The tracheostomy is increasingly being performed. In most cases, the tracheostomy sites are left to heal by secondary intention, so it leaves a depressed and wide scar that is cosmetically disfigured. Another problem os that the scar is also attached directly to the trachea itself and will move vertically with the trachea during the act of swallowing. Even though the tracheostomy scar is cosmetically acceptable, the mobility and retraction of the scar is a continual nuisance to the patient. We performed a retrospective study on 9 patients who had undergone revision of the depressed thracheostomy scar by the Renner Method from June, 1997 to February, 1999. The method includes transverse fusiform incision of the original scar and excision of the depressed portion of the scar to the level of the trachea itself. To prevent attachment of the skin and trachea, a bilateral subcutaneous flap and muscle flap were simply advanced to the midline and overlapped. Then the rest of scar that was not depressed was deepithelized and flipped to augment the soft tissue volume in the central depressed area. Satisfactory results were achieved in all patients without hematoma, infection, hypertrophic scar, and keloid formation. We believe this simple Renner method is one of the best ways of performing posttracheostomy scar revision.
Cicatrix* ; Cicatrix, Hypertrophic ; Deglutition ; Hematoma ; Humans ; Intention ; Keloid ; Retrospective Studies ; Skin ; Trachea ; Tracheostomy

This research was focused on overall examination of tissue alteration, wound healing promotion. After the hair on the dorsal surface was shaved, 5x5mm oval skin defect was formed. Experimental wounds of right side were irradiated on every day for 90 second with Ga-Al-As semi-conductor laser. Left side wounds served as control group. The rats were sacrificed on the 1st, 3rd, 5th, 7th, 14th, 21th day. For light microscopically, parafin section were stained with H&E, MT. The outcomes were as follows : 1. On 1st day, experimental and control group were seen acute inflammatory cell infiltration, edema. 2. On the 3rd days, both groups were seen crust development, collagen, blood vessel proliferation. 3. On the 5th days, experimental group were reduced edema and inflammatory cell infiltration than control group. 4. On the 7th days, both groups were observed edema, inflammatory cell infiltration disappearance and keratinocytes motility from wound defect. 5. On the 14th days, experimental group appeared collagen, blood vessel proliferation and hair follicle than control group. 6. On the 21th days, both groups were seen normal status re-epithelization. According to the above results, The wound-healing stimulated by laser radiation involves an increased rate of epithelial growth. LLLT was confirmed that it has fibroblast, blood vessel proliferation, influence initial wound healing process.
Animals ; Blood Vessels ; Collagen ; Edema ; Fibroblasts ; Hair ; Hair Follicle ; Keratinocytes ; Low-Level Light Therapy* ; Rats* ; Skin* ; Wound Healing ; Wounds and Injuries*

STUDY DESIGN: Case report. OBJECTIVES: To report a case of paraplegia in a patient with thoracic kyphosis after osteosynthesis for a fracture of the femur. SUMMARY OF LITERATURE REVIEW: There are few reports about cases of paraplegia after low extremity fracture surgery in patients with thoracic kyphosis with ankylosing spondylitis. MATERIALS AND METHODS: An 86-year-old female patient presented with right hip pain. She had undergone surgery for an intertrochanteric fracture of the femur in the supine position under general anesthesia. Immediately after surgery, she showed paraplegia. Postoperative thoracolumbar spine images revealed a fracture through the disc at T12 and L1. However, she did not complain of back pain or any neurologic deficits before surgery. RESULTS: Although the patient underwent emergent posterior decompression and fusion surgery, her neurologic compromise did not improve during 1 year of follow-up. CONCLUSIONS: It is necessary to check preoperative spine radiographs before surgery in elderly patients who have a kyphotic deformity and lower extremity fractures. Surgeons should consider changing the position of the patient and the type of anesthesia used during surgery when spine stability is in doubt.
Aged ; Aged, 80 and over ; Anesthesia ; Anesthesia, General ; Back Pain ; Congenital Abnormalities ; Decompression ; Extremities ; Female ; Femur* ; Follow-Up Studies ; Hip ; Humans ; Kyphosis ; Lower Extremity ; Neurologic Manifestations ; Paraplegia* ; Spine* ; Spondylitis, Ankylosing* ; Supine Position ; Surgeons

Hemangiomas are rare benign tumors of the adrenal gland. We report here on the CT findings of a cavernous hemangioma of the right adrenal gland. The CT revealed a well-delineated adrenal mass having an internal necrotic portion and tiny peripheral calcifications. After administration of the contrast media, the tumor showed peripheral enhancement on the arterial phase, and this was followed by progressive centripetal fill-in.
Adrenal Glands* ; Contrast Media ; Hemangioma ; Hemangioma, Cavernous*

Damage to adjacent teeth is one of the various complications that may occur during implant placement and is often the result of improper direction during fixture placement or excessive depth of placement. In general, if detrimental symptoms, such as reaction to percussion in damaged teeth, mobility, and pulp necrosis, are not present, osseointegration should be observed at follow-up. In three cases, the possibility of root damage due to an implant fixture placed too close to each adjacent tooth was perceived on radiographs. However, in all of these cases, there were no clinical symptoms or radiographic changes present in the tooth, and the implants did not exhibit decreased stability or peri-implantitis. Therefore, we can carefully predict that the implant fixture close to the adjacent tooth did not invade the cementum of the root, and therefore did not produce the suspected pulpal damage or periradicular symptoms. In this study, we considered both the implant status as well as the adjacent tooth.
Dental Cementum ; Dental Implants ; Dental Pulp Necrosis ; Follow-Up Studies ; Osseointegration ; Percussion ; Peri-Implantitis ; Prognosis ; Tooth

The indole alkaloid harmaline has been to cause tremor and ataxia, and produce cerebellar neurotoxicity in rat. Degeneration of Purkinje cell alligned in narrow parasagittal bands result from excitation of inferior olivary nucleus in harmaline-treated rats. The objective of this study was to investigate the hypothesis that excitation of climbing fiberinduced by harmaline mediates Purkinje cell injury or degeneration. For this purpose, the inferior olive of rats was chemically ablated by using 3-acetyl pyridine, a neurotoxic chemical, and cerebellar damage followed by administration of harmaline was analyzed using immunohistochemical markers for neurons, glial cells. The results demonstrated that a subset of Purkinje cell in the vermis and paravermis degenerated after harmaline treatment, but harmaline produced little or no Purkinje cell degeneration after inferior olivary ablation. These results suggested that harmalineinduced activation of inferior olivary neurons may lead to release of glutamate from climbing fiber synaptic terminal distributed over the Purkinje cells, and may lead to cytotoxic degeneration of Purkinje cells.
Animals ; Ataxia ; Cerebellum ; Glutamic Acid ; Harmaline* ; Neuroglia ; Neurons ; Olea ; Olivary Nucleus ; Presynaptic Terminals ; Purkinje Cells* ; Rats ; Tremor

BACKGROUND: Rosacea is a common and well known chronic cutaneous disease. The typical symptoms are cosmetic problems, and the recurrent nature of rosacea requires long term treatments that might have a profound effect on the quality of life (QOL) and mental health of these patients. However, there have been only epidemiological studies on Rosacea in the Korean dermatologic literature. OBJECTIVE: The aim of this study was to evaluate the QOL, psychosocial stress, anxiety and depression levels in Korean patients with rosacea and to determine the factors that have an impact on the QOL of rosacea patients. METHODS: A cross-sectional study was conducted on thirty-three adults with rosacea and who had visited our department and thirty-five healthy volunteers with no dermatologic disease or other chronic illness. The rosacea patients were diagnosed by dermatologists who decided the rosacea subtypes before the patients were enrolled in this study. The patients' subjective perceptions of severity were assessed using the Likert scales and the QOL was assessed using Skindex-29. The mental health interview included the psychosocial well-being index-short form (PWI-SF), the trait anxiety inventory (TAI) and the Beck depression inventory (BDI) as measures of psychosocial stress, anxiety and depression, respectively. The QOL, PWI-SF, TAI and BDI scores of the rosacea patients were compared with those of the controls. The subjective perceptions of severity, QOL and the PWI-SF, TAI and BDI scores were also compared between the erythemato-telangiectatic type patients and the papulopustular type rosacea patients. RESULTS: As compared with the controls (n=35), the rosacea patients (n=33) had a significantly decreased QOL (p=0.000). The scores of the PWI-SF, TAI and BDI for patients with rosacea were higher than those of the controls, meaning the rosacea patients had more psychosocial stress, anxiety and depression (p=0.000, 0.000, 0.001). No significant differences in the subjective perception of severity, QOL and mental health were found between the erythemato-telangiectatic and papulopustular type patients (p=0.825, 0.438, 0.268, 0.631). The high self-reported subjective perception of severity, psychosocial stress and anxiety showed significant correlations with low QOL. CONCLUSION: These results indicate that rosacea has a large impact on the patients' QOL and mental health. Taking into account the patients' subjective perception of disease severity and mental health as potential determinants of the QOL of rosacea patients, more attention and effort should be given to develop Korean versions of rosacea-specific QOL instruments as these might more accurately and objectively indicate the severity of the disease.
Adult ; Anxiety ; Chronic Disease ; Cosmetics ; Cross-Sectional Studies ; Depression ; Epidemiologic Studies ; Humans ; Mental Health ; Quality of Life ; Rosacea ; Weights and Measures

OBJECTIVES: The aim of this study was to retrospectively evaluate the clinical survival rate of Astra Tech implants in the maxillary molar region performed with sinus lift and bone graft. MATERIALS AND METHODS: Ninety-nine Astra Tech implants (Osseospeed) placed in the maxillary molar region using sinus lift from September 2009 to February 2012 were selected with a minimum follow-up period of 1 year. The height of alveolar bone, sinus approach technique, bone material and implant survival rate were evaluated. RESULTS: Of the 99 implants, the survival rate was 90.9%; 8 implants failed within 1 year after implant placement, and 1 implant failed 1 year after implant loading. All failed implants were placed with sinus lift simultaneously. The average height of alveolar bone before implant placement was 6.9 mm, while the height of alveolar bone of failed implants was 2.1 mm, on average. CONCLUSION: Astra Tech implants placed in the maxillary molar region had generally good survival rates, but the relationship between reduced pre-implant alveolar bone height and implant failure requires further attention.
Dental Implants ; Follow-Up Studies ; Maxillary Sinus* ; Molar ; Retrospective Studies ; Sinus Floor Augmentation ; Survival Rate* ; Transplants

BACKGROUND AND OBJECTIVES: According to previous reports, patients with vestibular migraine (VM) display variable results from vestibular function tests (VFT): central, peripheral, or normal. The aim of this study was to classify the VM patients into the three groups according to interictal VFT findings (central, peripheral or normal) and to clarify the relationship between VFT results and the clinical manifestations and prognosis in each group. SUBJECTS AND METHODS: We reviewed the medical records of 81 patients diagnosed as VM using the criteria of Neuhauser, et al. between December 2004 and June 2009. Patients were divided into three groups according to the results of VFT. We compared the clinical manifestations and prognosis between groups. Characteristics including dizziness, the nature of headache, associated otologic symptoms, hearing threshold, duration of illness, and recovery time were analyzed. RESULTS: The number of patients with central, peripheral vestibular dysfunction and normal finding in VFT were 15, 28, and 38 respectively. There were no significant differences in the nature of headache, associated otologic symptoms, hearing threshold, duration of illness, and recovery time. A small difference was observed in the mean age and characteristics of dizziness, but these were not significant. CONCLUSIONS: In patients with VM, classification according to the type of vestibular dysfunction was not helpful in the prediction of prognosis and clinical manifestations.
Dizziness ; Headache ; Hearing ; Humans ; Medical Records ; Migraine Disorders ; Prognosis ; Vertigo ; Vestibular Function Tests

PURPOSE: Prolonged urinary incontinence is one of the greatest concerns for patients undergoing radical prostatectomy. One of the possible causes for this urinary incontinence is a postoperative deficiency of the external striated urethral sphincter (EUS) complex and continence nerves. We evaluated the effect of posterior urethral reconstruction (PUR) in the early recovery of urinary continence after robotic-assisted radical prostatectomy. MATERIALS AND METHODS: Between January 2008 and March 2009 we performed robotic-assisted radical prostatectomy with PUR in 30 patients (PUR group) and without PUR in 30 patients (non-PUR group). We compared perioperative parameters and postoperative continence rates between the two groups. Continence was defined as no pads or one diaper per 24 hours and was assessed 1 month, 3 months, and 6 months after the procedure. RESULTS: Patients in the PUR group achieved better continence rates at 1 month (43% vs. 35%) and 3 months of follow-up (89% vs. 64%). At 6 months of follow-up, the continence rate was similar between the two groups (96% vs. 90%). No major complications were observed in the PUR group. However, 2 cases of anastomotic site leakage and 1 case of delayed bleeding were observed in the non-PUR group. CONCLUSIONS: Posterior urethral reconstruction appears to be an easy and reproducible technique in robotic-assisted radical prostatectomy. Our early experience demonstrates that PUR in robotic-assisted radical prostatectomy appears to confer early continence recovery and reduce intraoperative complications.
Follow-Up Studies ; Hemorrhage ; Humans ; Intraoperative Complications ; Prostatectomy ; Robotics ; Urethra ; Urinary Incontinence