We report a patient with an unusual manifestation of Trichophyton violaceum infection, who lives in Seoul. An 8-year-old male presented an erythematous nodule on the lower eyelid of the left eye which had persisted for 10 weeks. On physical examination, there was no abnormality except a skin lesion on the eyelid. The skin biopsy of the nodule showed epidermal hyperplasia and granulomatous change in the upper dermis. The biopsy specimen yielded Trichophyton uiolaceum on culture. The skin lesion disappeared 2 months after administration of ketoconazole.
Biopsy ; Child ; Dermis ; Eyelids ; Granuloma* ; Humans ; Hyperplasia ; Ketoconazole ; Male ; Physical Examination ; Seoul ; Skin ; Trichophyton*

The principle of surgery of the parotid gland is adequate removal of the tumor with functional and anatomical preservation of all blanches of the facial nerve. There are two main surgical approaches to superficial or total conservative parotidectomy. Anterior approach and posterior approach. Preliminary identification of the main trunk of the facial nerve is probably the most favoured techniques, but identification of the peripheral blanches of the facial nerve, with subsequent Proximal dissection to the main trunk, is long established but less popular technique. We have prospectively experienced the low incidence of facial nerve damage in series of 55 conservative parotidectomies performed using the anterior approach. The techniques employed is described with a deport of results obtained in the belief that this approach warrants greater popularity and saute technique.
Facial Nerve ; Incidence ; Parotid Gland ; Prospective Studies

PURPOSE: Marginal fit is a very important factor considering the restoration's long-term success. However, adding porcelain to copings can cause distortion and lead to an inadequate fit which exposes more luting material to the oral environment and causes secondary caries. The purpose of this study was to compare the marginal fit of 2 different all-ceramic crown systems before and after porcelain veneering. This study was also intended to verify the marginal fit of crowns originated from green machining of partially sintered blocks of zirconia (Lava CAD/CAM system) and that of crowns obtained through machining of fully sintered blocks of zirconia (Digident CAD/CAM system). MATERIAL AND METHODS: 20 crowns were made per each system and the marginal fit was evaluated through a light microscope with image processing (Accura 2000) at 50 points that were randomly selected. Each crown was measured twice: the first measurement was done after obtaining a 0.5 mm coping and the second measurement was done after porcelain veneering. The means and standard deviations were calculated and statistical inferences among the 2 groups were made using independent t-test and within the same group through paired t-test. RESULTS: The means and standard deviations of the marginal fit were 61.52 +/- 2.88 micrometer for the Digident CAD/CAM zirconia ceramic crowns before porcelain veneering and 83.15 +/- 3.51 micrometer after porcelain veneering. Lava CAD/CAM zirconia ceramic crowns showed means and standard deviations of 62.22 +/- 1.78 micrometer before porcelain veneering and 82.03 +/- 1.85 micrometer after porcelain veneering. Both groups showed significant differences when analyzing the marginal gaps before and after porcelain veneering within each group. However, no significant differences were found when comparing the marginal gaps of each group before porcelain veneering and after porcelain veneering as well. CONCLUSION: The 2 all-ceramic crown systems showed marginal gaps that were within a reported clinically acceptable range of marginal discrepancy.
Ceramics ; Crowns ; Dental Porcelain ; Light ; Zirconium

Reconstruction of the soft tissue defects on the plantar foot continues to be a difficult challenges because of the unique anatomical features. It should endure constant weight loading or alternate stimulus of shoes while standing or walking. The methods used for reconstruction of the soft tissue defects on the plantar foot are skin graft, local flap, cross leg flap, myocutaneous flap, neurovascular island and free flap. However, it is verb difficult to find a proper method to reconstruct the soft tissue defect of the first toe plantar area. The ideal reconstruction should provide tissue as durable yet sensitive, provide tissue components similar to the original lost tissue, be reliable, result in a donor site that is well tolerated, and entail one operative procedure with minimal morbidity Although the medial plantar flap was initially described to surface heel defects, many surgeons haute used this flap as a cross leg flap or a free flap to recover the first toe plantar area. Its use has always required a secondary surgical procedure or a difficult technique. In order to overcome this inconvenience, we used the flap based on the principle of reversing the direction of blood flow in a distal vascular pedicle to restore a defect of the anteromedial aspect of the foot. We haute experienced 3 cases of reverse medial plantar flap for the reconstruction of the great toe plantar area. Good functional and aesthetic results were obtained.
Foot ; Free Tissue Flaps ; Heel ; Humans ; Leg ; Myocutaneous Flap ; Shoes ; Skin ; Surgical Procedures, Operative ; Tissue Donors ; Toes* ; Transplants ; Walking

No abstract available.
Chin* ; Humans ; Membranes* ; Prostate* ; Prostatic Neoplasms* ; RNA, Messenger* ; RNA-Directed DNA Polymerase*

PURPOSE: The detection of bladder cancers by noninvasive techniques remains an unsolved problem. We evaluate the availability of an immunoassay for urinary nuclear matrix protein, NMP 22, as an indicator for transitional cell carcinoma of the bladder. MATERIALS AND METHODS: Three groups of subjects participated in this trial of NMP 22: 22 patients with transitional cell carcinoma (group 1), 12 patients with urinary tract infection (group 2) and 31 healthy volunteers (group 3). NMP 22 was determined by ELISA using a commercial test kit (NMP 22 Test Kit, Matritech Inc., USA), We compared urinary NMP 22 levels to the grade, stage, cytology and DNA flowcytometry of transitional cell carcinoma of bladder. RESULTS: NMP 22 values in these 3 groups were significantly different (group 1, median 24.81 U/mL; group 2, median 8.41 U/mL; and group 3, median 5.12 U/mL; Mann-Whitney U test for differences between 3 medians, p < 0.05). The patients with transitional cell carcinoma had significantly greater urinary NMP 22 levels than those with no evidence of tumor (Mann-Whitney U test for differences between 2 medians, p<0.01). There was no zelationship between the urinary NMP 22 levels and tumor grade, stage, cytology or DNA flowcytometry. CONCLUSIONS: It is possible that urinary NMP 22 could improve the detection of bladder transitional cell carcinoma.
Carcinoma, Transitional Cell* ; DNA ; Enzyme-Linked Immunosorbent Assay ; Healthy Volunteers ; Humans ; Immunoassay ; Nuclear Matrix* ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Tract Infections

STATEMENT OF PROBLEMS: In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective need of dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions. PURPOSE: The aims of the current study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze their dental treatment needs. MATERIAL AND METHODS: The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was more than 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea. RESULTS AND CONCLUSION: The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residual teeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (p < .05). The number of fixed partial denture in institutionalized elderly was lower than that of the same ages in control group (p < .05). The percentage wearing removable partial denture was not significant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institutionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institutionalized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was higher than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete denture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of institutionalized elderly were lower than that of the control group (p < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partial dentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in the maxilla (p < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teeth was less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of occluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase the awareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth are increasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control of dentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project of edentulous patients should be done by specialists who'll also be responsible for postmanagement. Through this research of institutionalized elderly, the oral health status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in order to solve the rising treatment needs of the elderly patients.
Aged ; Aging ; Caregivers ; Dental Arch ; Dental Care ; Dental Offices ; Dental Prosthesis ; Denture, Complete ; Denture, Partial, Fixed ; Denture, Partial, Removable ; Dentures ; Humans ; Mandible ; Maxilla ; Oral Health ; Prosthodontics ; Republic of Korea ; Societies, Dental ; Specialization ; Tooth

Male infertility occurs after spinal cord injury (SCI). However, little is known about the effect of SCI on male reproductive function. We evaluated objective assessment of spermatogenesis of spinal cord injured rats by quantitative micrometry and DNA flow cytometry analysis at various time intervals. SCI was produce(B in 30 rats by 710 spinal cord transection. Controls received similar surgery without transaction. From 10 randomly selected seminiferous tubules per subject the mean number of mature spermatids, Sertoli cells, tubular diameter and tubular wall thickness were determined in both groups. The percentage of haploid, diploid and tetraploid cells were determined of each subject by DNA (low cytometry, Two way analysis of variance (ANOVA) was performed. In the SCI rats the mean number of spermatid per tubule was significantly lower (p=0.01) than that of controls. The mean number of Sertoli cells per tubule was not different from that of controls. Mean of spermatid to Sertoli cell ratio per seminiferous tubule in SCI rats was significantly lower than in controls (p=0.048). No significant differences of tubulr wall thickness, diameter and percentage of haploid cells were noted between both groups. These results suggest that the effect of SCI on spermatogenesis is associated with inadequacy of spermatid formation and maturation delay of spermatid.
Animals ; Diploidy ; DNA ; Flow Cytometry ; Haploidy ; Humans ; Infertility, Male ; Male ; Rats* ; Seminiferous Tubules ; Sertoli Cells ; Spermatids ; Spermatogenesis* ; Spinal Cord Injuries* ; Spinal Cord* ; Tetraploidy

The elimination of most anticholinesterases depends on the kidney, even if the main organ for their metabolism is the liver. Renal excretion of pyridostigmine, edrophonium and neostigmine accounts for 15%, 70% and 50%, respectively. In the absence of renal function, the serum half-life of neostigmine is prolonged, its plasma clearance is decreased However, the pharmacodynamics of neostigmine have not been determined in renal failure. This study was designed to compare the neostigmine dynamics in 18 patients with normal renal function to that in 18 patients with renal failure(Group I & II, respectively). Using the flexor carpi ulnaris EMG via ulnar nerve stimulation with Train-Of-Four(TOF) under the constant infusion of vecuronium to produce about 85%-twitch depression, the responses of neostigmine with three different doses were obtained. The results are follows; 1) The constant infusion rates of vecuronium to maintain sbout 15&-twitch height prior to the administration of neostigmine showed no significant difference between two groups. 2) Immediately prior to each dose of neostigmine, the mean values of twitch heights were 11.7 to 13.7%. 3) There was no significant difference in the onset time, maximum twitch responses and antagonism effects between two groups in respect to each same dose of nesotigmine. 4) The duration of neostigmine with the half of ED only in Group II was significantly longer than that in Group I, even if the durations with the other doses in Group II were not significantly longer than those in Group L These results suggest that the reversal effect of neostigmine to vecuronium-induced block- ade may be outlasted in patients with renal failure and the prolongation of neostigmine effeet may render some benefits to reverse the relaxants which have the limitation of its elimination in this patients.
Cholinesterase Inhibitors ; Depression ; Edrophonium ; Half-Life ; Humans ; Kidney ; Liver ; Metabolism ; Neostigmine* ; Neuromuscular Blockade* ; Plasma ; Pyridostigmine Bromide ; Renal Insufficiency* ; Ulnar Nerve ; Vecuronium Bromide*

STUDY DESIGN: A retrospective study. PURPOSE: To comparatively investigated the rate of the adjacent segment degeneration and the clinical outcomes in patients with spondylolytic spondylolisthesis, spinal stenosis or degenerative spondylolisthesis. OVERVIEW OF LITERATURE: There have been few studies reported on the adjacent segment degeneration following posterior lumbar interbody fusion(PLIF). Many risk factors for the adjacent segment degeneration following PLIF have been proposed. The range of decompression has been presented as one of the risk factors, yet controversial. METHODS: This study enrolled sixty-three patients who had been treated with single-level PLIF and who were followed up for more than two years. The patients were divided into 3 groups based on the preoperative diagnosis. We analyzed the difference between the preoperative and postoperative intervertebral disc heights of the superior adjacent segments. The incidence rates of instability and the clinical outcomes were comparatively analyzed between each group. RESULTS: The average age of the patients was 55.8 years in the spondylolytic spondylolisthesis group, 65.9 years in the degenerative spondylolisthesis group and 60.4 years in the spinal stenosis group. The average follow-up period was 44 months, 43 months and 42 months, respectively. At the last follow-up, compared to the preoperative period, the intervertebral disc height decreased in all three groups. A statistically significant decrease (p < 0.01) was observed only in the spondylolytic spondylolisthesis group and no significant difference was observed between each group (p = 0.41). The incidence rate of instability and the clinical outcome were not significantly different between each group. CONCLUSIONS: Spondylolytic spondylolisthesis with total laminectomy and single-level PLIF showed no significant difference in the superior adjacent segment degeneration and instability, and the clinical outcome as compared to that of partial laminectomy with single-level PLIF for treating degenerative spondylolisthesis or spinal stenosis.
Decompression ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Laminectomy ; Preoperative Period ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spondylolisthesis