Lateral osteotomy has been chosen as a part of rhinoplasty for modification of the nasal bony vault, alteration of the base width of the lateral walls, establishment of a new profile line of the nasal dorsum and lateral profile line, and closure of the open roof. Various methods of lateral osteotomy may be employed, however Orientals have characteristically broad and flat noses Compared to caucasians and for an esthetically satisfactory result, it is important to correct both in rhinoplasty. In this study, the authors performed their devised method of lateral osteotomy in 12 patients for the correction of broad, flat nasal dorsum and deviated noses. The operations could be broadly categorized into two groups: 1) short lateral osteotomy in which the lateral osteotomy line was incomplete and short, extending to the infraorbital rim; and 2) green-stick transverse osteotomy which was induced by in-siturotation fracture by osteotomy and, if considered necessary, augmentation rhinoplasty and nasal tip plasty were also performed simultaneously. Our nasal osteotomy has limited mobilization, where as the previous method has total mobilization, and it has the advantages of repositioning the broad and deviated nose in a preferable direction and shape, as well as the capability of narrowing the preferable area selectively. Especially if there is a necessity to correct both broad and flat noses such as in Orientals, our osteotomy methods have a synergistic effect in esthetic outcome when performed with augmentation rhinoplasty with a silastic implant. There were no complications such as relapse or air-way obstruction during the 4.5-month follow-up period. However, a long-term follow-up period is needed to evaluate the complications considering the physiologic aspect of the nose.
Follow-Up Studies ; Humans ; Nose ; Osteotomy* ; Recurrence ; Rhinoplasty*

Despite substantial advances in dialysis techniques and machines, acute kidney injury (AKI) requiring renal replacement therapy (RRT) is still associated with up to 60% in-hospital mortality. However, there is little information on whether RRT overcomes the significant morbidity and mortality of AKI. What is most important in the treatment of AKI is that RRT is not a cause-specific therapy but life-supportive management. This review discusses the indications of, proper initiation of, and optimal prescription for RRT to improve the survival of critically ill patients with AKI.
Acute Kidney Injury* ; Critical Illness* ; Dialysis ; Hospital Mortality ; Humans ; Mortality ; Prescriptions ; Renal Replacement Therapy

Despite substantial advances in dialytic techniques and machines, acute kidney injury (AKI) requiring renal replacement therapy (RRT) is associated with up to 60% in-hospital mortality. But, there is no full detail of definite RRT to overcome the significant morbidity and mortality of AKI. What is most important in the treatment for AKI is that RRT is not a cause-specific therapy but a life-supportive management. This review discusses the indications of, proper initiation of, and optimal prescription for RRT to improve the survival of the patients with AKI.
Acute Kidney Injury ; Hospital Mortality ; Humans ; Kidney ; Prescriptions ; Renal Replacement Therapy

No abstract available.
Kidney Failure, Chronic ; Paraproteinemias ; Vasculitis

A 68-year-old Korean woman was consulted to the department of dermatology to evaluate ulcerated lesions on the perianal area, which developed about 3 weeks after a cadaveric renal trans-plantation. Histopathologic examination showed large atypical cytomegalic cells in the upper dermis. Polymerase chain reaction(PCR) study revealed positive cytomegalovirus(CMV) deoxyribonucleic acid(DNA) from the skin tissue. We herein present a case of cutaneous CMV infection presenting as perianal ulcers.
Aged ; Cadaver ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Dermatology ; Dermis ; Female ; Humans ; Kidney Transplantation ; Skin ; Ulcer*

Parkinson's disease most consistently involves pathologic changes in the substantia nigra, which is the major source of dopamine to the striatum. It has been shown that either fetal substantia nigra or adrenal medulla tissue implanted to the rat brain survives, produces dopamine, and improves behavioral abnormalities induced by deprivaion of the caudate nucleus of its dopaminergic innervation. Thus, grafts containing dopamine could be potential replacement for destroyed or damaged dopaminergic neurons in patients with Parkinson's disease. In the present study, authors administrated 6-hydroxydopamine into the right substantia nigra, and produced unilateral dopamine denervated Parkinson's experimental model using solid graft method and cell suspension implant, the results of these grafts were examined behaviorally, biochemically, immunohistochemically 3 months after grafting. In this study, a total of forty-five young(4 to 5 week old) rats were used and divided into three experimental groups-control group which underwent dopamine denervation without any grafting(15), solid graft group which was grafted fetal mesencephalon to the caudate-putamien(n=15) and cell suspension implant group which was grafted cell suspension fetal mesencephalon to the caudate-putamen(n=15). The apomorphine induced rotation test was performed at four weeks, eight weeks, twelve weeks after grafting. The dopamine concentration in the caudate-putamen was biochemically measured by High Performance Liquid Chromatography(HPLC) and immunohistochemically these grafts containing dopamine granules were stained by Avidin-Biotin immunoperoxidase staining with dopamine monoclonal antibody. The results were as follows ; 1) Behavioral testing was performed by apomorphine induced rotational test. A mean rotation number during the first five minutes following apomorphine injection was 40.0+/-.5 in control and 18.3+/-.9 in cell suspension implanted group at one month after grafting and these was more reduction of turning than that in solid graft group. The both graft groups demonstrated explicit reduction of turning by 58% and 55.3% when compared to the control group respectively 3 months after grafting. However the difference in reduction of turning between the two grafted groups was statistically not significant. 2) Biochemical measurements of dopamine concentration was done in pathologic and normal caudate-putamen. The concentration of dopamine was 13.5+/-3.1ng/mg of protein in normal subject and 0.6+/-0.2ng/mg of protein in the dopamine denervated caudate-putamen of the control group which was markedly reduced by 4.4% of dopamine concentration in the normal caudate-putamen. The concentration of dopamine in the cell suspension implant group was 3.2+/-1.2ng/mg of protein at three months after grafting and 3.0+/-1.1ng/mg of protein in the solid group and these values were increased in the concentration give 5 times more than those of pregrafting state. 3) In the results of immunohistochemical examination cells containing granules of dopamine were exclusively found in the grafted groups. In experimental Parkinson's disease model of Sprague-Dawley rats, it was found that the grafts of fetal mesencephalon to the caudate nucleus induced an elevation of dopamine concentration and symptomatic improvement. In the method of graft, cell suspension implant method brings faster effect, leaves less amount of damage to the host brain, and can be used in any area of the brain for the transplantation. Therefore graft of fetal mesencephalon using cell suspension grafting method might be effective treatment of patients with Parkinson's disease.
Adrenal Medulla ; Animals ; Apomorphine ; Brain ; Caudate Nucleus ; Denervation ; Dopamine ; Dopaminergic Neurons ; Humans ; Mesencephalon* ; Models, Theoretical ; Oxidopamine* ; Parkinson Disease ; Rats* ; Rats, Sprague-Dawley ; Substantia Nigra ; Transplantation ; Transplants

We experienced a case of congenital tuberculosis in 17 days old female infant who had miliary tuberculosis. She was admitted at the gae fo 17 days with a history of high fever and irritavility for 2 days, when she seemed to be weak, underdeveloped and undernourished, and there were diminished aeration on the right lung fields, hpatosplenomegaly,and stat ionary weight She was lst child born of 30 year-old woman after a 6 year of infertility and was normally born at the 37 weeks?gestation period with 2,500 Gm. Weight. She began to cough at the age of 7 days. Her mother, aged 28, was diagnosed as having tuberculous pelvic peritonitis, when she was operated on the left salphingostomy. Infan's chest film showed miliary tubercuous pattern and gastric washing exam. For A.F.B was positive but tuberculin skin test was negative. Finding of endometrial biopsy of mother was consistent with tuberculous eddometritis Diagnosis was established by onset,chilical syndrom,gastric washing, chest film, family history and maternal endometrial biopsy. The reviw of the related literature was made briefly.
Adult ; Biopsy ; Child ; Cough ; Diagnosis ; Female ; Fever ; Humans ; Infant ; Infertility ; Lung ; Mothers ; Peritonitis ; Skin Tests ; Thorax ; Tuberculin ; Tuberculosis* ; Tuberculosis, Miliary

Three cDNA fragments located within NS5 region of HCV were synthesized by RT using viral RNA extracted from blood sample of Korean patient as a template. The cDNAs were amplified by PCR, cloned into the T-vector, and the nucleotide sequences were determined. Comparative a analysis of the nucleotide and amino acid sequence of NS5 cDNAs showed that it is closely related with HCV type 1b. The cloned NS5 cDNA showed 91-94% homology at the nucleotide sequence level and 96-98% homology at the amino acid sequence level with several strains of the HCV type 1b. The NS5 cDNAs were subcloned into E. coli expression vectors to construct pRSETA5-1, pTHAN5-1, pRSETC5-2, pRSETBB1, pRESTCB1 and PRSETB-H3. Expression of the NS5 proteins was achieved by inducing the promoter with isopropyl-thio-P-D-galactoside (IPTG) and confirmed by SDS-polyacrylamide gel electrophoresis. The NS5 proteins were immunoreactive against sera from Korean hepatitis C patients in Western blot analysis. Among the recombinant NS5 proteins, pRSETA5-1 plasmid derived protein, coded from aa2022 to aa2521 of HCV polyprotein, showed the strongest immunoreactivity against sera from Korean hepatitis C patients in immunoblot analysis. These results suggest that NS5 proteins would be useful as an antigen for detection of antibody against HCV in the blood samples.
Amino Acid Sequence ; Base Sequence ; Blotting, Western ; Clone Cells* ; Cloning, Organism* ; DNA, Complementary ; Electrophoresis ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Plasmids ; Polymerase Chain Reaction ; RNA, Viral

In the autoimmune hemolytic anemia abnormal antibodies directed against red cells are produced by the patient himself. The pathologic mechanism in which erythrocyte survival is decreased as a result of the deposition of specific antibody on the red cell surface is uncertain. The abnormal antibody is most freqeuntly of the lgG or IgM class and occasionally may be IgA. A case of autoimmune hemolytic anemia was confirmed by CBC and Coombs test in a 11years old boy. We are reporting the laboratory data and our experiences of the patient with the reviews of the literatures.
Anemia, Hemolytic, Autoimmune* ; Antibodies ; Coombs Test ; Erythrocyte Aging ; Humans ; Immunoglobulin A ; Immunoglobulin M ; Male

In order to study the effects of stereotaxic destruction of distinct epileptogenic focus, the amygdala was destroyed with radiofrequency coagulator. A total of twenty Sprague-Dawley rats were divided into two group : the control group which underwent craniectomy on the biparietal area and was instilled crytal penicillin solution into the right amygdala on the basis of stereotaxic coordinates(n=10), and the amygdalectomy group which was performed selective amygdalectomy with radiofrequency coagulator after confirmation of clinical and electroencephalographic epileptic features after proceeding same methods of control group(n=10). The experimental epileptic models in rats were obtained by selective instillation of crystal penicillin solution into the right amygdala. The effects of amygdalectomy were investigated by observation of the changes in behavior and electroencephalographic recordings. The results were as follows ; 1) A typical behavioral seizure was shown in the control group and epilepticform discharge was prominent in crystal penicillin soultion instilled side, but there was no bilateral synchronous epileptic discharges during ictal stages. 2) In comparision to two groups, the severity and the frequency of behavioral seizure were more decreased in the stereotaxic amygdalectomy group. 3) The amygdalectomy group was shwon a significant decrease in amplitude and frequency of spikes, especially during interictal stages, compared to the control group. From the results of electroencephalographic and behavioral analysis, selective amygdalectomy with radiofrequency coagulator seemed to be an effective method to treat the crystal penicillin soulution induced epileptic rats.
Amygdala ; Animals ; Penicillins ; Rats* ; Rats, Sprague-Dawley ; Seizures