The osteoplasties of maxilla and mandible as the craniomaxillofacial surgery is popular and markedly developed in technically. In traditional osteoplasty, we have been use the mechanical saw, burr, cutting bar which is big sized instrument to transmit the energies to the saw or burr tips. So it is technically difficult to use such big instrument in narrow operative field Recently, the development of laser technology makes wider influence in the medical field. So, the laser is applying to high energy-using osteotomy in addition to hemangioma, tatoo, laserbrasion, hypertrophic scar and endoscopic surgery. The objective of the present study is to evaluate the extent of damage of bone and subsequent healing between the conventional mechnical saw osteotomies and the ND-YAG laser used osteotomies on the rabbit mandible angles by the histologic examination. Fifteen New Zealand white rabbits were used for the study. After exposure of rabbit's mandibular angle, one side of mandible angles were osteomized used by Nd-YAG laser and the other by the saw randomly. We compared the extent of damage and healing of laser and saw osteotomies at immediate, 2 week, 4 week, 3 months, 6 months postoperatively. The result revealed that, in two weeks after operation, the one of damaged bone was looks wider in laser osteotomies sites than by conventional mechanical saw osteotomies sites, but there is not remarkable differences between the laser and saw used group after 4 weeks, and we believe that it is possibility to use alser in craniomaxillofacial field saftly in near future.
Cicatrix, Hypertrophic ; Hemangioma ; Lasers, Solid-State* ; Mandible ; Maxilla ; Osteotomy ; Rabbits

Isolated pulmonary stenosis, a relatively common congenital anomaly that accounts for about 10 percent of all congenital heart disease, is characterized by stenosis of pulmonary valve itself, infundibulum or both of them. Since cardiac catherterization was applied to man by Cournand and Ranges, pulmonary stenosis had been easily diagnosed and many clinical studies had been investigated. It has a wide clinical spectrum depending on the degree of stenosis. The electrocardiogram, phonocardiogram and chest X-ray have proved useful in estimating the severity of hemodynamic facotrs in individual cases. This series comprises 47 cases in whom the clinical diagnosis of isolated pulmonary stenosis was confirmed by right heart catheterization with cardiac cineangiography at Severance Hospital, Yonsei University. An attempt was made to correlate the electrocardiographic, phonocardiographic, chest X-ray findings, and types of stenosis with the hemodynamic data in these cases. 1. Of 47 patients, 33 were male and 14 female. Their ages ranged from 2 to 42 years: the mean age was 19.1 years. 2. The incidence was 5.9 percent of all 797 catheterized congenital heart disease cases. The pulmonary valvular stenosis was 30 (68.3%), infundibular 7 (14.6%) and combined 10 (21.6%) cases. 3. The correlation between electrocardiogram and hemodynamic data were as follows. i) The regression equation between right ventricular sysytolic pressure (RVSP) and height of R wave in V1 lead (RV1) was RVSP=3.32 RV1+48.2: its correlation coefficient was 0.818 and it was very significant (p=0.000). ii) The higher the RVSP, the more the frontal axis of QRS complex shifted to the right side (r=0.55. p=0.001). iii) The RVSP of the groups with positive ECG findings such as p-pulmonale, right ventricular hypertrophy or right ventricular strain were much higher than the RVSP of the groups without such findings (p=0.032.0.000, 0.000). iv) The group with RV1 higher than 20 mm showed much more elevated mean of RVSP than the group with lower RV1 (p=0.000). v) The groups with the above mentioned positive ECG findings showed good correlation with the severity of RVSP which was arbitrarily classified as 49 or less, 50~100, and 100 mmHg or more (chi-square=8.96, 26.69, 19.06; p=0.011, 0.000, 0.000). 4. The group with late occurrence of the maximum intensity of the ejection systolic murmur showed higher mean of RVSP than the group with early peak of the murmur (p=0.014). 5. The means of RVSP of the groups with chest X-ray findings such as decreased pulmonary vascularity, were much higher than the means of RVSP of the groups without such findings (p=0.000, 0.005, 0.015). The groups with above mentioned positive chest X-ray findings showed good corelations with the severity of RVSP which was classified as above limits (chi-square=7.55, 10.94, 13.36; p=0.022, 0.004, 0.001). 6. Combined pulmonary valvular and infundibular stenosis showed more severe systolic pressure gradient and higher mean of RVSP than the isolated types (p=0.000).
Axis, Cervical Vertebra ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Catheters ; Cineangiography ; Constriction, Pathologic ; Diagnosis ; Electrocardiography ; Female ; Heart Defects, Congenital ; Hemodynamics* ; Humans ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Pulmonary Valve ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Thorax

Langerhans cell histiocytosis is a rare disorder with abnormal proliferation of histiocytes. Besides the infiltration of a variety of organs, patients with Langerhans cell histiocytosis can develop sclerosing cholangitis, with bile duct involvement, progressive fibrosis, and cirrhosis. We report a case of Langerhans cell histiocytosis with sclerosing cholangitis. Endoscopic retrograde cholangiopancreatography revealed multiple strictures and dilatations of left intrahepatic and extrahepatic bile duct. Endoscopic biopsy of common bile duct showed diffuse infiltration of histiocytes and eosinophiles in lamina propria. Immunohistochemical stain showed positive reactions for S-100 and CD1a and a negative reaction for cytokeratin in infiltrating histiocytes.
Bile Ducts ; Bile Ducts, Extrahepatic ; Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis, Sclerosing* ; Common Bile Duct ; Constriction, Pathologic ; Dilatation ; Eosinophils ; Fibrosis ; Histiocytes ; Histiocytosis, Langerhans-Cell* ; Humans ; Keratins ; Mucous Membrane

BACKGROUND/AIMS: The ability to visualize the small bowel mucosa by capsule endoscopy is limited. Moreover, studies involving small-bowel preparation with purgative drugs have failed to establish which preparations produce better images and higher diagnostic yields. The aim of this study was to evaluate the efficacies and diagnostic yields of different bowel preparations. METHODS: A cohort of 134 patients with suspected small bowel disease was randomly assigned to 3 groups. Patients in group A (n=44) fasted for 12 h before being administered an M2A capsule (Given Imaging, Yoqneam, Israel). Patients in group B (n=45) were asked to drink two doses of 45 mL of sodium phosphate (NaP) with water during the afternoon and evening on the day before the procedure and to drink at least 2 L of water thereafter. Patients in group C (n=45) drank 2 L of a polyethylene glycol (PEG) lavage solution the evening before the procedure. RESULTS: Overall cleansing of the small bowel was adequate in 43% of patients in group A, 77% of those in group B, and 56% of those in group C (group A vs group B, p=0.001). Diagnoses for obscure gastrointestinal bleeding were established in 9 patients (39%) in group A, 16 patients (69%) in group B, and 14 patients (50%) in group C. No significant difference in diagnostic yield was observed between groups. CONCLUSIONS: Bowel preparation with NaP for capsule endoscopy improved small-bowel mucosal visualization when compared to 12-h overnight fasting.
Capsule Endoscopy ; Cohort Studies ; Hemorrhage ; Humans ; Mucous Membrane ; Phosphates ; Polyethylene Glycols ; Prospective Studies ; Sodium ; Therapeutic Irrigation ; Water

BACKGROUND: Breast cancer patients suffer from lowered quality of life (QoL) after surgery. Breast conservancy surgery (BCS) such as partial mastectomy is being practiced and studied as an alternative to solve this problem. This study confirmed breast tissue reconstruction in a pig model by fabricating a 3-dimensional (3D) printed Polycaprolactone spherical scaffold (PCL ball) to fit the tissue resected after partial mastectomy. METHODS: A 3D printed Polycaprolactone spherical scaffold with a structure that can help adipose tissue regeneration was produced using computer-aided design (CAD). A physical property test was conducted for optimization. In order to enhance biocompatibility, collagen coating was applied and a comparative study was conducted for 3 months in a partial mastectomy pig model. RESULTS: In order to identify adipose tissue and fibroglandular tissue, which mainly constitute breast tissue, the degree of adipose tissue and collagen regeneration was confirmed in a pig model after 3 months. As a result, it was confirmed that a lot of adipose tissue was regenerated in the PCL ball, whereas more collagen was regenerated in the collagen-coated Polycaprolactone spherical scaffold (PCL–COL ball). In addition, as a result of confirming the expression levels of TNF-a and IL-6, it was confirmed that PCL ball showed higher levels than PCL–COL ball. CONCLUSION Through this study, we were able to confirm the regeneration of adipose tissue through a 3-dimensional structure in a pig model. Studies were conducted on medium and large-sized animal models for the final purpose of clinical use and reconstruction of human breast tissue, and the possibility was confirmed.

BACKGROUND/AIMS: Capsule endoscopy (CE) is widely used. However, CE has limitations including incomplete examination, inadequate bowel preparation, and retention. The aim of this study was to estimate the indications for and detection, completion, and retention rates of small intestine CE based on the 10-year data from the Korean Capsule Endoscopy Registry. METHODS: Twenty-four hospitals participated in this study. Clinical information, such as reasons for CE, method and quality of bowel preparation, and incomplete examination and capsule retention rates, was collected and analyzed. RESULTS: A total of 2,914 CEs were registered. The most common reason for CE was obscure gastrointestinal bleeding (59%). Significant lesions were detected in 66% of cases. Positive CE diagnosis occurred in 63% of cases. The preparation method did not significantly affect the quality of bowel preparation for CE. The overall incomplete rate was 33%, and was high in the elderly and those with poor bowel preparation. Capsule retention was 3% and high in patients with small bowel tumors and Crohn's disease and in children under 10 years of age. CONCLUSIONS: CE is a valuable technique; while the overall detection rate is high, incompletion and retention rates are also relatively high. CE should be carefully considered in the elderly and children less than 10 years of age, as well as in patients with small bowel tumors and Crohn's disease.
Aged ; Capsule Endoscopy* ; Child ; Crohn Disease ; Diagnosis ; Hemorrhage ; Humans ; Intestine, Small