PURPOSE: The reconstruction of femur and tibia defects following tumor resection remains a surgical challenge. The clinical outcome of free vascularized fibula graft (VFG) reconstruction with locking plate for massive femur and tibia defects of more than 10 cm that were secondary to skeletal tumor resection is reported. MATERIALS AND METHODS: Thirteen patients with a mean follow-up of 3.3 years were reviewed. Seven patients received vascularized fibula grafts in the femur and six in the tibia. The mean bony defect of the femur and tibia was more than 10 cm and the length of the grafted fibula was more than 15 cm. All defects were stabilized with long locking plates. RESULTS: All patients were free of disease at final follow-up; All VFGs were transferred successfully. All patients had a successful outcome with bony union. Stress fractures of the grafted fibula had occurred but the locking plate stabilized the fracture and healed until the last follow-up. All patients were able to walk without a brace after a mean of 9 months postoperatively. CONCLUSIONS: VFG with locking plate is a reliable reconstructive procedure for massive femur and tibia defects.
Braces ; Femur* ; Fibula* ; Follow-Up Studies ; Fractures, Stress ; Humans ; Tibia* ; Transplants*

OBJECTIVE: The purposes of this study were 1) to classify lingual dental arch form types based on the lingual bracket points and 2) to provide a new lingual arch form template based on this classification for clinical application through the analysis of three-dimensional virtual models of normal occlusion sample. METHODS: Maxillary and mandibular casts of 115 young adults with normal occlusion were scanned in their occluded positions and lingual bracket points were digitized on the virtual models by using Rapidform 2006 software. Sixty-eight cases (dataset 1) were used in K-means cluster analysis to classify arch forms with intercanine, interpremolar and intermolar widths and width/depth ratios as determinants. The best-fit curves of the mean arch forms were generated. The remaining cases (dataset 2) were mapped into the obtained clusters and a multivariate test was performed to assess the differences between the clusters. RESULTS: Four-cluster classification demonstrated maximum intercluster distance. Wide, narrow, tapering, and ovoid types were described according to the intercanine and intermolar widths and their best-fit curves were depicted. No significant differences in arch depths existed among the clusters. Strong to moderate correlations were found between maxillary and mandibular arch widths. CONCLUSIONS: Lingual arch forms have been classified into 4 types based on their anterior and posterior dimensions. A template of the 4 arch forms has been depicted. Three-dimensional analysis of the lingual bracket points provides more accurate identification of arch form and, consequently, archwire selection.
Classification* ; Cluster Analysis ; Dental Arch ; Humans ; Young Adult

OBJECTIVE: The purposes of this study were 1) to classify lingual dental arch form types based on the lingual bracket points and 2) to provide a new lingual arch form template based on this classification for clinical application through the analysis of three-dimensional virtual models of normal occlusion sample. METHODS: Maxillary and mandibular casts of 115 young adults with normal occlusion were scanned in their occluded positions and lingual bracket points were digitized on the virtual models by using Rapidform 2006 software. Sixty-eight cases (dataset 1) were used in K-means cluster analysis to classify arch forms with intercanine, interpremolar and intermolar widths and width/depth ratios as determinants. The best-fit curves of the mean arch forms were generated. The remaining cases (dataset 2) were mapped into the obtained clusters and a multivariate test was performed to assess the differences between the clusters. RESULTS: Four-cluster classification demonstrated maximum intercluster distance. Wide, narrow, tapering, and ovoid types were described according to the intercanine and intermolar widths and their best-fit curves were depicted. No significant differences in arch depths existed among the clusters. Strong to moderate correlations were found between maxillary and mandibular arch widths. CONCLUSIONS: Lingual arch forms have been classified into 4 types based on their anterior and posterior dimensions. A template of the 4 arch forms has been depicted. Three-dimensional analysis of the lingual bracket points provides more accurate identification of arch form and, consequently, archwire selection.
Classification* ; Cluster Analysis ; Dental Arch ; Humans ; Young Adult

PURPOSE: Though clavicle fractures are the second most common fractures to occur in active adults, there have been a few epidemiological studies conducted on the Korean population in recent years. To better understand clavicle fractures, an epidemiological study reflecting the changes in current life style and injury mechanism may be important. Hence, the purpose of this study was to conduct an epidemiological study on the Korean population. MATERIALS AND METHODS: This was a retrospective study of 973 patients (977 cases) who presented with clavicle fractures from January 2000 to August 2015. Radiological results were classified by the Allman system-3 groups and 7 subgroups. The study collected information regarding gender, age at the event of injury, injury mechanism, other associated injuries, occurrence rate of each year, and seasonal variation. RESULTS: The study consisted of 627 male patients (64.4%, 1 bilateral case) and 346 female patients (35.6%, 3 bilateral cases). The mean age at the time of injury was 31.8±24.9 years (male, 31.2±22.6 years; female, 32.7±28.7 years). Midshaft clavicle fractures (Allman group I) were the most common with 758 cases (77.6%). There were 397 cases with displacement (40.6%). The occurrence of clavicle fractures decreased with increasing age in male patients and showed a bimodal distribution in female patients. Injury due to a fall from standing height was the most common mechanism of injury. There were 61 cases (6.2%) who had other associated injuries and the most common associated injury was a rib fracture. The occurrence of clavicle fractures increased with time, and falling was associated with the highest occurrence rate of clavicle fractures. CONCLUSION: The mean age of clavicle fracture was 31.8 years in a recent 15-year period. The occurrence of fracture in male patients was 1.8 times than female patients, primarily occurring as midshaft fractures. There were more cases of displacement than minimally displaced cases. The most common injury mechanism was a fall from standing height, and the occurrence of clavicle fractures has shown an increasing trend recently.
Accidental Falls ; Adult ; Clavicle* ; Epidemiologic Studies* ; Female ; Humans ; Life Style ; Male ; Retrospective Studies ; Rib Fractures ; Seasons

The authors had studied the microsurgical anatomy of the choroidal fissure and the operative approaches directed through the fissure. In this study, eight formalin-fixed cadaveric hemisheres were examined. In four hemispheres, the intracranial vessels were perfused with colored silicone latex. The choroidal fissure is divided into three portion : (a) body portion, (b) atrial portion, and (c) temporal portion. Dissection through the body portion of the choroidal fissure exposes the velum interpositum, internal cerebral vein, and third ventricle. The quadrigeminal cistern, pineal region, and posterior part of the ambient cistern can be exposed through the atrial portion of the choroidal fissure. Opening through the temporal portion of the choroidal fissure exposes the structures in the ambient cistern, which include the basal vein, posterior cerebral artery, anterior and lateral posterior choroidal arteries, and hippocampal formation. This study provides valuable knowledges of microsurgical approaches to the third ventricle and basal cistern by demonstrating the neural nd vascular relaionship around the choroidal fissure.
Arteries ; Cadaver ; Cerebral Veins ; Choroid* ; Hippocampus ; Latex ; Posterior Cerebral Artery ; Silicones ; Third Ventricle

PURPOSE: In order to evaluate the efficacy of PEFL (cisplatin, etoposide, 5-fluorouracil and leucovorin) chemotherapy and to identify favorable subsets, we conducted a phase II trial of PEFL regimen for patients with carcinomas of unknown primary origin (CUPO). MATERIALS AND METHODS: A total of 38 patients was enrolled in this study between May 1995 and September 1997. CUPO was defined as the presence of metastatic cancer documented in the absence of an identifiable primary site. All entered patients were treated with PEFL combination chemotherapy (cisplatin 20 mg/m(2)/day i.v, days 1-5, etoposide 100 mg/m(2)/day i.v. days 1, 3 & 5, 5-fluorouracil 800 mg/m(2)/day continuous infusion days 1-5, and leucovorin 20 mg/m(2)/day i.v, days 1-5; repeated every 4 weeks). The end points of this study were response and survival. To identify favorable subsets, univariate and multivariate analyses were perfonned. RESULTS: Among 38 patients, 29 had measurable lesions. Three (11%) out of 27 evaluable patients had a complete response and 7 (26%) had a partial response (response rate 37%; 95% confidence interval 19~55%). The median survival of the total 38 enrolled patients was 9.1 (range; 1~21.9+) months. The median progression-free survival of the 27 evaluable patients was 5.3 (range 0~ 16.0) months. Among total 132 cycles of chemotherapy, leukopenia of grade II or more was observed in 15% and thrombocytopenia of grade I in 4%. There was no treatment-related death. Main non-hematologic toxicities were nausea/vomiting (79%), stomatitis (70%), and neurotoxicity (33%). The prognostic factor analyses identified 2 favorable subgroups; One was the patient group whose disease had poorly differentiated histology and presented in cervical lymph node. This group of patients had better response rate than other patients (response rate; 71% vs 25%, p=0.02). The other was the patient group who had normal tumor markers (CEA, CA 125 and CA 19-9). This group of patients had better survival than other patients(median survival; 14.8 vs 8.4 months, p=0.05). CONCLUSION: PEFL chemotherapy seemed to be moderately active and tolerable in patients with CUPO. Among heterogenous patients with CUPO, the subset with cervical lymph node and poorly differentiated histology responded better to the chemotherapy and those with normal tumor markers tended toward longer survival.
Disease-Free Survival ; Drug Therapy* ; Drug Therapy, Combination ; Etoposide ; Fluorouracil ; Humans ; Leucovorin ; Leukopenia ; Lymph Nodes ; Multivariate Analysis ; Stomatitis ; Thrombocytopenia ; Biomarkers, Tumor

No abstract available.
Chickenpox ; Herpesvirus 3, Human*

No abstract available.
Brain* ; Conus Snail* ; Dermoid Cyst* ; Magnetic Resonance Imaging ; Rupture

Paragonimiasis is the infestation of lung flukes of the trematode genus Paragonimus. This disease is common in Asia, and the southern part of Korea has been known as one of the endemic areas of Paragonimiasis westermanii in Korea. Human infection is associated with specific dietary habits, such as eating freshwater crawfish or crabs. In a 6 1/2-year-old boy with pleural effusion and eosinophilia, paragonimiasis was diagnosed by skin test, serologic exam, and histologic identification of the parasites in a skin lesion. The same diagnosis was entertained in his elder sister with silent pleural effusion. We describe herewith these rare cases of paragonimiasis in two siblings who had a history of eating cooked freshwater crabs.
Humans

PURPOSE: This study aims to compare the outcome of total body irradiation (TBI)- or non-TBI-containing conditioning regimens for leukemia in children. METHODS: We retrospectively evaluated 77 children conditioned with TBI (n=40) or non-TBI (n=37) regimens, transplanted at Chonnam National University Hospital between January 1996 and December 2007. The type of transplantation, disease status at the time of transplant, conditioning regimen, engraftment kinetics, development of graft-versus-host disease (GVHD), complications, cause of deaths, overall survival (OS), and event-free survival (EFS) were compared between the 2 groups. RESULTS: Among 34 patients with acute lymphoblastic leukemia (ALL), 28 (82.4%) were in the TBI group, while 72.7% (24/33) of patients with myeloid leukemia were in the non-TBI group. Although the 5-year EFS of the 2 groups was similar for all patients (62% vs 63%), the TBI group showed a better 5-year EFS than the non-TBI group when only ALL patients were analyzed (65% vs 17%; P=0.005). In acute myelogenous leukemia patients, the non-TBI group had better survival tendency (73% vs 38%; P=0.089). The incidence of GVHD, engraftment, survival, cause of death, and late complications was not different between the 2 groups. CONCLUSION: The TBI and non-TBI groups showed comparable results, but the TBI group showed a significantly higher 5-year EFS than the non-TBI group in ALL patients. Further prospective, randomized controlled studies involving larger number of patients are needed to assess the late-onset complications and to compare the socioeconomic quality of life.
Cause of Death ; Child ; Disease-Free Survival ; Graft vs Host Disease ; Hematopoietic Stem Cells ; Humans ; Incidence ; Kinetics ; Leukemia ; Leukemia, Myeloid ; Leukemia, Myeloid, Acute ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Quality of Life ; Retrospective Studies ; Stem Cell Transplantation ; Stem Cells ; Transplantation Conditioning ; Transplants ; Whole-Body Irradiation