Dentocutaneous fistula of the face neck is an infrequent manifestation of chronic dental infection. A periapical dental abscess may be initiated by disease, trauma, or thermal or chemical injury and develops into an extensive necrosis of surrounding tissue. Diagnostic errors can result in multiple excision, biopsies, and ineffective long-term antibiotic therapy. Awarness that periapical dental abscess is the most common etilolgic factor of cutaneous sinus tracts involves the face & neck will facilitate their early diagnosis and prevent needless treatment or anxiety for the patient. From 1994 to 1998, we have performed 6 cases of dentocutaneous fistula. Among of them, three were men and the others were women, age ranged from 18 to 66-year-old, and morbidity period was from 3 weeks to 3 years, the follow-up period ranged from 5 to 18 months (mean period 11 months). In conclusion, an understanding of the pathogenesis of cutaneous fistulae arising from dental infections will lead to proper early diagnosis and treatment without unnecessary surgery.
Abscess ; Aged ; Anxiety ; Biopsy ; Cutaneous Fistula ; Diagnostic Errors ; Early Diagnosis ; Female ; Fistula* ; Follow-Up Studies ; Humans ; Male ; Neck ; Necrosis ; Unnecessary Procedures

PURPOSE: This study is to evaluate the Brain CT manifestations of late hemorrhagic disease of the newborn. METHODS: We evaluated 13 cases with late hemorrhagic disease of the newborn, for whom brain CT scans were performed. Clinical indications for brain CT scan were mental changes(n=5), vomiting(n=2), irritability(n=2), seizure(n=3), and lethargy(n=1). We analyzed the result of the brain CT findings with attention to anatomic locations of hemorrhage and characteristics of hemorrhagic manifestations. RESULTS: Only one patient in 13 patients was normal on brain CT scan, and 12 patients showed hemorrhagic lesions. Among 12 patients, 5 cases had single hemorrhagic lesion(3 subdural hemorrhages and 2 intracerebral hemorrhages, and 7 cases had multiple lesions, in which subdural hemorrhage and subarachnoid hemorrhage were common respectively. The other common brain CT findings except hemorrhagic lesion were the mass effects with ventricle compression(n=11), midline shifting(n=6), ventricular dilatation(n=7), and fluid-fluid levels in hemorrhagic lesion(n=9). CONCLUSION: The common intracranial hemorrhages of late hemorrhagic disease of the newborn were subdural and subarachnoid hemorrhages. The associated CT findings were mass effect and fluid-fluid levels. Intracranial hemorrhage in late hemorrhagic disease of newborn could massively occurr. Thus brain CT scan should be done if any symptom for neurologic abnormality was present.
Brain* ; Cerebral Hemorrhage ; Hematoma, Subdural ; Hemorrhage ; Humans ; Infant, Newborn* ; Intracranial Hemorrhages* ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed ; Vitamin K Deficiency Bleeding

Laryngeal trauma is rare compared to other head and neck traumas, but it occurs, it can be life threatening. As for treatment, a laryngeal fracture that involves displacement of cartilage or extensive injury requires appropriate surgical treatments. For severe laryngeal fractures, conservative management is usually preferred with placing a stent to prevent laryngeal stenosis. But the downside of placing stents in the larynx includes the risk of granulation and infection. In this report, the authors describe a 35-year-old patient, who was diagnosed with blunt laryngeal trauma and treated by Horizontal partial laryngectomy. The patient's post-operative breathing and voice were fair, and airway stenosis did not occur afterwards.
Adult ; Cartilage ; Constriction, Pathologic ; Fractures, Cartilage ; Head ; Humans ; Laryngeal Cartilages ; Laryngectomy* ; Laryngostenosis ; Larynx ; Neck ; Respiration ; Stents ; Voice

The purpose of this study is to investigate the effect of nerve regeneration to island flap vascularity after crushing injury to pedicle nerve. A total of 40 adult male Sprague Dawley rats (200-250 gm) were used and divided into 4 groups (n = 10). Two inferior epigastric island flaps were elevated including panniculus carnosus on each rat: one retained innervation (control); the other was denervation by crushing injury to superficial epigastric nerve. After the flap elevation, vascularity of the flap was checked by laser doppler at superficial epigastric artery. Group 1 was vascularity of the flap after 1 day, group 2 after 3days, group 3 after 5 days, group 4 after 7 days. Under light and electron microscope, histologic changes were compared. In conclusion, our experimental study proved that vascularity of the epigastric island flap was slowly decreased with histologic findings of nerve regeneration. Denervated flap had more vascularity than other groups by 7 days. This study appears to be a valid one which treatment and post operative care of very small island flap such as distal finger tip amputation (Zone I level).
Adult ; Amputation ; Animals ; Denervation ; Epigastric Arteries ; Fingers ; Humans ; Male ; Nerve Regeneration* ; Rats ; Rats, Sprague-Dawley ; Surgical Flaps

No abstract available.
Fibronectins* ; Plasma* ; Pre-Eclampsia*

We describe a 28 year-old woman who had fever, general myalgia, tender erythematous subcutaneous nodules on whole body skin, and acute pleuritis after influenza vaccination. Temporal association between vaccination and her symptoms and skin biopsy result are in agreement with our diagnosis as leukocytoclastic vasculitis. A review found that there were a few similar cases involving the skin, kidney, and rarely nervous system, mostly with good prognoses. Our patient was treated by a short course of corticosteroid and no recurrence has been observed for five months. Although there is a possibility of an infection, the temporal association, the false-positive HCV ELISA test, and the increased serum IgE were interesting findings, which might account for this leukocytoclastic vasculitis after influenza vaccination.
Adult ; Biopsy ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Fever ; Humans ; Immunoglobulin E ; Influenza, Human* ; Kidney ; Myalgia ; Nervous System ; Pleurisy ; Prognosis ; Recurrence ; Skin ; Vaccination* ; Vasculitis*

Preadipocyte cell lines are useful models for investigating adipogenesis process. 3T3-L1 preadipocyte, which can be induced to differentiate into adipocyte in cell culture, is one of the most studied preadipocyte cell lines. When exposed to the appropriate differentiation inducer, including insulin, dexamethasone and 3-isobutyl- 1-methylxanthine, 3T3-L1 preadipocytes differentiate into adipocytes. This study was undertaken to evaluate the effect of epigallocatechin on differentiation of 3T3-L1 preadipocyte, and to test whether epigallocatechin can be useful to reduce fat deposition. Cell proliferation was determined by MTT(3,4,5-Dimethylthiazol-2,5-Diphenyl- Tetrazoliumbromide) spectro-photometry, fat content followed by cell differentiation was determined by Oil Red O staining, and the degree of differentiation into adipocytes were determined by measuring mRNA content and activity of glyceraldehydes 3-phosphate dehydrogenase (G3PDH). Epigallocatechin inhibited proliferation of preadipocytes, not into adipocytes. Fat storage during 3T3-L1 preadipocyte conversion into adipocyte was inhibited by epigallocathechin. Epigallocatechin decreased G3PDH, leptin mRNA and peroxisome proliferator-activated receptor(PPAR)gamma mRNA which were increased by differentiation of preadipocyte into adipocyte. These results suggest that epigallocatechin has a potential to serve as a fat-reducing drug.
Adipocytes ; Adipogenesis* ; Cell Culture Techniques ; Cell Differentiation ; Cell Line ; Cell Proliferation ; Dexamethasone ; Insulin ; Leptin ; Oxidoreductases ; Peroxisomes ; RNA, Messenger

PURPOSE:This study was undertaken to investigate the prevalence and the risk factors of thrombocytopenia in children taking valproate for convulsive disorders. METHODS:From Jan. 2000 to Dec. 2005, we reviewed the medical recordes of 54 children with convulsive disorders taking valproate over a period of 12 months. Then, we estimated the prevalence of thrombocytopenia, and analyzed the relationship between changes in platelet counts and other factors such as age, sex, serum valproate levels and the duration of valproate therapy. RESULTS:Six(11.1%) children taking valproate had at least one episode of thrombocytopenia. The platelet counts were significantly lowered at 3 months after valproate therapy and recovered after 6 months(P<0.05). The relationship between the platelet counts and other factors such as blood valproate levels, sex and age was not observed in our study. CONCLUSION:Thrombocytopenia can appear after a few months of therapy and regular monitorings of platelet counts in children taking valproate may be needed to prevent potential bleeding diathesis.
Child* ; Disease Susceptibility ; Hemorrhage ; Humans ; Medical Records ; Platelet Count ; Prevalence* ; Risk Factors* ; Thrombocytopenia* ; Valproic Acid*

BACKGROUND: Cardiac tamponade is associated with the expiratory increase and the expira-tory decrease in left ventricular filling flow. With Doppler echocardiography, we analyzed the respiratory variations of mitral and tricuspid inflows, and pulmonary and hepatic venous flows in patients with cardiac tamponade. METHODS: Respiratory hemodynamic changes in mitral and tricuspid inflows and pulmonary and hepatic venous flows were evaluated using Doppler echocardiography in 13 patients (6 men and 7 women; mean age 51+/-13 years) with large pericardial effusion and clinical cardiac tamponade, and compared the results with those of 11 control subjects (3 men and 8 women, mean age 53+/-13 years). Doppler examination was repeated after pericardiocentesis in 6 patients. RESULTS: Peak velocity of early diastolic mitral inflow (E velocity) decreased during inspiration compared with expiratory increase; the mean percentage change was 40%. Peak velocity of late diastolic mitral inflow (A velocity) decreased 13% during inspiration. E/A ratio decreased 31% during inspiration. Deceleration time (DT) and isovolumic relaxation time (IVRT) increased by 26% and 44%, respectively, during inspiration. But respiratory variations of tricuspid inflow were opposite to those of mitral inflow. Tricuspid E velocity increased during inspiration and decre-ased during expiration. The mean percentage change was 123%, which was larger than thte 40% of mitral inflow. The most characteristic findings of pulmonary venous flow during respiration were the expiratory increases of peak diastolic velocity (DV) and diastolic time-velocity integral (D-TVI). The mean percentage changes of peak systolic velocity (SV), DV and D-TVI during respiration were 27%, 45% and 53% respectively. In contrast, the SV and DV of hepatic venous flow increased during inspiration and decreased during expiration. The respiratory variations of peak systolic reverse flow velocity (SR) and peak diastolic reverse flow velocity (DR) were opposite to those of SV and DV. DR notably increased during expiration, and the mean percentage change was 61%. The ratio of RFI (Inspiratory reverse flow integral) to FFI (forward flow integral) of the tamponade group was 270%. The mean percentage changes of each parameters decreased after pericardiocentesis. CONCLUSION: Patients with cardiac tamponade showed inspiratory increases of diastolic tri-cuspid filling flow and hepatic forward flow. Expiratory increases included diastolic mitral filling flow, pulmonary venous systolic and diastolic flow, and hepatic venous reverse flow. Such res-piratory variations decreased after pericardiocentesis.
Cardiac Tamponade* ; Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Female ; Hemodynamics ; Humans ; Male ; Pericardial Effusion ; Pericardiocentesis ; Relaxation ; Respiration

C-shaped canals are known to present a complex canal anatomy with numerous fins connecting individual canals, thus requiring supplementary effort to accomplish a successful root canal treatment. This study examined the frequency of the C-shaped mandibular second molars and interrelation between the clinical records and radiographs to recognize them treated in the Department of Conservative Dentistry of the Chosun University Dental Hospital during a six-year period (1998 - 2004). This study reviewed the clinical records of 227 patients who underwent root canal treatment of the mandibular second molars. After opening the chamber, those cases with C-shaped orifices in the pulpal floor were selected, and the C-shaped root canal types were classified according to Melton's criteria. Three experienced dentists evaluated the radiographs of the C-shaped mandibular second molar on a viewer using a magnifying glass in order to determine if the root apex was fused or separated, the distal root canal was either centered or mesial shifted in the distal root, and if there was bilateral symmetry in a panorama. In conclusion, there is a high frequency of C-shaped mandibular second molars in Koreans. Simultaneous interpretation of the root shape and distal root canal using the preoperative, working length and post-treatment radiographs is important for diagnosing a C-shaped mandibular second molar.
Dental Pulp Cavity* ; Dentistry ; Dentists ; Glass ; Humans ; Molar*