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

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

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

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*

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.

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.

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

Anterior basal meningiomas, which belong the olfactory groove and suprasellar meningioma account for 12 to 22% of all intracranial meningioma. Anterior cranial base meningioma are difficult to operate on because of their proximity to the important neurovascular structure. The authors report 25 cases of large meningiomas of the anterior. cranial base operated on during recent 5-year period. The tumor ranged from 3cm to 6.5cm in diameter. Fifteen tumors were located in the suprasellae(included tuberculum sellae, planum sphenoidale, diaphragma sellae,and anterior clinoid process), ten on olfactory groove. The mean age of 19 female and 6 male patient was 55years. The main clinical symptom were visual disturbance, anosmia, headache, and psychotic syndrome. Tumors were approached in 11 cases by pterional, in 9 cases by bifrontal, in 3 cases by transbasal, in 2 case by orbitozygomatic infratemporal and in 1 case by combined approach with tranabasal and orbitozygomatic infratemporal. Total tumor removal was performed in 80% of cases. Postoperative complication include accentuated psychotic syndrome in two cases, worsening of visual function in two, major vessel injury in one, infection in one, CSF rhinorrhea in one, and oculomotor palse in one. Postoperative death was in four(16%). Results at follow up of the 21 survivours were good in 17(68%), fair in 4(16%). Selection criteria for operative approach is discussed with review of pertinent literature.
Female ; Follow-Up Studies ; Headache ; Humans ; Male ; Meningioma* ; Olfaction Disorders ; Patient Selection ; Postoperative Complications ; Skull Base ; Temazepam