The zygomaticomaxillary complex (ZMC) functions as a buttress for the face and is the cornerstone to a person's aesthetic appearance, by both setting the midfacial width and providing prominence to the cheek. Malar deficiency is often acquired by blunt injury incurred in a traumatic accident, resulting in ZMC fracture. A 48-year-old male patient presented a right ZMC fracture after contusion injury by a baseball. He only received conservative management and later he suffered discomfort during mouth opening at the moment of mastication, due to trismus involving the temporomandibular joint. In the current case, we describe a surgical technique, by which the malar body is shifted anteriorly and laterally after combined oblique-vertical osteotomy. The technique presented, eventually restored the former aesthetic position of the malar complex and symmetry, and, moreover, improved mastication function.
Baseball ; Cheek ; Contusions ; Fractures, Malunited ; Humans ; Male ; Mastication ; Middle Aged ; Mouth ; Osteotomy* ; Temporomandibular Joint ; Transplants* ; Trismus ; Wounds, Nonpenetrating

No abstract available.
Leiomyoma*

Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.
Diskectomy ; Humans ; Intervertebral Disc ; Laminectomy ; Leg ; Magnetic Resonance Imaging

Intramuscular hemangiomas are benign vascular lesions of skeletal muscle and constitutes less than 1% of all hemangiomas. Of all intramuscular hemangiomas, 13-25% occur in the head and neck, presenting lesions of enlarging soft tissue mass associated with pain. Usually they do not exhibit cutaneous changes, such as bluish skin discoloration as seen in cutaneous and superficial subcutaneous lesions. Because of their infrequency, deep location and unfamiliar presentation, intramuscular hemangomas are seldom correctly diagnosed clinically. We encountered a case of intramasseteric hemangioma in a 14-year-old female. She presented intermittent painful swelling on the right preauricular area. Sialography showed a multiple calcified lesion of the soft tissue, while CT scan and MRI showed a tumor mass lying in the masseter muscle. Angiography showed blush lesion but no tumor feeding arteries. After 6 months of intra-lesional sclerosing therapy with alcohol, total regression of tumor was obtained. As we experienced in this case, percutaneous sclerotherapy with alcohol could be the first therapeutic alternative.
Adolescent ; Angiography ; Arteries ; Deception ; Female ; Head ; Hemangioma ; Humans ; Magnetic Resonance Imaging ; Masseter Muscle ; Muscle, Skeletal ; Neck ; Salivary Gland Calculi* ; Sclerotherapy ; Sialography ; Skin ; Tomography, X-Ray Computed

BACKGROUND: Tissue inflammation and remodeling have been extensively studied in various tumors in relation with their invasiveness and metastasis. OBJECTIVE: The purpose of this study was to investigate the change in tissue inflammation and remodeling markers in cutaneous squamous cell carcinoma (SCC). METHODS: Expression levels of cyclooxygenase-2 (COX-2) as an inflammatory marker and matrix metalloproteinases-2 and -9 (MMPs 2/9) as remodeling markers were studied in mouse and human SCCs. Western blot analysis and RT-PCR for COX-2 and MMPs 2/9 were performed with skin samples from SCC patients and chronic ultraviolet B (UVB)-induced SCC from hairless mice. RESULTS: mRNA and protein levels of COX-2 and MMPs 2/9 were up-regulated with the higher sensitivity for MMP-9 in mouse SCCs, which were induced by chronic UVB irradiation. Consistently, COX-2 and MMPs 2/9 were up-regulated with the higher sensitivity for MMP-9 in human SCCs. CONCLUSION: COX-2 and MMPs 2/9 are up-regulated in well-differentiated cutanous SCC. Our findings indicate that inflammatory and tissue remodeling processes are actively induced during carcinogenesis of cutaneous SCC.
Animals ; Blotting, Western ; Carcinoma, Squamous Cell ; Cyclooxygenase 2 ; Humans ; Inflammation ; Matrix Metalloproteinases ; Mice ; Prostaglandin-Endoperoxide Synthases ; RNA, Messenger ; Skin ; Up-Regulation

Radical trachelectomy is a fertility-preserving alternative to radical hysterectomy in carefully selected young women with early-stage cervical cancer. However, in cases with subsequent severe cervical stenosis, assisted reproductive techniques can be difficult. This is a case report of a 34-year-old patient who underwent robot-assisted radical trachelectomy and cerclage for early-stage (IB2) adenosquamous carcinoma. Three months after surgery, the patient underwent ovarian stimulation using a gonadotropin-releasing hormone antagonist protocol. As it was impossible to perform transcervical embryo transfer due to the almost complete absence of the cervical opening, transmyometrial embryo transfer under ultrasound guidance was performed. This resulted in a successful singleton pregnancy. This is the first case of successful pregnancy conceived by in vitro fertilization with transmyometrial embryo transfer in a patient who had previously undergone robot-assisted radical trachelectomy.

Radical trachelectomy is a fertility-preserving alternative to radical hysterectomy in carefully selected young women with early-stage cervical cancer. However, in cases with subsequent severe cervical stenosis, assisted reproductive techniques can be difficult. This is a case report of a 34-year-old patient who underwent robot-assisted radical trachelectomy and cerclage for early-stage (IB2) adenosquamous carcinoma. Three months after surgery, the patient underwent ovarian stimulation using a gonadotropin-releasing hormone antagonist protocol. As it was impossible to perform transcervical embryo transfer due to the almost complete absence of the cervical opening, transmyometrial embryo transfer under ultrasound guidance was performed. This resulted in a successful singleton pregnancy. This is the first case of successful pregnancy conceived by in vitro fertilization with transmyometrial embryo transfer in a patient who had previously undergone robot-assisted radical trachelectomy.

Objective: The Patient Health Questionnaire–9 (PHQ-9) and PHQ-2 have not been validated in the general Korean population. This study aimed to validate and identify the optimal cutoff scores of the PHQ-9 and PHQ-2 in screening for major depression in the general Korean population. Methods: We used data from 6,022 participants of the Korean Epidemiological Catchment Area Study for Psychiatric Disorders in 2011. Major depression was diagnosed according to the Korean Composite International Diagnostic Interview. Validity, reliability, and receiver operating characteristic curve analyses were performed using the results of the PHQ-9 and Euro Quality of life-5 dimension (EQ-5d). Results: Of the 6,022 participants, 150 were diagnosed with major depression (2.5%). Both PHQ-9 and PHQ-2 demonstrated relatively high reliability and their scores were highly correlated with the “anxiety/depression” score of the EQ-5d. The optimal cutoff score of the PHQ-9 was 5, with a sensitivity of 89.9%, specificity of 84.1%, positive predictive value (PPV) of 12.6%, negative predictive value (NPV) of 99.7%, positive likelihood ratio (LR+) of 5.6, and negative likelihood ratio (LR-) of 0.12. The optimal cutoff score of the PHQ-2 was 2, with a sensitivity of 85.3%, specificity of 83.2%, PPV of 11.6%, NPV of 99.5%, LR+ of 5.1, and LR- of 0.18. Conclusion The PHQ-9 and PHQ-2 are valid tools for screening major depression in the general Korean population, with suggested cutoff values of 5 and 2 points, respectively.

The purpose of this study is to monitor genetically modified bean sprouts at traditional markets in Seoul and to investigate perception of traditional market merchants and high school students on genetically modified organisms (GMOs). We analyzed 30 bean sprouts that were selected at 11 traditional markets in Seoul using the method of polymerase chain reaction (PCR). Also, we compared perception of GMOs between merchants (n = 30) and students (n = 126). Knowledge test about GMOs was performed by students. The result of PCR, 16.7% of bean sprouts were confirmed as GM bean sprouts (n = 5). Students had significantly more exposure to information about GMOs than merchants (p < 0.05). Major information sources about GMOs were from mass media (television, newspaper and radio). About half of subjects were not aware that they eat GMOs and GMOs are sold to consumers. Only 17.3% of subjects had constant eating intent for GMOs after perceiving foods that he/she usually eats are GMOs. 51.3% of subjects had willingness to purchase GMOs if GMOs have same quality and lower cost than natural foods. 37.2% of subjects thought that GMOs would be harmful to humans. Students had more positive perception of GMOs' side effects than merchants (p < 0.01). There was no merchant who knew labeling of GMOs. 19.1% of students knew labeling of GMOs. Students' mean percentage of correct answers of six questions about GMOs was 45.2%. Therefore, providing adequate information about GMOs is needed for consumer's choice whether to purchase GMOs or not.
Eating ; Humans ; Mass Media ; Periodicals ; Organisms, Genetically Modified ; Organothiophosphorus Compounds ; Polymerase Chain Reaction

BACKGROUND: Many patients with psoriasis also suffer with pruritus. However, the literature on pruritus in psoriasis is sparse. OBJECTIVE: This study was undertaken to examine the expression of nerve growth factor (NGF) and its receptor (NGF-R) in psoriatic lesions, with or without pruritus, using a confocal laser scanning microscope. METHOD: A skin biopsy was obtained from 10 psoriatic patients with pruritus, 10 psoriatic patients without pruritus and 10 normal control subjects. Immunofluorescence staining and confocal laser scanning microscopy were performed. RESULTS: The psoriatic lesions with pruritus showed an increase in the expression of NGF and NGF-R compared with the psoriatic lesions without pruritus. NGF was expressed in the entire epidermis, but NGF-R was expressed in the basal cell layer only. The psoriatic lesions without pruritus showed an increase in the expression of NGF compared with the normal controls. There was no difference between the psoriatic lesions without pruritus and normal controls in the expression of NGF-R. CONCLUSION: These results indicate that possible pruritogenic factors in psoriasis are neurogenic factors including NGF, and provide the groundwork for further studies to clarify the mechanism involved in pruritus of psoriasis.
Biopsy ; Epidermis ; Fluorescent Antibody Technique ; Humans ; Microscopy, Confocal ; Nerve Growth Factor* ; Pruritus* ; Psoriasis* ; Skin