INTRODUCTION: To compare the change in frontal ramal inclination (FRI) in laterognathism after orthognathic surgery. MATERIALS AND METHODS: Twenty four patients (10 men, 14 women; mean age, 22.8+/-5.2 years) with minimal facial canting (< or =2 mm) and apparent menton deviation (5.9+/-2.4 mm) who had been operated on to correct facial asymmetry and skeletal CIII malocclusion, were selected. On a preoperative posteroanterior (PA) cephalogram, the FRI of the deviated side and non deviated side, L1 deviation amounts and menton deviation amounts were measured. The FRI differences between both sides were compared, and the correlations between the measured deviated elements and the FRI differences were analyzed. On a postoperative PA cephalogram, the shifting amount of L1, shifting amount of L7 and FRI of both sides were measured, and the correlations between the shifting elements and the change in FRI were analyzed. RESULTS: On the preoperative PA cephalogram, the FRI of the non deviated side was significantly greater than those of the deviated side. The differences in FRI, with a menton deviation amount showed a significant correlation. On the postoperative PA cephalogram, the FRI differences between the deviated and non deviated side were decreased significantly and mandibular transverse movement toward central position was noted. The mean shifting amounts of L7 were associated with the amount of change in the deviated side of FRI. CONCLUSION: Transverse shifting of the mandible through orthognathic surgery decreases the FRI difference, which showed laterognathism, and improves the facial contour.
Facial Asymmetry ; Humans ; Male ; Malocclusion ; Mandible ; Orthognathic Surgery

Lichen aureus is a variant of pigmented purpuric lichenoid dermatitis. The skin lesions usually appear asymptomatic rusty, copper, or orange colored roundish lichenoid erythematous-purpuric papules and patches on the lower extremities. Histologically, the epidermis shows minimal changes, with a dense lymphohistiocytic infiltrate observed in the superficial derrnis, typically distributed in a band-like fashion. The typical lesion is a single patch localized on the lower extremity. We report a rare case of segmental lichen aureus localized on the right lower extremity.
Citrus sinensis ; Copper ; Dermatitis ; Epidermis ; Lichens* ; Lower Extremity ; Skin

OBJECTIVES: Bok, Bcl-2-related ovarian killer, is a proapoptotic Bcl-2 family protein identified in the ovary based on its dimerization with the antiapoptotic protein Mcl-1. The present study examined the hormonal regulation and localization of Bok messenger RNA levels in the mouse ovary during the follicle development. METHODS: The animals were implanted subcutaneously with Silastic brand capsules containing the synthetic estrogen, DES at 21~23 days of age. Ovaries were collected 1~3 days after implantation for RNA analysis and in situ hybridization. Some mice were removed capsule for 1~2 days to induce ovarian follicle apoptosis. Ovaries were also collected from 26 day-old immature mice at various times after treatment with 10 iU PMSG. Some mice received a single intraperitoneal injection of 10 iU hCG to induce ovulation, and ovaries were obtained at different time intervals for Northern blot and in situ hybridization analysis, respectively. RESULTS: Treatment of immature mice with diethylstilbestrol (DES) for 24~48 h increased ovarian Bok mRNA levels. Bok mRNA was remained the same levels in mice removed DES for 24~48 h to induce apoptosis. High signals of Bok mRNA after DES treatment were detected in granulosa cells of early antral follicles. Treatment of immature mice with PMSG for 12 h increased markedly ovarian Bok mRNA expression which was detected mainly in preantral and atretic follicles. interestingly, low levels of Bok mRNA were also expressed in granulosa cells of preovulatory follicles. Treatment of PMSGprimed mice with hCG stimulated strongly ovarian Bok mRNA expression at 6~9 h. At that time, Bok mRNA was expressed in granulosa cells of atretic and small growing follicles. CONCLUSION: These results demonstrate that Bok is one of proapoptotic Bcl-2 members expressed in early growing and atretic follicles during the ovarian follicular development. Gonadotropins induce a transient increase of Bok gene expression in granulosa cells of preantral and preovulatory follicles indicating some role in the ovulatory process.
Animals ; Apoptosis ; Blotting, Northern ; Capsules ; Diethylstilbestrol ; Dimerization ; Estrogens ; Female ; Gene Expression ; Gonadotropins ; Granulosa Cells ; Humans ; In Situ Hybridization ; Injections, Intraperitoneal ; Mice* ; Ovarian Follicle ; Ovary* ; Ovulation ; RNA ; RNA, Messenger

The rectal prolapse syndome is a disease entity includes rectocele and rectal prolapse, presenting prolapse(procidentia) of rectum. In rectocele, rectum is prolapsed anteriorly into the vagina, whereas in procidentia, inferiorly out of the anus. This study was aimed at analyzing pathogenesis and adequacy of surgical treatment in rectocele and rectal prolapse. Twenty-one patients with rectocele and 18 patients with rectal prolapse were assessed pre- and post-operatively in respect to symptoms and signs, pathogenesis, defecography, and manometry. In analysis of symptoms and sings, constipation was the commonest in both diseases(86% of rectocele and 67% of rectal prolapse) and incontinence was not infrequently found in both diseases as well(14% of rectocele and 33% of rectal prolapse). In analysis of the underlying causes, two patients with rectal prolapse had prolapse from childhood. Defecography showed anorectal angle of rectal prolapse in rest and push period. They were significantly wider than those of rectocele(p<0.05). The perineal descent of rectal prolapse was longer than that of rectocele. In analysis of the associated factors, average number of delivery was more than three times in both diseases(3.5 of rectocele and 5.1 of rectal prolapse). We could easily find previous operation history in both diseases. Among them, hysterectomy was the most frequent, especially in patients with rectocele. The hemorrhoids was associated more common in rectocele than in rectal prolapse(p<0.05). Preoperative maximal resting pressure of rectal prolapse was more significantly decreased than that of rectocele(p<0.05). The sensation of fullness was significantly decreased in patients with rectal prolapse postoperatively(p<0.05). Patients with rectocele underwent levator plication by transrectal or vaginal approach. Patients with rectal prolapse underwent posterior rectopexy in 11 patients, resection and rectopexy in 3 patients, Delorme's operation and Thiersch operation in 2 patients each. Constipation was significantly improved in patients with rectocele postoperatively(p<0.05). Incontinence was markedly improved in patients with rectal prolapse postoperatively(p<0.05). At the interview about subjective improvement of symptom, 95% of patients with rectocele and 89% of patients with rectal prolapse were satisfied with surgery. In conclusion, rectocele and rectal prolapse can be categorized as rectal prolapse syndrome because both diseases have anatomical derangements caused by similar pathogenesis such as altered bowel habits, anatomical factor, delivery, past history of hysterectomy, and hemorrhoids. Levator plication and posterior rectopexy seem to be useful surgical methods of anatomical repair for the respective disease.
Anal Canal ; Constipation ; Defecography ; Hemorrhoids ; Humans ; Hysterectomy ; Manometry ; Prolapse ; Rectal Prolapse* ; Rectocele ; Rectum ; Sensation ; Vagina

Acute appendicitis is the most common operative disease in general surgery, but it is not also rate disease to see in other clinical department such as Internal Medicine and Obstetric and Gynecology, because it reqnires to differenciate from many other diseases which have similar symptoms. Expecially, because the clipical aymptoms of acute appendicitis are not typieal in children, elderly, and women, it is hard to be diagnosed as acute appendicitis and it is often misdiagnosed as other disease. We performed colonoscopy due to be interpretated aa one of the colon diseases rather than acute appendicitis. But in colonoscopic findings, there were hyperemie and edematous change on the appendiceal orifice of cecum(cherry or acorn shape). So we report 5 cases of acute appendicitis diagnosed br colonoscopy.
Aged ; Appendicitis* ; Child ; Colon ; Colonoscopy* ; Female ; Gynecology ; Humans ; Internal Medicine

PURPOSE: To investigate the correlation between the severity of diabetic retinopathy and the responses of multifocal electroretinogram (mERG). METHODS: The amplitude and peak time of mERG was evaluated in a group of 88 diabetics and 20 control subjects. The severity of diabetic retinopathy was determined according to the ETDRS scale using color fundus photographs and fluorescein angiograms. RESULTS: The amplitudes of the summed mERG and the central seven hexagons were significantly lower in diabetic patients compared with control subjects, and the more severe the diabetic retinopathy was , the less the amplitude was (P<0.05). The peak times of the summed mERG and the central seven hexagons were significantly delayed in diabetic patients, and the peak time was increased in parallel with the severity of retinopathy (P<0.05). These significant correlations between mERG responses and the severity of diabetic retinopathy was maintained even after the exclusion of patients with diabetic macular edema. CONCLUSIONS: The macular function in diabetic patients is correlated with the grade of diabetic retinopathy, and mERG may have a clinical application in evaluating macular function in these patients.
Diabetic Retinopathy* ; Fluorescein ; Humans ; Macular Edema

OBJECTIVE: Pituitary adenylate cyclase-activating polypeptide (PACAP), a novel hypothalamic neuropeptide, has been suggested to play a role in ovarian folliculogenesis. The present study evaluated the effect of PACAP on the growth of preantral follicles. METHODS: Preantral follicles were mechanically isolated from ovaries of 21-day-old rats and cultured in groups for 3 days in serum-free medium in the absence or presence of PACAP-38 (10-6 M). RESULTS: Treatment with PACAP-38 resulted in an increase in follicle diameter by 75% whereas treatment with follicle stimulating hormone (FSH) increased follicle diameter by 65%. PACAP-38 treatment enhanced the granulosa cell proliferation as measured by thymidine incorporation analysis. Furthermore, the production of progesterone by cultured granulosa cells and GFSHR-17 cell line was stimulated by PACAP-38. Interestingly, PACAP enhanced FSH action on stimulation of SF-1 and aromatase gene expression. CONCLUSION: The present results demonstrate that PACAP stimulated preantral follicle growth by potentiating proliferation and by stimulating steroidogenesis.
Animals ; Aromatase ; Cell Line ; Female ; Follicle Stimulating Hormone* ; Gene Expression ; Granulosa Cells ; Neuropeptides ; Ovarian Follicle* ; Ovary ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Progesterone ; Rats ; Thymidine

PURPOSE: To report one case of bilateral acute retinal necrosis (ARN) syndrome in the patient with acquired immunodeficiency syndrome (AIDS). METHODS: Bilateral retinal necrosis, occlusive vasculitis, vitreous opacity and inflammatory reaction in anterior chamber were noted in a 48-years old man with AIDS. RESULTS: The patient was diagnosed as bilateral ARN, but did not respond to intravenous acyclovir therapy. However, the patient was successfully treated with intravenous ganciclovir at a dosage of 5 mg/kg/day, which resulted in resolution of retinal lesion and improvement of visual acuity without complications such as retinal detachment. CONCLUSIONS: CMV retinitis, progressive outer retinal necrosis, ocular syphilis should be considered in the differential diagnosis of ARN syndrome in the AIDS patients and alternative treatment with ganciclovir should be considered promptly when the patient do not respond to acyclovir therapy.
Acquired Immunodeficiency Syndrome* ; Acyclovir ; Anterior Chamber ; Diagnosis, Differential ; Ganciclovir ; Humans ; Middle Aged ; Necrosis ; Retinal Detachment ; Retinal Necrosis Syndrome, Acute* ; Retinaldehyde ; Retinitis ; Syphilis ; Vasculitis ; Visual Acuity

Primary signet ring cell carcinoma of the prostate is extremely rare and about 18 cases have been reported in the literature. We report two cases of primary signet ring cell carcinoma of the prostate, arising in 79-year-old and 65-year-old men. Both cases were the poorly differentiated adenocarcinoma of the prostate with many signet ring cells. Signet ring cells were positive for prostatic specific antigen and prostatic acid phosphatase but negative for neutral and acid mucins. In summary, the signet ring cell carcinoma of the prostate is a rare variant of poorly differentiated adenocarcinoma of the prostate. The orgin of the prostate should be considered in cases of metastatic signet ring cell carcinoma, particularly when the signet ring cells are negative for neutral and acid mucins. Prostatic specific antigen and prostatic acid phosphatase should also be performed to confirm the primary signet ring cell carcinoma of the prostate.
Acid Phosphatase ; Adenocarcinoma ; Aged ; Carcinoma, Signet Ring Cell* ; Humans ; Male ; Mucins ; Prostate*

PURPOSE: We carried out this study to determine if there is any difference in the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG and if there are any factors influencing on the occurrence rate of EEG. METHODS: This study included 178 epileptic children who had visited neurology clinic of the department of pediatrics, Pusan National University Hospital from July 2005 to July 2006. The medical and EEG records of these children who had had both awake EEG and sleep EEG were reviewed. We analysed the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG. We investigated the related clinical factors which included sex, seizure types, underlying causes, age at first seizure, antiepileptic drug (AED) medication, age at recording, and background activity. RESULTS: Among 178 epileptic children, 91 patients (51.1%) showed epileptiform discharge in awake or sleep states, 10 patients (11.0%) abnormal only in awake, 40 patients (44.0%) abnormal only in sleep, 41 patients (45.0%) abnormal in both awake EEG and sleep EEG. The occurrence rate of sleep EEG was 81 of 178 patients (45.5%) which was more than that of the awake EEG (28.7%) (P<0.001). The occurrence rate of sleep EEG is more than that of the awake EEG regardless of sex and underlying causes. But there is no significant difference from awake EEG and sleep EEG in finding the epileptiform discharge in the patient with generalized seizure, younger than 5 years old at first seizure, younger than 10 years old at recording, no antiepileptic medication, and abnormal background activity. CONCLUSION: The sleep EEG is thought to be more helpful in the diagnosis of childhood epilepsy.
Child ; Electroencephalography ; Epilepsy ; Humans ; Neurology ; Pediatrics ; Seizures