A 34 year-old woman was hospitalized with anterior chest pain and indigestion. Chest radiograph and computed tomogram revealed a sewing needle in the cardiac cavity. She had no histories of surgical intervention, drug abuse, or acupuncture. We removed the needle from the right ventricle under cardiopulmonary bypass.
Acupuncture ; Adult ; Cardiopulmonary Bypass ; Chest Pain ; Dyspepsia ; Female ; Foreign Bodies* ; Heart Ventricles* ; Humans ; Needles* ; Radiography, Thoracic ; Substance-Related Disorders

Harlequin ichthyosis is a most severe form of lamellar ichthyosis, which is one of congenital ichthyosis, and X- linked inherited, very rare, fatal congenital dermatologic disorder. At second trimaster in utero, skin deformity is occurred. We experienced a case of Harlequin baby in female neonate who showed typical skin appearance at birth. The nose and were flattened. The chemosis and severe ectropion obscured the orbit, and her lips were everted. The all joints were flexed due to inelastic skin, and hands and feets were fixed and ischemic. Diagnosis was established by clinical features and histopathological studies. A brief review of literature was made.
Congenital Abnormalities ; Diagnosis ; Ectropion ; Female ; Foot ; Hand ; Humans ; Ichthyosis ; Ichthyosis, Lamellar* ; Infant, Newborn ; Joints ; Lip ; Nose ; Orbit ; Parturition ; Skin

Perigraft seroma is uncommon complication of polytetrafluoroethylene(PTFE) grafts applied as an arteriovenous shunt for hemodialysis. It is a collection of clear, sterile fluid confined to nonsecretory fibrous pseudomembrane, most commonly localized around the middle and distal portion of graft. The possible etiologic factors of perigraft seroma include poor graft incorporation, mechanical graft damage caused by alcohol and povidone-iodine, intraoperative streching of the graft, variations in quality control at the time of manufacture and contributing factors such as anemia and coagulopathy in uremia. The best strategy for management of perigraft seroma is not clear. spiration or drainage alone is not effective, and some authors advocate graft removal. We report a case of perigraft seroma around arterial end of PTFE graft along with a brief review of the literatures.
Anemia ; Drainage ; Humans ; Polytetrafluoroethylene ; Povidone-Iodine ; Quality Control ; Renal Dialysis* ; Seroma* ; Transplants ; Uremia

A 49-year-old man had a 5-year history of left proptisis accompanied by headache, ocular pain, ocular motility and visual disturbance. Corrected visual acuity was 1.0 in the right and 0.2 in the left eye. There was 9mm of left proptosis by Hertel exophthalmometry. A hard, nontender mass was palpable in the superotemporal part of the orbit. Lateral and up gaze were impaired in the left eye. On the slit lamp examination of the left eye, there were moderate corneal edema and erosions resulting from lagophthalmos. Computed axial tomgraphy showed a large ill-defined massi with homogenous enhancement in the superior temporal part of the left orbit. The mass was removed by modified Kronlein operation as much as possible and diagnosed as the adenoid cystic carcinoma of the lacrimal gland by the light microscopic examination. The tumor cell already extended to contiguous bone, blood vessel. perineurium and adjacent muscles. One month after the operation, 5040 rad of radiation therapy was given. The mass was remarkably decreased in size after radiation. We are planning further radiation therapy now.
Adenoids* ; Blood Vessels ; Carcinoma, Adenoid Cystic* ; Corneal Edema ; Exophthalmos ; Headache ; Humans ; Lacrimal Apparatus* ; Middle Aged ; Muscles ; Orbit ; Peripheral Nerves ; Visual Acuity

Furlow's palatoplasty has been used as the primary treatment for cleft palate. From 1991 to 1999, 24 submucous cleft palate patients underwent Furlow's palatoplasty. The follow-up period was 3 months to 8 years (mean 24 months). Patients were selected after a thorough study for velopharyngeal insufficiency including intraoral examinatioin, speech assessment, digital subtraction radiography (DSR). Postoperatively velopharyngeal function was reevaluated with speech assessment and digital subtraction radiography in the 7 cooperative patients. Speech parameters including hypernasality, nasal emission, and Allison scale were improved after surgery. Digital subtraction radiography provided the value of velopharyngeal gap and the degree of the motion of lateral pharyngeal wall, both of which were improved after surgery. Furlows palatoplasty has advantage such as no impairment of nasopharyngeal physiology, no hannful effect on the hard palate and the realignment of the levator muscle which plays important role on the movement of the soft palate. The results show that a Furlow's palatoplasty can satisfactorily correct velopharyngeal insufficiency in carefully selected submucous cleft palate patients.
Cleft Palate* ; Follow-Up Studies ; Humans ; Palate, Hard ; Palate, Soft ; Physiology ; Radiography ; Velopharyngeal Insufficiency

PURPOSE: Autologous vein graft is the most commonly used conduit for surgical revascularization of the small and medium sized vessels of the coronary and lower extremity circulations. But, 30~50% of these grafts succumb eventually to occlusive failure, often with recurrent morbidity that necessitates reoperation. The cause of failure is the vein graft atherosclerosis from the neointimal hyperplasia, which is the arterial remodeling process through adaptive thickening of the vein wall in response to the increased wall stress. We try to use cis-platin, DNA binding cell cycle specific inhibitory agent, against neointimal hyperplasia in experimental model. METHOD: 5 korean dogs had a autologous vein graft interposition at femoral or carotid arteries using saphenous or jugular veins bilaterally. One side of pairs is treated with cis-platin for one hour (study), while the other is not (conrol). After 4 weeks, we explanted 6 pairs of vein graft (3 jugular veins and 3 saphenous veins), and measured intimal thickness, intimal area and luminal area using videomorphometry, and analysed intimal ratio and luminal ratio. RESULT: Treatment with cis-platin reduced intimal thickness by 44% (P=0.0118) and intimal area by 50% (P=0.0124). Intimal ratio was decreased in the study group when compared to the control group by 0.18 versus 0.66 (P=0.001). The luminal area of the treated grafts was significantly larger than controls, having increased by 823% (P=0.0307), and luminal ratio having increased by 0.82 versus 0.34 (P=0.001). CONCLUSION: These results suggest that cis-platin reduced the development of neointimal hyperplasia in experimental vein grafts. In order to prove the obtained results to a higher degree, an accumulation of further cases is necessary.
Animals ; Atherosclerosis* ; Carotid Arteries ; Cell Cycle* ; DNA ; Dogs ; Hyperplasia ; Jugular Veins ; Lower Extremity ; Models, Theoretical ; Neointima ; Phenobarbital ; Reoperation ; Transplants* ; Veins*

PURPOSE: One of the most frequent complications related to dental implants is peri-implantitis, and the characteristics of implant surfaces are closely related to the progression and resolution of inflammation. Therefore, a technical modality that can effectively detoxify the implant surface without modification to the surface is needed. The purpose of this study was to evaluate the effect of erbium-doped: yttrium, aluminium and garnet (Er:YAG) laser irradiation on the microstructural changes in double acid-etched implant surfaces according to the laser energy and the application duration. METHODS: The implant surface was irradiated using an Er:YAG laser with different application energy levels (100 mJ/pulse, 140 mJ/pulse, and 180 mJ/pulse) and time periods (1 minute, 1.5 minutes, and 2 minutes). We then examined the change in surface roughness value and microstructure. RESULTS: In a scanning electron microscopy evaluation, the double acid-etched implant surface was not altered by Er:YAG laser irradiation under the condition of 100 mJ/pulse at 10 Hz for any of the irradiation times. However, we investigated the reduced sharpness of the specific ridge microstructure that resulted under the 140 mJ/pulse and 180 mJ/pulse conditions. The reduction in sharpness became more severe as laser energy and application duration increased. In the roughness measurement, the double acid-etched implants showed a low roughness value on the valley area before the laser irradiation. Under all experimental conditions, Er:YAG laser irradiation led to a minor decrease in surface roughness, which was not statistically significant. CONCLUSIONS: The recommended application settings for Er:YAG laser irradiation on double acid-etched implant surface is less than a 100 mJ/pulse at 10 Hz, and for less than two minutes in order to detoxify the implant surface without causing surface modification.
Dental Implants ; Inflammation ; Microscopy, Electron, Scanning ; Peri-Implantitis ; Yttrium

PURPOSE: To investigate the therapeutic effectiveness of ultrasound (US)-guided trigger point injection for myofascial trigger points (MTrPs) in the internal rotator muscles of the shoulder in post-mastectomy patients. MATERIALS AND METHODS: This pilot study was a non-controlled, prospective, clinical trial. Nineteen post-mastectomy patients with a diagnosis of at least one active MTrP in the subscapularis and/or pectoralis muscles were included. We performed trigger point injections into the subscapularis muscle deep behind the scapula as well as the pectoralis muscle for diagnostic and therapeutic purpose by the newly developed US-guided method. RESULTS: Visual analogue scale and range of motion of the shoulder for external rotation and of abduction showed significant improvement immediately after the first injection and 3 months after the last injection compared with baseline (p<0.05 for both). Duration from onset to surgery and duration of myofascial pain syndrome in the good responder group were significantly shorter than in the bad responder group (p<0.05). Patients did not report any complications related to the procedure or serious adverse events attributable to the treatment. CONCLUSION: In post-mastectomy patients with shoulder pain, US-guided trigger point injections of the subscapularis and/or pectoralis muscles are effective for both diagnosis and treatment when the cause of shoulder pain is suspected to originate from active MTrPs in these muscles, particularly, the subscapularis.
Adult ; Aged ; Anesthetics, Local/administration & dosage/therapeutic use ; Female ; Humans ; Injections, Intramuscular/methods ; Lidocaine/administration & dosage/therapeutic use ; Mastectomy ; Middle Aged ; Muscle, Skeletal/drug effects/ultrasonography ; Myofascial Pain Syndromes/drug therapy ; Pectoralis Muscles/drug effects/*ultrasonography ; Trigger Points/*ultrasonography

Purpose: The gold standard for assessing pubertal activation is the gonadotropinreleasing hormone (GnRH) stimulation test (GnRHST), which is invasive, timeconsuming, and inconvenient. This study evaluated whether a single random measurement of urinary luteinizing hormone (LH) concentration could substitute for the GnRHST in diagnosing and monitoring central precocious puberty (CPP) in girls. Methods: Fifty-five girls with breast buds before 8 years of age were assessed by both the GnRHST and urinary gonadotropin assays. Based on the GnRHST results, 29 girls were assigned to the CPP group (peak LH≥5 IU/L), and 26 were placed in the premature thelarche (PT) group (peak LH<5 IU/L). Auxological data and urine and serum samples were collected at baseline and after treatment with a GnRH agonist for 12 and 24 weeks. Results: Although the auxological data did not differ between the 2 groups, the serum levels of insulin-like growth factor-1, basal LH, follicle-stimulating hormone (FSH), estradiol, and peak LH; urinary LH; and peak serum LH/FSH and urinary LH/FSH ratios were higher in the CPP group than in the PT group. Pearson correlation analysis showed a positive correlation between the urinary and serum LH concentrations (r=0.660, P<0.001). Receiver-operating characteristic curve analyses showed that a urinary LH concentration of 0.725 IU/L was a cutoff that significantly predicted positivity on the GnRHST. Urinary LH and FSH concentrations declined significantly during GnRH agonist treatment. Conclusion A single, random measurement of urinary gonadotropin concentration could be a reliable tool for initial screening and therapeutic monitoring of CPP in girls.

Purpose: The gold standard for assessing pubertal activation is the gonadotropinreleasing hormone (GnRH) stimulation test (GnRHST), which is invasive, timeconsuming, and inconvenient. This study evaluated whether a single random measurement of urinary luteinizing hormone (LH) concentration could substitute for the GnRHST in diagnosing and monitoring central precocious puberty (CPP) in girls. Methods: Fifty-five girls with breast buds before 8 years of age were assessed by both the GnRHST and urinary gonadotropin assays. Based on the GnRHST results, 29 girls were assigned to the CPP group (peak LH≥5 IU/L), and 26 were placed in the premature thelarche (PT) group (peak LH<5 IU/L). Auxological data and urine and serum samples were collected at baseline and after treatment with a GnRH agonist for 12 and 24 weeks. Results: Although the auxological data did not differ between the 2 groups, the serum levels of insulin-like growth factor-1, basal LH, follicle-stimulating hormone (FSH), estradiol, and peak LH; urinary LH; and peak serum LH/FSH and urinary LH/FSH ratios were higher in the CPP group than in the PT group. Pearson correlation analysis showed a positive correlation between the urinary and serum LH concentrations (r=0.660, P<0.001). Receiver-operating characteristic curve analyses showed that a urinary LH concentration of 0.725 IU/L was a cutoff that significantly predicted positivity on the GnRHST. Urinary LH and FSH concentrations declined significantly during GnRH agonist treatment. Conclusion A single, random measurement of urinary gonadotropin concentration could be a reliable tool for initial screening and therapeutic monitoring of CPP in girls.