10/13 and involucrin in the cultured tissue showed the same pattern with normal oral mucosa suggesting that organotypic co-culture condition is able to induce cellular differentiation. 3. After insertion of polydioxanone mesh, increased tensile strength were observed. These results suggest that three-dimensional organotypic co-culture of the oral mucosa cell lines with the dermal equvalent consisting type I collagen and fibroblasts reproduce the morphologic and immunohistochemical characteristics similar to those in vivo condition. And increased physical properties by use of polydioxanone mesh will helpful for clinical applications.
Cell Line ; Coculture Techniques ; Collagen Type I ; Fibroblasts ; Humans ; Keratins ; Models, Theoretical ; Mouth Mucosa* ; Mucous Membrane ; Polydioxanone* ; Research Personnel ; Skin ; Tensile Strength ; Tissue Donors ; Transplants

PURPOSE: This study was performed to investigate the degree of symptom improvement after removal of bone fragment in patients with deformed pisiform bone associated with tendonitis of flexor carpi ulnaris. METHODS: Pisiform bone fragment removal was performed in 12 patients who had failed conservative treatment from January 2008 to December 2011. They were followed up at 2 weeks, 1 month, 2 months, 6 months, and 12 months after surgery. Their symptoms were assessed with Green score. RESULTS: Eleven of 12 patients who underwent bone fragment removal showed symptom improvement. Symptoms worsened in 1 patient due to pain and restricted range of motion caused by postoperative scar. CONCLUSION: The results of this study suggest that removal of bone fragment may be an effective treatment in patients with tendonitis of flexor carpi ulnaris accompanied by pisiform bone deformity whose pain does not improve with conservative management.
Congenital Abnormalities ; Humans ; Pisiform Bone ; Range of Motion, Articular ; Tendinopathy ; Tendons

No abstract available.
Mastoid* ; Otitis Media with Effusion* ; Otitis Media* ; Otitis*

PURPOSE: We evaluated the efficacy of brachial plexus block under the guide of ultrasonography for immediate management of open wound in patients with multiple trauma. METHODS: From July 2012 to April 2013, 34 patients with multiple trauma had brachial plexus block for immediate management of open wound in the upper extremity. We evaluated the patient satisfaction of the anesthesia and any complications related to the block. RESULTS: During the brachial plexus block, intravascular injection of lidocaine occurred in one patient. Except this, all patients who received brachial plexus replied they would choose brachial plexus block if they had to undergo the same surgery. CONCLUSION: Brachial plexus block is an effective anesthesia technique in the immediate management of open wound in upper extremities.
Anesthesia ; Brachial Plexus* ; Humans ; Lidocaine ; Multiple Trauma ; Patient Satisfaction ; Ultrasonography ; Upper Extremity ; Wounds and Injuries

PURPOSE: Certain pitching mechanics is thought to lead pitchers in danger of surgical risk and decrease performance. The objective of this study is to analyze the effect of shoulder hyperabduction position during early cocking phase in association with surgical risk and performance in professional baseball players.METHODS: From 2009 to 2013, total of 93 candidates reached minimum inning qualification. After exclusion criteria (overlapped players, foreign players, age over 31 years, proceed to other league and retirement), 19 players were analyzed with slow-motion pitching video for hyperabduction of the shoulder and hyperpronation of forearm in cocking-phase. Also players were analyzed with innings pitched, earned run average (ERA), walks and hits divided by innings pitched (WHIP) and surgical history with database offered by official Korean Baseball Organization website.RESULTS: Out of total 19 players, nine players had hyperabduction arm movement and 10 players did not. Group with hyperabduction had average age of 24.3 years old, average inning/ERA/WHIP for 5 years were 55 innings/yr, 6.52 ERA/yr and 1.33 WHIP/yr, respectively, and seven players (77%) had surgeries eventually. Group without hyperabduction arm movement had average age of 25.4 years old; average inning, ERA/WHIP for 5 years were 127 1/3 innings/yr, 4.84 ERA/yr, and 1.32 WHIP/yr, respectively and five players (50%) went for surgeries. Player performance (ERA, p=0.66; WHIP, p=0.14) was not statistically influenced by the certain arm position at cocking phase but average inning pitched was statistically affected (p<0.01).CONCLUSION: Hyperabduction of shoulder in early cocking phase of throwing motion does not lead to decrease in performance (ERA, WHIP) but will result in tremendous decline of average IP. Also, risk of surgery is not associated to hyperabduction motion of the shoulder.
Arm ; Baseball ; Forearm ; Mechanics ; Shoulder

Symmetrical Digital Gangrene (SDG) is characterized by the sudden onset of peripheral, symmetrical gangrene in the absence of any major vascular occlusive disease. Catecholamine inotropes are frequently used for the treatment of septic shock combined with an unstable hemodynamic state, and their usage can rarely induce SDG. There is no standard treatment for the SDG. Early recognition and prompt management of sepsis and expeditious process of weaning off of the inotropes are necessary to prevent progression of SDG. To the best of our knowledge, this is the first report in Korea regarding the treatment of SDG induced by catecholamine inotropes.

BACKGROUND AND OBJECTIVES: There has been considerable research interest in cholesteatoma in recent years but an understanding of the pathophysiology has been handicapped by the lack of a suitable research model. Recent advances in culture methods have contributed to the study of normal physiology or pathogenesis at the level of cells. However, the conventional keratinocyte culture of cholestearoma has some weak points, since it is done under a condition that is different from cellular environments and it cannot investigate cellular interaction among keratinocytes and other cells of cholesteatoma. The purpose of this study is as follows : first, we organize a new study model for cholesteatoma using a three-dimensional (3-D) culture method; and then we study fibroblast effects on keratinocytes under the 3-D culture system. MATERIALS AND METHODS: Aural cholesteatomas were obtained during middle ear operations. The keratinocytes and fibroblasts were first cultured separately and then co-cultured three-dimensionally. The pureness of keratinocyte layer was examined immunohistochemically. We studied fibroblast effects on keratinocytes under the 3-D culture system from the viewpoint of proliferation and differentiation. RESULTS: We could establish 3-D culture of keratinocytes under the influence of fibroblasts. The keratinocytes of the co-culture system showed more proliferation and less differentiation than keratinocytes under the same conditions except for anchoring fibroblasts. CONCLUSION: In this study, we successfully organized the 3-D culture system, a new study model for cholesteatoma, and identified fibroblast effects on keratinocytes. This new study model might be an effective tool for research on the interactions among various cells of cholesteatoma: however, further investigation and development would he necessary.
Cholesteatoma ; Cholesteatoma, Middle Ear ; Coculture Techniques* ; Disabled Persons ; Ear, Middle ; Fibroblasts* ; Humans ; Keratinocytes* ; Physiology

PURPOSE: Deterioration of local immunity in the adenoids may make them vulnerable to infection by microorganisms, resulting in otitis media with effusion. To determine the factors associated with this condition, we evaluated adenoid size, mucosal barrier, squamous changes of ciliated epithelium, IgA secretion, and BCL-6 expression in adenoids. MATERIALS AND METHODS: Seventeen children diagnosed with otitis media with effusion (OME group) and 20 children without any history of OME (control group) were enrolled. Their adenoids were sized by lateral view X-ray and stained with hematoxylin and eosin to detect squamous metaplasia. The adenoids were also stained with cytokeratin to evaluate mucosal barriers, and with anti- IgA antibody and anti- BCL-6 antibody to determine expression of IgA and BCL-6. RESULTS: The OME group showed greater incidence of squamous metaplasia, fewer ciliated cells, and lower expression of BCL-6 (p < 0.05 each). Deterioration of the mucosal barrier was detected in the OME group (p > 0.05). IgA secretion and adenoid size were the same for the OME and the control groups. CONCLUSION: These results suggest that increased squamous metaplasia and lower BCL-6 expression in adenoids may be associated with increased susceptibility to OME.
Adenoids/chemistry/*pathology ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulin A/analysis ; Immunohistochemistry ; Keratins/analysis ; Male ; Metaplasia ; Mucous Membrane/chemistry/pathology ; Otitis Media with Effusion/metabolism/*pathology ; Proto-Oncogene Proteins c-bcl-6/*analysis

No abstract available.
Weaning*

Osteochondroma is one of the most common benign tumors of the axial skeleton, but is rarely found in the facial bones and extremely rare in mandibular condyle. The clinical signs and symptoms of osteochondroma of mandibular condyle may resemble those seen in patients with temporomandibular joint (TMJ) dysfunction. Condylectomy have been the first choice for treatment of osteochondroma, but it may be with some complicaitons, loss of condylar vertical height, etc. A 57 years old female patient who had an osteochondroma on left mandibular condyle visited to our clinic. We did surgically remove the mass with favorable result, so we present the case with review of literatures.
Facial Bones ; Female ; Humans ; Mandibular Condyle ; Osteochondroma ; Skeleton ; Temporomandibular Joint