Access to the craniofacial skeleton and skull base requires osteotomies. An adequate exposure of neoplasms occupying the skull base and the oral cavity and oropharynx, especially retromolar trigone, is very important for precise tumor ablation. The demonstration by Tessier of the capacity for large segments of bone to survive removal and replacement has enabled skull base tumor surgery to grow into a subspeciality. Through the refined craniofacial exposure osteotomies, the surgery is safer, the operation shorter, and the result better both oncologically and reconstructively. We experienced 24 cases of exposure osteotomies consisting of 12 cases transzygomatic approaches, 1 case tranglabellar osteotomy, 1 case lateral transmaxillary approach, 1 case Le Fort II & midline splitting, and 9 cases mandibulotomy. There was no significant complication except a local wound infection in transzygomatic approach and one case of minimal malocclusion after parasymphyseal mandibulotomy. The orthotopic bone graft and the rigid fixation enables the postoperative morbidity to decrease. It seems that the previously inaccessible craniofacial tumors can be treated through the various exposure osteotomies.
Malocclusion ; Mouth ; Oropharynx ; Osteotomy* ; Skeleton ; Skull Base ; Transplants ; Wound Infection

In view of the potential of replicase protein as a diagnostic reagent for human caliciviruses (HuCVs), we have cloned and over-expressed this gene from the Snow Mountain-like Korean strains in Escherichia coli as a fusion protein with glutathione S-transferase (GST, and described the preliminary antigenic characterization of the recombinant products. Each 470bp fragment corresponding to highly conserved region of RNA-dependent RNA polymerase was generated by RT-PCR from stools of two diarrheal children, cloned in pMOSBlue T-vector, and subcloned between the EcoRI and SalI restriction sites of pGEX-47-3, a GST gene fusion vector, yielding pGCVpol. This construct expressed a Snow Mountain-like HuCV replicate under the control of the IPTG-inducible pac promoter. An extract prepared by sonication of the E. coli cell inclusion bodies bearing pGCVpol products was purified and analyzed by SDS-PAGE. After Coomassie blue staining, it was shown that the recombinant replicase migrated on the gels with an approximate molecular mass of 46.5 kDa, that was subsequently cleaved into a 26 kDa GST fragment and a 20.5 kDa replicase protein upon digestion with thrombin protease. The replicase was recognized on immunoblotting with the sera from symptomatic children with the HuCV-associated diarrhea but not by asymptomatic sera from adults. The results presented the first biological activity of individually expressed HuCV replicase subunit and provided important reagents for diagnosis of HuCV infection.
Adult ; Child ; Clone Cells ; Diagnosis ; Diarrhea ; Digestion ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; Gels ; Gene Fusion ; Glutathione Transferase ; Humans ; Immunoblotting ; Inclusion Bodies ; Indicators and Reagents ; RNA Replicase ; Snow* ; Sonication ; Staphylococcal Protein A ; Thrombin

The therapeutie efficacy of ranitidine was evaluated itn 48 in- and out- patients with endoscopically diagnosed 18 cases of gaetric ulcer and 30 casea of ducnienal ulcer. In the open study, every pabenta was treated with ranitidine 150 mg b.i.d. for 4 weeks, and waa followed up by gastroscopy after 4 weeks of the treatment. The reeults obtained were summarized as follows; 1) 15 out of 18 cases (83. 3%) of gastric ulcers and 26 out of 30 cases (86. 7%) of duodenal ulcers had been completely healed up in 4 weeks. 2) There was a significant relationship between healing of ulcer and the relief of symptoms (x =6.12, P<0.005).3) There were no significant untoward reactions, efther subjective or objective, to the administration of the drug, except one case of severe epigastic discomfort. In conclusion ranitidine appears to be fairy effective and safe for the treatment of patient with peptic ulcr diseases.
Duodenal Ulcer ; Gastroscopy ; Humans ; Peptic Ulcer* ; Ranitidine* ; Stomach Ulcer ; Ulcer

No abstract available.
Seasonal Affective Disorder* ; Seasons*

Patients with severe congestive heart failure due to rheumatic heart disease generally have both reduced cardiac output and increased pulmonary and systemic venous pressures. A study was therefore made of the use of vasodilator therapy with orally administered hydralazine, which acts on arteriolar resistance vessels and thus reduces afterload. 55 children aged from 4 years old to 15 year old were divided into two groups. Group I received oral hydralazine(4mg/kg/kay in 4 divided doses) in addition to digoxin therapy for mean duration of 10.5 months. Group II received oral digoxin only. The hemodynamic results using M-mode echocardiography, chest X-ray, and EKG between two groups were analyzed. 1) 4(78%) of 55 patients had only mitral valve involvement and another 12 patients had double valve involvement and all the patients belonged to functional class III or IV fo New York heart Association. 2) Left venticular end-diastolic dimensions and the height of R in V6 on EKG were not changed significantly in both groups. 3) Shortening fraction, LPEP/LVET, and RPEP/RVET were markedly improved in both groups, but the degree of improvement in group I was more significant than in group II. 4) 21(80%) of 26 patients in group I showed significant improvement in functional class(t=1.92, 0.05 Adolescent ; Cardiac Output ; Child* ; Child, Preschool ; Digoxin ; Echocardiography ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart ; Heart Failure* ; Hemodynamics ; Humans ; Hydralazine ; Mitral Valve ; Rheumatic Heart Disease ; Thorax ; Venous Pressure

BACKGROUND & PURPOSE: Of thalamic stroke syndrome, according to previous reports, the syndrome of hemiataxia and hemisensory loss (thalamic ataxia syndrome) is known to have localizing value confined to the lesion of posterolateral thalamus. And ataxia in thalamic ataxia syndrome is due to interruption of cerebellar outflow pathways. We observed the clinical characteristics of cerebellar manifestations in patients with thalamic ataxia syndrome to clarify intrathalamic cerebellar pathways because it is known that parts of cerebellar efferent fibers do not pass through the thalamus. METHODS: Ten patients with ataxia (5 men, 5 women ; mean age 64), out of 47 thalamic stroke patients admitted to Kyung Hee University Hospital from Jan. 1994 to May. 1995, were selected. The localization of the lesion was based on CT or MR imaging and ataxia was characterized in view of cerebellar functions - coordination of movement, regulation of equilibrium and muscle tone. RESULTS: Out of 10 patients, 4 patients were thalamic hematoma, 4 patients thalamic hematoma with intraventricular hemorrhage, 2 patients thalamic infarction. Four patients were hemiataxia-hemiparesis-hemisensory loss, 4 patients hemiataxia-hemisensory loss, 2 patients hemiataxia-hemiparesis. Posterolateral thalamus was involved in 4 patients, dorsal thalamus in 3 patients, posterolateral and dorsal thalamus in 3 patients. All patients had dysmetria, dysdiadochokinesia, kinetic tremor. Two patient has gait ataxia. Speech and ocular motility disturbances were not noted. CONCLUSION: Thalamic ataxia syndrome appeared in the lesion of posterolateral and dorsal thalamus. Common cerebellar manifestations symptoms of incoordination.
Ataxia* ; Cerebellar Ataxia ; Female ; Gait Ataxia ; Hematoma ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Stroke* ; Thalamus ; Tremor

Quantitative serial measurements of Alpha-fetoprotein (a-FP) and Beta-human chorionic gonadotropin (B-HCG) using radioimmunoassay were performed in a patient with recurrent non-germinomatous germ cell tumor (NGGCT) into CNS during radiotherapy and chemotherapy. When the pineal tumor was initially presented, elevated levels of serum a-FP and B-HCG fell dramatically to normal rage after the completion of cranial irradiation (5,060cGy). Three months later, the patient had a rise in serum and CSF tumor markers coincident with recurrence of tumor into lumbal spinal canal. Serum levels were not changed despite of 15 days of whole spine irradiation (2,000cGy) although decreased remarkably 1 month after the completion of radiotherapy (4,230cGy). At the time of relapse in the suprasella area and the cerebellopontine angle, serum and CSF levels rised again. As a result of two courses of chemotherapy the tumor markers fell markedly, but the tumor was spread to other sites into CNS. We conclude serial measurements of a-FP and B-HCG are useful for the diagnosis of the non-germinomatous germ cell tumor into CNS and for monitoring disease activity.
alpha-Fetoproteins ; Cerebellopontine Angle ; Chorionic Gonadotropin ; Cranial Irradiation ; Diagnosis ; Drug Therapy ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Pinealoma ; Radioimmunoassay ; Radiotherapy ; Rage ; Recurrence ; Spinal Canal ; Spine ; Biomarkers, Tumor*

Cardiac myxoma is a rare but potentially treatable cause of stroke. The diagnosis is rarely made on typical triad of constitutional, embolic, and obstructive symptoms, and it is difficult because there is no specific history, physical examination, chest X-ray, or electrocardiographic findings, but with the development of echocardiography the correct diagosis is now usualy made. Neurologic manifestation is frequent(25-45%) and presented with embolic infarction, aneurysm formation, intracranial hemorrhage, and distant metastasis. We experienced five patients with cardiac myxoma who presented with these neurologic manifestations. Also we should be considered in the differential diagnosis of cerebral infarction, particularly when multiple cerebral infarction and constitutional or obstructive symptoms are conjoined in young age stroke. We describe five patients who presented with embolic infarction, cerebral metastasis and aneurysm formation.
Aneurysm ; Cerebral Infarction ; Diagnosis ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Humans ; Infarction ; Intracranial Hemorrhages ; Myxoma* ; Neoplasm Metastasis ; Neurologic Manifestations* ; Physical Examination ; Stroke ; Thorax

Penile Horn occurs as a single or multiple lesions. It usually starts as warty growth that later becomes hyperkeratotic and assumes the appearance of a horn. A 22-year-old male patient was presented with a slow growing, asymptomatic, dark brownish colored, corn-shaped, protruding mass on prepuce of the penis for 5 months. Histopathologic finding showed verruca vulgaris. We think that penile horn in this case may be come from verruca vulgaris.
Animals ; Horns* ; Humans ; Male ; Penis ; Warts ; Young Adult

PURPOSE: High frequency oscillatory ventilation (HFOV) is used to support infants with severe respiratory failure unresponsive to conventional ventilation (CV). We reviewed chest radiographs before and after HFOV with clinical correlation in infants with respiratory distress syndrome (RDS). METHODS: Eighteen very low birth weight infants with RDS who had HFOV were included in this study. All patients were diagnosed as having RDS clinically and radiologically. Mean gestational age of infants was 27 weeks (range : 24-31 weeks). The mean duration of HFOV was 3 days (range : 14 hours-9 days). The chest radiographs of these infants within 3 hours before and after application of HFOV were retrospectively reviewed. Radiological findings based on aeration and parenchymal densities were classified into improved, no change, and progressed. Medical records were reviewed for FiO2 levels, clinical outcomes, complications, and causes of death. RESULTS: In 15 of 18 infants, aeration and parenchymal densities were improved and FiO2 levels were also improved after HFOV. Four of these 15 infants who showed improvement of radiological findings developed pneumothorax, sepsis, pulmonary or intestinal bleeding, and subsequently died. In remaining 3 infants in whom chest radiographs after HFOV showed no interval change or progression, oxygenation was also worsened and all died. CONCLUSION: Chest radiographs of HFOV-treated, very low birth weight infants showed improvement of aeration and parenchymal densities in most cases. Clinical outcome was good in infants who showed improvement on chest radiographs compared to those of progression group as far as there was no associated complication. Knowledge of radiological changes after HFOV will help in interpretation of chest radiographs in those HFOV-treated infants.
Cause of Death ; Gestational Age ; Hemorrhage ; Humans ; Infant* ; Infant, Very Low Birth Weight* ; Medical Records ; Oxygen ; Pneumothorax ; Radiography, Thoracic ; Respiratory Insufficiency ; Retrospective Studies ; Sepsis ; Ventilation*