Alveolar Bone Grafting ; Cicatrix ; Congenital Abnormalities ; Dentition, Mixed ; Fistula ; Humans ; Inlays ; Oral Hygiene ; Rehabilitation ; Ribs ; Tooth, Deciduous ; Transplants

A surgical approach involving the retromolar trigone, posterolateral maxilla, and pterygoid region is the most challenging in the field of maxillofacial surgery. The upper cheek flap (Weber-Ferguson incision) with subciliary extension and the maxillary swing approach have been considered as alternatives; however, neither approach provides sufficient exposure of the pterygoid region and the anterior portion of the mandibular ramus. In this report, we describe two cases in which a lower cheek flap approach was used for complete tumor resection in the retromolar trigone and the anterior mandibular ramus. This approach allows full exposure of the posterolateral maxilla and the pterygoid region as well as the retromolar trigone without causing major sensory disturbances to the lower lip. A mental nerve anastomosis after tumor resection was performed in one patient and resulted in approximately 90% sensory recovery in the lower lip. The lower cheek flap approach provides adequate exposure of the posterolateral maxilla, including the pterygoid, retromolar trigone, and mandibular ramus areas. If the mental nerve can be anastomosed during flap approximation, postoperative sensory disturbances to the lower lip can be minimized.
Cheek* ; Humans ; Lip ; Maxilla* ; Surgery, Oral

PURPOSE: The mortality rate of neonatal sepsis has been decreased, however, the incidence has not significantly decreased because of increased invasive procedures. This study was designed to make guidelines for choosing antibiotics by analyzing the causative microorganisms and their antibiotics sensitivity test according to the onset of neonatal sepsis. METHODS: One hundred seven cases of culture proven sepsis in 89 patients admitted to the NICU of Chonnam University Hospital from Jan. 2000 to Dec. 2004, were enrolled. By reviewing the medical records, clinical data, laboratory findings, causative organisms and their antibiotics sensitivity, and mortality were analyzed. RESULTS: The incidence of neonatal sepsis was 1.7 percent and more prevalent in premature and low birth weight infants. 85.4 percent of neonatal sepsis was late onset. Almost all microorganisms(92.9 percent) were gram-positive in early onset, however, two thirds were gram-positive and one third were gram-negative and Candida in late onset. Gram-negative organisms and Candida were more prevalent in patients who had central line. Gram-positive organisms were sensitive to vancomycin, teicoplanin, and gram-negative were sensitive to imipenem, and cefotaxime. CONCLUSION: Neonatal sepsis was more prevalent in premature and low birth weight infants. More than 90 percent were gram-positive in early onset, however, one third was gram-negative and Candida in late onset. The first choice of antibiotics were a combination of third generation cephalosporin and clindamycin in early onset, and third generation cephalosporin and glycopeptide in late onset. If there is no response to antibiotics treatment, the use of antifungal agents should be considered.
Anti-Bacterial Agents* ; Antifungal Agents ; Candida ; Cefotaxime ; Clindamycin ; Humans ; Imipenem ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Jeollanam-do ; Medical Records ; Mortality ; Sepsis* ; Teicoplanin ; Vancomycin

PURPOSE: Neuroendocrine (NE) cells in a prostate carcinoma may play important roles in tumor growth, proliferation and progression. The aim of this study was to evaluate the relationship between the NE cell differentiation status and pathological characteristics of prostate cancer. MATERIALS AND METHODS: Radical prostatectomy specimens from 215 patients were available for analysis. NE cell were detected by immunohistochemistry, using antibodies to chromogranin A (CgA). Tumor cell proliferation was assessed using the Ki-67 proliferation index (PI) employing the MIB-1 antibody. Staining of CgA was scored as: 0= no staining; 1= staining cell < 10; 2= staining 10-20; and 3= staining cell >20. Tumors were classified depending on their staining score, positive staining and growth pattern. RESULTS: NE cell differentiation was present in 25.1% (54/215) of tumors. The amount of NE cells significantly increased; from tumors with solitary scattered NE cells to both small and large clusters (p<0.05). NE cell differentiation and the growth pattern were correlated with the Ki-67 PI (p<0.05). With respect to high-grade tumors, an increased PI was found in tumors with positive NE cells compared with those with negative NE (p<0.05). Pathologically advanced tumors, or those with higher histological grades, were associated with NE cell differentiation and Ki-67 PI (p<0.05). CONCLISIONS: NE cell differentiation in prostate cancer may lead to increased proliferation, high-grade tumors and an advanced stage. The exact prognostic significance of NE still has to be addressed in larger prospective, comparative and highly selective clinical studies.
Antibodies ; Cell Differentiation ; Cell Proliferation ; Chromogranin A ; Humans ; Immunohistochemistry ; Neuroendocrine Cells* ; Prostate* ; Prostatectomy ; Prostatic Neoplasms*

PURPOSE: The ureteric length is the most important factor in determining the ideal length of a ureteral stent. In most literature, the ureteric length has been estimated according to the patient height. The ureteric length and reliability of the patient's height were both investigated. MATERIALS AND METHODS: The actual ureteral trace(AUT) and linear distance(LD) from the ureterorenal junction to the ureterovesical junction were measured on the 15 minute intravenous pyelography(IVP) view. A total of 203 patients(100 men, 103 women and 406 ureters), with normal findings, were studied. The AUT, LD and height were all measured. RESULTS: The mean+/-SD height and AUT of the right and left ureters of the patients were 164.3+/-8.3, 23.4+/-1.9 and 24.4+/-2.0cm, respectively. Mean LD of right and left ureters were 22.1+/-1.9 and 22.9+/-2.0cm, respectively. The patient's height showed significant correlations with both the AUT and LD, but these correlations were not linear (R2=0.024 [Rt], 0.059 [Lt]). However, the AUT and LD had a linear correlation (R2=0.879 [Rt], 0.884 [Lt]). Two formulae for estimating the AUT from measurement of the LD were suggested: Right AUT=0.94xright LD+2.6. Left AUT=0.96xleft LD+2.4. CONCLUSIONS: Our results have demonstrated that a patient's height was not reliable for estimating the ureteric length. The LD on IVP is preferable to the patient's height in estimating the ureteric length.
Body Height ; Female ; Humans ; Male ; Stents ; Ureter* ; Urography*

Alveolar Bone Grafting ; Alveolar Process ; Bone Marrow ; Bone Transplantation ; Busan ; Female ; Humans ; Male ; Maxilla ; Surgery, Oral ; Transplants

Adult ; Animals ; Dogs ; Electric Stimulation ; Humans ; Latency Period (Psychology) ; Osteogenesis ; Osteogenesis, Distraction ; Osteopontin ; Osteotomy

PURPOSE: To determine the malignant potential in clinically localised small renal cell carcinoma (RCC) (≤4cm) in patients using postoperative pathologic outcomes. MATERIALS AND METHODS: We performed a retrospective analysis of 2,085 patients in 7 urology centres with clinical T1a RCC who underwent nephrectomy. The pathologic upstaging group (PUG) was defined by pathologic T3a after the operation. Multivariate analyses were used to examine predicting factors for the risk of PUG. Next, Kaplan-Meier analysis was used to examine the PUG for worse recurrence-free survival during the follow-up period. RESULTS: The PUG had 73 patients (3.5%); they were older and had a larger tumour size than the other patients (all p<0.001). After adjusting for clinical characteristics, age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02–1.06) and tumour size greater than 3 cm (OR, 1.94; 95% CI, 1.21–3.11) were found to be independent predictors for the PUG after nephrectomy. Furthermore, the PUG had worse recurrence-free survival during the follow-up period. CONCLUSIONS: In this multi-institution analysis, RCC 3 cm or greater in older patients had a high malignant potential compared to relatively small tumours in younger patients. These results may be helpful for stratifying patients to manage small renal masses.
Carcinoma, Renal Cell* ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Multivariate Analysis ; Nephrectomy ; Retrospective Studies ; Urology

Vacuum-assisted closure therapy is an alternative method for a massive subcutaneous emphysema treatment. It is easily applicable and shows rapid effectiveness in massive subcutaneous emphysema, intractable with chest tube drainage.
Chest Tubes ; Drainage ; Negative-Pressure Wound Therapy ; Subcutaneous Emphysema

STUDY DESIGN AND OBJECTIVE: Tumor necrosis factor-alpha(TNF-alpha), a key inflammatory mediator, has been demonstrated in spinal cord injury (SCI). However, the expression of TNF receptors following SCI remains to be identified. To elucidate the expressions of TNF receptor I (TNFRI), TNFRII, XIAP, and their function in SCI, in situ hybridization and RT-PCR were performed in a SCI model. MATERIAL AND METHODS: Sprague-Dawley rats were anesthetized with halothane and laminectomized at the level of the eleventh and twelfth thoracic vertebra. Using a modified New York University Impactor, SCI was induced by dropping a 10 gm weight from a height of 20 mm. The rod of the impactor had a constant circular surface, 3 mm in diameter. After induction of the injury, rats were placed in a temperature and humidity-controlled chamber overnight. RESULTS: The TNFRI gene was not detected in the control rats, but the TNFRII gene was expressed in the neurons in the control rats. The TNFRI gene expression was maximally increased in the spinal cord 1 day after the SCI; however, that of the TNFRII gene occurred 3 days after the SCI. In the white matter, both the TNFRI and TNFRII genes were increased in the oligodendrocytes 3 days after the SCI. The XIAP gene was increased in neurons of the gray matter 1 and 3 days after the SCI, but was not detected in the white matter after the SCI. CONCLUSION: Up-regulation of the expression of TNFRII occurs later than that of TNFRI in the spinal cord after a SCI. TNFR may be related to neuronal survival considering its similar expression pattern to that of XIAP. The results from these studies may lead to alternative therapeutic targets of TNF receptors in spinal cord injury, providing the basis for developing agonist and antagonist systems for TNF receptor subtypes and also for encouraging better strategies for the treatment of spinal cord disorders related to trauma.
Animals ; Apoptosis* ; Gene Expression ; Halothane ; In Situ Hybridization ; Necrosis ; Neurons ; Oligodendroglia ; Rats* ; Rats, Sprague-Dawley ; Receptors, Tumor Necrosis Factor* ; Spinal Cord Diseases ; Spinal Cord Injuries* ; Spinal Cord* ; Spine ; Tumor Necrosis Factor-alpha* ; Up-Regulation