The frontal sinus has importance from the aesthetic and functional points of view, so management of the frontal sinus should be conducted. The management may differ with the severity of displacement, the extent of displacement, as well as the involvement of the brain and nasofrontal duct. Fifteen patients with frontal sinus fracture were managed differently depending on the severity of their injuries for between 14 and 31 months, and then evaluated. During the follow-up period, encountered no complications and the overall result of the foreh ead contour was satisfactory.
Brain ; Follow-Up Studies ; Frontal Sinus* ; Humans

This retrospective study comprise 595 patients with facial bone fractures in various accidents and treated in the department of Plastic and Reconstructive Surgery, the Chung Buk National University Hospital between September 1991 and December 1997. The medical records of these 595 patients were reviewed and analyzed in order to obtain the clinical pattern and understand the therapeutic modalities. The following results were obtained. 1. The most prevalent age group was the third decade(35.1%). 2. The monthly incidence was the highest in September and the most common accident time was between 6:00 p.m. and midnight. 3. The most common etiology was motor vehicle accidents(59.5%) followed by assault(26.2%), fall(11.4%), sports(2.7%). 4. The male predominated over female in 4.27:1 ratio. 5. The most common fracture site was nose(30.0%) followed by mandible(26.7%), zygoma(23.3%), orbit(8.6%), maxilla(8.1%), frontal sinus(3.2%). 6. The most common fracture site of mandible was parasymphsis(34.9%) followed by angle(27.1%), condyle(23.4%), symphysis(14.5%). 7. The soft tissue injury was the most common associated injury(51.1%). Fcial soft tissue injuries were sustained by 53.3% in the highest rate associated with the associated injuries. 8. Open reduction was used for 63.7% of total cases while 33.8% of total cases required closed reduction, and 2.5% of total cases treated conservatively. 9. The complication rate was 14.1% and the ophthalmologic complication rate comprise 44.9% of all complications.
Chungcheongbuk-do ; Facial Bones* ; Female ; Humans ; Incidence ; Male ; Mandible ; Medical Records ; Motor Vehicles ; Plastics ; Retrospective Studies ; Soft Tissue Injuries

No abstract available.
Animals ; Clone Cells* ; Cloning, Organism* ; Mast Cells* ; Mice*

OBJECTIVE: Perinatal hemorrhagic stroke (PHS) is common cause of cerebral palsy, congenital hemiparesis, and subsequent behavioral, cognitive, and language problems. Despite of this importance, risk factors for this condition have not been studied. This study was undertaken to survey the clinical features and risk factors of PHS. METHODS: A retrospective study was carried out on 24 newborns with PHS who were admitted to the neonatal intensive care unit (NICU) of Daegu Fatima hospital from January 2004 to July 2009. Cases of PHS in neonates (28 weeks' gestational age through 28 days of life) were identified through neuroimaging studies, clinical findings and chart review. Two controls per case were randomly selected. Risk factors of PHS were assessed and clinical features of PHS were reviewed. RESULTS: We identified 24 cases of PHS (19 intracerebral hemorrhage, 4 intracerebral hemorrhage with subarachnoid hemorrhage, 1 subarachnoid hemorrhage). PHS was more common in male (15 males and 9 females). Case presented with encephalopathy (100%), seizures (20.8%) and cyanosis (4.2%). The neuroimaging findings of PHS were more commonly unilateral (78.3%), and right-hemisphere (73.9%). PHS was most often seen in temporal lobe (38.2%). There were no statistical and significant risk factors of PHS. CONCLUSIONS: Newborns with PHS typically present with encephalopathy (lethargy, hypotonia, apnea, feeding disability) and seizures. The neuroimaging findings were more commonly unifocal, unilateral and seen in temporal lobe. Additional prospective studies are needed to determine the prevalence and risk factors of PHS.
Apnea ; Cerebral Hemorrhage ; Cerebral Palsy ; Cyanosis ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Intensive Care, Neonatal ; Male ; Muscle Hypotonia ; Neuroimaging ; Paresis ; Prevalence ; Retrospective Studies ; Risk Factors ; Seizures ; Stroke ; Subarachnoid Hemorrhage ; Temporal Lobe

Ulcerative colitis is a chronic relapsing inflammatory disease of the colonic and rectal mucosa, which affects children as well as adults. Inflammation caused by ulcerative colitis is limited to the colon and rectum, to the mucosa and submucosa, and is involved continuously, with varying degrees of ulceration, hemorrhage, edema, and regenerating epithelium. Ulcerative colitis most commonly presents with the onset of diarrhea, later associated with hematochezia, but usually without systemic signs of fever, weight loss, or hypoalbuminemia. Approximately 30% of cases have moderate signs of systemic illness. Although less commonly seen than in Crohn's disease, the first sign of ulcerative colitis may be growth failure characterized by decreased linear growth velocity. We experienced a case of ulcerative colitis with growth disturbance and treated with sulfasalazine. During follow up for a year, the symptoms subsided, and the height and weight increased.
Adult ; Child ; Colitis, Ulcerative* ; Colon ; Crohn Disease ; Diarrhea ; Edema ; Epithelium ; Fever ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Hypoalbuminemia ; Inflammation ; Mucous Membrane ; Rectum ; Sulfasalazine ; Ulcer* ; Weight Loss

OBJECTIVE: The incidence rate of stroke as a result of intracranial arterial stenosis (ICAS) is higher in Asian countries than in the West. We aimed to analyze the regression, lack of change, or progression of asymptomatic ICAS after the administration of rosuvastatin and associated factors.METHODS: The patients who had undergone computed tomography angiography (CTA) at our hospital and had been diagnosed with ICAS with no ischemic event in the stenosed vascular territory were included in the study. They were administered 20mg of rosuvastatin per day. After a follow-up period of at least 6 months after treatment, the patients were examined using CTA again and the clinical information and imaging results were analyzed.RESULTS: In total, 48 patients were diagnosed with asymptomatic ICAS. During the final follow-up examination, it was found that the stenotic lesion regressed in 30 patients, whereas it remained unchanged or progressed without any adverse effects in 18 patients. In univariate analysis, the regressed group showed significantly higher differences in the levels of total cholesterol and low-density lipoprotein (LDL) between their initial and final values (both, p=0.031 for both). In the multivariate analysis, a significantly higher difference in the levels of LDL between its initial and final measurement was seen in the regressed group (p=0.035, odds ratio(OR) 3.9).CONCLUSIONS: Rosuvastatin was found to have better lipid-lowering effects for total cholesterol and particularly LDL in patients whose ICAS had regressed. We concluded that rosuvastatin administration can be recommended for the treatment of patients with asymptomatic ICAS.
Angiography ; Asian Continental Ancestry Group ; Atherosclerosis ; Cholesterol ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Incidence ; Lipoproteins ; Multivariate Analysis ; Rosuvastatin Calcium ; Stroke

OBJECTIVES: Hearing loss disrupts the balance of auditory-somatosensory inputs in the cochlear nucleus (CN) of the brainstem, which has been suggested to be a mechanism of tinnitus. This disruption results from maladaptive auditory-somatosensory plasticity, which is a form of axonal sprouting. Axonal sprouting is promoted by transforming growth factor (TGF)-β signaling, which can be inhibited by losartan. We investigated whether losartan prevents maladaptive auditory-somatosensory plasticity after hearing loss. METHODS: The study consisted of two stages: determining the time course of auditory-somatosensory plasticity following hearing loss and preventing auditory-somatosensory plasticity using losartan. In the first stage, rats were randomly divided into two groups: a control group that underwent a sham operation and a deaf group that underwent cochlea ablation on the left side. CNs were harvested 1 and 2 weeks after surgery. In the second stage, rats were randomly divided into either a saline group that underwent cochlear ablation on the left side and received normal saline or a losartan group that underwent cochlear ablation on the left side and received losartan. CNs were harvested 2 weeks after surgery. Hearing was estimated with auditory brainstem responses (ABRs). Western blotting was performed for vesicular glutamate transporter 1 (VGLUT1), reflecting auditory input; vesicular glutamate transporter 2 (VGLUT2), reflecting somatosensory input; growth-associated protein 43 (GAP-43), reflecting axonal sprouting; and p-Smad2/3. RESULTS: Baseline ABR thresholds before surgery ranged from 20 to 35 dB sound pressure level. After cochlear ablation, ABR thresholds were higher than 80 dB. In the first experiment, VGLUT2/VGLUT1 ratios did not differ significantly between the control and deaf groups 1 week after surgery. At 2 weeks after surgery, the deaf group had a significantly higher VGLUT2/VGLUT1 ratio compared to the control group. In the second experiment, the losartan group had a significantly lower VGLUT2/VGLUT1 ratio along with significantly lower p-Smad3 and GAP-43 levels compared to the saline group. CONCLUSION: Losartan might prevent axonal sprouting after hearing loss by blocking TGF-β signaling thereby preventing maladaptive auditory-somatosensory plasticity.
Animals ; Axons ; Blotting, Western ; Brain Stem ; Cochlea ; Cochlear Nucleus ; Evoked Potentials, Auditory, Brain Stem ; GAP-43 Protein ; Hearing Loss ; Hearing ; Losartan ; Plastics ; Rats ; Tinnitus ; Transforming Growth Factors ; Vesicular Glutamate Transport Protein 1 ; Vesicular Glutamate Transport Protein 2

BACKGROUND: To collect high concentration of granulocytes for transfusion to neutropenic cancer patients with infections, we investigated the effect of G-CSF or dexamethasone as granulocyte mobilizers and 10% pentastarch (PS) as the sedimentation agent in granulocyte collection by leukapheresis. Subsequently, the therapeutic effect of the granulocyte transfusions was assessed. METHODS: Forty five leukapheresis were performed with CS-3000Plus (Baxter, Deerfield, IL, USA) using 10% pentastarch. The donors were classified into three groups according to their premedication drugs and the interface detector offset; group 1 used dexamethasone with offset 15 (n=16), group 2 used dexamethasone with offset 33 (n=16), and group 3 used G-CSF with offset 33 (n=10). We compared total collected granulocyte counts and granulocyte collection efficiency (GCE). RESULTS: The mean counts of total granulocytes collected and GCE were as follows; 0.9 0.5 x 1010 and 31.6 14.3% in group 1, 1.3 0.6 x 1010 and 39.0 14.2% in group 2, and 1.6 0.9 x 1010 and 63.9 32.2% in group 3, respectively. The counts of granulocytes collected in group 3 was significantly higher than that in group 1 (P<0.05). The GCE of group 3 was significantly higher than that of group 1 and group 2 (P<0.05). Sixteen granulocyte transfusions were performed to 11 patients. We observed successful therapeutic effects in 10 out of 16 transfusions (63%). CONCLUSIONS: G-CSF indicates greater potency than dexamethasone although its high cost is limitation of routine use as mobilizing agents and PS was an excellent red cell sedimenting agent in granulocyte collection. Large volume granulocyte transfusions allow high therapeutic effects in neutropenic patients with marrows of sufficient regenerating capacity.
Bone Marrow ; Dexamethasone ; Granulocyte Colony-Stimulating Factor ; Granulocytes* ; Humans ; Hydroxyethyl Starch Derivatives* ; Leukapheresis* ; Neutropenia ; Premedication ; Tissue Donors

BACKGROUND: Splenectomy is often performed for the patients with refractory chronic immune thrombocytopenic purpura (ITP). Still, there are no generally accepted guidelines for the minimum level of platelet count and the average requirement of platelet transfusion so that the patients can safely undergo splenectomy. We evaluated the changes of platelet count and transfusion requirements around the splenectomy in patients with chronic ITP. METHODS: We reviewed the medical records of 25 patients with chronic ITP. We compared the platelet counts at admission, immediately pre-op and several post-op days. We also investigated the number of platelet concentrates transfused around splenectomy. We determined the effect of splenectomy according to Difino's classification. RESULTS: The median platelet counts of the patients was 18x109/L (7-238x109/L) on admission and recovered to 108x109/L (22-460x109/L) on preoperation day by platelet transfusion and immunosuppressive treatment. The platelet counts were rapidly recovered after splenectomy from the day of operation. Only 3 patients needed platelet transfusion after splenectomy. Thirteen among twenty five patients (52%) underwent operation without platelet transfusion support. Most transfusions were done before the surgery and 80% (12/15) of the patients required transfusion of more than 10 units of random donor platelet concentrate. Twenty one patients (84%) showed the complete remission after splenectomy. CONCLUSION: Splenectomy can lead to rapid remission even in most cases of refractory chronic ITP. Many cases can undergo the operation only with treatment modalities other than transfusion such as immunosuppressive agents and/or immunoglobulin. The minimum level of platelet counts for splenectomy may be safe over 50x109/L and about 10 units of platelet concentrate may be enough for preparation of splenectomy.
Blood Platelets* ; Classification ; Humans ; Immunoglobulins ; Immunosuppressive Agents ; Medical Records ; Platelet Count ; Platelet Transfusion* ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy* ; Tissue Donors

Experinece in the management of 74 patients with delayed traumatic intracranial hemorrhage(DTICH) of 474 head injury from January 1996 to December 1996 is poresented with emphasis on the incidence, occurring time, risk factors and outcome. The incidence of DTICH was 15.6% of all hospitalized head-injury patients. After an injury, every patient had an immediate computerized tomography(CT) scan to diagnose intracranial pathology and then CT follow-up was carried out according to intial CT finding and reurological deficit. The lesion was almost occurred in patients with initial abnormal CT finding(85.1%). 82.4% of DTICH were noted within 72 hours after injury. The delayed epidural hematoma and intracerebral hemorrhage were almost noted in first 72 hours(>90%), but the delayed subdural hemorrhage was found after a time interval varying from 6 hours to 10 days. So we strongly recommend CT follow-up in 4-8hour, 24-72hour, and then 7th day after head injury, especially in patients with initial abnormal CT findings. The risk factor of the delayed lesion was not hypotension, hypoxia, and consciousness level, but age of patients and the initial CT finding. The development of DTICH was not heralded by neurological deterioration. The prognosis of DTICH was not worse than non-DTICH. The patient with delayed subdural hemorrhage was better than the patient with non-delayed lesion(including hemorrhage and normal CT finding).
Anoxia ; Cerebral Hemorrhage ; Consciousness ; Craniocerebral Trauma* ; Follow-Up Studies ; Head* ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Intracranial Hemorrhages* ; Pathology ; Prognosis ; Risk Factors