BACKGROUND: Free radical-mediated oxidative damage has been implicated in ischemic brain injury. There are also increasing evidences that nitric oxide is involved in the mechanisms of cerebral ischemia. To elucidate the effect of nitric oxide synthesis inhibition on the hydroxyl radical formation, we used a method based on the chemical trapping of hydroxyl radical in the form of the stable adducts 2,3-DHBA following salicylate adminstration. METHODS: Sprague-Dawley rats were subjected to 15 min of global cerebral ischemia by both carotid artery occlusion plus systemic hemorrhagic hypotension (35 mmHg). Artificial CSF including salicylate (5 mM) was continuously infused through a microdiaysis probe implanted in the left hippocampus CA1. Hippocampal extracellular fluid was sampled at regular intervals before, during, and after ischemia. The levels of 2,3-DHBA were assayed by HPLC with electrochemical detection during 15 minutes of ischemia and reperfusion period. RESULTS: Cerebral blood flow was reduced to 5% level of control in ischemic period, but increased 3 or 4 times in early phase of reperfusion period, and returned to normal 50 to 60 minutes after the cessation of ischemia. Inhibition of NOS by L-NAME did not prevent ischemia-induced 2,3-DHBA elevation, but increased its level during reperfusion. This increase in 2,3-DHBA could be reversed by L-arginine. The elevated 2,3-DHBA after IR in L-NAME treated rats was not due to either changes in CBF or local blood brain barrier permeability. CONCLUSIONS: The above results indicate NO protects brain from damages by hydroxyl radical, at least less than one hour after initiation of reperfusion.
Animals ; Arginine ; Blood-Brain Barrier ; Brain ; Brain Injuries ; Brain Ischemia ; Carotid Arteries ; Chromatography, High Pressure Liquid ; Extracellular Fluid ; Hippocampus ; Hydroxyl Radical* ; Hypotension ; Ischemia ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Permeability ; Rats* ; Rats, Sprague-Dawley ; Reperfusion

BACKGROUND: Zygoma is a major buttress of the midfacial skeleton, which is frequently injured because of its prominent location. Zygoma fractures are classified according to Knight and North based on the direction of anatomic displacement and the pattern created by the fracture. In zygomaticomaxillary complex (ZMC) fracture many incisions (lateral eyebrow, lateral upper blepharoplasty, transconjunctival, subciliary, subtarsal, intraoral, direct percutaneous approach) are useful. We reviewed various approaches for the treatment of ZMC fractures and discussed about incisions and fixation methods. METHODS: A retrospective review was conducted of patients with ZMC fracture at a single institution from January 2005 to December 2014. Patients with single zygomatic arch fracture were excluded. RESULTS: The identified 694 patients who were admitted for zygomatic fractures from which 192 patients with simple arch fractures were excluded. The remaining 502 patients consisted of 439 males and 63 females, and total 532 zygomatic bone was operated. Orbital fracture was the most common associated fracture. According to the Knight and North classification the most frequent fracture was Group IV. Most fractures were fixated at two points (73%). CONCLUSION: We reviewed our cases over 10 years according to fracture type and fixation methods. In conclusion, minimal incision, familiar approach and fixation methods of the surgeon are recommended.
Blepharoplasty ; Classification ; Eyebrows ; Female ; Humans ; Male ; Maxillary Fractures ; Maxillofacial Injuries ; Methods* ; Orbital Fractures ; Retrospective Studies ; Skeleton ; Zygoma ; Zygomatic Fractures

Spinal cord lipomas are commonly associated with spinal dysraphism. The lipomas without spinal dysraphism have been reported to be only 1% of all spinal cord lipomas. We report two cases of patients with spinal intramedullary lipomas without dysraphism. One patient was a 57-year-old man who had lower back pain and right-sided sciatica for 20 years. Magnetic resonance imaging (MRI) of the spine demonstrated an intradural mass occupying L1 to L2. The other patient was a 27-year-old woman who had back pain and gait disturbance for 5 months. MRI of the spine showed an elongated intradural mass occupying T7 to T9. Total laminectomy with partial resection of the lesions was performed on both patients. Pathological studies confirmed the diagnosis of spinal cord lipoma. They exhibited no dysraphism. Postoperatively, neurological symptoms improved in both patients.
Adult ; Back Pain ; Diagnosis ; Female ; Gait ; Humans ; Laminectomy ; Lipoma* ; Low Back Pain ; Magnetic Resonance Imaging ; Middle Aged ; Sciatica ; Spinal Cord ; Spinal Dysraphism ; Spine

OBJECTIVES: To identify dentists' perceptions regarding the possible introduction of private health insurance plans, thereby providing basic data to improve the existing dental health insurance system. METHODS: A self-report survey was conducted with a total of 126 dentists in Jeollabuk-do Province. The survey was designed to gather information on the dentists' positions, perceptions and attitudes toward on a proposed introduction of privately run insurance schemes. RESULTS: A negative general consensus was found for the privately run scheme. Also it appeared that an overall review was required. CONCLUSIONS: Considering the high percentage of negative responses in the present study, it seems necessary to pro-actively reflect and complement potential issues in the current system before implementing privately run schemes in efforts to establish a solid foundation for operating dental insurance plans best suitable to the needs and characteristics of premium payers.
Complement System Proteins ; Consensus ; Dentists ; Humans ; Insurance ; Insurance, Dental ; Insurance, Health

No abstract available.
Mortality* ; Rhinoplasty* ; Sepsis* ; Transplants*

PURPOSE: During the course of bacterial meningitis, TNF-alpha produced by macrophages and monocytes in response to LPS and other inflammatory and immune stimulation, is now recognized as a primary mediator in the pathogenesis of infection, injury and inflammation and in the process of host defence. TNF-alpha was increased vascular permeability by inducing morphologic and structural changes of endothelial cells by a direct toxic effect. The authers observed the concentration of CSF TNF-alpha, which was useful or not to differentiate bacterial meningitis from viral meningitis. METHODS: In 57 children with meningitis (10 bacterial meningitis, 47 viral meningitis) were studied, at Ewha Womans University Hospital from Jan. 1995 to Oct. 1995. In the time of diagnosis, chemistry, smear, culture, latex agglutination test, TNF-alpha of CSF were checked. In bacterial meningitis, Follow up spinal tapping was performed 48 hours, 1 week after treatement, in viral meningitis, follow up was performed 2 to 7 days after treatement. RESULTS: The positive rate of CSF TNF-alpha and mean concentration of CSF TNF-alpha were significantly different between two groups (bacterial meningitis : 90% (9/10), 1026 +/- 390.1pg/mL vs. viral meningitis : 6.3% (3/47), 12.6 +/- 61.9pg/mL) (P<0.01). Positive rate of the concentration of CSF TNF-alpha in the group of bacterial meningitis was changed 90% at pretreatement period, 80% at 48 hours after treatement, 10% at 7days after treatement. Changing of positive rate by the diagnositic method, the positive rate of culture of CSF was 10%, gram smear was 40%, latex agglutination was 50% at 48 hours after treatement. CONCLUSION: The concentration of CSF TNF-alpha was rapid and sensitive method of differentiation between bacterial meningitis and viral meningitis, which was reduced the use of excessive antivbiotics.
Agglutination ; Capillary Permeability ; Chemistry ; Child ; Diagnosis ; Early Diagnosis* ; Endothelial Cells ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Latex ; Latex Fixation Tests ; Macrophages ; Meningitis ; Meningitis, Bacterial* ; Meningitis, Viral ; Monocytes ; Spinal Puncture ; Tumor Necrosis Factor-alpha*

PURPOSE: During the course of bacterial meningitis, TNF-alpha produced by macrophages and monocytes in response to LPS and other inflammatory and immune stimulation, is now recognized as a primary mediator in the pathogenesis of infection, injury and inflammation and in the process of host defence. TNF-alpha was increased vascular permeability by inducing morphologic and structural changes of endothelial cells by a direct toxic effect. The authers observed the concentration of CSF TNF-alpha, which was useful or not to differentiate bacterial meningitis from viral meningitis. METHODS: In 57 children with meningitis (10 bacterial meningitis, 47 viral meningitis) were studied, at Ewha Womans University Hospital from Jan. 1995 to Oct. 1995. In the time of diagnosis, chemistry, smear, culture, latex agglutination test, TNF-alpha of CSF were checked. In bacterial meningitis, Follow up spinal tapping was performed 48 hours, 1 week after treatement, in viral meningitis, follow up was performed 2 to 7 days after treatement. RESULTS: The positive rate of CSF TNF-alpha and mean concentration of CSF TNF-alpha were significantly different between two groups (bacterial meningitis : 90% (9/10), 1026 +/- 390.1pg/mL vs. viral meningitis : 6.3% (3/47), 12.6 +/- 61.9pg/mL) (P<0.01). Positive rate of the concentration of CSF TNF-alpha in the group of bacterial meningitis was changed 90% at pretreatement period, 80% at 48 hours after treatement, 10% at 7days after treatement. Changing of positive rate by the diagnositic method, the positive rate of culture of CSF was 10%, gram smear was 40%, latex agglutination was 50% at 48 hours after treatement. CONCLUSION: The concentration of CSF TNF-alpha was rapid and sensitive method of differentiation between bacterial meningitis and viral meningitis, which was reduced the use of excessive antivbiotics.
Agglutination ; Capillary Permeability ; Chemistry ; Child ; Diagnosis ; Early Diagnosis* ; Endothelial Cells ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Latex ; Latex Fixation Tests ; Macrophages ; Meningitis ; Meningitis, Bacterial* ; Meningitis, Viral ; Monocytes ; Spinal Puncture ; Tumor Necrosis Factor-alpha*

Fine-needle aspiration (FNA) biopsy has become the procedure of choice for initial diagnosis of adrenal masses. However, there have been relatively few reports discussing the FNA cytologic features of adrenal cortical carcinoma. Recently, we experienced a case of FNA cytology of bilateral adrenal cortical carcinoma in a 61-year old man. The smear revealed loosely cohesive pleomorphic tumor cells with hemorrhagic and necrotic background. The tumor cells showed oval to spindle hyperchromatic nuclei and prominent nucleoli with frequent mitotic figures. The cytoplasm of tumor cells was relatively abundant and sometimes vacuolated. These cytologic findings were interpreted as an adrenal cortical carcinoma, undifferentiated pattern.
Adrenocortical Carcinoma ; Biopsy ; Biopsy, Fine-Needle ; Child* ; Cytoplasm ; Diagnosis ; Hemangiosarcoma ; Humans ; Mass Screening* ; Middle Aged ; Urinalysis* ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: Blepharoptosis is often associated with telecanthus and the presence of epicanthal fold in telecanthus is one of unique features in Asian eyelids. The purpose of this article is to define telecanthus and pseudotelecanthus, and to determine optimal surgical procedure depending on classification of telecanthus. METHODS: Among 187 patients with blepharoptosis who had the advancement procedure of the Muller's muscle-levator aponeurosis composite flap for ptosis, 55 patients underwent Flowers' split V-W plasty concomitantly with shortening the medial canthal tendon for correction of telecanthus from September 2003 to January 2011. Among them, 52 patients were followed up for 16 months. We newly defined telecanthus because Mustarde ratio is inaccurate to measure in certain cases and then made a definition of pseudotelecanthus. Besides, we also classified telecanthus into mild, moderate and severe types based on its severity. RESULTS: Telecanthus is defined when the ICD (inner canthal distance) is greater than 110% of normal ICD. Pseudotelecanthus is a telecanthus like a wide skin bridge formed between the eyes because of the epicanthal fold in the normal ICD. Flowers' split V-W plasty combined with shortening medial canthal tendon was very effective in mild and moderate telecanthus with almost invisible scar and no recurrence occurring. In severe types, however, it showed high incidence (28%) of incomplete correction of telecanthus. CONCLUSION: New definition of telecanthus can be easily applied to any case and we think the classification of telecanthus is useful to select an appropriate operative procedure. Split V-W plasty with shortening of medial canthal tendon is a very effective procedure in mild and moderate telecanthus. Besides, it is also effective in improving the treatment outcomes of ptosis in cases of blepharoptosis associated with telecanthus.
Asian Continental Ancestry Group ; Blepharoptosis ; Cicatrix ; Craniofacial Abnormalities ; Eye ; Eyelids ; Humans ; Incidence ; Mustard Plant ; Recurrence ; Skin ; Surgical Procedures, Operative ; Tendons

Ehlers-Danlos syndrome (EDS) is an inherited disorder of collagen biosynthesis and structure, characterized by skin hyperextensibility, joint hypermobility, aberrant scars, and tissue friability. Besides the skin, skeleton (joint) and vessels, other organs such as the eyes and the intestine can be affected in this syndrome. Accordingly, interdisciplinary cooperation is necessary for a successful treatment. Three basic surgical problems are arising due to an EDS: decreased the strength of the tissue causes making the wound dehiscence, increased bleeding tendency due to the blood vessel fragility, and delayed wound healing period. Surgery patients with an EDS require an experienced surgeon in treating EDS patients; the treatment process requires careful tissue handling and a long postoperative care. A surgeon should also recognize whether the patient shows a resistance to local anesthetics and a high risk of hematoma formation. This report describes a patient with a wide open wound on the foot dorsum and delayed wound healing after the primary approximation of the wound margins.
Anesthetics, Local ; Blood Vessels ; Cicatrix ; Collagen ; Connective Tissue Diseases ; Ehlers-Danlos Syndrome ; Foot ; Hematoma ; Hemorrhage ; Humans ; Intestines ; Joint Instability ; Postoperative Care ; Skeleton ; Skin ; Wound Healing ; Wounds and Injuries