Uni- or bilateral mandibular hypoplasia can be associated with various syndromes or is acquired after early traumatic or inflammatory disease in the temporomandibular joint(TMJ). Early treatment is necessary to avoid consequent impairment of midfacial growth. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth, but the new procedure of bone lengthening which was presented by McCarthy et al. represents a limited surgical intervention and therefore open up a new perspective of treatment, especially in younger children with severe deformities. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, a tilted occlusal plane, and a short mandible. A 14-years-old boy with facial asymmetry, who was fractured on both condyle and mandibular symphysis before 8 years ago, was treated by mandibular ramus lengthening, symphysial widening and surgically assisted rapid palatal expansion with corticotomy. After allowing 1 week for the healing of the periosteum, the distraction was performed at the rate of 0.5-1.0mm per day for 7 days on maxilla and 14 days on mandible. The device was maintained on maxilla and mandible for 12 weeks following distraction. The difference in ramus and mandibular transverse deficiency were corrected and facial asymmetry was improved with complex distraction osteogenesis.
Bone Lengthening ; Child ; Congenital Abnormalities ; Dental Occlusion ; Facial Asymmetry ; Goldenhar Syndrome ; Humans ; Male ; Mandible ; Maxilla ; Osteogenesis, Distraction* ; Periosteum ; Transplants

Accidents, Traffic ; Dentition ; Fractures, Comminuted ; Humans ; Immobilization ; Mandible ; Mandibular Fractures ; Retrospective Studies ; Wounds and Injuries

BACKGROUND AND OBJECTIVES: We investigated the relationship between the degree of enophthalmos and the volume of herniated orbital tissue measured from computed tomography scan in the isolated blowout fractures of orbital wall. SUBJECTS AND METHOD: In this retrospective study, 100 patients with isolated blowout fractures were evaluated. We classified them into 4 groups according to the site of fracture (medial and inferior) and the presence of symptoms like diplopia and limitation of ocular motility, which needs an operation. The volume of orbit and herniated orbital tissue has been measured by computed tomography scans using three-dimensional reconstruction technique, and the degree of enophthalmos was evaluated with Hertel's ophthalmometer. We compared the volume from which we got from the computed tomography scan, the degree of enophthalmos and the presence of symptoms to figure out the mutual relation between the groups. RESULTS: In the case of medial blowout fracture group, the volume of herniated orbital tissues increased significantly with the presence of symptoms and was in proportion to the extent of enophthalmos (p<0.05). The volume expansion of orbit associated with 2 mm of enophthalmos as calculated by the regression curve was 3.1 ml or 12.8 % in the no-symptoms groups. Finally, in the case of inferior blowout fracture group, there was no evidence of mutual relation. CONCLUSION: These results suggest that surgical intervention is required even though there isn't any symptom for medial blowout fractures, especially when the orbit volume is more than 12.8%. In cases of inferior blowout fractures, a close follow-up is needed even though the extent of fracture is small.
Diplopia ; Enophthalmos ; Follow-Up Studies ; Humans ; Orbit ; Retrospective Studies

Macrophage infiltration has been observed in the renal biopsy specimens of diabetic nephropathy (DN), and hyperglycemic state stimulates the renal expression of RANTES (regulated upon activation, normal T-cell expressed and secreted) and MCP-1 (monocyte chemoattractant protein-1). Upregulation of RANTES and MCP-1 with infiltrating macrophages may play a crucial role in the development and progression of DN. Genetic polymorphisms of RANTES and its receptors were reported to be independent risk factors for DN. We genotyped single nucleotide polymorphism (SNPs) in the MCP-1 G-2518A, CCR2 G46295A, RANTES C-28G and G-403A in 177 diabetic end-stage renal disease (ESRD) patients and 184 patients without renal involvement (controls) in order to investigate the effects of these SNPs on DN in Korean patients with type 2 DM. There were no differences in the frequencies of SNPs and the distribution of haplotypes of RANTES promoter SNPs between two groups. In conclusion, there were no associations of MCP-1, CCR2 and RANTES promoter SNPs with diabetic ESRD in Korean population. Prospective studies with clearly-defined, homogenous cohorts are needed to confirm the effect of these genetic polymorphisms on DN.
Aged ; Asian Continental Ancestry Group/*genetics ; Chemokine CCL2/*genetics ; Chemokine CCL5/*genetics ; Chi-Square Distribution ; Diabetes Mellitus, Type 2/complications ; Female ; Gene Frequency ; Genotype ; Haplotypes ; Humans ; Kidney Failure, Chronic/ethnology/etiology/*genetics ; Korea ; Male ; Middle Aged ; *Polymorphism, Single Nucleotide ; Promoter Regions, Genetic

Eosinophilic granulomatosis with polyangiitis (EGPA), previously called Churg-Strauss syndrome, is an anti-neutrophil cytoplasmic antibody associated vasculitis, accompanied by asthma, hypereosinophilia, nonfixed pulmonary infiltrates, and sinusitis. Peripheral neuropathy is common in patients with EGPA; however, a few cases of EGPA with central nervous system (CNS) involvement have been reported. A 45-year-old female referred for right side weakness and posterior neck pain was diagnosed as EGPA with subarachnoid hemorrhage and mononeuritis multiplex. She was effectively treated with a high dose glucocorticoid, cyclophosphamide, and intravenous immunoglobulin. EGPA with CNS involvement is uncommon and causes significant morbidity and mortality. Therefore more rapid and accurate diagnostic evaluation may be required. EGPA should be considered in patients with neurological symptoms and hypereosinophilia.
Antibodies, Antineutrophil Cytoplasmic ; Asthma ; Central Nervous System ; Churg-Strauss Syndrome ; Cyclophosphamide ; Eosinophils* ; Female ; Humans ; Immunoglobulins ; Middle Aged ; Mononeuropathies* ; Mortality ; Neck Pain ; Peripheral Nervous System Diseases ; Sinusitis ; Subarachnoid Hemorrhage* ; Vasculitis

PURPOSE: Advances in the treatment of congenital heart disease and a decline in the incidence of rheumatic fever has led to changes in the causative organisms and the clinical outcome of infective endocarditis(IE). We sought to analyze the clinical outcome, prognostic factors, causative organisms and corresponding antibiotic sensitivity in IE. METHODS: Retrospective analysis of medical records of 104 children diagnosed and treated with IE at Severance Hospital, Yonsei University College of Medicine from January 1986 to June 2003 was undertaken. According to the Duke criteria, 55 patients were classified into the definite group(DG) and possible group(PG). RESULTS: Thirty one cases(56.4%) fulfilled the criteria for the definite group in the Duke criteria, whereas 24 cases(43.6%) fulfilled the criteria for the possible group. The most common chief complaint on admission was fever(93%). The most common infecting organism was Staphylococcus aureus, which was found in 14 cases(48.3%). Three cases(21.4%) of this organism were methicillin- resistant S. aureus(MRSA). Other causative organisms were alpha-streptococcus(seven cases, 24.1%), Staphylococcus epidermidis(three cases, 10.3%), Citrobacter freundii(one case, 3.8%), Enterococcus faecium(one case, 3.4%) and Candida albicans(three cases, 10.3%). Penicillin-resistant organisms were found in 90.5%(19/21) of total cases and the most sensitive antibiotics were vancomycin(13/13, 100 %) and teicoplanin(12/12, 100%). One case of IE due to MRSA unresponsive to vancomycin was treated with Arbekacin. CONCLUSION: The incidence of IE caused by S. aureus, especially MRSA, is increasing. Multi-drug resistant organisms are also emerging as a frequent cause of IE. Thus, in patients strongly suspected of having IE in patients with underlying heart disease, glycopeptides such as vancomycin combined with aminoglycosides should be considered, and if fever and positive blood cultures continue despite treatment with glycopeptides, a consideration of the use of new antibiotics may improve the treatment results.
Aminoglycosides ; Anti-Bacterial Agents ; Candida ; Child ; Citrobacter ; Endocarditis* ; Enterococcus ; Fever ; Glycopeptides ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Incidence ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Retrospective Studies ; Rheumatic Fever ; Staphylococcus ; Staphylococcus aureus ; Vancomycin

PURPOSE: In treating carcinoma of the esophagus, a gastric drainage procedure seems to be necessary with esophago gastrostomies because of the inevitable incidental bilateral truncal vagotomy which occurs during the esophagectomy. There are potential hazards with a pyloroplasty such as jeopardizing the blood supply to the mobilized stmach, shortening its length for substitution, leakage, dumping syndrome, and bile reflux gastritis. The aims of the study are to compare the postoperative outcome of patients with and without pyloroplasty after an esophagectomy for esophageal cancer, and to evaluate the necessity of pyloroplasty in the vagotomized intrathoracic stomach after esophageal surgery. METHODS: During the years 1996 to 2001, 23 patients with carcinoma of the esophagus underwent an esophagectomy followed by esophagogastrostomy with or without pyloroplasty. The medical records of the patients were evaluated retrospectively. RESULTS: There were no statiscally significant differences between the pyloroplasty group and the no-pyloroplasty group with regards to the average hospital stay, resumption of oral feeding, removal of the nasogastric tube, and the daily gastric drainage. CONCLUSION: Postoperative symptomatic evaluation of patients who had esophageal cancer and underwent an esoph-agectomy and an esophagogastrostomy, with or without pyloroplasty supports the concept that the drainage procedure is unnecessary in the gastric replacement of the esophagus.
Bile Reflux ; Drainage ; Dumping Syndrome ; Esophageal Neoplasms ; Esophagectomy* ; Esophagus* ; Gastritis ; Gastrostomy ; Humans ; Length of Stay ; Medical Records ; Retrospective Studies ; Stomach ; Vagotomy, Truncal

BACKGROUND AND OBJECTIVES: We tried to investigate the effectiveness of various methods of reinnervation including nerve-muscle pedicle transfer, nerve anastomosis, nerve implantation. MATERIALS AND METHOD: Forty Sprague-Dawley rats were used. Control group and experimental groups each consisted 5 rats, as follows: a denervated tibial nerve without reinnervation (control), a common peroneal nerve and 2X2 mm tibialis anterior muscle pedicle grafted to the denervated gastrocnemius muscle after the removal of epimysium (group I), a common peroneal nerve and 4X4 mm tibialis anterior muscle pedicle grafted to the denervated gastrocnemius muscle after the removal of epimysium (group II), a common peroneal nerve and 2X2 mm tibialis anterior muscle pedicle grafted to the denervated gastrocnemius muscle after removal of epimysium and part of muscle (group III), a common peroneal nerve and 4X4 mm tibialis anterior muscle pedicle grafted to the denervated gastrocnemius muscle after removal of epimysium and part of muscle (group IV), a common peroneal nerve and 2X2 mm tibialis anterior muscle pedicle inserted to the denervated gastrocnemius muscle (group V), a common peroneal nerve inserted to the denervated gastrocnemius muscle (group VI), and anastomesed common peroneal nerve to distal tibialis nerve (group VII). Electromyography, muscle contraction power study, histotological analysis and counting of motor end-plate were applied for estimating the reinnervation of denervated muscle. RESULTS: In motor nerve conduction studies, Group VII and III showed significantly higher amplitude of the compound muscle action potentials than other groups. In muscle contraction power studies, Group VII and III showed significantly powerful contraction. In histological analysis, group VII and III showed less muscle atrophy. The motor end-plate count was more in the groups VII, III, I, V, VI, II and IV in order. CONCLUSION: Nerve anastomosis and 2X2 mm nerve-muscle pedicle transfer showed more successful regeneration of denervated muscle than other reinnervation methods including nerve implantation.
Action Potentials ; Animals ; Electromyography ; Motor Endplate ; Muscle Contraction ; Muscle, Skeletal* ; Muscular Atrophy ; Nerve Transfer ; Neural Conduction ; Peroneal Nerve ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Tibial Nerve ; Transplants

Purpose: The aim of this study was to analyze the perioperative complications and oncological outcomes of radical prostatectomy (RP) in patients who underwent multiple prostate biopsies.
Materials and Methods: A total of 1,112 patients who underwent RP between January 2009 and April 2016 at 4 different centers were included in this study. We divided these patients into 2 groups: patients who underwent only 1st biopsy, and those who underwent 2nd or more repeated biopsies. The association between the number of prior biopsies and perioperative complications and biochemical recurrence (BCR) was analyzed.
Results: Of 1,112 patients, 1,046 patients (94.1%) underwent only 1st biopsy, and 66 (5.9%) underwent 2nd or more repeated biopsies. There were no significant differences in preoperative prostate-specific antigen levels, operation times, blood loss volumes, or hospital stay durations (all p＞0.05). Patients who underwent multiple prostate biopsies presented with a localized tumor significantly more often (p＜0.05). The Gleason score and rate of positive surgical margins were significantly lower in patients with multiple biopsies (all p＜0.05). The Cox proportional hazards model analysis indicated that there was no association between the number of prior prostate biopsies and BCR (p＞0.05). Kaplan-Meier curve analysis indicated that BCR-free survival rates between the 2 groups were similar (p＞0.05).
Conclusions Multiple prostate biopsies are not associated with an increased risk of perioperative complications, adverse pathological outcomes, or higher rates of BCR in patients who have undergone RP. (Korean J Urol Oncol 2020;18:24-31)

No abstract available.
Child* ; Humans ; Korea* ; Myocarditis* ; Rheumatic Fever*