Anal incontinence following pelvic trauma, surgery, or neurologic disorders has significant medical and social implication. Both Chetwood in 1902 and Bistom in 1944 utilized coccygeal origin portion of the gluteus maximus muscle for the anal sphincter reconstruction. The gluteus maximus muscle is a broad, fan-shaped muscle with a wide origin from the ilium sacrum and coccyx and a narrow insertion along the iliotibial band of the lateral femur. Its blood supply is from the inferior gluteal artery and its innervation is from L-5, S-1 roots by means of the inferior gluteal nerve Incisions are placed at the inferior border of the ischial tuberosity. Subcutaneous tunnels are created about the rectum and gluteal and perirectal incisions. Two overacting slings are being created Their opposing pull creates sphincter or valve effect about the distal rectum. We have experienced 2 cases of irregular, deep soft tissue defects of the perianal region requiring muscle coverage with the gluteus maximus muscle overlapping slings. We think the use of the gluteus maximus muscle is one of the most useful method for reconstruction of the anal sphincter mechanism.
Anal Canal* ; Arteries ; Coccyx ; Femur ; Ilium ; Nervous System Diseases ; Rectum ; Sacrum

No abstract available.
Chronic Disease* ; Risk Factors*

Oral corticosteroids (OCS) are frequently used during pregnancy, but patterns of their usage and indications are understudied. We described OCS utilization among pregnant women in South Korea using the Health Insurance Review and Assessment database, 2010–2021. Among 4,574,294 pregnancies, 6.2% (n = 283,001) were exposed to OCS, with the annual prevalence increasing from 4.98% in 2010 to 6.65% in 2021. Methylprednisolone and prednisolone accounted for 90% of OCS use during pregnancy, and the median duration of prescriptions was four days. Respiratory and skin diseases were the most common indications, and prescriptions for pregnancy-associated conditions increased notably after 2017, coinciding with insurance coverage for infertility treatments. OCS prescriptions declined during the first trimester and increased near delivery, suggesting discontinuation upon pregnancy recognition. Our findings highlight the common and increasing use of OCS during pregnancy, mainly for acute conditions, underscoring the need for further research on their safety in pregnant populations.

Oral corticosteroids (OCS) are frequently used during pregnancy, but patterns of their usage and indications are understudied. We described OCS utilization among pregnant women in South Korea using the Health Insurance Review and Assessment database, 2010–2021. Among 4,574,294 pregnancies, 6.2% (n = 283,001) were exposed to OCS, with the annual prevalence increasing from 4.98% in 2010 to 6.65% in 2021. Methylprednisolone and prednisolone accounted for 90% of OCS use during pregnancy, and the median duration of prescriptions was four days. Respiratory and skin diseases were the most common indications, and prescriptions for pregnancy-associated conditions increased notably after 2017, coinciding with insurance coverage for infertility treatments. OCS prescriptions declined during the first trimester and increased near delivery, suggesting discontinuation upon pregnancy recognition. Our findings highlight the common and increasing use of OCS during pregnancy, mainly for acute conditions, underscoring the need for further research on their safety in pregnant populations.

Oral corticosteroids (OCS) are frequently used during pregnancy, but patterns of their usage and indications are understudied. We described OCS utilization among pregnant women in South Korea using the Health Insurance Review and Assessment database, 2010–2021. Among 4,574,294 pregnancies, 6.2% (n = 283,001) were exposed to OCS, with the annual prevalence increasing from 4.98% in 2010 to 6.65% in 2021. Methylprednisolone and prednisolone accounted for 90% of OCS use during pregnancy, and the median duration of prescriptions was four days. Respiratory and skin diseases were the most common indications, and prescriptions for pregnancy-associated conditions increased notably after 2017, coinciding with insurance coverage for infertility treatments. OCS prescriptions declined during the first trimester and increased near delivery, suggesting discontinuation upon pregnancy recognition. Our findings highlight the common and increasing use of OCS during pregnancy, mainly for acute conditions, underscoring the need for further research on their safety in pregnant populations.

Oral corticosteroids (OCS) are frequently used during pregnancy, but patterns of their usage and indications are understudied. We described OCS utilization among pregnant women in South Korea using the Health Insurance Review and Assessment database, 2010–2021. Among 4,574,294 pregnancies, 6.2% (n = 283,001) were exposed to OCS, with the annual prevalence increasing from 4.98% in 2010 to 6.65% in 2021. Methylprednisolone and prednisolone accounted for 90% of OCS use during pregnancy, and the median duration of prescriptions was four days. Respiratory and skin diseases were the most common indications, and prescriptions for pregnancy-associated conditions increased notably after 2017, coinciding with insurance coverage for infertility treatments. OCS prescriptions declined during the first trimester and increased near delivery, suggesting discontinuation upon pregnancy recognition. Our findings highlight the common and increasing use of OCS during pregnancy, mainly for acute conditions, underscoring the need for further research on their safety in pregnant populations.

Extracellular matrix component is degraded by enzymes of thematrix metalloproteinases(MMPs). MMPs are produced by both hemopoietic and structural cells. Increased activity of MMP-3 in periodontium is strongly associated with inflammatory periodontal disease. The purpose of the present study was to estimate the effect of BMP-7 on regeneration of periodontium. The optical density was measured by microwell plate reader at 450 nm.The difference of the optical density and the relative activity ofMMP-3 according to the concentration were statistically analyzed by one way ANOVA. The results were as follows: 1.Tetracycline-HCl showed the tendency to inhibit the activity of MMP-3 at the concentration lower than 25microgram/ml. 2.Doxycycline-HCl inhibited significantly the activity of MMP-3 at the concentration lower than 100microgram/ml. 3.Minocycline-HCl inhibited the activity of MMP-3 at the concentration in the range of 10 to 200microgram/ml. Within the limit of the present study, the above results suggested that bone morphogenetic protein-7 may play a important role in development of periodontium.
Bone Morphogenetic Protein 7 ; Extracellular Matrix ; Matrix Metalloproteinases ; Periodontal Diseases ; Periodontium ; Regeneration

PURPOSE: Acute measles encephalitis(ME) is characterized by an abrupt onset of fever and obtundation, frequently accompanied by seizures and multifocal neurological signs. The aim of this study was to clarify the clinical manifestation, progression and the brain SPECT patterns in patients with acute ME. METHODS: This study included 11 children with acute ME admitted to Chonbuk National University Hospital. Ten patients received a first dose of measles vaccine, one patient did not receive a first dose, and no patients received a second dose. ME was diagnosed based on characteristic clinical pictures, measles antibodies by ELISA and abnormal CSF findings. Brain MRI and brain SPECT were performed in 11 patients with acute ME. RESULTS: There were four males and seven females whose ages at onset ranged between 18 months and 14 years(mean : 10.5 years). The main clinical neurologic pictures were loss of consciousness(10) and seizure(five). The titer of IgG and IgM antimeasles antibodies in serum were positive in 10 patients. In CSF, nine patients had IgG antibodies and one patient had IgM antibodies. The concentration of protein(mean : 124+/-60 mg/dL) and WBC counts(mean : 158+/-157/microL) in CSF were elevated in all patients. In electroencephalographic examination, nine patients showed increased slow waves. Seven of 11 patients(63.6%) revealed high signal intensity on the brain MRI. In contrast, all patients showed hypoperfusion in brain SPECT examination. According to brain SPECT, the perfusion deficits were frequently observed in the frontal lobe(nine), temporal (nine), parietal(eight) and thalamus(eight). CONCLUSION: Brain SPECT is more sensitive than MRI for the evaluation of brain damage in early stages of acute ME.
Antibodies ; Brain* ; Child ; Electroencephalography ; Encephalitis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fever ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Jeollabuk-do ; Magnetic Resonance Imaging ; Male ; Meals* ; Measles ; Measles Vaccine ; Perfusion ; Seizures ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: To investigate the prevalence and related risk factors of infection with human papillomavirus(HPV) in young adults, and the interrelationships among the risk factors, school-based survey was conducted in Busan. METHODS: A total of 1,430 male and female students(aged 16~25) participated in the survey that included self-administered questionnaire and, for males, physician-performed collection of exfoliated genital cells, for females, self-collection of vaginal cells. The prevalences of 25 HPV types were evaluated by a polymerase chain reaction-based assay. RESULTS: HPV DNA detected more frequently in female students(15.2%) than in male students(8.7%). In female students, currently smoking cigarettes(OR=3.8, 95% CI=1.7~8.3) and having had penetrative sexual intercourse(OR=12.7, 95% CI=7.2~22.2) were the significant risk factors for HPV infection; in male students, there was nothing to show statistical significance. Smoking rate was 53.8% in males and 17.7% in females, and 55.6% of male students and 25.9% of female students reported having had a sexual intercourse. Smokers were more likely to have had a sexual intercourse than nonsmokers(OR=4.0, 95% CI=2.5~6.2, males; OR=9.1, 95% CI=5.6~14.7, females). CONCLUSIONS: According to the strong interrelationship between sexual intercourse and smoking, multilateral behavioral intervention is needed to prevent infection with HPV.
Adolescent* ; Busan ; Coitus ; DNA ; Female ; Humans* ; Male ; Papillomavirus Infections* ; Prevalence ; Risk Factors* ; Sexual Behavior ; Smoke ; Smoking ; Young Adult ; Surveys and Questionnaires

PURPOSE: The purpose of this study is to evaluate the surgical outcomes of the clavicle lateral end fracture fixed with an oblique T locking compression plate (LCP). MATERIALS AND METHODS: Fourteen clavicle lateral end fractures were fixed with the oblique T-LCP and followed up for at least 1 year after the surgery. Thirteen cases were unstable Neer type II fractures and one case was nonunion of the Neer type I fracture. The mean age was 46 years of age (range, 26~70). In ten cases, augmenting sutures with the absorbable suture material were placed in the coraco-clavicular ligament and around the plate and the clavicle to improve the stability of fracture fixation. Autogenous iliac bone graft was done in four cases. The clinical outcomes were evaluated by using UCLA scoring system and KSS (Korean Shoulder Score). RESULTS: The mean UCLA score was 33.5 and the mean KSS was 94.9. Average time of bone union was 11.9 weeks (range, 6~28), including 1 case with a delayed union. There was no complication such as loss of fixation or nonunion. CONCLUSION: Fixation with the oblique T-LCP is a good option providing reliable functional results in clavicle lateral end fractures.
Clavicle ; Fracture Fixation ; Ligaments ; Shoulder ; Sutures ; Transplants