We report a case of atrophoderma of Pasini and Pierini in which the characteristic soft atrophic patch with cliffdrop border developed on the neck and two well-demarcated indurated atrophic patches were on both shoulders. We took biopsies from centers and margins of each lesion. Histipathologic findings from atrophic center showed marked dermal atrophy comparing to that from margin of the lesion on the neck, but the atrophic center and margin of the lesion on the shoulder showed morphea-like features without, distinct differences between two.
Atrophy ; Biopsy ; Neck ; Shoulder

This retrospective study comprised 50 patients(57 fractures) with pediatric mandibular fractures sustained in various accidents and treated in the Department of Plastic and Reconstructive Surgery at the Dong-A Medical Center from September 1990 till May 2005. These patient's medical records were then retrospectively analysed in order to gain insight into a clinical pattern. 1.The seasonal and monthly incidence was the highest in Summer and August, the commonest accident time was between 12:00 p.m and 06:00 p.m. 2.The highest incidence in the age was between seven and nine years old, with male predominating over female in 1.7:1 ratio. 3.The most common cause of mandibular fractures was motor vehicle accidents followed by fall, exercise accident and others. 4.Nasal bone fracture was the commonest associate facial bone fracture. 5.Open reduction was done in 59% of total cases. 6.The cases of condyle fracture were treated with closed reduction or conservative management. Complications were malocclusion(4), TMJ limitation(2), asymmetry(2).
Facial Bones ; Female ; Fractures, Bone ; Humans ; Incidence ; Male ; Mandibular Fractures* ; Medical Records ; Motor Vehicles ; Plastics ; Retrospective Studies ; Seasons ; Temporomandibular Joint

No abstract available.

Maxillary lateral incisors usually exhibit a single root with a single canal. However, maxillary lateral incisor teeth with unusual morphology of root canal system are frequently reported. These cases of variable root canal anatomy can be treated well by nonsurgical endodontic methods. A detailed description of root canal morphology is fundamental for successful endodontic treatment. Treatment using an operating microscope, radiographs from different angles, and cone-beam computerized tomography (CBCT) can produce more predictable endodontic outcomes.
Cone-Beam Computed Tomography ; Dental Pulp Cavity ; Incisor* ; Methods ; Tooth

Exposing sound structure of a subgingivally fractured tooth using orthodontic extrusion is considered to be a conservative way to re-establish biologic width without sacrificing esthetics or jeopardizing periodontal support of neighboring teeth. When a misaligned tooth is traumatically involved, a more comprehensive approach combining tooth extrusion and re-alignment may be necessary for a successful restorative outcome. This case report describes a successful esthetic management of a patient with complicated crown-root fracture on the maxillary right central incisor and pre-existing malocclusion in the maxillary anterior region. Forced eruption along with re-alignment of teeth by orthodontic movement seems to allow re-positioning of the fracture line to a favorable position and correction of crowding, providing a better esthetic result.
Crowding ; Esthetics ; Humans ; Incisor ; Malocclusion ; Orthodontic Extrusion* ; Tooth*

For treatment of the pressure sore, variable methods have been developed such as skin graft, local flap, myocutaneous or fasciocutaneous flap. The myocutaneous flap has been used commonly for the coverage and padding of the wound. However, sacrifice of the deep muscles causes some problems such as intraoperative bleeding, functional disabilities of donor sites, and difficulty in controling the volume of the flap for the skin reability of myocutaneous flaps. To overcome these disadvantages, we tried perforator-based myocutaeous island flaps for reconstruction of buttock area. During the dissection of the flap, we could control the volume and shape of the flap exactly depending on the perforator. And minimal morbidity of the donor site is expected because of significant volume of gluteus maximus muscle need not be sacrificed. The perforator-based flaps are especially indicated for ambulatory patients, and for paraplegic patients as well. Clinically, total of 20 cases were treated with 13 parasacral perforator-based myocutaneous island flaps and 7 parasacral perforator-based fasciocutaeous island flaps. The mean operating time was 84 minutes, and the mean flap size was 8x9.2 cm. In donor sites, primary closure were done in all cases, post operative complications were wound dishescence in 1 case, venous congestion in 3 cases, but immediately improved. Recurrence was not reported.
Buttocks ; Hemorrhage ; Humans ; Hyperemia ; Muscles ; Myocutaneous Flap ; Pressure Ulcer* ; Recurrence ; Skin ; Surgical Flaps ; Tissue Donors ; Transplants ; Wounds and Injuries

BACKGROUND: Definite criteria for determining severity of organophosphate poisoning have not been made. Discovery of the third neuromuscular syndrome, the intermediate syndrome, have made it more complicating then ever. Objectives of this study is to determine early prognostic factors of outcome and development of a new treatment algorithm. METHOD: 74 patients admitted to Severance hospital with acute organophosphate poisoning during 5 years were included. We made a protocol concerning the initial consciousness level, QTc interval, PVC, serum cholinesterase, the intermediate syndrome, total hospital, ICU day, length of ventilator support, disposition and have done a study retrospectively. Multiple regression and Chi-square was used as statistical analysis. Significant statistical P-value was 0.05. RESULTS: The total hospital days were prolonged as serum cholinesterase levels were lower, the age was older and mental status graver.(p<.05) The length of ventilatory support was prolonged when patient's serum cholinesterase level was very low, they were unconscious and serum cholinesterase level not recovered to 500 IU/ml within initial 3 days. The intermediate syndrome was significantly related to the prolonged cholinesterase inhibition. CONCLUSION: As an early prognostic factor for the length of ventilatory support in organophosphate poisoning, 1) level of concsiousness and 2) serum cholinesterase level at admission, 3) recovery to more than 500 IU/ml within initial 3 days are useful. Especially when the serum cholinesterase level is not recovered to more than 500 IU/ml within initial 3 days, it is essential to observe closely for the possibility of an intermediate syndrome.
Cholinesterases ; Consciousness ; Humans ; Organophosphate Poisoning* ; Retrospective Studies ; Ventilators, Mechanical

BACKGROUND: The dipstick methodology is the most fundamental urinalysis but interfered by many factors. We evaluated the effect of semen contamination on the urine dipsticks. METHODS: Thirty-two specimens for semen analysis were enrolled. After semen was directly applied on urine dipsticks, residual samples were diluted in pooled normal urine. Urine dipsticks were performed at each dilution titer. Seminal plasma separated by centrifugation of semen were also tested in the same manner. RESULTS: All semen showed positive results for blood, protein and leukocytes. The intensities of reaction for blood and leukocytes were correlated with sperm concentration. The negative conversion of blood and protein occurred at 1:100, and that of leukocytes occurred at 1:50. Seminal plasma showed nearly the same findings. CONCLUSIONS: Semen contamination of urine may cause false positive reaction especially for blood and protein on the urine dipsticks. It should therefore be considered when assessing unexplained, transient hematuria or proteinuria.
Centrifugation ; False Positive Reactions ; Hematuria ; Leukocytes ; Proteinuria ; Semen Analysis ; Semen* ; Spermatozoa ; Urinalysis

OBJECTIVES: The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery. MATERIALS AND METHODS: Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT. RESULTS: The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01). CONCLUSIONS: For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration.
Apicoectomy ; Cone-Beam Computed Tomography ; Humans ; Molar* ; Tooth

BACKGROUND: Many liver transplant surgeons think that portal vein cold perfusion is essential during liver procurement. However, it may limit the perfusion to the pancreas and small intestine and may lengthen the procedure. If visceral arteries are not ligated, perfusates passing the spleen and the small intestine can eventually cool the liver. Aorta only perfusion is rapid and easy and can be performed with the better perfusion of the pancreas and small intestine than with conventional perfusion. However, it may delay the cooling of the liver. The purpose of this study was to evaluate the feasibility of aorta only perfusion compared with conventional perfusion as an alternative method for multiorgan procurement. METHODS: Male mongrel dogs of 16-18 kg were used. In the control group (n=5), standard multiorgan procurement method, including portal vein perfusion, was performed. In experimental group (n=4), aorta only perfusion without superior mesenteric artery ligation was performed. An isotonic citrate solution was used as a perfusate. In the control group, a total amount of 800 to 1000 ml of the perfusate was used to each portal vein and aorta perfusion. In the experimental group, 1500 to 2000 ml of the perfusate were infused only to aorta. After donor liver procurement, 200 to 300 ml of the perfusate was added to the portal vein and the hepatic artery at a ratio of 8:2. Core temperature changes of the liver during perfusion with preservation solution were checked at 5-second intervals. Standard orthotopic liver transplantation was performed. Wedge liver biopsies were performed after procurement and 1 hour after reperfusion. A liver function test was performed, and the hematologic features, and the coagulation profiles were measured preoperatively and one hour after reperfusion. In histologic examination, injuries of hepatic vessel endothelia and hepatocytes were evaluated semiquantitatively under light microscopic and electron microscopic exams. RESULTS: A comparion of the two groups showed no differences in operation time, anhepatic time, and ischemic time. The values of the leukocyte count, the hemoglobin, hematocrit, the prothrombin time,the partial thromboplastin time, the total protein/albumin, bilirubin, ALT/AST and alkaline phosphatase were not different between two groups. Falling of liver core temperature during perfusion was slightly delayed in experimental group. However the delayed time was less than 2 minutes until to reach the temperature of 10oC. The histological grading scores of hepatocytes and endothelial damage determined from light microscopic and electron microscopic examinations were not different from each other. CONCLUSIONS: There was no difference between aorta only perfusion group and portal vein perfusion group, including the severity of liver damages. Therefore, liver procurement without in situ portal perfusion may be a reasonable alternative to combined portal and aorta perfusion on the background of rapid procurement and benefit to the pancreas and small intestine procurement.
Alkaline Phosphatase ; Animals ; Aorta ; Arteries ; Bilirubin ; Biopsy ; Citric Acid ; Dogs ; Hematocrit ; Hepatic Artery ; Hepatocytes ; Humans ; Intestine, Small ; Leukocyte Count ; Ligation ; Liver Function Tests ; Liver Transplantation* ; Liver* ; Male ; Mesenteric Artery, Superior ; Pancreas ; Partial Thromboplastin Time ; Perfusion* ; Portal Vein ; Prothrombin ; Reperfusion ; Spleen ; Tissue Donors