Potentially, some donor site complications are associated with the harvesting of autogenous tricortical iliac bone grafts for anterior spinal fusion. The purpose of this study was to evaluate the reliability of the anterior iliac crest reconstruction after harvesting autogenous iliac grafts for anterior spinal fusion. We devided into two groups : the study group were the anterior iliac crest reconstruction in 57 patients with minimal twelve months follow up period, the control group were not the anterior iliac crest reconstruction in 21 patients who could not obtain the rib from retroperitoneal approach. The average follow up was obtained at 43.3 months(12 to 72 months) in study group, at 41.6 months(12 to 60 months) in control group. The study group had a tendency to improve the donor site pain after incorporation of the rib graft and the control group tend to remain the donor site pain till late especially in the thinner group and combined disease group. In residual deformity of the donor site, the study group was superior to the control group. Residual deformity of the study group was associated with the complications such as displacement and resorption of the grafts. Cosmetic residual deformity tends to be higher in the thinner group. Radiographically all rib gragts incorporated in situ in 51 patients despite of some cases of migration(Average 11 weeks and 4 days) and clinical results did not affect by biological behavior of rib grafts on the follow up radiogram. The authors attempted anterior iliac crest reconstruction using the implants (Mennen plate in 3 patients, threaded pin in 3 patients) after large harvesting of autogenous tricortical graft in 6 patients who could not obtain the rib from retroperitoneal approach or could not fit the rib too the defect. In those cases the results were satisfactory clinically. These results suggest anterior iliac crest reconstruction can minimize painful deformity after the harvesting of autogenous tricortical iliac grafts for anterior spinal fusion.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Ribs ; Spinal Fusion ; Tissue Donors ; Transplants

There are many women who want larger and brighter eyes that will give a favorable impression. Surgical methods that make the eye larger and brighter include double eyelidplasty, epicanthoplasty, as well as lateral canthoplasty. Double eyelidplasty produces changes in the vertical dimension of the eyes, whereas epicanthoplasty and lateral canthoplasty create changes in the horizontal dimension of the eyes. Epicanthoplasty, a surgical procedure which enlarges the eye horizontally, is performed at the inner corner of the eye, whereas lateral canthoplasty enlarges the outer edge of the eye. In particular, if the slant of the palpebral fissure is raised and the horizontal dimension of the palpebral fissure is short, adjusting the slant of the palpebral fissure through lateral canthoplasty can achieve an enlargement of eye width and smoother features. Depending on the patient's condition, even better results can be achieved if this procedure is performed in conjunction with other procedures, such as double eyelidplasty, epicanthoplasty, eye roll formation surgery, fat graft, and facial bone contouring surgery. In this paper, the authors will introduce in detail their surgical method for a cosmetic lateral canthoplasty that lengthens the lateral canthal angle and corrects the outer tail of the eyes, in order to ease the unfavorable impression.
Facial Bones ; Female ; Humans ; Methods ; Tail* ; Transplants ; Vertical Dimension

Zonisamide was administered to 20 patients with refractory epileptic seizures. The mean duration of the administration was 6 months, and the mean dosage was 7.2 mg/kg/day. The efficacy of zonisamide was rated remarkable in 15% of the cases, improvement in 40%, and no change in 45%. The response rates of zonisamide were 62.5% for myoclonic seizures, 50% for tonic-clonic seizures, 80% for atonic seizures and 33.3% for atypical absence seizures. There was no correlation between the clinical response and dose or serum concentration of the drug. The adverse effects were observed in 35% of the cases which were drowsiness, dizziness, ataxia, nausea, and vomiting. In all cases, however, the administration of zonisamide could be continued.
Ataxia ; Child* ; Dizziness ; Epilepsy* ; Epilepsy, Absence ; Humans ; Nausea ; Seizures ; Sleep Stages ; Vomiting

Spindle cell lipoma was first described in 1975 by Enzinger and Harvey as a variant of lipomas. Histopathological findings show the lipomatous tissue to be replaced by a mixture of uniform spindle cells and mature fat cells closely associated with a mucoid matrix and a varying number of collagen fibers. Immunohistochemical staining is reported to give assistance in the differential diagnosis af spindle cell lipoma from other fibrous or neural tumors. Also, it can be used to investigate the origin of the spindle cells. We report a case of spindle cell lipoma in a 41-year-old female. She had a solitary, normal skin colored, bean sized, subcutaneous mass on the forearm. Most of the spindle cells were strongly positive for vimentin, CD34 and NSE, but negative for actin, factor VIII, S-100 protein and neuro- filaments. The tumor was excised. No recurrence was recognized in a 10 month follow up period.
Actins ; Adipocytes ; Adult ; Collagen ; Diagnosis, Differential ; Factor VIII ; Female ; Follow-Up Studies ; Forearm ; Humans ; Lipoma* ; Recurrence ; S100 Proteins ; Skin ; Vimentin

BACKGROUND: Healthcare-associated infections (HAIs) are among the most important threats to patient safety. When hospitalized children face these threats, there is morbidity, mortality, prolonged hospitalization, and increased healthcare costs. Research on local healthcare epidemiology is necessary to enhance collective knowledge and evidence formanaging this problem. METHODS: We performed a retrospective analysis of databases of patients who were diagnosed with HAIs at Chung-Ang University Hospital (CAUH) from 2007 through 2011. Cases were selected from the microbiology registry databases. The data on prevalence of HAIs in various wards and its annual trends were compared to previously reported nationwide data. Moreover, we analyzed the patterns of antibiotic susceptibility results for HAI pathogens. RESULTS: A total of 181 HAIs were identified in 122 patients. The HAI rate among pediatric patients at CAUH was 2.4/1,000 person-hospital days. Urinary tract infections (UTIs) (53 episodes, 29.3%) were the most common, followed by pneumonia (33 episodes, 18.2%). Staphylococcus aureus was found to be the most common gram-positive organism, whereas Escherichia coli was the most common gram-negative organism. Methicillin-resistant S. aureus (MRSA) comprised 84% of the S. aureus infections. Imipenem resistance was detected in 58.8% and 55.0% of Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively. CONCLUSION: Between 2007 and 2011, UTIs were the most common type of HAIs, and MRSA was the most common pediatric HAI pathogen, both in the general ward and intensive care unit at the CAUH. Further research on the epidemiology and pathogenesis of HAIs is necessary and prevention measures should be implemented to prevent HAIs in children.
Acinetobacter baumannii ; Child ; Child, Hospitalized ; Delivery of Health Care ; Escherichia coli ; Health Care Costs ; Hospitalization ; Humans ; Imipenem ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Patient Safety ; Patients' Rooms ; Pneumonia ; Prevalence ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus aureus ; Urinary Tract Infections

The objectives of palatoplasty are to close the palatal defect completely and create and adequately functioning velopharyngeal mechanism for normal speech production. The goal is to minimize adverse effects on maxillofacial growth. The are various surgical techniques in cleft palate repair procedure. According to the report of Bardach and Salyer, two-flap palatoplasty allows closure of the palatal cleft with minimal or no exposure of the bare bone by downward rotation of the mucoperiosteal flap instead of posterior transposition. Thus, two-flap palatoplasty is totally different from the concepts and techniques of other palatoplasties and it results in minimal or no adverse effects on maxillofacial growth. But, there have been no reports about two-flap palatoplasty in Korea. We retrospectively reviewed postoperative complications of 172 consecutive nonsyndromic patients with cleft palate repaired by single operator(two-flap palatoplasty 120 cases, pushback palatoplasty 52 cases). Submucous cleft palate patients were excluded from the study group. Age at cleft repair was from 3 months to 51 years and mean follow-up period was 29 months. Cleft palate fistulas occurred in 20 of 172 patients(11.6%), and fistula rate was similar in patients with two-flap palatoplasty (10.8%) and in patients with pushback palatoplasty (13.5%). Type of palatoplasty, extent of clefting, and age at palate repair did not significantly affect the fistula formation. Of the 52 cleft palates repaired with pushback palatoplasty, there has been one postoperative bleeding that resulted in reoperation. But, of the 120 cleft palates repaired with two-flap palatoplasty, there has been no incidence of postoperative bleeding. Two-flap palatoplasty is considered to be another choice of operative method of palatoplasty. However, more in-depth study is needed to clarify the relationship between two-flap palatoplasty and speech pattern, maxillofacial growth.
Cleft Palate ; Fistula ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Korea ; Palate ; Postoperative Complications ; Reoperation ; Retrospective Studies

PURPOSE: Chlorpromazine(CPZ) is known to inhibit glutamate dehydrogenase(GDH). Reductive amination of alpha-ketoglutarate is catalyzed by GDH and forms glutamate, a major excitatory neurotransmitter. Thus, we hypothesized that CPZ might have a seizure-protective effect by inhibition of glutamate release from the excitatory presynaptic nerve terminal. The present study was designed to investigate the protective effect of CPZ on pentylenetetrazole(PTZ)-induced seizure in rats. METHODS: Twenty male Sprague-Dawley rats were equally divided into 2 groups. CPZ(20 mg/kg) was administered to experimental animals by subcutaneous injection, while normal saline to control animals. Twenty minutes later, seizures were chemically induced by intraperitoneal injection of PTZ(60 mg/kg). Seizure severity was evaluated by using a scoring system of seizure behaviors:0, no seizure; 0.5, abnormal behavior; 1, myoclonic jerk; 2, myoclonic jerk with jumping; 3, forelimb clonus with preserving righting reflex; 4, generalized clonic seizure with brief loss of righting reflex; 5, generalized tonic clonic seizure; 6, expire. A greater score represents a more severe seizure. RESULTS: The seizure behavior scores(2.8+/-0.2) in the experimental group were significantly lower than those(3.9+/-0.4) in the control group(P<0.05). CONCLUSION: This study demonstrates that CPZ decrease PTZ-induced seizure severity in rats. Our results suggest that CPZ may have a seizure-protective effect. We hope that further studies on this issue should be performed in near future.
Amination ; Animals ; Chlorpromazine* ; Forelimb ; Glutamic Acid ; Hope ; Humans ; Injections, Intraperitoneal ; Injections, Subcutaneous ; Male ; Myoclonus ; Neurotransmitter Agents ; Pentylenetetrazole* ; Rats ; Rats, Sprague-Dawley ; Reflex, Righting ; Seizures*

PURPOSE: Chlorpromazine(CPZ) is known to inhibit glutamate dehydrogenase(GDH). Reductive amination of alpha-ketoglutarate is catalyzed by GDH and forms glutamate, a major excitatory neurotransmitter. Thus, we hypothesized that CPZ might have a seizure-protective effect by inhibition of glutamate release from the excitatory presynaptic nerve terminal. The present study was designed to investigate the protective effect of CPZ on pentylenetetrazole(PTZ)-induced seizure in rats. METHODS: Twenty male Sprague-Dawley rats were equally divided into 2 groups. CPZ(20 mg/kg) was administered to experimental animals by subcutaneous injection, while normal saline to control animals. Twenty minutes later, seizures were chemically induced by intraperitoneal injection of PTZ(60 mg/kg). Seizure severity was evaluated by using a scoring system of seizure behaviors:0, no seizure; 0.5, abnormal behavior; 1, myoclonic jerk; 2, myoclonic jerk with jumping; 3, forelimb clonus with preserving righting reflex; 4, generalized clonic seizure with brief loss of righting reflex; 5, generalized tonic clonic seizure; 6, expire. A greater score represents a more severe seizure. RESULTS: The seizure behavior scores(2.8+/-0.2) in the experimental group were significantly lower than those(3.9+/-0.4) in the control group(P<0.05). CONCLUSION: This study demonstrates that CPZ decrease PTZ-induced seizure severity in rats. Our results suggest that CPZ may have a seizure-protective effect. We hope that further studies on this issue should be performed in near future.
Amination ; Animals ; Chlorpromazine* ; Forelimb ; Glutamic Acid ; Hope ; Humans ; Injections, Intraperitoneal ; Injections, Subcutaneous ; Male ; Myoclonus ; Neurotransmitter Agents ; Pentylenetetrazole* ; Rats ; Rats, Sprague-Dawley ; Reflex, Righting ; Seizures*

PURPOSE: Despite decades of clinical experience with the ketogenic diet(KD), its efficacy and mechanisms of action have been examined in few animal studies. The present study was designed to investigate the effects of the KD on pentylenetetrazole(PTZ)-induced seizure severity in rats. METHODS: Thirty-eight male Sprague-Dawley rats were divided into two equal groups. Dietary treatment was initiated at P22. The KD group was fasted for a day and then fed a KD consisting of a [fat] : [protein+carbohydrate] ratio of 4.3 : 1 for 26 days, while the control group was fed a standard rodent chow. Blood beta-hydroxybutyrate(beta-OHB) levels were assayed on treatment days 0, 20, and 24. Seizures were chemically induced by intraperitoneal injection of PTZ(60mg/kg of body weight) between treatment days 22 and 27. Seizure severity was evaluated by using a scoring system of seizure behaviors : 0, no seizure; 0.5, abnormal behavior; 1, myoclonic jerk; 2, myoclonic jerk with jumping; 3, forelimb clonus with preserving righting reflex; 4, generalized clonic seizure with brief loss of righting reflex; 5, generalized tonic clonic seizure; 6, expire. A greater score represents a more severe seizure. RESULTS: Blood levels of beta-OHB were low(<0.3mM) and showed no significant differences in both groups on day 0. Rats fed the KD developed an increased level of ketosis that was significantly above the levels found in the control group on days 20 and 24 (p<0.001). The KD group(2.37+/-0.27) exhibited significantly(p<0.05) lower seizure score than the control group(3.37+/-0.35). CONCLUSION: The KD was previously reported to increase PTZ-induced seizure thresholds in rats. In our study, rats fed the KD exhibited significantly decreased PTZ-induced seizure scores relative to controls. This suggests that the KD can not only increase the resistance to seizure but also decrease the severity of seizure induced by PTZ.
3-Hydroxybutyric Acid ; Animals ; Forelimb ; Humans ; Injections, Intraperitoneal ; Ketogenic Diet* ; Ketosis ; Male ; Myoclonus ; Pentylenetetrazole ; Rats ; Rats, Sprague-Dawley ; Reflex, Righting ; Rodentia ; Seizures*

OBJECTIVE: A dichotomous Thl and Th2 cytokine profile has been associated with reproductive failure and success, respectively. The purpose of our study was to determine the levels of Thl cytokine (IFN- y ) secreted by peripheral blood mononuclear cells (PBMCs) form women with unexplained recurrentabortion (URA) and fertile controls in response to trophoblast antigen. METHODS: PBMCs were isolated from 30 nonpregnant women with URA and from 10 nonpregnant fertile controls. Following 4 days of culture (1 * 10(6) cells/mL) with and without a protein extract derived from a trophoblast cell line (30 ug/mL, protein). None of the women had allergies, atopy or recent infection. Cytokines were measured in supernatants with enzyme-linked immunosorbent assay (ELISA) kits. IFN- r kit was obtained from BOISOURCE (lower limit of sensitivity, 15.6 pg/mL for IFN- r ). All values below the lowest limit of sensitivity as determined by test kit standards were considered negative. The cytokine stimulation test is considered positive if the IFN- r concentration increases by 200% or more with the trophoblast antigen stimulation. Datas are presented as mean+ SEM. Nonparametric testing (Mann-Whitney U) was used for analysis with P<0.05 considered statistically significant. RESULTS: The Thl-type cytokine (IFN- r ) was detected in 20(67%) of 30 supernatants from women with URA. In contrast, 2 (20%) of trophoblast-activated PBMC culture supernatants from the 10 parus women with normal reproductive histories was detected IFN- r and but were significantly lower than levels in women with URA who had secreted IFN- r upon trophoblast stimulation (99.80+ 18.17 pg/mL versus 166.47 + 36.96 pg/mL, p<0.05). Spontaneous secretion of IFN- r was significantly higher in culture supernatants from women with URA than in supernatants from women with successful reproductive histories (41.36.09+6.99 pg/mL versus 25.89+9.34 pg/mL, p<0.05). CONCLUSION: These data indicate that there are significant differences between women with URA and women with normal reproductive histories in their regulation of the Thl-cytokine (IFN- r) in response to trophoblast. Thl-type immunity to trophoblast is associated with URA and may play a role in reproductive failure.
Abortion, Spontaneous* ; Cell Line ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Hypersensitivity ; Pregnancy ; Reproductive History ; Trophoblasts*