No abstract available.
Cefazolin* ; Erythromycin* ; Latency Period (Psychology)* ; Membranes* ; Rupture*

No abstract available.
Latency Period (Psychology)* ; Osteogenesis, Distraction* ; Rabbits*

OBJECTIVE: In patients with hemorrhagic cavernous malformation(CMs) located in critical brain region that were thought to pose an excessive risk for microsurgical resection, Gamma Knife radiosurgery(GKRS) has been used as an alternative management option for these lesions. The purpose of this study is to evaluate the efficacy of GKRS for hemorrhagic CMs. METHODS: Among the patients of hemorrhagic CMs who had been treated by using Leksell Gamma Knife, 20 patients who had been followed up more than 2 years were analysed for their postradiosurgical results. RESULTS: Mean target volume was 3199mm3(224-9300mm3). Mean maximal dose was 28.9Gy(15-50Gy) and mean marginal dose was 16.5Gy(9-25Gy). 50% isodose or greater was used for the margins of the lesions. Mean follow-up period after GKRS was 51 months(24-112months). During the follow-up period, 3 patients suffered from rebleeding at 5, 6, and 28 months after radiosurgery, respectively. Two cases had a rebleeding in latency period(time interval from GKRS to its maximal effect on vascular obliteration, usually 2-4 years in case of CMs) and another one case after latency period. The annual rebleeding rate was 3.1%(first 2 years after radiosurgery 5%, thereafter 1.7%). Delayed radiation-induced complications occurred in 4 cases at 4, 7, 15 and 18 months after radiosurgery. CONCLUSION: The use of GKRS as an alternative management strategy to the hemorrhagic CMs which located in critical brain region and so had potential risk for microsurgical resection is thought to be available. And the GKRS would reduce the rate of rebleeding of CMs, especially after 2-3 years of latency periods.
Brain ; Follow-Up Studies ; Humans ; Latency Period (Psychology) ; Radiosurgery*

Alveolar bone graft has several benefits such as bony support to teeth adjacent to the cleft, bony matrix for eruption of teeth in the line of the cleft, stability of maxillary segments, and elimination of oronasal fistula. But wide gap alveolar cleft is difficult to treat using bone graft, because a large amount of bone harvesting is required and complete closure by using local attached gingiva is difficult to achieve. Therefore we introduced bilateral interdental distraction osteogenesis method to treat patients who had wide alveolar gap. From August, 1999 to April, 2000, we treated 4 patients of unilateral complete alveolar cleft(aged 10 - 4 years) by using this method. Distraction device was fitted to the supporting teeth. And then horizontal osteotomy was performed bilaterally at the level of 3 - 5 mm away from the dental roots, vertical osteotomy was performed between the second premolar and the first molar. Simultaneously, oronasal fistula was repaired. After the latency period of 3 to 5 days, we distracted bilateral distal segments as distraction protocol. After completing distraction, device was left for about 4 weeks before initiating the post-operative orthodontic treatment. The alveolar bone graft and buccal mucosa local flap were not required in these patients. By using interdental distraction osteogenesis, wide gap alveolar cleft was treated effectively.
Bicuspid ; Fistula ; Gingiva ; Humans ; Latency Period (Psychology) ; Molar ; Mouth Mucosa ; Osteogenesis, Distraction* ; Osteotomy ; Tooth ; Transplants

OBJECTIVE: To establish management strategy and to improve outcome of callosal arteriovenous malformations(AVMs), forty-six consecutive cases hospitalized from 1984 to 2001 are analyzed. METHODS: Clinical and radiologic files were reviewed. Average follow-up period was 20.3 months in microsurgery group, and 28.2 months in radiosurgery group. RESULTS: The resection rate of microsurgery was considered total in 12 patients(85.7% ), subtotal 2(14.3%). The final clinical outcome of microsurgery was good in 13 patients(92.8%), fair in 1(7.2%). One patient with splenial lesion had postoperative disconnection syndrome. Initial insults and hemodynamic complications were the major cause of an unfavorable outcome. In radiosurgery the complete regression of nidus was considered in 16 patients(51.6%), partial shrinkage in 13(41.9%), and no response in 2(6.5%). The clinical outcome of radiosurgery was good in 26 patients(83.9%), fair in 3(9.75%), and poor in 2(6.5%). Rebleeding during the latency period(3 patients), radiation necrosis(1 patients) and initial insults(1 patients) were the major cause of postradiosurgery morbidity. Rebleeding during the latency period occurred in 3 patients(9.7%). Two lesions were in the splenium, and one lesion in the body of corpus callosum. All lesions were larger than 3cm in diameter. Two of them occurred during the second year, and the rest one during the third year of latency period. CONCLUSION: Microsurgery, which eliminates the risk of bleeding immediately, is referred for callosal AVMs. Radiosurgery is another effective treatment modality for splenial lesions with large bridging veins that interfere with microsurgical approach, and combined endovascular treatment would be strongly recommended for the splenial lesions larger than 3cm in diameter that has higher risk of hemorrhage during the latency period.
Arteriovenous Malformations* ; Corpus Callosum ; Follow-Up Studies ; Hemodynamics ; Hemorrhage ; Humans ; Latency Period (Psychology) ; Microsurgery ; Radiosurgery ; Veins

Distraction osteogenesis(DO) is defined as a gradual mechanical process of mechanical stretching two vascularized bone surface apart with a critical rate and rhythm such that new bone forms within the expanding gap, reliably bridges the gap, and ultimately remodels to normal structure. DO has become a mainstay in bone tissue engineering and has significantly improved our armamentarium for reconstructive craniomaxillofacial procedures. But the molecular and biological mechanisms that regulate the formation of new bone during distraction osteogenesis are not completely understood. BMPs are potent osteoinductive agents. Our hypothesis was that BMPs, especially BMP-2 and BMP-4, might play an importent role in the signaling pathways that link the mechanical forces created by distraction to biological responses and in promting new bone formation. Using a rabbit's mandible, we investigated the expression of BMP-2, -4 at different time points during distraction osteogenesis. The purpose of this study is to research the pattern of expression of BMP-2, -4 in new bone formation during distraction osteogenesis of the rabbit mandible. The experimental group was applied gradual distraction (0.7mm a day by twice a day, 4.9mm in total, for 7 days) and the control group was carried out osteotomy alone. They were examined clinically, histologically, and by RT-PCR analysis. On 3 days after osteotomy, the high level of expression of BMP-2, -4 was detected. But, the expression of BMP-4 was decreased during latency period. As distraction was started, its expression was increased and maintained till postoperative 28days. In control group, the expression of BMP-4was remarkably decreased till postoperative 14 days. On the other hand, the expression of BMP-2 was no difference between experimental group and control group. The expression of BMP-4 was maintanined at high level during the entire experimental period in both group. These findings suggested that excellent bone formation during distraction osteogenesis is associated with enhanced expression of BMP-4 genes by mechanical tension stress.
Bone and Bones ; Hand ; Latency Period (Psychology) ; Mandible* ; Mechanical Processes ; Osteogenesis ; Osteogenesis, Distraction* ; Osteotomy

Cavernous malformation(CM) is one of the most common intracranial vascular anomaly. CM have dynamic lesion behavior and various clinical spectrum. Hemorrhagic risk and neurological disability seem to be related to multiple factors, including lesion location, age, gender, state of the reproductive cycle, and previous hemorrhage. Selecting the best treatment modality, each clinical scenario requires the proposal of a distinct management approach aimed at weighing the treatment risk against the best estimate of the cumulative natural risk. Management strategies include expectant follow-up in patients with asymptomatic or inaccessible lesions and microsurgical excision of symptomatic and accessible lesions. Radiosurgery could be applied for the progressively symptomatic lesions in inoperable locations, but the mortality and morbidity due to recurrent hemorrhage during latency period and radiation injury should be concerned.
Follow-Up Studies ; Hemorrhage ; Humans ; Latency Period (Psychology) ; Mortality ; Natural History ; Radiation Injuries ; Radiosurgery ; Risk Management

Dermatofibrosarcoma protuberans(DFSP) is an unusual, locally aggressive, cutaneous neoplasm of low grade malignancy. Several histologic variants have been described. Among them, fibrosarcomatous dermatofibrosarcoma protuberans is associated with a higher rate of local recurrence and distal metastases as well as a shorter latency period of time until recurrence than does ordinary DFSP. As a result, it needs more intense treatments and more vigorous follow up. A 37-year-old man presented with an asymptomatic erythematous hard nodule and several reddish papules on the chest for 2 years. Histopathologic examination revealed fibrosarcomatous dermatofibrosarcoma protuberans. We, herein, report an unusual case of fibrosarcomatous dermatofibrosarcoma protuberans.
Adult ; Dermatofibrosarcoma* ; Follow-Up Studies ; Humans ; Latency Period (Psychology) ; Neoplasm Metastasis ; Recurrence ; Thorax

PURPOSE: Paraffinoma is a granulomatous reaction to paraffin or oily substances. We report delayed diagnosis of paraffinoma that was misdiagnosed as chalazion. CASE SUMMARY: A 49-year-old male presented with masses, swelling, and erythema in the right lower eyelid, masses and swelling in the right upper eyelid, and intermittent conjunctival injection that had appeared 3 months ago. The patient admitted having received paraffin injection to the right lateral canthal area and nasal bridge for cosmetic purposes by non-medical personnel 17 years prior to presentation. The mass showed partial response to intralesional triamcinolone injection but did not respond to systemic steroid. CONCLUSIONS: Paraffinoma can present diagnostic confusion given its protracted latency period and discordance of injection area and mass location. Detailed history taking is required and the possibility of paraffinoma should be considered for mass lesions of the eyelid.
Chalazion* ; Delayed Diagnosis ; Erythema ; Eyelids* ; Humans ; Latency Period (Psychology) ; Male ; Middle Aged ; Paraffin ; Triamcinolone

Mandibular symphyseal distraction osteogenesis is an alternative approach for correcting mandibular transverse deficiencies and dental crowding. The traditional approaches for these are extraction of teeth and arch expansion with traditional orthodontic treatment. Also extractions are usually unavoidable in patients with severe crowding. The purpose of this study is to evaluate the effect of mandibular symphyseal distraction osteogenesis by use of tooth-borne expansion appliance. All of 12 patients had been performed distraction osteogenesis. The surgical procedures were accomplished under local anesthesia and intravenous sedation in an ambulatory surgical setting using a routine distraction protocol. The latency period was 5 days or 7 days after symphyseal osteotomies. The rate and rhyth is a intermittent, 0.75mm or 1.0 mm per day and stabilized for 6, 8 weeks after distraction. The time of orthodontic tooth movement after distraction was variable from 2 weeks to 8 weeks (mean 3 weeks). All patients had been evaluated with study casts, plain periapical films, panorama radiograms before and after surgery. Mandibular symphyseal distraction osteogenesis increased mandibular arch width and corrected dental crowding, with paralleling tooth-borne movement, without proclination of the mandibular incisors.
Anesthesia, Local ; Humans ; Incisor ; Latency Period (Psychology) ; Malocclusion ; Mandible* ; Osteogenesis, Distraction ; Osteotomy ; Tooth ; Tooth Movement