Authors report herein a case of a 27-year-old male patient who had been suffering from chronic ulcerative dermatitis with scar-like changes and successive involvement of the ankles, limb folds, nape and abdomen, and no tendency to heal from age 4. At the age 14, an immunologic study showed a selective IgA deficiency with partial T-lymphocyte inactivation. Ten years later, at age 24, he showed a severe form of morphea over a generalized area and disabling joint contractures, and was diagnosed as disabling pansclerotic morphea with an IgA value that returned to a near normal level. At the age 27, an adult-fist, 7×6×4cm sized, squamous cell carcinoma with an easy bleeding tendency like an overgrowing granulation tissue vascular tumor had developed on the chronic ulcerative lesion on the posterior aspect of the right ankle for 2 months. Aggressive metastatic lesion occurred on the right popliteal area 3 months later. He died 1 month thereafter.
Abdomen ; Adult ; Ankle ; Carcinoma, Squamous Cell* ; Contracture ; Dermatitis ; Epithelial Cells* ; Extremities ; Granulation Tissue ; Hemorrhage ; Humans ; IgA Deficiency ; Immunoglobulin A ; Joints ; Male ; Scleroderma, Localized* ; T-Lymphocytes ; Ulcer*

No abstract available.
Orbit*

PURPOSE: To investigate the therapeutic effectiveness of ultrasound (US)-guided trigger point injection for myofascial trigger points (MTrPs) in the internal rotator muscles of the shoulder in post-mastectomy patients. MATERIALS AND METHODS: This pilot study was a non-controlled, prospective, clinical trial. Nineteen post-mastectomy patients with a diagnosis of at least one active MTrP in the subscapularis and/or pectoralis muscles were included. We performed trigger point injections into the subscapularis muscle deep behind the scapula as well as the pectoralis muscle for diagnostic and therapeutic purpose by the newly developed US-guided method. RESULTS: Visual analogue scale and range of motion of the shoulder for external rotation and of abduction showed significant improvement immediately after the first injection and 3 months after the last injection compared with baseline (p<0.05 for both). Duration from onset to surgery and duration of myofascial pain syndrome in the good responder group were significantly shorter than in the bad responder group (p<0.05). Patients did not report any complications related to the procedure or serious adverse events attributable to the treatment. CONCLUSION: In post-mastectomy patients with shoulder pain, US-guided trigger point injections of the subscapularis and/or pectoralis muscles are effective for both diagnosis and treatment when the cause of shoulder pain is suspected to originate from active MTrPs in these muscles, particularly, the subscapularis.
Adult ; Aged ; Anesthetics, Local/administration & dosage/therapeutic use ; Female ; Humans ; Injections, Intramuscular/methods ; Lidocaine/administration & dosage/therapeutic use ; Mastectomy ; Middle Aged ; Muscle, Skeletal/drug effects/ultrasonography ; Myofascial Pain Syndromes/drug therapy ; Pectoralis Muscles/drug effects/*ultrasonography ; Trigger Points/*ultrasonography

PURPOSE: The subepithelial connective tissue graft(SCTG) has been proven to be a highly predictable treatment modality for coverage of gingival recession. This case report was performed to evaluate the effect of various root coverage procedures using SCTG on gingival recession. MATERIALS AND METHODS: Three patients presents with Miller's class I recession defect on the maxillary canine. Each other SCTG(coronally advanced flap, Bruno's Tech., envelope Tech.) were performed for root coverage. Clinical parameters assessed included recession depth, recession width, and keratinized gingival width. Measurements were taken at baseline and 2 months and follow up end. RESULTS: The average of root coverage was 4 mm(100% of the pre-operative recession depth) at the 2, 5 months examination. The average increase of keratinized tissue between the baseline and the 2 months amounted to 3.2mm. CONCLUSION: Within the above results, various root coverage using SCTG is an effective procedure to Miller's class I recession defect and patient could be satisfied aesthetic requirement.
Connective Tissue ; Follow-Up Studies ; Gingival Recession ; Humans ; Keratins ; Transplants

Intracisternal accessory nerve schwannomas are very rare; only 18 cases have been reported in the literature. In the majority of cases, the tumor origin was the spinal root of the accessory nerve and the tumors usually presented with symptoms and signs of intracranial hypertension, cerebellar ataxia, and myelopathy. Here, we report a unique case of an intracisternal schwannoma arising from the cranial root of the accessory nerve in a 58-year-old woman. The patient presented with the atypical symptom of hoarseness associated with recurrent laryngeal neuropathy which is noted by needle electromyography, and mild hypesthesia on the left side of her body. The tumor was completely removed with sacrifice of the originating nerve rootlet, but no additional neurological deficits. In this report, we describe the anatomical basis for the patient's unusual clinical symptoms and discuss the feasibility and safety of sacrificing the cranial rootlet of the accessory nerve in an effort to achieve total tumor resection. To our knowledge, this is the first case of schwannoma originating from the cranial root of the accessory nerve that has been associated with the symptoms of recurrent laryngeal neuropathy.
Accessory Nerve* ; Cerebellar Ataxia ; Electromyography ; Female ; Hoarseness ; Humans ; Hypesthesia ; Intracranial Hypertension ; Middle Aged ; Needles ; Neurilemmoma* ; Spinal Cord Diseases ; Spinal Nerve Roots

PURPOSE: The present study was performed to evaluate the effect of erbium:yttrium-aluminium-garnet (Er:YAG) laser irradiation on the change of hydroxyapatite (HA)-coated implant surface microstructure according to the laser energy and the application time. METHODS: The implant surface was irradiated by Er:YAG laser under combination condition using the laser energy of 100 mJ/pulse, 140 mJ/pulse and 180 mJ/pulse and application time of 1 minute, 1.5 minutes and 2 minutes. The specimens were examined by surface roughness evaluation and scanning electron microscopic observation. RESULTS: In scanning electron microscope, HA-coated implant surface was not altered by Er:YAG laser irradiation under experimental condition on 100 mJ/pulse, 1 minute. Local areas with surface melting and cracks were founded on 100 mJ/pulse, 1.5 minutes and 2 minutes. One hundred forty mJ/pulse and 180 mJ/pulse group had surface melting and peeling area of HA particles, which condition was more severe depending on the increase of application time. Under all experimental condition, the difference of surface roughness value on implant surface was not statistically significant. CONCLUSIONS: Er:YAG laser on HA-coated implant surface is recommended to be irradiated below 100 mJ/pulse, 1 minute for detoxification of implant surface without surface alteration.
Dental Implants ; Durapatite ; Electrons ; Freezing

No abstract available.
Atrophy ; Pityriasis* ; Tinea Versicolor*

We studied the intradural variations of spinal nerve rootlets in 100 cases of Korean adults. The results of the study are as follows ; 1. The incidence of intrasegmental variations (abberrant rootlets) is high in cervical segments and decreased toward lumbosacral segments. The incidence is higher in posterior rootlets than anterior, except cervical sesments. 2. The incidence of intersegmental variations is higher in posterior rootlets than anterior, and generally high in cervical and lumbar segments. 3. We divide the intersegmental variations into supernumerary rootlets, dividing rootlets, and anastomosing rootlets, and among them the incidence of anastomosing rootlets is higher. We divide the anastomosing rootlets into parallel anastomosing rootlets, uniting anastomosing rootlets, and rearrangement anastomosing rootlets. 4. The anterior to posterior anastomosing of spinal nerve rootlet is present in 4 of cases studied.
Adult ; Humans ; Incidence ; Spinal Nerves*

BACKGROUND: Little Is known about the compared efficiency of different third generation enzyme-linked immunosorbent assays (ELISA) fort the detection of anti-HCV. We examine the relative sensitivity and specificity of three third-generation anti-HCV assays, and results of discrepant samples among the anti-HCV ELISA are compared with data of a third-generation recombinant immunoblot assay and reverse transcription polymerase chain reaction (RT-PCR) . METHODS:A total of 167 samples (61 positive and 106 negative), screened by a second-generation IMx(R) anti-HCV assay (Abbott 2.0; Abbott Laboratories, USA), weve tested with Innotest HCV 3.0(R) (Green Cross, Korea), LG HCD 3.0(R) (LG, Korea) and DONG-A HCV 3.0(R) (Dong-4, Korea). The discrepant specimens among the 4 anti-HCV ELISA were tested by LG HCD Confirm(R) (LG, Korea) and RT-PCR. RESULTS: The concordance rates of all 4 ansi-HCV ELISA were 80.2% (134/167) and 92.2% (154/167), respectively. The 28 and 31 of 33 specimens showing discrepancy among 4 anti-HCV ELISA were tested with LG HCD Confirm and RT-PCR, respectively. Serum HCV RNA was positive in 2 of 2 reactive and in 6 of 26 nonreactive on LG HCD Confirm. The sensitivity, specificity, positive predictive value, negative predictive value and concordance rate of 4 anti-HCV ELISA were 97.7%, 85.2%, 70.0%, 99.0% and 88.5% (Abbott 2.0) ; 81.4%, 96.7%, 89.7%, 93.7% and 92 7% (Innotest 3.0), 81.4%, 98.4%, 94.6%, 93.8% and 93.9% (LG 3.0), 86.0%, 95.7%, 88.1%, 95.1% and 93.3% (DONG-A 3.0), respectively. CONCLUSIONS: These data indicate that the sensitivity and specificity of 3 third-generation anti-HCV ELISA are comparable, and that these reagents demonstrate improved specificity compared to the second-generation ELISA.
Enzyme-Linked Immunosorbent Assay* ; Indicators and Reagents ; Polymerase Chain Reaction ; Reverse Transcription ; RNA ; Sensitivity and Specificity

OBJECTIVES: Laryngomicrosurgery (LMS) is used to manage most vocal fold lesions. However, the functional voice outcome of the LMS might be diverse due to the influence of various factors. We intend to evaluate the incidence and etiologic factors of persistent dysphonia after LMS for benign vocal fold disease (BVFD). METHODS: We performed a retrospective review of 755 patients who underwent LMS for BVFD. We analyzed the clinical characteristics, preoperative and postoperative two onths voice studies. Postsurgical dysphonia was defined as grade 1 or above in GRBAS (grade, roughness, breathiness, asthenia, and strain) scale. Thirty nine patients (5.2%; 25 males and 14 females; average, 42.9 years; range, 21 to 70 years) were diagnosed with postsurgical dysphonia. RESULTS: There was no correlation between the diagnosis, coexistence with laryngopharyngeal reflux disease, habit of smoking, or occupational voice abuse and voice outcome. The patients with a worse preoperative acoustic parameter had aworse voice outcome. Stroboscopic findings showed excessive scarring or bowing in 21 cases, presence of lesion remnant in eight cases, prolonged laryngeal edema in five and no abnormal findings in three. CONCLUSION: Great care should be taken in patients with worse preoperative jitter. With a few exceptions, postoperative dysphonia can be avoided by the use of an ppropriate surgical technique.
Acoustics ; Asthenia ; Cicatrix ; Dysphonia ; Humans ; Incidence ; Laryngeal Edema ; Laryngopharyngeal Reflux ; Male ; Retrospective Studies ; Smoke ; Smoking ; Vocal Cords ; Voice