We developed an animal model to recreate the condition of an open fracture in communication with the maxillary sinus. We then studied wound healing of the sinus wall structures following fracture in the presence of autogenous bone and alloplastic implant. This model is designed to simulate the repair of an orbital floor fracture in humans. The New Zealand White rabbit was used as the animal model. Standardized 8mm defects were made bilaterally in the maxillary sinuses to include bone and mucosa in 36 rabbits. Two different implants and autogenous calvarial bone graft were placed in the soft-tissue pockets to obturate the defects, exposing one surface of the implant to the open sinus. Medpor porous polyethylene, silicone and calvarial bone implant were compared. Animals were killed at 1, 2 and 8 weeks after implantation. Gross examination of the specimens for the amount of mucosal closure and implant tissue fixation was performed. Histological sections were evaluated for bone and soft-tissue morphology juxtaposed to the implant. Complete closure of the mucosal defect was demonstrated with each type of implant. Medpor implants showed both vascular and soft-tissue ingrowth into pores by week 1. Bone ingrowth was seen by week 2. Closure of the Medpor obturated defects occurred more rapidly than in the silicone group. The Medpor implants and calvarial bone demonstrated bone and soft-tissue fixation, callus formation and maturation, while mature overlying mucosa was reconstituted over the defects. Silicone implants demonstrated a fibrous tissue reaction within 1 week of implantation and they never became fixed to bone or soft tissue. Maxillary sinus wall regeneration occurred in all defects. This study supports clinical observations of maxillary sinus wall regeneration in humans.
Animals ; Bony Callus ; Fractures, Open ; Humans ; Maxillary Sinus ; Models, Animal ; Mucous Membrane ; New Zealand ; Orbit ; Polyethylene ; Rabbits ; Regeneration ; Silicones ; Tissue Fixation ; Transplants ; Wound Healing

BACKGROUND: Because of the common etiologic factor, such as smoking, lung cancer and chronic obstructive Pulmonary disease are often present in the same patient. The preoperative prediction of remaining pulmonary function after the resectional surgery is very important to prevent serious complication and postoperative respiratory failure. 99mTc-MAA perfusion scan has been used for the prediction of postoperative pulmonary function, but it may be inaccurate in case of large V/Q mismatching. We compared 99mTc-DTPA radioaerosol inhalation scan with 99mTc-MAA perfusion scan in predicting postoperative lung function. METHOD: Preoperative inhalation scan and/or perfusion scan were performed and pulmonary function test were performed preoperatively and 2 month after operation. We predicted the postoperative pulmonary functions using the following equations. Postpneumonectomy FEV1=Preop FEV1x% of total function of lung to remain RESULTS: 1) The inhalation scan showed good correlations between measured and predicted FEV1, FVC and FEF25-75%. (correlation coefficiency; 0.94, 0.91, 0.87 respectively). 2) The perfusion scan also showed good correlations between measured and predicted FEV1, FVC and FEF25-75%. (correlation coefficiency; 0.86, 0.72, 0.97 respectively). 3) Among three parameters, FEV1 showed the best correlations in the prediction by lung scans. 4) Comparison between inhalation scan and perfusion scan in predicting pulmonary function did not show any significant differneces except FVC. CONCLUSION: The inhalation scan and perfusion scan are very useful in the prediction of postoperative lung function and don't make a difference in the prediction of pulmonary function although the former showed a better correlation in FVC.
Humans ; Inhalation* ; Lung ; Lung Neoplasms ; Perfusion* ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Respiratory Insufficiency ; Smoke ; Smoking

Agenesis of dorsal pancreas is a rare congenital anomaly that arises from the failure of the dorsal pancreatic bud of endodermal cells to form the body and tail of the pancreas. It may be associated with diabetes mellitus, pancreatic exocrine dysfunction, or abdominal pain. Complete or partial agenesis of dorsal pancreas has been reported in a small number of pediatric and adult patients. A case is herein described involving a complete agenesis of dorsal pancreas and diabetes mellitus. A 38-year-old man with a 7-months history of non-insulin dependent diabetes mellitus was admitted due to weight loss and abdominal pain. Abdominal ultrasonography and computed tomography showed a normal biliary tree and enlarged head of the pancreas without visualization of the pancreatic body and tail. Endoscopic retrograde cholangiopancreatography (ERCP) revealved the short duct of Wirsung in the uncinate process and a head without opacification of any ducts in the pancreatic body or tail. The patient underwent explo-laparotomy for evaluation of the suspected pancreatic cancer. The patient was diagnosed as having complete agenesis of the dorsal pancreas by ERCP, CT, and surgery.
Abdominal Pain ; Adult ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Diabetes Mellitus ; Endoderm ; Head ; Humans ; Pancreas* ; Pancreatic Ducts ; Pancreatic Neoplasms ; Ultrasonography ; Weight Loss

Benign metastasizing leiomyoma (BML) is a rare entity, defined as a muscle tumor in association with one or more smooth muscle tumor of the uterus and without evidence of any extra uterine primary site. The lung is the most common site of involvement,(2) and the etiology of BML remains unknown. We experienced a case of BML arising in pelvic and para-aortic lymph nodes and report with a brief review of literature.
Leiomyoma ; Lung ; Lymph Nodes ; Muscles ; Smooth Muscle Tumor ; Uterus

An intussusception in adulthood is an unusual cause of bowel obstruction. It accounts for up to 5% of all intussusception. Approximately 90% of cases are secondary to a definite lesion such as malignancy or lipoma. Most patients are asymptomatic and the lesion is often detected incidentally at colonoscopy, operation and autopsy. Strangulated intussuscetion is a rare case and also requires emergency operation. A 32-year-old woman visited our emergency room because of severe epigastric pain. Abdominal CT revealed a low density mass in bowel loop and distended small bowel loops filled with fluid. Colonoscopic finding showed huge purple-colored coil-spring lesion in the ascending colon. From this findings, we diagnosed a strangulated intussusception. Surgically removed specimen revealed a small intestinal lipoma.
Adult ; Male ; Female ; Humans

PURPOSE: The lung is the second most common site of metastasis from colorectal cancer. Of all patients who undergo a curative resection for colorectal cancer, 10% to 15% will develop lung metastasis. As a hepatic resection of colorectal liver metastases results in improved survival, many reports have suggested that a pulmonary resection of a colorectal lung metastasis would also improve survival. The aim of this study was to analyze the postoperative outcomes of and the prognostic factors for a surgical resection of a lung metastasis. METHODS: Between August 1997 and March 2006, 27 patients underwent surgical resections for colorectal lung metastases at Seoul St. Mary's hospital. A retrospective review of patients' characteristics and various tumor factors was performed. RESULTS: The mean interval between colorectal resection and lung metastasis was 24.0 +/- 15.1 months. The overall 3- and 5-year survival rates were 76.5% and 22.2%, respectively. The mean follow-up after pulmonary resection was 39.5 +/- 21.6 months (range, 3.3 to 115 months). Except for the existence of hilar-lymph-node metastasis (P < 0.001), no risk factors that we studied were statistically significant. Two patients had hilar-lymph-node metastasis. They survived for only for 3.3- and 11.6-months, respectively. CONCLUSION: In our study, we found that a pulmonary resection for metastases from colorectal cancer may improve survival in selected patients.
Colorectal Neoplasms ; Follow-Up Studies ; Humans ; Liver ; Lung ; Neoplasm Metastasis ; ortho-Aminobenzoates ; Retrospective Studies ; Risk Factors ; Survival Rate

Dextran of a low molecular weight (dextran 40) is frequently used to improve regional perfusion after surgery in spite of the potentially serious complications such as noncardiogenic pulmonary edema, oliguric renal failure, and coagulopathy that have been widely reported. Dextran is used to improve cochlear microcirculation in sudden deafness of vascular origin, but the frequency of complications is rarely reported in the field of otolaryngology. We reviewed the literature of a case we experienced in which a pregnant woman, after recovering from pulmonary edema caused by treatment for sudden deafness with dextran, had a successful vaginal delivery.
Dextrans* ; Female ; Hearing Loss, Sudden* ; Humans ; Microcirculation ; Molecular Weight ; Otolaryngology ; Perfusion ; Pregnant Women* ; Pulmonary Edema* ; Renal Insufficiency

In the field of surgery, there are a large number of studies in progress for more minimally invasive surgery and cosmetic improvements. Among these studies, NOTES (natural orifice transluminal endoscopic surgery) and single-port laparoscopic surgery are the 2 studies attracting the most attention. Single-port laparoscopic surgery is a procedure where laparoscopic surgery is performed through a single incision at the umbilicus or another region. Until now, many kinds of surgeries were performed by single-port laparoscopy. In this article, the authors attempt to explain the procedures of single-port laparoscopic appendectomy in detail based on our experiences.
Appendectomy ; Cosmetics ; Laparoscopy ; Umbilicus

PURPOSE: The purpose of this study was to examine the developmental delay in non- handicapped low birth weight infants, with an emphasis on the delayed language development and the perinatal risk factors affected early language development. METHODS: The sample consisted of 31 preterm infants with birth weight less than or equal to 2,000 g who had no obvious neurological impairment at the age of 18-32 months. Each infant was assessed using three instruments; the Bayley Scales of Infant Development, the Capute Scales, and the Sequenced Language Scale for Infants (SELSI). RESULTS: On Bayley Scales of Infant Development, mental developmental index (MDI) was 81.0+/-17.1 and psychomotor developmental index (PDI) was 90.3+/-13.7. On the Capute scales, 38.7% of infants exhibited a significant language delay, below 70 at the age of 18- 32 months. On the SELSI, expressive language was delayed 5.7 months, receptive language, 5.4 months. On the Capute scales, expressive language was significantly related with gestational age and duration of oxygen therapy. Receptive language was associated with gestational age only. On the SELSI, language developmental quotient was influenced by gestational age, days on ventilation, and duration of oxygen therapy. CONCLUSION: 38.7% of non-handicapped low birth weight infants exhibited clinically significant delay in language development at the age of 18-32 months. Language delay was significantly related with gestational age, days on ventilation, and duration of oxygen therapy. The most single significant perinatal risk factor for language delay was gestational age.
Birth Weight ; Child ; Child Development ; Disabled Persons ; Gestational Age ; Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Premature ; Language Development Disorders ; Language Development* ; Oxygen ; Risk Factors ; Ventilation ; Weights and Measures

We performed single port transumbilical appendectomy and cholecystectomy using the TriPort (R-port, Advanced Surgical Concepts, Wicklow, Ireland), inserted through a transumbilical incision in a cadaver model. A articulating instrument, Autonomy(TM) (Cambridge Endo, MA, USA) in right hand was used for retraction in addition to a standard laparoscopic instrument in left hand for dissection and coagulation. Both procedures were technically successful. In conclusion, single port surgery may be performed safely. And in the near future, more complex procedures could be performed through single port in accordance with the advancement of the instruments.
Appendectomy ; Cadaver ; Cholecystectomy ; Hand ; Laparoscopy