A retrospective study was made of 10 consecutive patients who underwent mandibular reconstruction with PCBM from December 1994 to July 1996. Free autogenous iliac bone in the from of particulate cancellous bone and marrow was densely packed into the crib that was adapted to bridge the mandibular discontinuity defect. Frozen-treated autogenous mandibular bone, splitted autogenous rib, and titanium mesh(Dumbach, Leibinger) were used as cribs carrying the PCBM. All ten cases underwent successful healing with the formation of a continuous bony union with the remaining mandible. The rate of resorption was assessed by sequential panoramic radiographs. The mean horizontal dimension of the madibular defects was 44mm and the mean vertical dimension of the reconstructed segments was 23mm. The bony height of the reconstructed segments retained about 90% of the bony height of over a 1-year period. We confirmed that PCBM grafts were the most successful and predictable grafts in mandibular discontinuity reconstruction.
Bone Marrow* ; Humans ; Infant Equipment ; Mandible ; Mandibular Reconstruction* ; Retrospective Studies ; Ribs ; Titanium ; Transplants ; Vertical Dimension

Allergic fungal sinusitis (AFS) is a benign, noninvasive form of fungal sinusitis. Histologically, AFS is characterized by allergic mucin, which consists of eosinophilic mucinous material with occasional laminar deposits of eosinophils. A diagnosis of AFS can be made when there is a demonstration of characteristic allergic mucin and an appearance of fungal hypae scattered within the mucin with no evidence of tissue invasion, or when fungi cultures yield positive results. Until now, no cases of AFS have been reported in Korea, though there have been many cases of mycetomas and a few cases of invasive fungal sinusitis. We present the first two cases of AFS in Korea. The patients demonstrated characteristic allergic mucin, fungal hypae scattered within the mucin, and no evidence of tissue invasion on histopathology. Nasal polyps, involvement of the unilateral sinuses, peripheral eosinophilia, an elevated total IgE, and hyperattenuated masses observed in the CT supported the diagnosis of AFS. The patients recovered and did not display recurrence after surgery and treatment with topical steroids and saline irrigation.
Diagnosis ; Eosinophilia ; Eosinophils ; Fungi ; Humans ; Immunoglobulin E ; Korea ; Mucins ; Mycetoma ; Nasal Polyps ; Recurrence ; Sinusitis* ; Steroids

BACKGROUND: Do-Not-Resuscitate(DNR) order has been used without specific legislation commonly in hospitals of Korea. We designed this study to assess the current use of DNR order in the emergency department and to make a database for establishing a policy for DNR order, especially in ER. METHODS: We retrospectively reviewed medical records of 164 patients who expired in the emergency department of Severance hospital from Sep. 1996 to Aug. 1997. We evaluated age, sex, diagnosis, specific department involved, whether written orders were made and medical care after decision of DNR. The patients were divided into 2 groups : DNR vs CPR. To determine factors influencing DNR decision, we searched for presence of malignancy, irreversible shock, unconsciousness and chronic illness. The logistic regression analysis was used for statistical significance. RESULTS: We found that 102(62.2%) out of 164 expired patients had a DNR order. But only in 59% of cases, were written DNR order on the chart. Factors which had the most influence on decision of DNR were malignancy and age. The sex, chronic illness, irreversible shock, and unconsciousness were not significant factors. CONCLUSION: We found malignancy and old age as an important factor when DNR order had been made. But further evaluation of other factors may be necessary to establish definitely a policy for DNR order.
Cardiopulmonary Resuscitation ; Chronic Disease ; Diagnosis ; Emergency Service, Hospital ; Humans ; Korea ; Logistic Models ; Medical Records ; Retrospective Studies* ; Shock ; Unconsciousness

Laurence-Moon-Biedl syndrome is an autosomal recessive disorder characterized by obesity, hypogenitalism, polydactyly, mental retardation and retinitis pigmentosa. Occasionally, this syndrome is accompanied by renal anomaly, nystagmus, cataract, syndactyly, microcephaly, oxycephaly and congenital heart disease. Recently, we have experienced a 8-year-old female patient who has retinitis pigmentosa, obesity, and polydactyly. We report a case of Laurence-Moon-Biedl syndrome with a review of literature.
Cataract ; Child ; Craniosynostoses ; Female ; Heart Defects, Congenital ; Humans ; Intellectual Disability ; Laurence-Moon Syndrome* ; Microcephaly ; Obesity ; Polydactyly ; Retinitis Pigmentosa ; Syndactyly

No abstract available.
Adult* ; Cholesterol* ; Gyeongsangbuk-do* ; Humans ; Jeollanam-do* ; Triglycerides*

BACKGROUND AND OBJECTIVES: Many authors(Simmons,1973, McGath et al.,1989) described that a small percentage(1-2 %) of patients initially complaining of vertigo was found to have bilateral vestibular failure (BLVF). This study evaluates the findings of vestibular function test (VFT) including rotating chair test (ROT) and computerized dynamic posturography test (CDP) in the patients with BLVF demonstrated by caloric test and others. Method : 400 vertigo patients were given VFT from June,1994 to October,1995. In the patients who had absent or reduced responses (total eye speed <10 degrees per second) in cold (17 C) water caloric testing or decreased responses in the range of lower fequencies during ROT, we evaluated their VFT results and clinical features. RESULTS: There were 38 cases out of total 400 patients(9.5%). Many patients with BLVF had rotational response magnitudes (at 0.04 Hz and above) that were within normal limits. CBP has shown vestibular dysfunction patterns in 32 patients. Hearing tests were normal in 9 cases and mixed hearing loss in 2 cases. Many patients experienced several episodes of acute vertigo with persistent imbalance; Only 4 patients complained of persistent oscillopsia. Viral infection (vestibuloneuronitis), immune reactions and toxic factors may play a role in the etiology of this rare BLVF. CONCLUSION: Our incidence of 9.5% is much higher than what was reported in the literature. Herb medications and frequent injections of aminoglycosides may be responsible for this higher incidence of BLVF. ROT is useful in detecting and predicting the remaining vestibular function in the BLVF patients.
Aminoglycosides ; Caloric Tests ; Electronystagmography ; Hearing Loss, Mixed Conductive-Sensorineural ; Hearing Tests ; Humans ; Incidence ; Vertigo ; Vestibular Function Tests* ; Water

No abstract available.
Microsatellite Repeats

BACKGROUND: Absorbable materials offer many advantages in the reconstruction of orbital walls; however, the possibility of postoperative enophthalmos after complete absorption cannot be excluded. We evaluated the postoperative results of absorbable mesh plates used as onlay implanting on the medial orbital wall to determine whether they are suitable for medial orbital wall reconstruction. METHODS: The study included 20 patients with medial orbital wall fractures who were followed up for more than 2 years postoperatively. We used absorbable mesh plates in all of the patients. We measured the following: the changes in the expanded orbital volume by comparing the preoperative and postoperative computed tomography (CT) scans and the degree of clinical enophthalmos. RESULTS: There were no major complications associated with the use of absorbable materials such as infection, migration, or extrusion of mesh plates during the long-term follow-up. The orbital volumetric changes between the preoperative and postoperative CT scans were not statistically significant. However, the expanded orbital volume was not related to the degree of clinical enophthalmos. CONCLUSIONS: The reconstructed orbital wall may provide supportive scar tissue to the orbital contents even after the absorbable materials have dissolved completely. Absorbable mesh plates could be another option for the reconstruction of the medial orbital wall.
Absorbable Implants ; Absorption ; Cicatrix ; Enophthalmos ; Follow-Up Studies* ; Humans ; Inlays ; Orbit* ; Orbital Fractures

Gestational trophoblastic disease (GTD) is a condition of uncertain etiology, choriocarcioma, or placental-site hydatidiform moles, invasive moles, choriocarcinoma, and placental-site trophoblastic tumors. It arises from the abnormal proliferation of trophoblastic tissue and spreads beyond the uterus hematogenously. The early diagnosis of GTD is important to ensure timely and successful management and the preservation of fertility. We report the unusual case of a metastatic choriocarcinoma that formed bullae on the lung surface and presented as recurrent pneumothorax in a 38-year-old woman with elevated beta-human chorionic gonadotropin (hCG) levels. She underwent thoracoscopic wedge resection of the involved lung and four subsequent cycles of consolidation chemotherapy. No other evidence of metastatic disease or recurrent pneumothorax was noted during 22 months of follow-up. GTD should be considered in the differential diagnosis of spontaneous pneumothorax in reproductive-age women with an antecedent pregnancy and abnormal beta-hCG levels.
Adult ; Choriocarcinoma* ; Chorionic Gonadotropin ; Consolidation Chemotherapy ; Diagnosis, Differential ; Drug Therapy ; Early Diagnosis ; Female ; Fertility ; Follow-Up Studies ; Gestational Trophoblastic Disease ; Humans ; Hydatidiform Mole, Invasive ; Lung ; Neoplasm Metastasis* ; Pneumothorax* ; Pregnancy ; Trophoblastic Tumor, Placental Site ; Trophoblasts ; Uterus

BACKGROUND: Although deferasirox (DFX) is reported to have anti-tumor effects, its anti-leukemic activity remains unclear. We evaluated the effect of DFX treatment on two murine lymphoid leukemia cell lines, and clarified the mechanisms underlying its potential anti-leukemic activity. METHODS: L1210 and A20 murine lymphoid leukemia cell lines were treated with DFX. Cell viability and apoptosis were evaluated by the 3-(4,5-dimethylthaizol-2-yl)-5-(3-carboxymethylphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay and fluorescence-activated cell sorting (FACS) analysis, respectively. Immunoblotting was performed to detect the expression of key apoptotic proteins. RESULTS: In dose- and time-dependent manner, DFX decreased viability and increased apoptosis of murine leukemic cells. Fas expression was significantly higher in A20 cells than in L1210 cells at all DFX concentrations tested. Although both cell lines exhibited high caspase 3 and caspase 9 expression, a critical component of the intrinsic mitochondrial apoptotic pathway, expression was greater in L1210 cells. In contrast, caspase 8, a key factor in the extrinsic apoptotic pathway, showed greater expression in A20 cells. Cytochrome c expression was significantly higher in L1210 cells. In both cell lines, co-treatment with ferric chloride and DFX diminished the expression of these intracellular proteins, as compared to DFX treatment alone. CONCLUSION: Treatment with DFX increased caspase-dependent apoptosis in two murine lymphoid leukemia cell lines, with differing apoptotic mechanisms in each cell line.
Apoptosis* ; Caspase 3 ; Caspase 8 ; Caspase 9 ; Cell Line* ; Cell Survival ; Cytochromes c ; Flow Cytometry ; Immunoblotting ; Leukemia* ; Leukemia, Lymphoid