This is a case report of a cystic hygroma with polycystic kidney in a fetus which was suspected by ultrasonography and was confirmed by autopsy. Recently, we have experienced this case in 25-year old woman repeatedly and we report that with a brief review of relevant literature.
Adult ; Autopsy ; Female ; Fetus ; Humans ; Lymphangioma, Cystic* ; Polycystic Kidney Diseases* ; Ultrasonography

OBJECTIVES: Sleep disorders cause changes of autonomic nervous system (ANS) which affect cardiovascular system. Primary insomnia (PI) makes acceleration of sympathetic nervous system (SNS) tone by sleep deficiency and arousal. Obstructive sleep apnea syndrome (OSAS) sets off SNS by frequent arousals and hypoxemias during sleep. We aimed to compare the changes of heart rate variability (HRV) indices induced by insomnia or sleep apnea to analyze for ANS how much to be affected by PI or OSAS. METHODS: Total 315 subjects carried out nocturnal polysomnography (NPSG) were categorized into 4 groups - PI, mild, moderate and severe OSAS. Severity of OSAS was determined by apnea-hypopnea index (AHI). Then we selected 110 subjects considering age, sex and valance of each group's size [Group 1 : PI (mean age=41.50+/-13.16 yrs, AHI <5, n=20), Group 2 : mild OSAS (mean age=43.67+/-12.11 yrs, AHI 5-15, n=30), Group 3 : moderate OSAS (mean age 44.93+/-12.38 yrs, AHI 16-30, n=30), Group 4 : severe OSAS (mean age=45.87+/-12.44 yrs, AHI >30, n=30)]. Comparison of HRV indices among the four groups was performed with ANCOVA (adjusted for age and body mass index) and Sidak post-hoc test. RESULTS: We found statistically significant differences in HRV indices between severe OSAS group and the other groups (PI, mild OSAS and moderate OSAS). And there were no significant differences in HRV indices among PI, mild and moderate OSAS group. In HRV indices of PI and severe OSAS group showing the most prominent difference in the group comparisons, average RR interval were 991.1+/-27.1 and 875.8+/-22.0 ms (p=0.016), standard deviation of NN interval (SDNN) was 85.4+/-6.6 and 112.8+/-5.4 ms (p=0.022), SDNN index was 57.5+/-5.2 and 87.6+/-4.2 (p<0.001), total power was 11,893.5+/-1,359.9 and 18,097.0+/-1,107.2 ms2 (p=0.008), very low frequency (VLF) was 7,534.8+/-1,120.1 and 11,883.8+/-912.0 ms2 (p=0.035), low frequency (LF) was 2,724.2+/-327.8 and 4,351.6+/-266.9 ms2 (p=0.003). CONCLUSIONS: VLF and LF which were correlated with SNS tone showed more increased differences between severe OSAS group and PI group than other group comparisons. We could suggest that severe OSAS group was more influential to increased SNS activity than PI group.
Acceleration ; Anoxia ; Arousal ; Autonomic Nervous System ; Cardiovascular System ; Heart ; Heart Rate ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Sympathetic Nervous System

There are 3 basic methods for surgical treatment of axillary osmidrosis; 1) method that removes only subcutaneous cellular tissue without removing skin 2) method that removes skin and subcutaneous cellular tissue en bloc, and 3) method that partially removes skin and subcutaneous cellular en bloc as well as removing the subcutaneous cellular tissue of the adjacent region. We studied the results of partial removal of the skin and subcutaneous cellular tissue en bloc, as well as the removal of subcutaneous cellular tissue of the adjacent region to compare the results of the bipedicled flap with the graft conversion method. There was no difference between two methods in results and complication rates. There are 3 advantage to this procedure. First, about 70-80% of apocrine glands were centrally distributed among the axillary hairbearing region therefore, resection of the central portion of axillary hair distribution area is important for good result. Second, the preservation of the subdermal plexus with careful excision of adjacent underlying subcutaneous tissue under the aid of the magnifying surgical loupe, is important for good wound healing. Third, the central excision of the axillary hair distribution area provides good exploration for undermining and defatting of the undersurface of the adjacent area, therefore it tooks a shorter operation time.
Apocrine Glands ; Hair ; Skin ; Subcutaneous Tissue ; Transplants ; Wound Healing

The maxillary alveolar ridge separates the palate from the lip and clefts of the primary palate have a cleft of the alveolus as well. In the most common clefts of the primary palate, the alveolar portion of the cleft is located between the lateral incisor, if present, and the canine. The cleft may also pass between the central incisor and the lateral incisor, rarer forms of clefts may pass between the central incisor or more distally on the maxillary arch. There are still considerable differences of opinion as to the optimal time for closure of alveolar defects, with or without concomitant bone grafting. But the preferred time for the operation with bone graft is between age 9 and 11 before the canine teeth have fully erupted. As an alternative to primary bone grafting, Skoog developed the periosteoplasty, or "boneless bone graft" technique, in which periosteal continuity was established between maxillary segments by the transfer of local periosteal flaps from the anterior maxillary wall. this procedure, which takes advantage of the propensity of periosteum to form bone in young children, leads to the formation of new bone within the alveolar cleft in spite of the fact that no bone graft is used.This study attempts to defin the effectiveness of early alveolar cleft repair with gingivo-vestibular-mucoperiosteal flap.The results in 6 unilateral alveolar clefts and 1 bilateral alveolar cleft, which is corrected early by gingivo-vestibular-mucoperiosteal flap, have been satisfactory alveolar arch continuity and alveolar bone formation with tooth eruption.
Alveolar Process ; Bone Transplantation ; Child ; Cuspid ; Humans ; Incisor ; Lip ; Osteogenesis ; Palate ; Periosteum ; Tooth Eruption ; Transplants

No abstract available.
Bandages* ; Gentian Violet* ; Gentiana* ; Methicillin-Resistant Staphylococcus aureus* ; Wounds and Injuries*

OBJECTIVES: This study was designed to assess the change of heart rate variability (HRV) at resting, upright, and psychological stress in anxiety disorder patients. METHODS: HRV was measured at resting, upright, and psychological stress states in 60 anxiety disorder patients. We used visual analogue scale (VAS) score to assess tension and stress severity. Beck depression inventory (BDI) and state trait anxiety inventories I and II (STAI-I and II) were used to assess depression and anxiety severity. Differences between HRV indices were evaluated using paired t-tests. Gender difference analysis was accomplished with ANCOVA. RESULTS: SDNN (Standard deviation of normal RR intervals) and low frequency/high frequency (LF/HF) were significantly increased, while NN50, pNN50, and normalized HF (nHF) were significantly decreased in the upright position compared to resting state (p < 0.01). SDNN, root mean square of the differences of successive normal to normal intervals, and LF/HF were significantly increased, while nHF was significantly decreased in the psychological stress state compared to resting state (p < 0.01). SDNN, NN50, pNN50 were significantly lower in upright position compared to psychological stress and nVLF, nLF, nHF, and LF/HF showed no significant differences between them. CONCLUSION: The LF/HF ratio was significantly increased after both physical and psychological stress in anxiety disorder, but did not show a significant difference between these two stresses. Significant differences of SDNN, NN50, and pNN50 without any differences of nVLF, nLF, nHF, and LF/HF between two stresses might suggest that frequency domain analysis is more specific than time domain analysis.
Anxiety ; Anxiety Disorders* ; Autonomic Nervous System ; Depression ; Equipment and Supplies ; Heart Rate* ; Humans ; Stress, Psychological*

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is hardly controllable organism among the pathogen of nosocomial infection, because it is resistant to most antibiotics except vancomycin and local treatment with most antiseptics are not effective to eradicate MRSA from the infected wounds. There is increasing fear that MRSA infection can be spread widely in the hospitals. The effectiveness of Gentian Violet against MRSA was reported by Saji et al in 1992 for the first time. We tried Gentian Violet dressing on MRSA infected wounds to evaluate whether at not the Gentian Violet is effective to eradicate 11RSA which existed in the open wound. METHODS: 24 patients were treated by wet dressing with 0.1%Gentian Violet soaked gauze twice daily. They included 10 cases of sacral and trochanteric pressure sore, 6 cases of postoperative wound infectious, 3 cases of posttraumatic skin defects, 2 cases of DM foot, 1 case of post infectious skin defect and 2 cases of electrical burn, The wound culture was evaluated for elimination of MRSA infection twice weekly. RESULTS: The clinical results revealed that MRSA was not detected in all cases within 34days (average 13.5 days) after topical administration 0.1% Gentian Violet. CONCLUSION: There is no evidence of tissue irritation with Gentian Violet dressing on open wound or wound margin. After negative conversion of MRSA with Gentian Violet dressing, gram (-) organism was isolated in a half of the cases. 0.1% Gentian Violet topical administration is a useful treatment method of wound infection with MRSA.
Administration, Topical ; Anti-Bacterial Agents ; Anti-Infective Agents, Local ; Bandages* ; Burns ; Cross Infection ; Femur ; Foot ; Gentian Violet* ; Gentiana* ; Humans ; Methicillin-Resistant Staphylococcus aureus* ; Pressure Ulcer ; Skin ; Vancomycin ; Viola ; Wound Infection* ; Wounds and Injuries*

The present study compared the actigraphic indices between both wrist actigraphies (WATGs), and the sleep estimates between each WATG and nocturnal polysomnography (NPSG) to assess their differences and consistencies. We studied 22 right-handed subjects (mean age 43.9+/-13.3 years, M:F=14:8) with untreated primary sleep disorders (primary insomnia=8, simple snorer=2, obstructive sleep apnea=12) undergone by overnight both WATGs and NPSG, simultaneously. Comparison and correlation were analyzed between right and left wrist actigraphic data. In the sleep estimates of both WATGs and NPSG, each WATG was compared and correlated with NPSG in sleep period time (SPT), total sleep time (TST), sleep latency (SL), sleep efficiency (SE) and wake time (WT). Sleep indices between both WATGs showed significant positive correlations with no correlations in SL and fragmentation index (FI). There were no differences in sleep indices between both WATGs. SPTs of both WATGs, SL of left WATG, and TST of right WATG showed positively significant correlations, and SE of right WATG did negatively significant correlation in sleep indices between each WATG and NPSG. As each WATG was compared to PSG, SPTs of both WATGs and WT of right WATG were decreased, and TST and SE of right WATG and SL of left WATG were increased. Inconsistent SL and FI between both WATGs indicate that the activities between both WATGs can differentially happen during wake or arousal. Inconsistent sleep estimates between each WATG and NPSG may indicate the limited usefulness in measuring and analyzing one-night sleep by using WATG.
Arousal ; Functional Laterality ; Polysomnography* ; Sleep Wake Disorders ; Wrist*

Mandible fractures have recently been managed by rigid internal fixation with miniplate and screws more often than by traditional interosseous wiring methods. The purpose of this paper was to compare traditional interosseous wiring with miniplate fixation in open reduction of mandible fracture, especKweonially in operative results and costs. From June of 1989 to June of 1998, there were 142 patients, admitted to the department of Plastic and Reconstructive Surgery, Chun-Cheon Sacred Heart Hospital, Hallym University. Of those, 101 patients were managed by open reduction, and among them, 83 patients were treated with miniplate fixation, but 18 patients had recently been treated with interosseous wiring methods. No significant difference was noted between the two groups in terms of complications, but the overall cost of miniplate and screws was higher than interosseous wiring, while the mean operative time was longer in the group treated with miniplate fiation. The authors recommend interosseous wiring technique for patients with mandible fractures requiring open reduction and fixation, except for absolute indications of rigid internal fixation.
Gangwon-do ; Heart ; Humans ; Mandible* ; Operative Time ; Plastics

OBJECTIVES: There are a lot of studies that analyze the interaction between the emotion of disgust and the functional brain images using fMRI and PET. But studies using sLORETA (standardized low resolution brain electromagnetic tomography) almost do not exist. The aim of this research is to explore the relationship of the emotion of disgust and the cortical activation using sLORETA analysis. METHODS: Forty five healthy young adults (27.1+/-2.6 years) participated in the study. While they were watching 4 neutral images and 4 disgusting images associated with mutilation selected from the international affective picture system (IAPS), participants' EEGs were taken for 30 seconds per one picture. Through these obtained EEG data, sLORETA analysis was performed to compare EEGs associated with neutral and negative images. RESULTS: During looking for visual disgusting stimulus, all participants reported unpleasantness, arousal and stress. In sLORETA analysis, the decrease of current density in theta wave was shown at left frontal superior gyrus (BA10) and middle gyrus (BA10, 11). This voxel cluster consists of a total of 11 voxels and the threshold of t value indicating statistically significant decreases in the current density (p<0.05) was -1.984. There were no differences between male and female in the degree of being disgusted by the stimuli. CONCLUSION: This finding may suggest that the activation of dorsolateral prefrontal cortex might be associated with regulating disgust emotion.
Arousal ; Brain ; Electroencephalography ; Female ; Humans ; Magnetic Resonance Imaging ; Magnets ; Male ; Prefrontal Cortex ; Young Adult