No abstract available.

No abstract available.
Diagnosis* ; Tuberculosis, Lymph Node*

A number of methods have been introduced for support the orbital floor following a maxillectomy without orbital exenteration or severe facial trauma. These methods including skin graft and muscular sling provided the unsatisfactory results, like as diplopia, orbital ptosis, enophthalmos and severe facial deformity. Therefore the bone and soft tissue reconstructions using microvascular free flaps were performed recently by many surgeons, but long time operation, donor site morbidity, postoperative large scar, and ptosis of the flap were pointed out as disadvantages of free flap reconstruction. Vascularized calvarial bone flap, a modified method of free calvarial bone graft, was adequate for reconstruction of the orbital floor and the infraorbital rim as a horizontal buttress, especially in case of poor vascular bed and postradiated state. The authors introduced the vascularized calvarial bone flap for the orbital floor and the infraorbital rim reconstruction in 3 cases of maxillectomy, and could be obtained satisfactory results aesthetically and functionally.
Cicatrix ; Congenital Abnormalities ; Diplopia ; Enophthalmos ; Free Tissue Flaps ; Humans ; Orbit* ; Skin ; Tissue Donors ; Transplants

No abstract available.
Free Tissue Flaps*

Nonspecific immune parameters such as natural killer(NK) activity, antibody-dependent cellular cytotoxicity(ADCC), production of leukocyte migration inhibitory factor(LlF) and levels of immune complex(IC) were assessed in 47 patients with rheumatoid arthritis (RA) 20 with degenerative arthritis (DA) and 40 healthy controls. Peripheral blood (PB) as well as synovial fluid (SF) were collected from both RA and DA patients before treatment. Mononuclear cell suspensions and sera were prepared and submitted for the in vitro tests; 4-hr chromium-release assays using human K562 and mouse L1210 cells as targets for NK and ADCC assays respectively, 2-step agarose assay for LIF and platelet aggregation test for IC. Results revealed that 1) LIF activity of PB lymphocytes (PBL) from both RA and DA patients showed a significant (P < 0.05) decrease as compared with that from healthy controls. 2) PB-NK activity from RA patients showed an insignificant decrease as compared with that from DA or healthy controls. However, mononuclear cells isolated from SF (SFL) of RA patients exhibited significantly(P < 0.02) lower NK activity than PBL from the same patients. 3) In ADCC assays with PBL no significant differencies were observed among the 3 groups. 4) Higher titers of IC were detected in both PB and SF from RA patients than DA, and a negative correlation was found between serum IC levels and PB-NK activity. These data are discussed in light of previous reports, and a hypothesis regarding a decreased nonspecific cell-mediated immunity in conjunction with an increased humoral immune response, particularly in local sites, is proposed as one of the mechanisms underlying the pathogenesis of RA.
Adult ; Antibody-Dependent Cell Cytotoxicity ; Antigen-Antibody Complex/immunology ; Arthritis, Rheumatoid/immunology* ; Female ; Human ; Killer Cells, Natural/immunology ; Leukocyte Migration-Inhibitory Factors/biosynthesis ; Male ; Middle Age ; Synovial Fluid/immunology

We have experienced a case of aortic dissecting aneurysm in pregnant woman. She felt initially severe chest pain which was radiated to the neck on the 3days before delivery. Thereafter dyspnea and generalized edema were developed for 1 month after delivery. She was diagnosed as aortic dissectLn, Debakey type-II. During cardiopulmonary bypass, the selective cerebral perfusion was done through the right and left commom carotid arteries. Aortic replacement with Hemashield vascular graft and reimplantation of innominate artery, resuspension of aortic valve, repair of intimal tear were performed. The postoperative course was uneventful.
Aneurysm, Dissecting ; Aortic Valve ; Brachiocephalic Trunk ; Cardiopulmonary Bypass ; Carotid Arteries ; Chest Pain ; Dyspnea ; Edema ; Female ; Humans ; Neck ; Perfusion ; Pregnant Women* ; Replantation ; Tears ; Transplants

Intensive chemotherapy with or without stem cell rescue has become widely accepted for treatment of neuroblastoma because increased dose-intensity correlates with improved response rates. For neuroblastoma that is resistant to intensive chemotherapy, further use of high-dose therapy is unlikely to be beneficial. For disease that recurs after myeloablative consolidation, high-dose salvage therapy may not be feasible because of poor bone marrow reserve and may not be justified in view of its morbidity in the absence of a realistic chance for cure. One treatment option in these difficult clinical settings is chronic oral administration of low-dose etoposide. However, there has been a few clinical reports for the experience of oral etoposide for refractory neuroblastoma. We now present 2 cases of successful response of oral etoposide for refractory neuroblastoma.
Administration, Oral ; Bone Marrow ; Drug Therapy ; Etoposide* ; Neuroblastoma* ; Salvage Therapy ; Stem Cells

When a surgeon fails to save intracranial segement of the facial nerve and can not identify the proximal segment of the facial nerve due to severe adhesion or severe brain stem compression by the tumor, the interpositional graft has no place in helping this patient. Hypoglossal-facial nerve (XII-VII) direct side to end anastomosis is the effective facial reanimation technique used in such a case. This technique compensates for the drawbacks of classical XII-VII anastomosis, and the bothersome strong mass movement and hemiparalysis of the tongue. We recently experienced a case where XII-VII direct side-to-end anastomosis was applied. We report our case with literature review.
Brain Stem ; Facial Nerve ; Facial Paralysis ; Humans ; Hypoglossal Nerve ; Tongue ; Transplants

A case of cervical chordoma diagnosed by fine needle aspiration is discussed. A 41year-old male was admitted due to dyspnea on neck flexion. Radiologic image revealed a retrotracheal superior mediastinal solid mass. Aspiration cytology showed many clusters of oval or large polygonal cells having abundant eosinophilic or bubbly cytoplasm in an amorphous blue-gray mucoid background. The nuclei were round and showed size variation, coarse granular chromatin, and indistinct nucleoli. Some cells contained brown granular pigments in the cytoplasm. Mitoses were rarely found. The cytoplasm was strongly positive for PAS stain. Immunohistochemical stains using cell block revealed positive reaction for cytokerain, EMA, vimentin, and S-100 protein. The confirmative diagnosis was made by following excisional biopsy. Electron microscopic study revealed large pools of intracytoplasmic glycogen and microfilaments. This is the first case of cervical chordoma diagnosed by aspiration cytology to our knowledge in Korean literature.
Actin Cytoskeleton ; Biopsy ; Biopsy, Fine-Needle* ; Chordoma* ; Chromatin ; Coloring Agents ; Cytoplasm ; Diagnosis ; Dyspnea ; Eosinophils ; Glycogen ; Humans ; Male ; Mitosis ; Neck ; S100 Proteins ; Vimentin

Lymphangioma usually occurs in children and usually involves neck and axillary region. Renal or perirenal cystic lymphangioma, hepatic lymphangiomatosis and splenic lymphangiomatosis are very rare disorders. Perirenal cystic lymphangioma combined with multiple hepatic cysts or multiple splenic cysts suspected to be lymphangiomatosis has not been reported in adults in this country until now. The patient was a 43-year-old woman who had been diagnosed with multiple splenic cysts about ten years ago. She presented with a perirenal cystic lesion discovered incidentally and we detected small multiple hepatic cysts additionally with abdominal CT. We removed perirenal cyst surgically and a perirenal lymphangioma was confirmed.
Adult ; Child ; Female ; Humans ; Kidney ; Liver ; Lymphangioma ; Lymphangioma, Cystic ; Neck ; Spleen