Elephantiasis nostras, the result of recurrent skin infection or chronic lymphedema is characterized by marked skin fibrosis and massive enlargement of a body part. We present a case of elephantiasis nostras due to chronic recurrent erysipelas which affected the lower extremities in a 62-year-old man. The patient had had persisting non-pitting edema, and tender multiple verrucous brownish plaques and nodules on both lower legs for 1 year. On histological examination, there was hyperkeratosis and papilomatosis in the epidermis, fibroplasia, dilated thick walled venules and collagen fibers oriented vertical to the skin surface, and hyperplasia of eccrine ducts in the dermis.
Collagen ; Dermis ; Edema ; Elephantiasis* ; Epidermis ; Erysipelas ; Fibrosis ; Humans ; Hyperplasia ; Leg ; Lower Extremity ; Lymphedema ; Middle Aged ; Skin ; Venules

Deep skin and soft tissue defects with exposed bone and tendon is difficult to treat, because skin graft rarely survives and flap surgery is sacrifice of donor site. Since "Stage I" membrane was developed by Yannas and Bruke in 1980, numerous kinds of artificial skin have been developed. The adaptability of "Terudermis", developed by the Terumo Co., as an artificial skin composed of sponge made of a fibrillar atelocollagen and a heat-denatured atelocollagen, was clinically evaluated on application to 13 cases presenting deep skin and soft tissue defect with exposed bones and tendons from October 1997 to march 1998. Terudermis has the advantage of allowing early incorporation of fibroblasts and capillaries into its collagen sponge due to very weak dehydrothermal cross-linking. Before Terudermis graft, several days of wet dressing and debridement were required to prepare healthy well-vascularized bed because Terudermis was weak on unsanitary wounds. After bed preparation, Terudermis was grafted like usual skin graft. Tie-over bolster dressing or compressive dressing was used case by case. The dressing was opened 2~3 days after Terudermis grafting. Wet dressing was done daily until the skin graft was done. Autologous skin graft was done 2-3 weeks after Terudermis graft. Our clinical results indicated that Terudermis was beneficial in treating 77% of our patients. Through the use of this new method, treatment of severe skin and soft tissue defects that are usually treated by musculocutaneous or other conventional skin flaps can be replaced by Terudermis as an new artificial dermis.
Bandages ; Capillaries ; Collagen ; Debridement ; Dermis ; Fibroblasts ; Humans ; Membranes ; Porifera ; Skin ; Skin, Artificial ; Tendons ; Tissue Donors ; Transplants ; Wounds and Injuries*

PURPOSE: The aim of this study was to evaluate the periodontal and prosthodontic complications of multiple freestanding implants in the posterior jaws for up to 1 year of function. MATERIAL AND METHODS: Eight patients received 20 implants posterior to canines. Two or more implants were consecutively inserted to each patient. Single crowns were delivered onto the implants. Marginal bone loss, implant mobility, probing depth, and screw loosening were examined to evaluate the clinical success of such restorations for maximum 1 year of functional loading. RESULTS: All the implants performed well during the observation period. Neither periodontal nor prosthodontic complications were found except a slight porcelain chipping. While the marginal bone level was on average 0.09 mm lower around the implant after 6 months of loading, it was 0.15 mm higher after 1 year. CONCLUSION: Within the limits of this investigation, separate single-tooth implant restorations to replace consecutive missing teeth may clinically function well in the posterior jaw.
Cohort Studies ; Crowns ; Dental Implants, Single-Tooth ; Dental Porcelain ; Humans ; Jaw ; Prospective Studies ; Prosthodontics ; Tooth

Purpose: This study examined the impact of a virtual reality intervention program based on psychological needs on behavioral and psychological symptoms, apathy, and quality of life (QOL) in patients with dementia or mild cognitive impairment living in nursing facilities. Methods: This study is nonequivalent control group pretest-posttest design of quasi-experimental study. The study collected data from November 18, 2020 to July 24, 2021 from patients with dementia or mild cognitive impairment (30 in the experimental group and 30 in the control group) at three nursing facilities in G city using self-reporting and caregiver-informant reporting methods. The analysis employed the chi-square test, Fisher’s exact test, paired t-test, independent t-test, Wilcoxon signed rank test, Mann–Whitney U, repeated measures ANOVA, GEE, using SPSS/WIN 27.0. Results: The severity of behavioral and psychological symptoms (Wald χ2 = 2.68, p = .102) and the care burden of caregivers (Wald χ2 = 1.72, p = .190) were not significant and was no significant time and group interaction effect (Wald χ2 = 0.63, p = .426, Wald χ2 = 0.52, p =. 471). The difference in apathy and QOL score were statistically significant for the group-time interaction (F = 43.65, p < .001; F = 4.35, p= .041). Conclusion The virtual reality intervention program of this study shows a positive effect on the apathy reduction and QOL of patients with dementia or mild cognitive impairment residing in nursing facilities.

We compared the diagnostic accuracy of the simple x-ray with that of the computed tomography, and analyzed the surgical results according to the timing of operation in 52 patients with suspected orbital blowout fractures who complained diplopia after midfacial trauma. Of all the cases, 40 orbital fractures were confirmed with CT and forced duction test and the remaining 12 patients were thought to have transient functional impairment because the clinical signs were resolved with time. CT detected all the 40 actual fractures, so the dignostic accuracy(100%) was higher than that of the simple x-ray(75%) which detected 30 fractures of the 40 actual fractures(p=0.001). We operated 19 patients who have persistent diplopia, enophthalmos of more than 2 mm, and large fracture defect, and there was significant improvement of symptoms and signs in patients on whom operations were performed within 2 weeks after trauma rather than after 2 weeks.
Diagnosis* ; Diplopia ; Enophthalmos ; Humans ; Orbit* ; Orbital Fractures

No Abstract Available.
Hair*

Three-types of expandable metallic stents were constructed to evaluate the differences between the stents : one, formed in a cylindrical zigzag pattern with stainless steel wire (Gianturco stent), another, made by coating the Gianturco stent with silicone rubber(Silicone stent), the third, made by coating the Gianturco stent with 24 carat gold(God stent) for tissue acceptance. A total of 69 stents(each 23 stents of Glanturco, Silicone, and Gold stents) of 8-12 mm in diameter and 20 mm long were placed into normal abdominal aorta, inferior vena cava and iliac artery of nine adult dogs for 2 weeks to 11 months. It was more difficult to introcuce Silicone stent into an introducing sheath than Gianturco or Gold stent due to the thickness of silicone rubber, Four Gianturco stents and three Silicone stents showed migration but Gold stent did not. Luminal narrowing or occlusion was noted in 3 Silicone stents, in 2 Gianturco stents, and in 1 Gold stent. Neointimal proliferation over the stent wires was more rapid and even in God stent than Silicone or Gianturco stent. Although further study is needed, Gold stent seems to be better than Gianturco or Silicone stent as an endovascular graft material.
Adult ; Animals ; Aorta, Abdominal ; Dogs* ; Humans ; Iliac Artery ; Phenobarbital ; Silicon ; Silicone Elastomers ; Silicones ; Stainless Steel ; Stents* ; Transplants ; Vena Cava, Inferior

After publishing 2001 version of the Korean Medication Algorithm for Schizophrenia, the strategy of pharmacologic treatment for schizophrenia has been altered with the rapid advancement in the area of psychopharmacology. Currently, the feasibility of this algorithm has been evaluated. Guidelines require updating when significant new evidence appears. Recently, several guidelines of the treatment of schizophrenia including the APA practice guideline, the Expert Consensus Guideline Series and the Texas Medication Algorithm Project (TMAP) Antipsychotic Algorithm for Schizophrenia were revised. In this review, the authors briefly discussed the problems and limitations of the Korean Medication Algorithm for Schizophrenia and presented the direction of future revision on the model of above-mentioned guidelines.
Consensus ; Drug Therapy ; Methods* ; Practice Guidelines as Topic ; Psychopharmacology ; Schizophrenia* ; Texas

The loss of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). The collapse of the posterior support will eventually cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance and decreased masticatory function. Patients with destroyed dentition need extensive prosthetic treatments. Proper diagnosis and treatment planning are necessary for the stability of the neuromuscular system and the TMJ, and esthetic and functional definitive restorations. In this case, 63 year-old male presented with decreased masticatory force and esthetic problems due to pathologic destruction of teeth structure on entire dentition. Based on assessment of OVD including intraoral findings, radiographic examination and diagnostic cast, full-mouth rehabilitation with increase of OVD was planned using fixed partial denture and removable partial denture. Diagnostic wax-up was done after 4 mm increase of OVD determined by assessment of OVD. The OVD was maintained with the overlay type removable interim prostheses for 12 weeks to ascertain his comfort and adaptation to the new OVD. After the adaptation period, second interim prostheses with tooth preparation maintaining the established OVD was delivered. After 4 weeks, final prostheses were fabricated and delivered. After 7 month follow-up period, occlusal stability is maintained. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.
Bite Force ; Dentition ; Denture, Partial, Fixed ; Denture, Partial, Removable ; Follow-Up Studies ; Humans ; Male ; Masticatory Muscles ; Prostheses and Implants ; Temporomandibular Joint ; Tooth ; Tooth Preparation ; Tooth Wear ; Vertical Dimension

Lymphangiectasia (acquired lymphangioma) is a rare disease that resembles congenital lymphangioma clinically and histopathologically. It usually occurs as a result of acquired lymphatic obstruction secondary to surgery, irradiation, recurrent infection, primary or secondary lymphedema, pressure, and scar due to chronic inflammation, etc. We herein report a case of vulvar lymphangiectasia of a 15-year-old female. She has suffered from swelling on both legs since the age of 5. She was presented because of multiple grouped vesicles and papules containing clear fluid, which resembled frog's spawn and has developed on the vulvar area since the age of 9.
Adolescent ; Cicatrix ; Female ; Humans ; Inflammation ; Leg ; Lymphangioma ; Lymphedema* ; Rare Diseases