No abstract available.
Humans ; Spondylolisthesis*

No abstract available.
Hand*

No abstract available.
Cerebral Hemorrhage* ; Mucormycosis*

The goals of the reduction mammoplasty are to reduce the volume of the breast, to create aesthetic shape that is stable over time, to maintain blood supply and innervation to the nipple-areolar complex, and to make fine limited scars. There are 3 rationales in our reduction mammoplasty. To reduce the scar, we perform the periareolar incision. To make effective reduction of the breast volume, and to preserve blood supply and innervation to the nipple-areolar complex, we use a central or an inferior pedicle technique. To prevent areolar widening, we use a purse-string suture. We performed the periareolar reduction mammoplasty to 36 breasts in 18 patients from Jul. 1998 to Jun. 2000. The mean follow up period was 8 months. The mean age was 41 and mean resection amount was 420 gm per breast. Most patients satisfied with their fine periareolar scars, adequate size of breasts and the innervation of the nipple-areolar complex. We applied this procedure to all kinds of macrostomia. The greatest advantage of the periareolar reduction mammoplasty is the inconspicuous limited scar. Other advantages over conventional technique include preservation of sensitivity to the nipple-areolar complex and shorter operative time. As disadvantages, 10 breasts(28%) showed areolar widening. In 8 of 10 breasts with areolar widening, purse-string suture was not applied in the skin flap margin of the outer circle and reoperation was executed to reduce the areolar size by excision of the widened areola. The application of the purse-string suture was carried out in 6 breasts. Two breasts with purse-string suture showed areolar widening possibly due to loosening of the purse-string suture knot. There were persistent periareolar wrinkles in 4 breasts and poor sensitivity to the nipple-areolar complex in 6 breasts in which more than 500 gm of breast tissue per breast was resected. Periareolar reduction mammoplasty is optimal for patients who require reduction of lesser than 500 grams per breast. In the severe macromastia with or without ptosis, inverted T-incision is preferable to the periareolar incision, and periareolar incision can be modified by adding wedge resection of the outer excess skin flap inferiorly which results in a periareolar and vertical scar below the nipple-areolar complex.
Breast ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Macrostomia ; Mammaplasty* ; Operative Time ; Reoperation ; Skin ; Sutures

OBJECTIVE: This study was to compare the characteristics between parthenogenetic mES (P-mES) cells and in vitro fertilization mES cells. MATERIAL AND METHODS: Mouse oocytes were recovered from superovulated 4 wks hybrid F1 (C57BL/6xCBA/N) female mice. For parthenogenetic activation, oocytes were treated with 7% ethanol for 5 min and 5microgram/ml cytochalasin-B for 4 h. For IVF, oocytes were inseminated with epididymal perm of hybrid F1 male mice(1x106/ml). IVF and parthenogenetic embryos were cultured in M16 medium for 4 days. Cell number count of blastocysts in those two groups was taken by differential labelling using propidium iodide (red) and bisbenzimide (blue). To establish ES cells, blastocysts in IVF and parthenogenetic groups were treated by immunosurgery and recovered inner cell mass (ICM) cells were cultured in LIF added ES culture medium. To identity ES cells, the surface markers alkaline phosphatase, SSEA-1, 3, 4 and Oct4 staining were examined in replated ICM colonies. Chromosome numbers in P-mES and mES were checked. Also, in vitro differentiation potential of P-mES and mES was examined. RESULTS: Although the cleavage rate (> or =2-cell) was not different between IVF (76.3%) and parthenogenetic group (67.0%), in vitro development rate was significantly low in parthenogenetic group (24.0%) than IVF group (68.4%) (p<0.05). Cell number count of ICM and total cell in parthenogenetic blastocysts (9.6+/-3.1, 35.1+/-5.2) were significantly lower than those of IVF blastocysts (19.5+/-4.7, 63.2+/-13.0) (p<0.05). Through the serial treatment procedure such as immunosurgery, plating of ICM and colony formation, two ICM colonies in IVF group (mES, 10.0%) and three ICM colonies (P-mES, 42.9%) in parthenogenetic group were able to culture for extended duration (25 and 20 passages, respectively). Using surface markers, alkaline phosphatase, SSEA-1 and Oct4 in P-mES and mES colony were positively stained. The number of chromosome was normal in ES colony from two groups. Also, in vitro neural and cardiac differentiation derived from mES or P-mES cells was confirmed. CONCLUSION: This study suggested that P-mES cells can be successfully established and that those cell lines have similar characteristics to mES cells.
Alkaline Phosphatase ; Animals ; Antigens, CD15 ; Bisbenzimidazole ; Blastocyst ; Cell Count ; Cell Line ; Embryonic Stem Cells* ; Embryonic Structures ; Ethanol ; Female ; Fertilization in Vitro* ; Humans ; Male ; Mice* ; Oocytes ; Propidium

OBJECTIVE: Despite increased survival in patients with cardiac arrest, it remains difficult to determine patient prognosis at the early stage. This study evaluated the prognosis of cardiac arrest patients using brain injury, inflammation, cardiovascular ischemic events, and coagulation/fibrinolysis markers collected 24, 48, and 72 hours after return of spontaneous circulation (ROSC).METHODS: From January 2011 to December 2016, we retrospectively observed patients who underwent therapeutic hypothermia. Blood samples were collected immediately and 24, 48, and 72 hours after ROSC. Neuron-specific enolase (NSE), S100-B protein, procalcitonin, troponin I, creatine kinase-MB, pro-brain natriuretic protein, D-dimer, fibrin degradation product, antithrombin-III, fibrinogen, and lactate levels were measured. Prognosis was evaluated using Glasgow-Pittsburgh cerebral performance categories and the predictive accuracy of each marker was evaluated. The secondary outcome was whether the presence of multiple markers improved prediction accuracy.RESULTS: A total of 102 patients were included in the study: 39 with good neurologic outcomes and 63 with poor neurologic outcomes. The mean NSE level of good outcomes measured 72 hours after ROSC was 18.50 ng/mL. The area under the curve calculated on receiver operating characteristic analysis was 0.92, which showed the best predictive power among all markers included in the study analysis. The relative integrated discrimination improvement and category-free net reclassification improvement models showed no improvement in prognostic value when combined with all other markers and NSE (72 hours).CONCLUSION: Although biomarker combinations did not improve prognostic accuracy, NSE (72 hours) showed the best predictive power for neurological prognosis in patients who received therapeutic hypothermia.
Biomarkers ; Brain Injuries ; Creatine ; Discrimination (Psychology) ; Fibrin ; Fibrinogen ; Heart Arrest ; Humans ; Hypothermia, Induced ; Inflammation ; Lactic Acid ; Phosphopyruvate Hydratase ; Prognosis ; Retrospective Studies ; ROC Curve ; Troponin I

The purpose of this study was to evaluate the influence of different types of PLGA scaffolds on the formation of human auricular and septal cartilages. The scaffolds were formed in tubular shape from 110,000 g/mol PLGA (poly lactic glycolic acid) and 220,000 g/mol one. Elastic cartilage was taken from the ear of a patient aged under 20 years old and hyaline cartilage from the nasal septum. The chondrocytes cells were then isolated by Klausburn method. After second passages, the chondrocytes were seeded on the PLGA scaffolds followed by in vitro culture for one week. The cells-PLGA scaffold complex was implanted at the back of nude mouses for 8 weeks. The tissue engineered cartilages were separated from nude mouse and examined histologically after staining with the Hematoxylin Eosin and Verhoeff. The formation of extracellular matrix and the porosity of the scaffolds were examined by scanning electron microscopy. The pores were well formed and uniformly distributed in both 110,000 g/mol and 220,000 g/mol PLGA scaffolds. The extracellular matrix was formed better in 110,000 g/mol PLGA compared to 220,000 g/mol one. And hyaline cartilage was proliferated better in vitro culture than elastic cartilage. After 8 weeks in vivo culture, cartilage was well formed with 110,000 g/mol PLGA, however lumen was collapsed. In contrast with 220,000 g/mol PLGA scaffold, neocartilage was formed in minimal amount while the architecture of scaffold was well preserved. Elastic cartilage seems to be better than hyaline one in terms of neocartilage formation. From the analysis after Verhoeff staining the cartilages, the neocartilage from elastic cartilage was proved to be elastic cartilage. In summary, there was no significant difference between elastic cartilage and hyaline cartilage in their morphologies, proliferation rates and the degree of cartilage formation since they were tissue engineered, however marked difference was found in neocartilage formation and preservation of scaffold architecture between 110,000 g/mol PLGA scaffold and 220,000 one. From the present findings, it is concluded that the influence of scaffold materials is significantly higher than that of different types of cells on the formation of new tissues.
Animals ; Cartilage* ; Chondrocytes* ; Ear ; Elastic Cartilage ; Eosine Yellowish-(YS) ; Extracellular Matrix ; Hematoxylin ; Humans* ; Hyalin* ; Hyaline Cartilage ; Mice ; Mice, Nude ; Microscopy, Electron, Scanning ; Nasal Septum ; Porosity ; Young Adult

We treated a total of 4 patients with midfacial hypoplasia, aged 12 to 19 years, using distraction osteogenesis between January 1998 and June 1999. In 3 patients with severe maxillary hypoplasia, we used rigid external distraction device developed by Dr. Polley. The distraction was performed from 5 days after Le Fort I osteotomy at a rate of 1 mm/day for 10 to 15 days. After distraction was completed, the device was left in place for another 6 weeks for bony consolidation. And then, an orthodontic face mask was used with elastic traction for 2 months. In one patient with partial hypoplasia of the midface, the osteotomized zygoma and a part of the maxilla was distracted selectively using rigid external distraction device a total of 15 mm. In the degree of SNA, mean value improved from 75.0(75.5, 75.0, 74.5) to 81.8(81.5, 83.0, 81.0) after 6 months later. In relapse rate, distracted length decreased from 10 mm to 6 mm, 15 mm to 8 mm, 13mm to 7 mm at 6 months later resulting in relapse rate of 44.3%. The follow-up period was from 7 to 26 months. Advantages of rigid external distraction device are highly effective technique of maxillary distraction, easy control of vector of distraction and no additional surgical procedure for removal of the device. In conclusion, the external distraction device is very useful for midface distraction.
Follow-Up Studies ; Humans ; Masks ; Maxilla ; Osteogenesis, Distraction ; Osteotomy ; Recurrence ; Traction ; Zygoma

We treated 9 patients with hemifacial microsomia or facial asymmetry between April 1998 and November 1999. The age of patients ranged from 21 to 45 years(mean 24.6). Six were women, 3 were men. The follow up period was 6 to 24 months(mean 15.3 months). The operative procedure was based on the Ortiz Monasterio's simultaneous mandibuiar and maxillary distraction technique. Ortiz Monasterio only freed the pterygomaxillay junction of the affected side, leaving the nasal septum and pterygomaxillary junction of the unaffected side intact. They also used external corticotomy on mandible. We modified the original Ortiz Monasterio's method by using complete Le Fort I osteotomy with complete separation of both pterygomaxillary junction and mandibular osteotomy to avoid the resistance during the distraction. In one patient of scleroderma with severe atrophy of the mandible and soft tissue on the right face, a free scapular osteocutaneous flap was done. One month later, simultaneous distraction of the maxilla, the transferred scapula bone and the mandible was performed. Among the 9 patients, bidirectional distraction was done in one patient, and intraoral device was applied in 3 patients. After 5 days of latent period, distraction was performed at a rate of 1 mm per day. After 6 to 8 weeks of consolidation period, intermaxillary fixation and distraction device were removed. Preoperatively, the deviation of occlusal plane ranged from 8 to 13 (mean 10.5 ). The length of distraction ranged from 7 mm to 20 mm(mean 13 mm). In 2 patients, there were radiologic evidences of relapse 6 months after distraction, but no significant change of facial appearance was found. Seven patients have maintained stable preoperative occlusion of of teeth as previous conditions and preoperative lateral open bite was improved postoperatively in 2 patients. Postoperative occlusal plane ranged from 0 to 1.
Adult* ; Atrophy ; Dental Occlusion ; Facial Asymmetry* ; Female ; Follow-Up Studies ; Goldenhar Syndrome ; Humans ; Male ; Mandible ; Mandibular Osteotomy ; Maxilla ; Nasal Septum ; Open Bite ; Osteotomy ; Recurrence ; Scapula ; Surgical Procedures, Operative ; Tooth

PURPOSE: The purpose of this study was to investigate the value of the alveolar-arterial (A-a) oxygen gradient for patients with community-acquired pneumonia (CAP) in the emergency department (ED). METHODS: A prospective study of patients with CAP in the ED was performed. Patients with clinical and a radiographic diagnosis of CAP were enrolled. Inflammatory biomarkers, such as WBC (white blood cell) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and A-a oxygen gradient were measured. The severity of CAP was assessed by three prediction rules: The Pneumonia Severity Index (PSI), CURB65 (confusion, blood urea nitrogen, respiratory rate, blood pressure and age> or =65 yrs), and the Infectious Disease Society of America (IDSA) and American Thoracic Society (ATS) rules. The value of each biomarker (WBC, CRP, ESR) and A-a oxygen gradient for the prediction of mortality and CAP severity were assessed. RESULTS: A total of 126 patients with CAP were included. Sixteen patients, older and in the high-risk group, died within 30 days. Non-survivors had a significantly increased A-a oxygen gradient compared to survivors (91.20 vs. 46.71 mmHg, respectively; p<.01) and a high-sensitivity to C-reactive protein (158.57 vs. 91.28 mg/dL, respectively; p<.01). The median A-a oxygen gradient was significantly higher with severe disease based on the three prediction rules. In regression logistic analyses, the area under the receiver operating characteristic curve of the alveolar-arterial oxygen gradient was 0.807(95% confidence interval, 0.727-0.872). The addition of A-a oxygen gradient to the three prediction rules significantly increased the area under the receiver operating characteristic curve. CONCLUSION: These results suggest that A-a oxygen gradient is useful for the prediction of mortality and disease severity among CAP patients in the ED. The A-a oxygen gradient, as an adjunct to CAP prediction rules, may be worth while for the assessment of prognosis and severity.
Americas ; Biomarkers ; Blood Pressure ; Blood Sedimentation ; Blood Urea Nitrogen ; C-Reactive Protein ; Communicable Diseases ; Diagnosis ; Emergencies ; Humans ; Mortality ; Oxygen* ; Pneumonia* ; Prognosis ; Prospective Studies ; Respiratory Rate ; ROC Curve ; Survivors