Dentocutaneous fistula of the face neck is an infrequent manifestation of chronic dental infection. A periapical dental abscess may be initiated by disease, trauma, or thermal or chemical injury and develops into an extensive necrosis of surrounding tissue. Diagnostic errors can result in multiple excision, biopsies, and ineffective long-term antibiotic therapy. Awarness that periapical dental abscess is the most common etilolgic factor of cutaneous sinus tracts involves the face & neck will facilitate their early diagnosis and prevent needless treatment or anxiety for the patient. From 1994 to 1998, we have performed 6 cases of dentocutaneous fistula. Among of them, three were men and the others were women, age ranged from 18 to 66-year-old, and morbidity period was from 3 weeks to 3 years, the follow-up period ranged from 5 to 18 months (mean period 11 months). In conclusion, an understanding of the pathogenesis of cutaneous fistulae arising from dental infections will lead to proper early diagnosis and treatment without unnecessary surgery.
Abscess ; Aged ; Anxiety ; Biopsy ; Cutaneous Fistula ; Diagnostic Errors ; Early Diagnosis ; Female ; Fistula* ; Follow-Up Studies ; Humans ; Male ; Neck ; Necrosis ; Unnecessary Procedures

BACKGROUND: Psoriasis is a disabling and intractable disease influencing the psychosocial life of the patients. Patients who are frustrated with orthodox medicine may explore alternative therapies. OBJECTIVE: This study was done to research on the actual condition of the use of alternative medicine in the patients with psoriasis. METHODS: A self-administered questionnaire was constructed, and was given to the patients to answer our questions. RESULTS: Among 128 patients with psoriasis, 61 (47.7%) reported previous use of one or more forms of alternative medicine. The absence of satisfactory long-term effects of physician-provided therapy was the main reason for patients trying alternative medicine. Persons without skin s disease and the mass media were the main sources of information on alternative medicine. CONCLUSION: Alternative therapies were widely utilized by subjects participating in this study, and dermatologists need to be aware of alternative treatments employed by their patients.
Complementary Therapies* ; Humans ; Mass Media ; Psoriasis* ; Skin

The proportion of human immunodeficiency virus (HIV) infected patients aged 50 and older has greatly increased since the beginning of the epidemic, particularly after the introduction of combination antiretroviral therapy. In Korea, 25% of those infected with HIV were older than 50 in 2009. Older untreated patients with HIV demonstrate faster rates of CD4 lymphocyte loss and more rapid progression to acquired immunodeficiency syndrome and death than younger individuals. Most studies have shown that compared with younger patients, patients over 50 generally have a slower immunologic response to antiretroviral therapy, despite a better virological response. Management of HIV infection in older patients is particularly complex, mainly because they are more likely to have co-morbidities necessitating specific medications that may interact with antiretroviral drugs. Patients living longer with HIV are more likely to develop diseases associated with aging, and at an earlier age, than those without HIV. These include dementia, coronary artery disease, dyslipidemia, metabolic syndrome, diabetes, and osteoporosis.
Acquired Immunodeficiency Syndrome ; Aged ; Aging ; Coronary Artery Disease ; Dementia ; Dyslipidemias ; HIV ; HIV Infections ; Humans ; Korea ; Lymphocytes ; Osteoporosis

Microsatellite mutator phenotype (MMP) tumors were reported in a subset of gastrointestinal carcinomas. The molecular pathogenesis of MMP tumors shows defects in the DNA mismatch repair genes, and also many germline and somatic mutations were reported in the MMP tumors. However, the detection of genetic defects in the MMP tumors is very difficult, mainly because many genes are included in the DNA mismatch repair genes. This study was undertaken to determine the best strategy for detecting defects in the DNA mismatch repair genes in gastrointestinal carcinomas. One of the effective ways for detecting defects in DNA mismatch repair genes is to screen the MMP tumors and evaluate the products of DNA mismatch repair genes by performing the multiplex RT-PCR method. We have screened the MMP tumors by using 5 microsatellite markers in the 12 cancer cell lines, 120 colon carcinomas and 99 gastric carcinomas and found 6 MMP cell lines, 10 MMP colon cancers, and 9 MMP gastric carcinomas. In addition, we evaluated 6 DNA mismatch repair gene products (hMSH2, hMSH3, hMSH6, hMLH1, hPMS1 and hPMS2) by multiplex RT-PCR analysis and found decreased expression of the DNA mismatch repair genes in 5 (hMSH6 in DLD-1 and HCT-15; hMSH2 in LoVo; hMLH1 and hMSH3 in HCT-116; hMLH1 in SNU-638) out of 6 MMP cell lines. We also found a decreased expression of hMLH1 in 3 out of 10 MMP colon carcinomas, and in 6 out of 9 MMP gastric carcinomas. Our results indicate that the expression analysis of the DNA mismatch repair genes by multiplex RT-PCR method can reduce the number of genes subjected to mutational analysis and is convenient for screening the responsible DNA mismatch repair genes.
Cell Line ; Colon ; Colonic Neoplasms ; DNA Mismatch Repair* ; DNA* ; Mass Screening ; Microsatellite Repeats* ; Phenotype*

The symptoms and signs of acute pulmonary arteries thrombosis are nonspecific. So clinical suspicion is the most important in the diagnosis. Treatment of pulmonary thromboembolism include anticoagulant, thrombolytic agent, or surgical intervention. We experienced a case of recurrent pulmonary thromboembolism without coagulation defect and any risk factor except old age and obese. Initially we treated with heparin, but clinical symptoms were aggravated. After we changed to urokinase (total 330 million IU/2 days), the pulmonary arteries obstruction were resolved and clinical symptoms were improved without any complications. So we report this clinical experience with review of articles.
Diagnosis ; Heparin ; Pulmonary Artery ; Pulmonary Embolism* ; Risk Factors ; Thrombosis ; Urokinase-Type Plasminogen Activator*

The purpose of this study is to investigate the effect of nerve regeneration to island flap vascularity after crushing injury to pedicle nerve. A total of 40 adult male Sprague Dawley rats (200-250 gm) were used and divided into 4 groups (n = 10). Two inferior epigastric island flaps were elevated including panniculus carnosus on each rat: one retained innervation (control); the other was denervation by crushing injury to superficial epigastric nerve. After the flap elevation, vascularity of the flap was checked by laser doppler at superficial epigastric artery. Group 1 was vascularity of the flap after 1 day, group 2 after 3days, group 3 after 5 days, group 4 after 7 days. Under light and electron microscope, histologic changes were compared. In conclusion, our experimental study proved that vascularity of the epigastric island flap was slowly decreased with histologic findings of nerve regeneration. Denervated flap had more vascularity than other groups by 7 days. This study appears to be a valid one which treatment and post operative care of very small island flap such as distal finger tip amputation (Zone I level).
Adult ; Amputation ; Animals ; Denervation ; Epigastric Arteries ; Fingers ; Humans ; Male ; Nerve Regeneration* ; Rats ; Rats, Sprague-Dawley ; Surgical Flaps

OBJECTIVES: This study aims to examine the possible reasons of unmet dental need, considering the relationship between the socioeconomic and oral health status in Korea. METHODS: The study was designed as a cross-sectional study, using the data of the 4th Korea National Health and Nutritional Examination Survey. The samples were selected with a stratified clusters sampling method. The subjects were 8,808 out of 23,478 people, which participated in the health examination survey and the oral examination. Statistical analysis was conducted using SPSS18.0, according to complex sampling design. 26 variables reflecting demographic, social and economic characteristics, and an oral health status, were all examined for a complex sampling frequency analysis. Further, their distributional differences were confirmed by chi-square analysis. RESULTS: About 40% of the subjects failed to receive dental treatment when it was required. 'Financial burden' was the main reason, with the percentage of 39.1%, followed by 'busy with school or work' (22.4%), 'lower on the priority scale' (15.2%) and 'fear of dental treatment' (12.1%). 'Other reasons' were 5.9%. In addition to this, 2.9% of the subjects stated 'there was no one to help with their children', 1.6% was 'dental clinics were too far to go' and 0.8% was due to 'poor mobility and other health problems'. It was observed that younger than 6 years old, especially, seemed to have a high level of fear of dental treatment. The students due to school and the elderly were concerned with financial burden. Moreover, low-level educated and low-level income, also have their financial problems as the main reason. On the other hand, highly educated and those that were better-off, financially, were 'busy with school or work' as the main reason. CONCLUSIONS: The primary reason for unmet dental need was the financial burden in Korea. Also, it was confirmed that there were various reasons, according to the demographic, social and economic characteristics, such as their age, education levels and incomes, rather than oral health status.
Aged ; Cross-Sectional Studies ; Diagnosis, Oral ; Hand ; Humans ; Korea ; Oral Health ; Social Class

We experienced a case of cutis marmorata telangiectatica congenita in a 2-year-old girl. The patient had reddish to violet reticulated patches with telangiectasia on the left leg and left side of trunk since birth. The circumference of the affected leg was decreased. No other associated anomalies were found on physical and X-ray examinations. The skin biopsy revealed dilatation and proliferation of capillaries with mild perivascular inflammatory cell infiltration in all layers of the dermis and subcutaneous fat.
Biopsy ; Capillaries ; Child, Preschool ; Dermis ; Dilatation ; Female ; Humans ; Leg ; Parturition ; Skin ; Subcutaneous Fat ; Telangiectasis ; Viola

Lower lip defects can result from congenital or acquired problems, such as congenital naevi, hemangioma, tumor, trauma and infectious disease. The principal function of the lip is oral competence. The lips also play a role in deglutition and articulation, as well as being a symbol of beauty and appeal. Defects of up to one third of the lower lip can be closed primarily, but large defects require more complex techniques including distant and free flap reconstruction that have been used with varying degrees of aesthetic and functional success. The authors experienced 10 cases of lower lip reconstruction from July 2002 to March 2003 using V-Y advancement local flap, Abbe flap, double barrel type flap, depressor anguli oris musculocutaneous flap, gracilis musculocutaneous free flap and fibular osteocutaneous free flap combined with forearm fasciocutaneous free flap. The mean age of the patients, 6 males and 4 females, at the time of the procedures was 64.4 years (from 56 to 74 years). Based on our experience, local flap was the best choice for small lower lip defects. However large and total lip defects that do not have normal adjacent tissues required free flap. The disadvantages of the free flap were bulkiness, bad color change, and drooping of the flap. In conclusion, analyzing the results of the various flap surgeries, we could identify the advantages and disadvantages of each type of flaps, which will help us to create the proper method of lower lip reconstruction.
Beauty ; Communicable Diseases ; Deglutition ; Female ; Forearm ; Free Tissue Flaps ; Hemangioma ; Humans ; Lip* ; Male ; Mental Competency ; Myocutaneous Flap

BACKGROUND: Modern physicians' role as a model is very important in advocating health promoting behaviors for their patients. In this study, we compared health promoting behaviors and corresponding health perceptions between law students and medical students with evaluation of the association between health promoting behaviors and corresponding health perceptions. METHODS: The data of this survey, conducted among law students and medical students attending a university in a metropolitan city in June, 2004, were collected by self-administered questionnaire based on FANTASTIC lifestyle checklist adjusted to reflect Korean circumstances. RESULTS: Qestionnaires from 74 law students and 136 medical students were analysed. The medical students showed better health behaviors in terms of fastening seatbelt, leisure time, sleep, and salt intake reduction. The medical students showed better health perceptions in terms of exercise, activity, body weight, animal fat and salt intake reduction, smoking cessation. The law students showed better perceptions in being impatient. Significant association between health behavior and health perception was observed in relationship with family and friends, exercise, activity, breakfast, reduced intake animal fat, smoking cessation, reduced drug and drinking habits, sleep, fastening seatbelt, regular physical exam, positive thought, and school satisfaction in the law students. In the medical students, significant association was observed in relationship with family and friends, exercise, breakfast, reduced drinking, sleep, fastening seatbelt, coping skills for stress, regular physical exam, and positive thought. CONCLUSION: Even though the medical students were more concerned about and engaged in some health promoting behaviors, other factors affecting medical students' health promoting behaviors than health perception should be addressed further.
Adaptation, Psychological ; Animals ; Body Weight ; Breakfast ; Checklist ; Drinking ; Friends ; Health Behavior* ; Health Promotion ; Humans ; Jurisprudence* ; Leisure Activities ; Life Style ; Physician's Role ; Smoking Cessation ; Students, Medical ; Surveys and Questionnaires