Two patients, sought treatment for chief complaints of protruding frontal tooth and desired treatment to reduce the prominence of lips, were diagnosed as bimaxillary protrusion via clinical and cephalometric analysis. The authors corrected them by combined surgical and orthodontic treatment. As pre-surgical survey, paper and cast surgery were performed and wafer and resin sprint were constructed. We performed anterior maxillary and mandibular osteotomies in first premolar site to retract the maxillary and mandibular dentoalveolar segment in order to; 1) Decrease prominence of upper and lower lips. 2) Create proper lower incisor intrusion. By use of intramaxillary fixation, prompt oral intake was possible. We made good result of esthetic improvement and there was no evidence of relapse and any complication.
Adult* ; Bicuspid ; Humans ; Incisor ; Lip ; Mandibular Osteotomy ; Recurrence ; Tooth

BACKGROUND AND OBJECTIVES: Cell proliferation and differentiation are regulated by growth factors and growth factor receptors. Inappropriate expressions of growth factors and oncogenes may influence the biological and clinical phenotype of tumor. But there are still controversy regarding their clinical attributions in head and neck cancer. The authors evaluated the prognostic significance of p53 protein, EGF and c-erbB-2 expression in the squamous cell carcinoma of head and neck to determine their relationship with the clinicopathologic parameters. MATERIALS AND METHODS: Paraffin embedded tissue specimen from 64 cases of squamous cell carcinomas of head and neck were studied by immunohistochemical staining. RESULT: p53 protein, EGF and c-erbB-2 were expressed 53.1%, 29.7% and 57.8%, respectively, in 64 cases of head and neck cancer. The positive expression of p53 protein was associated closely with T-stage and clinical stage. This expression was statistically significant(P<0.05). There were no significant relationships between the reactivity of EGF, c-erbB-2 and clinical parameters. CONCLUSION: The expressions of p53 protein, EGF and c-erbB-2 could be related to oncogenesis in squamous cell carcinoma of the head and neck. And, the expression of p53 protein can be used as a prognostic factor in head and neck squamous cell carcinoma.
Carcinogenesis ; Carcinoma, Squamous Cell* ; Cell Proliferation ; Epidermal Growth Factor* ; Head and Neck Neoplasms ; Head* ; Intercellular Signaling Peptides and Proteins ; Neck* ; Oncogenes ; Paraffin ; Phenotype ; Receptors, Growth Factor

PURPOSE: To design and test the CT simulator phantom for geometrical test. MATERIAL AND METHODS: The PMMA phantom was designed as a cylinder which is 20 cm in diameter and 24 cm in length, along with a 25x25x31 cm3 rectangular parallelepiped. Radio-opaque wires of which diameter is 0.8 mm are attached on the other surface of the phantom as a spiral. The rectangular phantom was made of four 24x24x0.5 cm3 square plates and each plate had a 24x24 cm2, 12x12 cm2, 6x6 cm2 square line. The squares were placed to face the cylinder at angles 0degrees, 15degrees, 30degrees, respectively. The rectangular phantom made it possible to measure the field size, couch angle, the collimator angle, the isocenter shift and the SSD, the measurements of the gantry angle from the cylindrical part. A virtual simulation software, AcQSimTM, offered various conditions to perform virtual simulations and these results were used to perform the geometrical quality assurance of CT simulator. RESULTS: A 0.3~0.5 mm difference was found on the 24 cm field size which was created with the DRR measurements obtained by scanning of the rectangular phantom. The isocenter shift, the collimator rotation, the couch rotation, and the gantry rotation test showed 0.5~1 mm, 0.5~1degrees0.5~1degrees, and 0.5~ 1degreesdifferences, respectively. We could not find any significant differences between the results from the two scanning methods. CONCLUSION: The geometrical test phantom developed in the study showed less than 1 mm (or 1degrees) differences. The phantom could be used as a routine geometrical QC/QA tools, since the differences are within clinically acceptable ranges.
Polymethyl Methacrylate ; Silver Sulfadiazine

A combined anterolateral and posterior approach with thoracotomy has been recommended as the traditional surgical approach for the tumors of the thoracic spine. Recently, because of the morbidity associated with open thoracotomy, the thoracoscopically assisted surgical technique was introduced successfully in thoracic spinal surgery. Herein, we report a combined surgical technique for giant cell tumor of the thoracic spine (T10) consisting of bilateral thoracoscopic anterior release of the spine followed by a posterior en bloc spondylectomy and reconstruction by orthopedic surgeons. The thoracoscopic spinal surgery is safe and effective alternative for other open thoracotomic procedures in the approach to the anterior thoracic spine, avoiding the disadvantage inherent to thoracotomy.
Giant Cell Tumors ; Orthopedics ; Spine* ; Thoracoscopy ; Thoracotomy

PURPOSE: Breast cancer is second most common cancer in women. Most of the patients with breast cancer treated with mastectomy take breast reconstruction. Nipple reconstruction is an important step in breast reconstruction. Many surgeons have investigated of nipple reconstruction using the flap technique after breast reconstruction with the autologous tissue. The objective of this study is to evaluate the results of nipple reconstruction using the C-V flap technique after breast reconstruction only with the breast expander. METHODS: From April 2006 to May 2008, the authors treated 17 patients of nipple reconstruction using C-V flap technique, who received breast reconstruction only with the breast expander. As we have predicted decrease in the size of reconstructed nipple, we designed flap a little larger than wanted nipple size. Nipple splint was applied for 4-6 months for minimizing decrease of the size of reconstructed nipple. The diameter and height of the reconstructed nipple were measured and patient's satisfaction score was assessed. RESULTS: Mean follow-up duration was 12.5 months. Among the 17 patients, the average absorption rate by height of nipple was 47.0%. Partial necrosis was noted in 1 case, and treated well with conservative management. There were no other significant complications noted. Patient's satisfactory score was assessed by the height, design and location of the nipple. The average of satisfaction score was 85%, 68%, 62% and total average was 83%. CONCLUSION: The authors experienced 17 patients of nipple reconstruction using the C-V flap technique after breast reconstruction only with the breast expander. The absorption rate of the size of the nipple, complications and patient's satisfactory score of this study were similar to those of nipple reconstruction after breast reconstruction with the autologous tissue. It is expected that nipple reconstruction after breast reconstruction only with the breast expander is safe and reliable. It is considered that a long-term study is necessary.
Absorption ; Breast ; Breast Neoplasms ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Mastectomy ; Necrosis ; Nipples ; Splints

PURPOSE: Gynecomastia is an abnormal increase in the volume of the male breast. Subcutaneous mastectomy was the first surgical treatment for gynecomastia. But because of the complications such as nerve injury and scar formation, subcutaneous mastectomy has been substituted with liposuction. Recently various techniques including ultrasound-assisted liposuction has been used for treatment of gynecomastia. The purpose of this study is to evaluate the results of XPS(R) microresector (Shaver) for treatment of gynecomastia. METHODS: 17 patients, 33 breasts of gynecomastia, Simon grade I or II have been treated with XPS(R) microresector (Shaver). The mean age was 24.5. The subcutaneous tissue and glandular tissue were removed with XPS(R) microresector (Shaver). The operation time, the weight of removed tissue and patients' satisfaction score were accessed. RESULTS: The mean operation time was 78.2 minutes. The mean weight of removed tissue was 113.8 g. There were no significant complications such as necrosis, hematoma, infection or scar contracture. Patients' satisfactory score of scar, shape and confidence were 8.4, 8.2 and 8.4 respectively. As the average score was 8.3, most of the patients were satisfied with their breasts. CONCLUSION: The authors have treated 17 patients suffering from gynecomastia with XPS(R) microresector (Shaver). We obtained short operation time, early recovery, minimal operative scar and less complications with XPS(R) microresector (Shaver) for the treatment of gynecomastia, and patients were satisfied with the results of our method. We concluded that XPS(R) microresector (Shaver) is an alternative option for the treatment of gynecomastia.
Breast ; Cicatrix ; Contracture ; Gynecomastia ; Hematoma ; Humans ; Lipectomy ; Male ; Mastectomy, Subcutaneous ; Necrosis ; Stress, Psychological ; Subcutaneous Tissue

A 8-yrs-old boy was admitted because of convulsion and coma. The diagnosis of Cushing's syndrome(key word) associated with hypertensive encephalopathy(key word) due to right adrenocortical carcinoma(key word) was made by clinical features, biochemical studies, radiological studies and pathological examination. The tumor was successfully resected by right adrenalectomy. But 22 months later after operation, he died of dyspnea and heart failure. A brief review of literature was presented.
Adrenalectomy ; Coma ; Cushing Syndrome* ; Diagnosis ; Dyspnea ; Heart Failure ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Male ; Seizures

A 8-yrs-old boy was admitted because of convulsion and coma. The diagnosis of Cushing's syndrome(key word) associated with hypertensive encephalopathy(key word) due to right adrenocortical carcinoma(key word) was made by clinical features, biochemical studies, radiological studies and pathological examination. The tumor was successfully resected by right adrenalectomy. But 22 months later after operation, he died of dyspnea and heart failure. A brief review of literature was presented.
Adrenalectomy ; Coma ; Cushing Syndrome* ; Diagnosis ; Dyspnea ; Heart Failure ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Male ; Seizures

Reactive oxygen species such as superoxides, hydrogen peroxide (H2O2) and hydroxyl radicals have been suggested to be involved in the catalytic action of nitric oxide synthase (NOS) to produce NO from L-arginine. An examination was conducted on the effects of oxygen radical scavengers and oxygen radical-generating systems on the activity of neuronal NOS and guanylate cyclase (GC) in rat brains and NOS from the activated murine macrophage cell line J774. Catalase and superoxide dismutase (SOD) showed no significant effects on NOS or GC activity. Nitroblue tetrazolium (NBT, known as a superoxide radical scavenger) and peroxidase (POD) inhibited NOS, but their inhibitory actions were removed by increasing the concentration of arginine or NADPH respectively, in the reaction mixture. NOS and NO-dependent GC were inactivated by ascorbate/FeSO4 (a metal-catalyzed oxidation system), 2'2'-azobis-amidinopropane (a peroxy radical producer), and xanthine/xanthine oxidase (a superoxide generating system). The effects of oxygen radicals or antioxidants on the two isoforms of NOS were almost similar. However, H2O2 activated GC in a dose-dependent manner from 100 microM to 1 mM without significant effects on NOS. H2O2-induced GC activation was blocked by catalase. These results suggested that oxygen radicals inhibited NOS and GC, but H2O2 could activate GC directly.
Animal ; Antioxidants/pharmacology ; Brain/enzymology ; Catalase/pharmacology ; Cell Line ; Guanylate Cyclase/metabolism* ; Hydrogen Peroxide/pharmacology ; Macrophages/enzymology ; NADP/pharmacology ; Nitric-Oxide Synthase/metabolism* ; Nitroblue Tetrazolium/pharmacology ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species/metabolism* ; Signal Transduction ; Superoxide Dismutase/pharmacology

BACKGROUND: Postoperative pain control in children is a difficult problem for management. Fentanyl is one of the most commonly used narcotics in infants and children due to its rapid onset and brief duration. Infants older than 3 months had a lower incidence of apnea than adults given fentanyl; however, the dosage of fentanyl varies a great deal depending on the purpose and plan for the postoperative management. This study is designed to evaluate the effective dose of intraoperative intravenous fentanyl for pain control following inguinal herniorrhaphy in pediatric patients. METHODS: Sixty children for inguinal herniorrhaphy under general anesthesia were divided into four groups. Group I received no analgesics as a control. Group II, III and IV received intravenous fentanyl 0.5 microgram/kg, 1 microgram/kg and 1.5 microgram/kg respectively. Fentanyl was injected intravenously at the beginning of fascia closure. Extubation time and the degree of pain was evaluated. RESULTS: Our result showed that group III and IV had a lower pain score than that of the control group during the first 30 min in the recovery room (p<0.05), but no significant differences were found between the group III and group IV. The time interval from fascia closure to extubation was prolonged in the group II, III and IV compared to the control group (p<0.05). But no significant differences were found between the three groups. CONCLUSION: We suggest that intravenous administration of fentanyl 1 microgram/kg at the closure of fascia would be an easy, simple and effective means for relieving postinguinal herniorrhaphy pain in recovery room.
Administration, Intravenous ; Adult ; Analgesics ; Anesthesia, General ; Apnea ; Child* ; Fascia ; Fentanyl* ; Herniorrhaphy* ; Humans ; Incidence ; Infant ; Narcotics ; Pain, Postoperative ; Recovery Room