No abstract available.

No abstract available.

No abstract available.
Lipectomy*

Anal incontinence following pelvic trauma, surgery, or neurologic disorders has significant medical and social implication. Both Chetwood in 1902 and Bistom in 1944 utilized coccygeal origin portion of the gluteus maximus muscle for the anal sphincter reconstruction. The gluteus maximus muscle is a broad, fan-shaped muscle with a wide origin from the ilium sacrum and coccyx and a narrow insertion along the iliotibial band of the lateral femur. Its blood supply is from the inferior gluteal artery and its innervation is from L-5, S-1 roots by means of the inferior gluteal nerve Incisions are placed at the inferior border of the ischial tuberosity. Subcutaneous tunnels are created about the rectum and gluteal and perirectal incisions. Two overacting slings are being created Their opposing pull creates sphincter or valve effect about the distal rectum. We have experienced 2 cases of irregular, deep soft tissue defects of the perianal region requiring muscle coverage with the gluteus maximus muscle overlapping slings. We think the use of the gluteus maximus muscle is one of the most useful method for reconstruction of the anal sphincter mechanism.
Anal Canal* ; Arteries ; Coccyx ; Femur ; Ilium ; Nervous System Diseases ; Rectum ; Sacrum

BACKGROUND: The purpose of this study was to evaluate the postoperative magnetic resonance imaging (MRI) results of minimal-tying (one medial-row tie among 4 medial-row sutures) on the medial-row in double-row suture-bridge configuration (2x2 anchor with 4x4 suture stands). METHODS: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using 2x2 anchor double-row configuration. The mean age was 61.3 years (range, 31-81 years). Two double-loaded suture anchors were used for medial-row. Four medialrow stitches were made with only one medial-row knot-tying (the most anterior suture). Lateral-row was secured using the conventional suture-bridge anchor technique; all 4 strands were used for each anchor. Repair integrity was evaluated with MRI at mean 6.2 months postoperatively. Retear and the pattern of retear, change of fatty infiltration, and muscle atrophy of supraspinatus were evaluated using pre- and postoperative MRI. RESULTS: Repaired tendon integrity was 38 for type I, 30 for type II, 6 for type III, 4 for type IV, and 1 for type V, according to Sugaya classification. Considering type IV/V as retear, the rate was 6.3% (5 out of 79 patients). Medial cuff failure was observed in 4 patients. Fatty atrophy of supraspinatus was significantly improved postoperatively according to Goutallier grading (p=0.01). The level of muscle atrophy of supraspinatus was not changed significantly after surgery. CONCLUSIONS: Minimal tying technique with suture configuration of four-by-four strand double-row suture-bridge yielded a lower retear rate (6.3%) in medium to large rotator cuff tears.
Arthroscopy ; Atrophy ; Classification ; Humans ; Magnetic Resonance Imaging ; Muscular Atrophy ; Rotator Cuff* ; Shoulder ; Suture Anchors ; Sutures ; Tears* ; Tendons

Phenolate type siderophore was produced in Pseudomonas sp. PY002 (P. sp. PY002) which cultured in M9 minimal medium supplemented with 0 to 500 uM of dipyridyl. Pyochelin, a kind of siderophore, was detected as a single broad absorption band (280 nm) at pH 12.0, which is a characteristic of phenolate type siderophore. The 280 nm absorption spectrum of pyochelin was changed to 310 nm at pH 1.5. The pyochelin produced was a structurally unique phenolate siderophore, designated 2-[2-(o-hydroxyphenyl)-2-thiazolin-4-yl]-3-methyl-4-thiazolidine car- boxylic acid on the analysis of infrared radiation and 'H and ""C nuclear magnetic resonance spectroscopy. Additionally, purified pyochelin increased the cell growth rate, like as growth fac- tor. All these results suggest that phenolate type siderophore play an important role in cell growth of P. sp. PY002.
Absorption ; Hydrogen-Ion Concentration ; Magnetic Resonance Spectroscopy ; Phenol* ; Pseudomonas* ; Spectrum Analysis

PURPOSE: A number of drugs are capable of changing body weight as a side effect. A number of neurotransmitter systems acting in several hypothalamic nuclei are pivotal to the storage regulation of body fat. Leptin is a protein encoded by the ob gene that is expressed in adipocyte. It regulates eating behavior by activating the action to the satiety center in the hypothalmus. The purpose of this study is to investigate the changes of serum leptin in children with epilepsy. METHODS: Serum leptin levels were measured in 43 epileptic patients (30 males, 13 females) receiving valproate or carbamazepine by radioimmunoassay. Thirty patients (19 males, 11 females, 10.0+/-5.0 years of age) were treated with valproate (VPA group) and 13 patients (11 males, 2 females, 9.1+/-4.0 years of age) were treated with carbamazepine (CBZ group). Obesity index and body mass index were calculated before and during anticonvulsant medications. RESULTS: 1) Body mass indices were significantly increased after VPA or CBZ medication; from 17.24+/-2.74 to 18.47+/-2.60 in VPA group, from 16.77+/-1.69 to 17.43+/-3.01 in CBZ group. 2) Obesity indices were increased without statistical significance after medication in both group. 3) Serum leptin levels were significantly higher in VPA group (4.54+/-4.77ng/ml) than CBZ group (2.47+/-2.26ng/ml). CONCLUSION: Body weight gain after VPA medication in susceptible individual might be related to a certain mechanism that elevates serum leptin level.
Adipocytes ; Adipose Tissue ; Body Mass Index ; Body Weight ; Carbamazepine ; Child* ; Epilepsy ; Feeding Behavior ; Female ; Humans ; Leptin* ; Male ; Neurotransmitter Agents ; Obesity ; Radioimmunoassay ; Valproic Acid ; Weight Gain

BACKGROUND: Spinal cord ischemia initiates a deleterious cascade of biochemical events that ultimately result in an increased intracellular calcium concentration. Many papers have been published on this topic but without a clear consensus on the best way of minimizing the problem. For the further study of preventing neurological injury after spinal ischemia, the proper animal model is necessary. In this study we compared spinal ischemia time on neurologic and histopathologic outcome, and inflammatory gene expression in transient spinal ischemia. METHODS: Rats were anesthetized with halothane, and divided into 4 groups:12.5 minutes of spinal ischemia (Group 1), 15 minutes of spinal ischemia (Group 2), 17.5 minutes of spinal ischemia (Group 3), and 20 minutes of spinal ischemia (Group 4). Spinal ischemia was produced by both induced hypotension and thoracic aortic cross clamping. After spinal ischemia neurologic scores were assessed after 1, 3, 6, and 24 hours. After 24 hours, rats were euthanized and spinal cords were removed for histopathologic assessment and an assay of TNF-alpha and IL-1 mRNA. RESULTS: The neurologic scores worsened according to the ischemia time. The histopathologic scores correlated well with the neurologic scores. The TNF-alpha and IL-1 mRNA expression results of group 2 were larger than those of group 1. There were no significant differences between group 2, group 3, and group 4. CONCLUSIONS: Inflammatory gene expressions are increased during transient spinal ischemia. After 15 minutes of ischemia, no further increase of mRNA expression was shown. The 15 minutes of spinal ischemia was sufficient for the spinal ischemic study in rats.
Animals ; Calcium ; Consensus ; Constriction ; Gene Expression ; Halothane ; Hypotension ; Interleukin-1 ; Ischemia* ; Models, Animal ; Rats* ; RNA, Messenger* ; Spinal Cord ; Spinal Cord Ischemia ; Tumor Necrosis Factor-alpha

This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice, but combined endodontic-periodontic treatment allowed the tooth to be saved.
Dental Pulp Necrosis ; Diagnosis ; Incisor* ; Membranes ; Periodontal Diseases ; Tooth ; Transplants

PURPOSE: To determine the characteristic CT findings of infectious sacroiliitis and ankylosing spondylitis. MATERIAL AND METHOD: We retrospectively reviewd CT findings in 10 patients with infectious sacroiliitis confirmed by culture and clinical follow ups and in 5 patients with ankylosing spondylitis by HLA-B27 typing. Mean ages were 30 years in ankylosing spondylitis and 29 years in infectious sacroiliits. CT scans were obtained with GE 9800 or Toshiba 900-S scanner. We analyzed CT findings in regard to the morphology and the degree of bone erosion, and the adjacent soft tissue change. RESULT: All cases of ankylosing spondylitis had bilateral and asymmetic bone erosion, predominantly in ilium, showing subchondral sclerosis on ilium. Infectious sacroiliitis showed unilateral involvement and soft tissue swelling in 10 cases and abscess in 5 cases. CONCLUSION: We concluded that CT was useful in the differentiation between infectious sacroiliitis and ankylosing spondylitis.
Abscess ; Follow-Up Studies ; HLA-B27 Antigen ; Humans ; Ilium ; Retrospective Studies ; Sacroiliitis* ; Sclerosis ; Spondylitis, Ankylosing* ; Tomography, X-Ray Computed