No abstract available.
Humans ; Orthognathic Surgery*

The mandibular contour determines the shape of the lower part of the face and thus influences the appearance of the face. A patient with a large, squarish, or broad face who desires a small, round, or slender face can undergo mandibular contouring surgery to reduce the width of the lower face. The successful correction of a prominent mandibular angle by conventional angle ostectomy has been reported. But, in the majority of patients with a widened facial appearance, both the mandibular angle and part of the mandibular body anterior to it are protuberant laterally, so both must be resected. The purpose of this study is to introduce a new method of performing mandibular contouring surgery, more effectively and easily, and to reduce postoperative complication and evaluate its results. We treated 6 patients who has prominent mandibular angle using multiple step osteotomy with angle-splitting ostectomy. The advantages of this new method are as following. (1) easily performable (2) effective mandibular contouring surgery by reducing the width of lower face (3) producing a natural relief of the mandibular angle (4) low risk of soft tissue damage and complications (5) shortening of the operation time. etc.
Humans ; Osteotomy ; Postoperative Complications

No abstract available.
Drug Therapy*

OBJECTIVE: Cardiovascular disease is the most frequent cause of death in rheumatoid arthritis(RA) patients and hyperhomocysteinemia is an independent risk factor for cardiovascular disease. We evaluated the status of homocysteine, vitamin B12 and folate in RA patients and the influence of the drugs used in RA on homocysteine and vitamin levels. METHODS: Fifty-six RA patients and 22 controls were studied. Plasma total homocysteine was measured by HPLC method and serum folate and vitamin B12 were measured by chemiluminescence immunoassay. In RA patients, age, sex, disease duration, medications and laboratory findings were analyzed. RESULTS: Serum vitamin B12 level was significantly lower in RA patients compared to controls(p=0.033). No significant difference in serum folate level was found between RA patients and controls but plasma total homocysteine level was significantly higher in RA patients. There was no difference in plasma total homocysteine level between patients taking MTX with folate and controls, but plasma total homocysteine level was significantly higher in patients not taking MTX compared with controls(p=0.028). In RA patients taking only hydroxychloroquine(HCQ) as a DMARD, there was significantly lower serum folate level(p=0.033) and higher plasma total homocysteine level(p=0.043) compared with controls. There was a significant negative correlation between plasma total homocysteine level and serum folate level in RA patients(r=-0.319, p=0.017). CONCLUSION: Plasma total homocysteine level was increased in RA patients but not in patients taking MTX and folate. These findings suggested that folate supplementation may be effective to prevent hyperhomocysteinemia in RA patients.
Antirheumatic Agents ; Arthritis, Rheumatoid* ; Cardiovascular Diseases ; Cause of Death ; Chromatography, High Pressure Liquid ; Folic Acid* ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Luminescence ; Plasma* ; Risk Factors ; Vitamin B 12* ; Vitamins*

PURPOSE: To assess the effectiveness of subsegmental transcatheter arterial chemoembolization(TAE) forhepatocellular carcinomas(HCCs) on the basis of tumor necrosis rate. MATERIAL AND METHODS: Between May 1996 andMarch 1998, ten patients with single HCC after subsegmental TAE underwent surgical resection. Subsegmental TAE wasperformed by injecting a mixture of lipiodol and adriamycin followed by gelatin sponge particles into the distalbranches of the subsegmental arteries. Tumor size and the extent of necrosis were analyzed in ten resectedlesions, and in all patients, complications after subsegmental TAE were assessed. RESULTS: The size of resectedtumors ranged from 1 to 5,5cm. On histological examination, complete necrosis was seen in 6 to 10 resected lesionsand 95% necrosis in three. In the remaining lesion, 85% necrosis had occured. Complete necrosis was noted in 4 of6 small HCCs(less than 3cm in diameter), while in the remaining two the extent of necrosis was 95%. Nocomplications were observed. CONCLUSION: For the treatment of HCC, subsegmental TAE is safe and effective.Curative therapy must, however, involve follow-up and repeated TAE.
Arteries ; Carcinoma, Hepatocellular* ; Doxorubicin ; Ethiodized Oil ; Follow-Up Studies ; Gelatin ; Humans ; Liver Neoplasms ; Necrosis ; Porifera

To evaluate exercise capacity, treadmill test and exercise pulmonary function test with cycle ergometer were preformed in 52 patients(pts) (M/F : 18/34, mean age : 43+/-11 yrs) with mitral stenosis before and 5~10 days after percutaneous mitral balloon valvuloplasty(PMV). Twenty four pts had atrial fibrillation. The results are as follow : 1) The mitral valve area increased from 0.9+/-0.2 to 1.8+/-0.3cm2(P<0.001). 2) The duration of exercise time on treadmill test(modified Bruce protocol) increased from 7.7+/-3.3min to 11.1+/-2.6min(P<0.001), but peak heart rate(HR) and maximum double product(MDP) did not change significantly. After exclusion of the patients with atrial fibrillation, peak HR and MDP increased from 157+/-24beats/min and 22350+/-8220mmHg beat to 165+/-19beats/min and 26290+/-5770mmHg beat respectively(P<0.05). 3) Diffusion capacity and diffusing capacity/alveolar volume at rest decreased from 95+/-25% and 112+/-24% to 87+/-22% and 100+/-18% respectively(p<0.001). 4) FVC, FEV1, FEV1/FVC, FEF25~75% and maximum voluntary ventilation increased from 77+/-12%, 79+/-16%, 104+/-10%, 69+/-25%, and 68+/-14%, to 80+/-11%, 84+/-14%. 106+/-9%, 78+/-25%, and 74+/-12%, respectively(P<0.05). But total lung capacity, residual volume and functional residual capacity did not change significantly. 5) Maximum oxygen consumption, anaerobic threshold, oxygen pulse and maximum work load during exercise increased form 53+/-14%, 34+/-8%, 6.2+/-2.1ml/min and 48+/-18 watts to 61+/-13%, 39+/-7%, 7.3+/-2.0ml/min and 58+/-20 watts respectively(P<0.0005). We conclude that oxygen transport and exercise capacity improve within 10days after PMV and the improvement results from not only hemodynamic improvement but also improvement of static pulmonary function.
Anaerobic Threshold ; Atrial Fibrillation ; Balloon Valvuloplasty* ; Diffusion ; Exercise Test ; Functional Residual Capacity ; Heart ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Oxygen Consumption* ; Oxygen* ; Residual Volume ; Respiratory Function Tests ; Total Lung Capacity ; Ventilation

OBJECTIVE: The positive rates of hepatitis B virus (HBV) markers differ according to age, sex, race, locality, sexual behavior, socioeconomic conditions, immunologic and genetic factors. It is a well-known fact that Korea is one of the endemic areas of HBV infection in the world. Past many reports have presented that the positive rates of HBsAg and anti-HBs in Korea were about 6~14% and 30~62%, respectively. However there were a few epidemiological surveys of rural communities on the positive rates of HBV markers. The present study undertook to determine the positive rates of HBsAg and anti-HBs in Hwasun county, a rural area of Korea. METHODS: We performed Population-based cross- sectional study by random cluster sampling of registered residents in Hwasun county. Out of the 2,920 subjects (4.1%) scheduled for the survey, 1,913 residents underwent the actual examination. We tested HBsAg and anti- HBs by reversed passive hemagglutination (RPHA) and passive hemagglutination (PHA), respectively. RESULTS: The positive rates of HBsAg and anti-HBs in all subjects were 5.6% and 20.8%, respectively, and those were 5.4% and 20.4% in 168 pregnant women, respectively. The positive rate of HBsAg was significantly higher in male (8.2%) than in female (4.0%) (p< 0.01). The positive rate of anti-HBs was 21.4% in female, but it was not significanly higher than in male (19.6%). There were no significant differences according to age groups in the positive rates of HBsAg and anti-HBs. CONCLUSION: There are no significant changes in the positive rates of HBsAg and anti-HBs between the present study for Hwasun county and past many reports in Korea. Although the rate of hepatitis B vaccination increased significantly, it was not effective because that the vaccinated total numbers in the rural area of Korea were probably small. So it is very important to undertake a nationwide program of hepatitis B immunization and to educate the residents in rural areas of Korea.
Continental Population Groups ; Female ; Hemagglutination ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Humans ; Immunization ; Korea* ; Male ; Pregnant Women ; Rural Population ; Sexual Behavior ; Vaccination

We report here a case of strongyloidiasis in a 72-year-old diabetic patient (woman) accompanied by gastrointestinal stromal tumor receiving imatinib therapy, first diagnosed as hypereosinophilic syndrome and treated with steroids for uncontrolled eosinophilia. She suffered from lower back pain and intermittent abdominal discomfort with nausea and diagnosed with gastrointestinal stromal tumor. After post-operative imatinib treatment eosinophilia persisted, so that steroid therapy was started under an impression of hypereosinophilic syndrome. In spite of 6 months steroid therapy, eosinophilia persisted. Stool examination was performed to rule out intestinal helminth infections. Rhabditoid larvae of Strongyloides stercoralis were detected and the patient was diagnosed as strongyloidiasis. This diagnosis was confirmed again by PCR. The patient was treated with albendazole for 14 days and her abdominal pain and diarrhea improved. This case highlights the need for thorough investigation, including molecular approaches, to test for strongyloidiasis before and during steroid therapies.
Aged ; Albendazole/administration & dosage ; Animals ; Diabetes Mellitus, Type 2/complications ; Eosinophilia/complications/*drug therapy ; Female ; Gastrointestinal Stromal Tumors/complications/*drug therapy ; Humans ; Imatinib Mesylate/*administration & dosage ; Steroids/*administration & dosage ; Strongyloides stercoralis/genetics/isolation & purification/physiology ; Strongyloidiasis/*drug therapy/parasitology

OBJECTIVES: These days, the main injection laryngoplasty technique is cricothyroid (CT) approach. However, patients who have previously undergone other neck treatments, such as thyroidectomy or neck dissection have distorted anatomical landmark makes this approach more difficult. The aim of this study is to determined the efficiency of transcartilaginous (TC) approah as compared with CT approach for unilateral vocal fold paralysis patients, especially for previously neck treated patients. METHODS: From March 2005 to February 2008, 137 consecutive injection laryngoplasties were performed in patients with unilateral glottic insufficiency. Percutaneous injection was performed under local anesthesia into the vocalis muscle, using disposable 25 G 4 cm long needles through the cricothyroid membrane or directly through the thyroid cartilage. Of the 137 patients, 124 completed acoustic, perceptual, stroboscopic, and subjective evaluations prior to the injection and at 3 months after the injection. RESULTS: In the 124 patients, the CT and TC approaches were used in 94 and 30 patients, respectively. Acoustic and perceptual parameters (GRBAS, MPT, jitter, shimmer), voice handicap index, and grades of mucosal waves and glottic closure were significantly improved after the injection in both the CT and TC groups (P<0.05). Only two patients (6.6%) had penetration difficulties, because of ossification of the thyroid cartilage. The overall success rates of the CT and TC approaches were 86.2%, 93.3%, respectively. However, the success rate of the TC approach in patients who had previously undergone neck treatments was significantly higher than that of the CT approach (100% vs. 65% P<0.05). CONCLUSION: Based on the preliminary results of this trial, injection laryngoplasty using a TC approach was an effective alternative to the CT approach, especially in patients who had previously undergone neck surgeries.
Acoustics ; Anesthesia, Local ; Humans ; Laryngeal Muscles ; Laryngoplasty ; Membranes ; Neck ; Neck Dissection ; Needles ; Paralysis ; Thyroid Cartilage ; Thyroidectomy ; Vocal Cord Paralysis ; Vocal Cords ; Voice

Rosai-Dorfman disease (RDD) is an idiopathic histioproliferative disorder of lymph node and extranodal site. Bone involvement is very rare. We report a case of extranodal RDD of the tibia in 32-year old male. The patient presented with pain with no evidence of lymphadenopathy. Clinico-radiologic diagnosis was metastatic carcinoma or Langerhans cell histiocytosis, but, histopathologic examination confirmed the diagnosis with RDD. We performed curettage on the osteolytic lesion of tibia. In South Korea, there was no report about RDD of the extremity and we want to report this case with review of the literature.
Curettage ; Diagnosis ; Extremities ; Histiocytosis, Langerhans-Cell ; Histiocytosis, Sinus* ; Humans ; Korea ; Lymph Nodes ; Lymphatic Diseases ; Male ; Tibia*