The tongue is located inside the oral cavity at rest, and the structural interrelations between the tongue and the oral cavity is essentially important for normal tongue function. Macroglossia is clinically diagnosed whenever the tongue does not fit the oral cavity, thus patients complain of noisy breathing, drooling, speech and swallowing dysfunction, malocclusion, and social ridicule. Partial glossectomy for macroglossia volume has been assumed to be difficult. In this study, we attempted to measure the tongue volume with the plaster tongue model in a 7-year-old macroglossia patient. This method is reliable and simple for measuring the tongue volume in macroglossia.
Child ; Deglutition ; Glossectomy* ; Humans ; Macroglossia* ; Malocclusion ; Mouth ; Respiration ; Sialorrhea ; Tongue*

The posterior cruciate ligament is the primary static restraint to posterior translation of the tibia and provides proprioception within the knee. The goals of treatment in the injuries of PCL are restoration of normal tibiofemoral stability and reduction of long term osteoarthrosis of the knee. The purpose of this study is to cornpare functional outcome, muscle power, and posterior stability between conservative treatment and reconstruction with autogenous RPTB augmented with Kennedy LAD in PCL injuries. Twenty-seven patients with PCL rupture who have been treated from November 1990 to May 1996 were reviewed. The patiens were divided into conservative group and reconstruction group. Conservative treatment was done in 15 patients and reconstruction by autogenous bone patellar tendon bone with Kennedy LAD was performed in 12 patients. All patients were evaluated with posterior stress x-ray films, KT-2000 knee ligament arthrometer, Cybex 340 isokinetic dynamometer, subjective Cincinnati symptom rating scale and Lysholm knee score, complication. The results were as follows; 1. Mild and moderate posterior instability was remained in spite of BPTB graft and need more stable fixation technique and vigorous rehabilitation program. 2. At the angular velocity of 90 degree/sec and 180 degree/sec, the muscle strenth of quadriceps was decreased after PCL injury in both group in the test of Cybex 340 isokinetic exercises. The power of hamstrings were not changed after PCL injuries. 3. Average Lysholm knee score was 89 points in reconstruction group and 78 points in conservative group and average Cincinnati symptom-rating scale was 8.4 points in reconstruction group and 7.1 points in conservative group. More satisfied functional results and subjective symptoms were revealed in the reconstruction group and statiscal significancy (p<0.05) was showed when comparing conservative group with reconstruction poup. 4. Good clinical results did not always coincidence with lesser posterior instability and clinical results were influenced by associated injury of the knee. The more combined ligament injury of the knee, the worse clinical results.
Exercise ; Humans ; Knee ; Ligaments ; Osteoarthritis ; Patellar Ligament ; Posterior Cruciate Ligament ; Proprioception ; Rehabilitation ; Rupture ; Tibia ; Transplants ; X-Ray Film

Ureteral duplication is the most common developmental abnormality of the upper urinary tract. The upper pole ureter is often associated with a ureterocele and the lower pole ureter, the V-U reflux. A case of bilateral double collecting system associated with bilateral ureteroceles in a 6-month old Korean male is presented with review of literature.
Humans ; Infant ; Male ; Ureter ; Ureterocele* ; Urinary Tract

A case of mucocele of the sphenoid sinus with blurred vision and headache is presented. Mucocele of the sphenoid sinus is relatively rare and benign. Accurate diagnosis is possible through Brain CT scan and MRI. But it should be included in the differential diagnosis of malignancy or pituitary tumor, and unnecessary treatment such as radiotherapy or craniotomy should not be performed. In this case, mucocele is extended into sella turcica which is markedly destroyed and eroded. We removed it by sublabial transseptal sphenoidal sinusotomy and drainage without difficulties and postoperative complications.
Brain ; Craniotomy ; Cytochrome P-450 CYP1A1 ; Diagnosis ; Diagnosis, Differential ; Drainage ; Headache ; Magnetic Resonance Imaging ; Mucocele* ; Pituitary Neoplasms ; Postoperative Complications ; Radiotherapy ; Sella Turcica ; Sphenoid Sinus* ; Tomography, X-Ray Computed

No abstract available.

The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993. 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft. fractures. 3. The Im erlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open-with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major-complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of . fracture and then made early joint motion exercise and ambulation.
Congenital Abnormalities ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Joints ; Tibia ; Tibial Fractures* ; Walking ; Wounds and Injuries

The use of artificial skins for full thickness wounds is an accepted technique, but unfortunately the take rate is low and the aesthetical result is not acceptable. The freeze-drying treatment of allogenic tissues can destroy cells with preserving the structural organization of extracellular matrices, permitting allogenic transplantation. In this study we investigated a new method to process the allogenic skin for transplantable allogenic dermis and this dermis was evaluated in a full thickness wound model. The results are as followings; 1. After treatment with NaCl and SDS solution and then with freeze-drying method, the allogenic dermis shows acellular dermal matrix with preserved normal extracellular matrix. 2. This allogenic dermis became completely incorporated into the wound without evidence of rejection or replacement by scar tissue. 3. The take rate of thin autografts overlying the allogenic dermis that were applied simultaneously was comparable to take rate of autograft alone. 4. The reduction in secondary contraction by allogenic dermis treated wounds was significant. 5. After grafting with cultured keratinocytes, the degree of epithelial coverage was 70% at 2 weeks. In conclusion, the allogenic dermis processed with our method displayed lack of antigenicity, and rapid revascularization. This allogenic dermis can permit simultaneous engraftment of an overlying STSG or cultured kerationocytes, reduce secondary contraction and improve cosmesis of full thickness wounds.
Acellular Dermis ; Autografts ; Cicatrix ; Dermis* ; Extracellular Matrix ; Keratinocytes ; Skin ; Skin, Artificial ; Transplants ; Wounds and Injuries*

Multiple Choice Question(MCQ) method of examination has long been used as the national medical licensing examination in Korea. If properly used, the MCQ method of examination has considerable value fo r evaluation, and in fact, it has become popular due to its economy of scale, ease of marking and consistency. Moreover, with this method of examination, a large number of candidates can be tested at once and the marking can even be read by automatic readers. However, MCQ does not lend itself so well to problem-solving, which is a far more real-life situation than having to choose between a number of pre-formed alternatives. This, again, however, can be much improved by increasing the proportion of question items associated with interpretation and problem solving level of cognitive domain, and adopting various types of MCQ. This study was planned to examine the proportions of question items by their levels of cognitive domains and the types MCQ together with the contents of medical knowledge of the Korean National Medical Licensing Examinations (NMLE) conducted in 1992 and 1993. All 880 question items (440 question items in each year) were reviewed one by one by three medical education specialists and the levels of cognitive domains, types of MCQ and contents of questions were judged by test subjects. Major findings obtained from the study are as follows: 1) In both years of 1992 and 1993, recall level question items formed 68.0% of all MCQ question items of NMLE. Problem-solving level question items were only 77.% in 1992 and 11.1% in 1993. 2) Major types of MCQ were 'best answer type' one correct answer type'. They were 40.7% and 30.9% of all respectively in 1992, and 35.0% and 32.0% respectively in 1993. Some subjects such as urology and internal medicine were adopting more 'combined response type' MCQ than other subjects. 3) Knowledge contents asked in the NMLE varied very much from subject to subject. However, the names of diseases were the most prevalent answers asked and they were 21.6% in 1992 and 18.2% in 1993. This study suggests that the Korean NMLE should increase the proportion of question items measuring the interpretation and/or problem-solving level of knowledge, and adopt several different types of MCQ.
Education, Medical ; Internal Medicine ; Korea ; Licensure* ; Problem Solving ; Specialization ; Urology

No abstract available.
Echocardiography* ; Heart Defects, Congenital* ; Prenatal Diagnosis*

Teramethylammonium(TMA) in one of the synthetic compounds of nicotine that act at ganglionic site. The major action of TMA consists of initial stimulation followed by a more persistent depression of all autonomic ganglia by binding to a cholinergic receptor. It is well believed that the level of membrane potential in arterial smooth muscle is an important regulator of tension development. Depolarization and hyperpolarization by only few millivolts results in significant changes in tension. In general, the agents of vascular smooth muscle induce vascular relaxaion. The present study was undertaken to elucidate the effect of TMA on vascular contractility in the isolated rabbit thoracic aorta with or without endothelial cell, and mechanisms involved in the change of vascular contractility by TMA. The results obtained are summarized as follows ; 1) In the presence of endothelial cell, TMA induced a relaxtion of the aorta precontracted with norepinephrine but induced a contraction in the aorta without endothelial cells, indicating that in the rabbit aorta, relaxations produced by TMA were the endothelium-dependent. 2) The addition of inhibitor such as methylene blue, hemoglobin, hydroquinone and p-bromophenacyl bromide during the TMA-induced relaxation reversed the contractile tension to a level similar to or higher than that before the addition of TMA in rabbit thoracic aorta.This relaxation effect of TMA suggest that the TMA-inducdd relaxation in rabbit aorta is due to the release of endotheline derived relaxing factor(EDRF). 3) Relaxation induced by TMA was antagonized by atropine and thus the TMA does seem to act on the muscarinic receptors. 4) TMA reduced the norepinephrine-induced Ca++ influx into rabbit smooth muscle membrane. From the above results, it may be concluded that TMA-induced vacular relaxation in rabbit aorta is due to the release of EDRF. Mechanism involved in the relaxation induced by TMA may be the stimulation of soluble guanylate cyclase and increased tissue cGMP concentrations.
Aorta ; Aorta, Thoracic* ; Atropine ; Depression ; Endothelial Cells ; Endothelins ; Endothelium ; Endothelium-Dependent Relaxing Factors* ; Ganglia, Autonomic ; Ganglion Cysts ; Guanylate Cyclase ; Membrane Potentials ; Membranes ; Methylene Blue ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Nicotine ; Norepinephrine ; Receptors, Muscarinic ; Relaxation