Delirium ; Diabetes Mellitus ; Fibula ; Fistula ; Forearm ; Free Tissue Flaps ; Humans ; Hypertension ; Incidence ; Mouth Neoplasms ; Necrosis ; Osteoradionecrosis ; Pneumonia ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Surgery, Oral ; Thigh ; Tissue Donors ; Wound Healing

OBJECTIVE: The purpose of this study is to review the surgical results of 19 patients with idiopathic trigeminal neuralgia treated by percutaneous ballooning compression(PBC) of trigeminal gasserian ganglion under brief general anesthesia. METHODS: The mean patient age was 63.5 years(range, 27-78). The mean follow-up period was 24 months(range, 1-46). Three patients had already undergone radiofreqnency trigeminal rhizotomy and two patients had previously microvascular decompression. The balloon was inflated by injecting radio-contrast media 0.7-1cc in amount. The mean inflating time is 81 seconds(range, 60-90). RESULTS: During the procedure, brief intraoperative bradycardia and hypotension were noted in seven cases(36.7%). All patients had immediate relief of pain except 1 case. 18 cases(94.5%) of patients were satisfied or very satisfied with their pain relief. There were immediate, mild to moderate sensory complication of hypesthesia, dysesthesia or paraesthesia in all cases and the immediate motor complication-difficulty of mastication in 3 cases, transient 6th nerve palsy in 2 cases. The immediate motor and sensory complications disappeared or much improved after 3-4 months. CONCLUSION: It is the simple technique that can be performed effectively in a brief period of general anesthesia. This procedure might be one of attractive methods in the treatment of idiopathic trigeminal neuralgia.
Abducens Nerve Diseases ; Anesthesia, General ; Bradycardia ; Follow-Up Studies ; Humans ; Hypesthesia ; Hypotension ; Mastication ; Microvascular Decompression Surgery ; Paresthesia ; Rhizotomy ; Trigeminal Ganglion* ; Trigeminal Neuralgia*

The purpose of this study is to assess abdominal sensation after free TRAM flap for breast reconstruction. 74 patients underwent breast reconstruction with free TRAM flap by authors and were followed up to check the sensation on abdomen following the surgery at the out patient clinic. They are compared with 20 female volunteer controls. Abdomens were divided into 13 zones, and assessed for superficial touch, superficial pain, temperature, two-point discrimination, and vibration. For all five sensory modalities, subjects were found to have decreased sensation in the umbilical and infraumbilical regions. This was statistically significant compared with controls. Division following pedicle dissection showed more reduction of sensation than non-dissection side. Both Inguinal areas below the donor site closure also showed markedly decreased sensation. Sensation on most area of abdomen recovered in postoperative 1 year, however, there were remained hypoesthesia in umbilical and infraumbilical area after post operative 1 year. This study clearly demonstrates that there is a significant and persistent reduction in abdominal sensibility following free TRAM flap surgery.
Abdomen* ; Breast* ; Discrimination (Psychology) ; Female ; Humans ; Hypesthesia ; Mammaplasty* ; Sensation ; Tissue Donors ; Vibration ; Volunteers

Tow surgically treated cases of thoracic tuberculous spondylitis with multievel involvement are presented. Radical debridement produced large deficit in the anterior structures and spinal instability. A reconstruction with mesh cylinder graft and combined anterior instrumentation surgery in one stage operation. Anterior Instrumentation provided immediate stability and protected against development of kyphotic deformity. There was no persistence or recurrence of infection after surgery. The average length of follow up was 24month including 12month, 18month course of chemotherapy.
Congenital Abnormalities ; Debridement ; Drug Therapy ; Follow-Up Studies ; Recurrence ; Spondylitis* ; Transplants

Body Mass Index ; Breast ; Cervix Uteri ; Chemoprevention ; Early Diagnosis ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Larynx ; Liver ; Lung ; Male ; Medical Records ; Mouth ; Mouth Neoplasms ; Neoplasms, Second Primary ; Polymethacrylic Acids ; Prognosis ; Risk Factors ; Smoke ; Smoking ; Stomach ; Survival Rate

Objective: This study aimed to determine the serum Dickkopf 1 (DKK1) levels in ankylosing spondylitis (AS) patients and decipher the mechanism of tumor necrosis factor (TNF)-mediated DKK1 regulation in human AS enthesis cells. Methods: The sera were obtained from 103 patients with AS and 30 healthy controls (HCs). The enthesis of facet joints were obtained from 4 AS patients and 5 controls. The serum levels of DKK1 were measured using ELISA and compared between AS and HCs. The impact of TNF on DKK1 expression in human primary spinal enthesis cells was evaluated using various molecular biology techniques and bone formation indicators. Results: AS patients showed higher serum DKK1 levels than HCs after adjusting for age (917.4 [615.3∼1,310.0] pg/mL vs. 826.2 [670.3∼927.8] pg/mL, p=0.043). TNF treatment promoted bone formation and DKK1 expression in both control enthesis cells and those of AS. This enhanced bone formation by TNF was pronounced in AS-enthesis than those of controls. Mechanically, TNF induced NF-κB activation upregulates the DKK1 transcript level. While, NF-κB inhibitor led to downregulate DKK1 expression in the enthesis. Besides, DKK1 overexpression promoted bone formation in enthesis. Conclusion TNF induced DKK1 expression in the enthesis through NF-κB activation. TNF-induced DKK1 expression may play a bone formation in the radiologic progression of ankylosing spondylitis.

Objective: This study aimed to determine the serum Dickkopf 1 (DKK1) levels in ankylosing spondylitis (AS) patients and decipher the mechanism of tumor necrosis factor (TNF)-mediated DKK1 regulation in human AS enthesis cells. Methods: The sera were obtained from 103 patients with AS and 30 healthy controls (HCs). The enthesis of facet joints were obtained from 4 AS patients and 5 controls. The serum levels of DKK1 were measured using ELISA and compared between AS and HCs. The impact of TNF on DKK1 expression in human primary spinal enthesis cells was evaluated using various molecular biology techniques and bone formation indicators. Results: AS patients showed higher serum DKK1 levels than HCs after adjusting for age (917.4 [615.3∼1,310.0] pg/mL vs. 826.2 [670.3∼927.8] pg/mL, p=0.043). TNF treatment promoted bone formation and DKK1 expression in both control enthesis cells and those of AS. This enhanced bone formation by TNF was pronounced in AS-enthesis than those of controls. Mechanically, TNF induced NF-κB activation upregulates the DKK1 transcript level. While, NF-κB inhibitor led to downregulate DKK1 expression in the enthesis. Besides, DKK1 overexpression promoted bone formation in enthesis. Conclusion TNF induced DKK1 expression in the enthesis through NF-κB activation. TNF-induced DKK1 expression may play a bone formation in the radiologic progression of ankylosing spondylitis.

Quadricuspid aortic valves (QAVs) is a rare congenital malformation. We report two cases of QAV associated with aortic regurgitation. The one is incidentally diagnosed and uncomplicated, and the other is symptomatic and associated with infective endocarditis. In most cases, QAVs are associated with valve regurgitation, with a concurrent stenosis in some patients, while only a small number of QAVs are functionally normal. Once the diagnosis has been made, echocardiographic follow-up is recommended, because of progression to severe valve regurgitation and the risk of infective endocarditis.
Aortic Valve Insufficiency* ; Aortic Valve* ; Constriction, Pathologic ; Diagnosis ; Echocardiography ; Endocarditis* ; Humans

Body Mass Index ; Carcinoma, Squamous Cell ; Cheek ; Female ; Gingiva ; Humans ; Lip ; Lymph Nodes ; Male ; Mouth ; Mouth Floor ; Mouth Neoplasms ; Neoplasm Metastasis ; Palate ; Prevalence ; Prognosis ; Recurrence ; Retrospective Studies ; Smoke ; Smoking ; Survival Rate ; Tongue

PURPOSE: Solid pseudopapillary tumor (SPT) of the pancreas is a rare benign or low-grade pancreatic neoplasm with distinct clinicopathologic features. The purpose of this study was to evaluate the clinical presentation of SPT and to examine the etiology of this tumor by performing immunohistochemical staining. METHODS: From October 1994 to March 2005, 35 cases of SPT who underwent operations were retrospectively reviewed. The clinicopathologic findings and late results of treatment were studied in 7 cases of borderline malignant SPT and in 28 cases of the benign SPT. Immunohistochemical staining was performed for alpha1-antitrypsin, alpha1-antichymotrypsin, neuron specific enolase, chromogranin, synaptophysin, vimentin and cytokeratin. RESULTS: The mean age of the patients was 31.8 years. SPT's were more common in women (77.1%) and the tumors were usually located in the body and the tail of the pancreas (68.6%). There were statistically significant differences in the men (P=0.016), for the masses with calcification (P=0.029), and for the solid masses (P=0.018) between the malignant SPT (including the borderline malignant SPT) and the benign SPT (P=0.014). The SPTs stained positive for alpha1-antitrypsin, neuron specific enolase, and vimentin in all cases, and they were alpha1-antichymotrypsin positive in 94.1% (16/17), chromogranin positive in 18.8% (3/16), synaptophysin positive in 12.5% (2/16), and cytokeratin positive in 18.2% (2/11). All 35 patients underwent curative resection and they are all alive without any evidence of recurrence at a mean follow-up of 44.2 months. CONCLUSION: SPT is a rare tumor that behaves less aggressively than other pancreatic tumors, and surgical resection can result in cure. This tumor thought to originate from a stem cell capable of differentiating into endocrine cells or exocrine cells.
Endocrine Cells ; Female ; Follow-Up Studies ; Humans ; Keratins ; Male ; Pancreas* ; Pancreatic Neoplasms ; Phosphopyruvate Hydratase ; Recurrence ; Retrospective Studies ; Stem Cells ; Synaptophysin ; Vimentin