Restoration of anteroposterior projection of the zygomatic body and facial width are key elements in treatment of complex zygomatic fractures. Traditionally, it has been understood that for most fractures of the zygoma, three-point fixation of the zygomaticofrontal suture, inferior orbital rim, and zygomaticomaxillary buttress generally produces exact structural restoration. Recently, the importance of accurate reduction of the zygomatic arch through coronal incision has been favored in complex zygomatic fractures. Though coronal incision has the advantages of accurate reduction and fixation as a result of extensive exposure of the fractured area, this procedure also has many disadvantages including injury to the facial nerve, paresthesia, alopecia, scar formation, longer operating time, protracted hospitalization, etc. As well, there have been no objective data to prove the fact that four-point fixation through coronal incision is superior to traditional three-point fixation. From May, 1994 to December, 1998, the authors treated 45 patients by traditional three-point (n=20) and coronal four-point fixation (n=25) with random sampling. To assess the difference between the two methods the authors measured the axial angle of the zygoma, the axial angle of the zygomatic arch, and the degree of zygomatic arch inclination on submentovertex X-ray, and then analyzed the measurements by the paired T-test(p < 0.05). As a result, the axial angle of the zygoma and zygomatic arch assessed by anteroposterior projection, as well as the facial width showed no statistical difference between the two groups, respectively(p = 0.26, p = 0.18). Mean while, the degree of zygomatic arch inclination representing the local contour of the fractured zygomatic arch was statistically significant between the two groups(p < 0.05). Thus, the traditional three-point fixation method may be widely acceptable in treatment of complex zygomatic fractures with anterior three-point or zygomatic arch comminution.
Alopecia ; Cicatrix ; Facial Nerve ; Hospitalization ; Humans ; Orbit ; Paresthesia ; Sutures ; Zygoma ; Zygomatic Fractures

Frontometaphyseal dysplasia is an uncommon genetic syndrome affecting bone and connective tissue. This condition is characterized by the prominence of supraorbital ridges, hyperostosis of the skull, mandibular hypoplasia and malocclusion with antegonial notching, underdeveloped paranasal flaring of the long bone, and a widened iliac wing. Frontometaphyseal dysplasia has an X-linked dominant trait. Clinical manifestations are more severe in males and have extreme variability in females. We present an 11-year-old boy who had frontometaphyseal dysplasia with disfigured face due to bilaterally urinary tract malformation and chronic urinary tract infection. To improve facial appearance, his prominent supraorbital ridges were contoured by ostectomy and burring through bicoronal incision. Urologic operation was performed simultaneously. Histologically, resected bony specimen revealed bony tissue with normal trabecular pattern suggesting exostotic bone. The patient healed without any postoperative complications and he and his parents were satisfied with his final facial morphology.
Child ; Connective Tissue ; Female ; Humans ; Hyperostosis ; Male ; Malocclusion ; Parents ; Postoperative Complications ; Skull ; Urinary Tract ; Urinary Tract Infections

BACKGROUND: Although several kinds of treatment methods(destructive therapy, immunotherapy, etc) for plane warts have been attempted but there have been no entirely satisfactory treatments, because the plane wants are seen to recur frequently. OBJECTIVE: This study was aimed to evaluate the combination therapy of griseofulvin and immunotherapy(dinitrochlorobenzene=DNCB, diphenylcycloprope none=DPCP) on plane warts. METHOD: Sixteen patients(age range, 9 to 41; mean age, 21.8 years) with VPJ were treated with the combination therapy with griseofulvin(500mg/day) and single contact immunotherapy(DNCB or DPCP).
Dinitrochlorobenzene ; Griseofulvin* ; Immunotherapy ; Warts*

In anesthetized cats the effects of lactate-activated muscle spindle upon the group Ia muscular afferent fibers were studied. Laminectomy was done from L5 to Sl spinal cord level. Extracellular recording was done at dorsal root to record the impulse discharge from group Ia muscular afferent fibers. 1) Muscle spindle of Gastrocnemius-Soleus muscle were activated by lactate injection and exhibited increased impulse discharge through group Ia muscular afferent fibers. 2) There was latency of 7-12 seconds before muscle spindle is activated by lactate injection. But the whole response was not dose related. 3) The response pattern after lactate injection was divided into three groups which were excitation, inhibition and inhibition with preceding excitation. 4) Some responses were similar to those of bradykinin, sympathetic stimulation (adrenaline injection) and succinylcholine injection. 5) It was suggested that muscle spindle has characteristics of polymodal receptor which has responses to not only mechanical stimulation but also chemical stimulation.
Animals ; Bradykinin ; Cats ; Lactic Acid ; Laminectomy ; Muscle Spindles ; Spinal Cord ; Spinal Nerve Roots ; Stimulation, Chemical ; Succinylcholine

BACKGROUND/AIMS: The endoscopic mucosal resection has now been adopted for a useful modality in both curative therapy and accurate diagnosis of early gastric cancer. A retrospective study was done to evaluate the indication and the limitation of endoscopic mucosal resection of early gastric cancer. METHODS: We studied 20 cases of early gastric cancer treated by endoscopic mucosal resection in Chungnam National University Hospital from November, 1995 to July, 1997. RESULTS: 1) The size affected the curability: 83. 3% of lesions less than 2 cm and 50. 0% of those larger than 2 cm were resected completely. 2) The depth of cancer invasion affected the curability: 87. 5% of lesion confined to mucosa were resected completely, while all of submucosal cancers were resected incompletely. 3) Among fourteen cases resected completely, three cases of lesions larger than 2 cm were residual cancer and two of those less than 2 cm were recurred locally. CONCLUSIONS: To be a curative therapy by endoscopic mucosal resection of early gastric cancer, we think that careful selection of the lesion, that is lesion less than 2cm and confined to mucosa, is necessary
Chungcheongnam-do ; Diagnosis ; Mucous Membrane ; Neoplasm, Residual ; Retrospective Studies ; Stomach Neoplasms*

The goal of fracture treatment is to restore the patient to pre-injury function level. But the outcome assessment after orthopedic interventions has usually focused on physician-defined parameters of technical success, such as fracture union, alignment and range of motion rather than patient function and quality of life. However, the correlation among improvements in these parameters and functional status, psychosocial well being is inconsistent and weak in the elderly. Therefore authors assessed the functional status after surgical intervention of hip fractures in the elderly with functional recovery score(FRS). Independence in basic activities of daily living, in instrumental activities of daily living, in mobility, freedom from pain and intact memory were assessed in 133 hip fractures in the elderly. The hip fractures in the elderly resulted in 24.8% loss of function after the first year. The older the age, the more the loss of function after surgery of hip fractures. The more functional loss was observed in female patients and in patients with poor postoperative radiological results, but statistically insignificant (P>0.05). The more functional loss was observed in patients with underlying medical disease preoperatively and it was statistically significant (P<0.05). We recommend the evaluation of functional status in the elderly after hip fractures.
Activities of Daily Living ; Aged* ; Female ; Freedom ; Hip Fractures* ; Hip* ; Humans ; Memory ; Orthopedics ; Quality of Life ; Range of Motion, Articular

We describe an 18-year-old male with generalized pruritic, tense annular or polycyalic blistera on normal-appearing skin or erythematous bases. Histopathological fmdings of an iatact early blistering showed subepidermal blistering and papillary neutrophilic gnicroabscesses. A direct immunofluctescent study of a section from the skin adjacent to a lesioti revealed linear deposits of IgA at the dermoepidermal junction. There were no deposits of IgG, lgM, or C3. In 1.0M NaC1 eplit skin, IgA was found to be bound linearly on the epidermal roof. The patient respmded weIl to eteroid and dapsone therapy.
Adolescent ; Blister ; Dapsone ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Linear IgA Bullous Dermatosis* ; Male ; Neutrophils ; Skin ; Transcutaneous Electric Nerve Stimulation

INTRODUCTION AND OBJECTIVES: A kidney in the growing state and the possibility of spontaneous improvement are characteristics of the pediatric ureteropelvic junction obstruction (UPJO) that make the treatment of this disease difficult. We have tried to determine the histopathologic changes of the kidneys with UPJO relating to age, differential renal function and urinary tract infection (UTI). METHODS: The total number of patients was 38 (40 kidneys). The age at the operation time was under 3 months in 9 cases (9 kidneys), 3 to 12 months in 10 cases (10 kidneys), and 1 to 18 years in 20 cases (21 kidneys). Needle biopsies from 3 different sites at the lower pole of the kidney were taken. The tissue was blindly observed for the presence of irreversible change (arteriolar thickening, glomerulosclerosis, interstitial fibrosis and periglomerular fibrosis) and reversible change (inflammatory cell infiltration) by light microscopy. Each pathological finding was graded as I, II or III, and each grade was given a numerical value. Statistical analysis was done with ANOVA. RESULTS: Although the kidneys from patients under 3 months tended to show better histopathologic findings, there was no statistically significant difference in all 5 pathologic findings regardless of patient age. 5 cases (5 kidneys) with previous percutaneous nephrostomy (PCN) were not included in any group for analysis due to possible histologic changes of the renal parenchyma. Inflammatory cell infiltration, arteriolar thickening, glomerulosclerosis and periglomerular fibrosis were statistically significant in patients with previous or present UTI (14 kidneys) compared to the patients without UTI (26 kidneys). The patients with a mean differential renal function less than 30% (7 kidneys) as measured by DTPA or DMSA renal scan showed statistically significant changes in all of the 5 histopathologic findings compared to the patients with differential renal function greater than 30% (27 kidneys). 4 cases with bilateral UPJO (6 kidneys) were excluded from comparing the differential renal function. 5 kidneys with previous PCN had statistically significant degree of glomerulosclerosis compared to others. CONCLUSIONS: Although we did not determine whether pediatric UPJO affects renal growth, it is probable that statistically significant irreversible histopathologic changes do not occur according to age. Considering histopathologic findings only, differential renal function and UTI Should be key factors in deciding the management of pediatric UPJO. In addition, PCN seems to induce more severe histopathologic changes of the kidney.
Biopsy, Needle ; Fibrosis ; Humans ; Kidney* ; Microscopy ; Nephrostomy, Percutaneous ; Pentetic Acid ; Pregnenolone Carbonitrile ; Succimer ; Urinary Tract Infections

To compare the differences between hemodialysis and essential hypertension patients and its affecting factors of left ventricular hypertrophy and left ventricular systolic dysfucntion in patients with hemodialysis, M-mode and two dimensional echocardiography were performed in 77 essential hypertension without azotemia and 78 chronic renal failure patients receiving maintenance hemodialysis. M-mode measurement including LV mass (192.56+/-63.6g vs 300.01+/-95.99g, P=0.000), r/th (radius/LV thickness, 4.41+/-0.97 vs 4.74+/-1.0, P=0.039), LV dimemsion and fractional shortening (4.68+/-0.6 vs 5.63+/-0.97, P=0.000, 30.0+/-19.7% vs 36.6+/-97%, P=0.000 respectively) showed more severe eccentric LV hypertrophy and LV dysfunction in patients with hemodialysis than those of essential hypertension. Using Pearson correlation in hemodialysis patients, Interdialytic weight gain was positively correlated with LVEDD (r=0.318, P=0.005). In addition to the determinant, serum PTH level was negatively (r=-0.344, P=0.002) and Kt/V (r= 0.0487, P=0.003) was positively correalated with systolic function. The hypertension and dialysis duration, patient's age, had no relationship with LV function and mass in this study. In Conclusion, LV hypertrophy and LV systolic dysfunction occur more frequently in hemodialysis patients than in essential hypertension patients. And the LV systolic dysfunction, which is acutally related with the patient's quality of life, was partially explained by serum parathyroid level and Kt/V. But additional laboratory and prospective clinical studies are needed to further elucidate the mechanisms involved in the development of LVH and LV impairment in hemodialysis patients.
Azotemia ; Dialysis ; Echocardiography* ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Quality of Life ; Renal Dialysis* ; Ventricular Dysfunction, Left ; Weight Gain

BACKGROUND: Nail lacquer strengthens and protects the nail plate by preventing excess loss of moisture and providing a hard surface. On the other hand, it may produce allergic contact and irritant dermatitis, paronychial and nail bed inflammation and infection, dystrophic nails and onycholysis. OBJECTIVE: The purpose of study was to investigate the effect of the nail lacquer on the barrier function of the nail. METHODS: The study populatian consisted of 25 healthy young subjects who had not applied the nail lacquer to the nail for the last 3 months. Nail lacquer was applied to the left thumb and middle fingernail for 6 weeks and then removed by acetone. Transonychial water loss(TOWL) of the treated left fingernails and the untreated corresponding right fingernails was measured with an Evaporimeter. Lipids of the nails were extracted from distal nail cuttings and analysed by thin layer chromatography. RESULTS: 1. Before application of the nail lacquer, there was no difference in TOWL between the left and right fingernails while the TOWL of the thumb nail was higher than that of the middle fingernail with a statistical significance(p<0.05). 2. The TOWL of the left fingernails, measured 1 day, 2, 4 and 6 weeks after application of the nail lacquer, was lower than that of the untreated right fingernails with a statistical significance( p< 0.05). 3. The TOWL of the left fingernails, measured 1, 3 and 7 days after removal of the nail lacquer by acetone, was not different statistically from that of the untreated right fingernails. 4. Lipid analysis demonstratcd that the cholesterol content was higher in the left fingernail which had been covered with nail lacquer than in the untreated right fingernail. 5. There was no clinical adverse effect observed during application of the nail lacquer or after removal of it. CONCLUSION: According to the results of the study, nail lacquer has some occlusive effects on transonychial water evaporatior . Because increased cholesterol content may be due to perturbations of barrier function , further studies of the effect of the nail lacquer on the barrier function of the nail will be needed.
Acetone ; Cholesterol ; Chromatography, Thin Layer ; Dermatitis, Irritant ; Hand ; Inflammation ; Lacquer* ; Nails ; Onycholysis ; Thumb