Many authors reported the etiology of hypoplasia of the nasomaxillary complex as trauma, infection, underdevelopment. To correct these deformities, Le Fort II Osteotomy and its modification has been popularly applied. This method enabled total advancement of nasomaxillary complexes and acquirememt of midfacial esthetics. But it has some limitations such as various occlusal deviation or lateral shifting of nasomaxillary complex in case of nasomaxillary retrusion. We grouped these patients as follows : 1. Nasomaxillary retrusion without shifting of nasomaxillary complex (1) Anteroposterior deviation of occlusal plane (2) Lateral deviation of occlusal plane(including canting) (3) Supero-inferior deviation of occlusal plane (4) Combined disturbance of occlusal plane without shifting of nasamaxillary complex 2. Lateral shifting of nasomaxillary complex with or without deviation of occlusal plane We performed Le Fort II and I combined osteotomy on eleven cases of midfacial deformity from June 1994 to July 1997 and in most of the cases, followed up maximum 36 months and could acquire positional stability and improvement of facial eathetics.
Congenital Abnormalities* ; Dental Occlusion ; Esthetics ; Humans ; Osteotomy*

No abstract available.

Absence status consists of prolonged episodes during which there is a disturbance of mental function in association with a continuous repetitive or intermittent spike and wave pattern on the electroencephalography. We report a 14 year-old male who had previous history of partial to secondiary generalized seizure, showed absence status during acute phase of brainstem infarction.
Adolescent ; Brain Stem Infarctions* ; Brain Stem* ; Electroencephalography ; Humans ; Male ; Seizures ; Status Epilepticus*

PURPOSE: To evaluate the clinical outcomes of visual acuity and foveal thickness after vitrectomy for an idiopathic epiretinal membrane (ERM). METHODS: We retrospectively reviewed the records of 62 patients (62 eyes) with ERM who had been treated with vitrectomy between 2004 and 2009. Visual acuity and central macular thickness from optical coherence tomography imaging were obtained preoperatively and at every postoperative follow-up visit. RESULTS: Mean preoperative visual acuity and central macular thickness were 0.495 +/- 0.292 log MAR and 414.645 +/- 95.528 microm, respectively. Mean visual acuity and central macular thickness 1 month after surgery were 0.389 +/- 0.373 log MAR and 341.484 +/- 73.676 microm, respectively. Visual acuity improved within 9 months and central macular thickness significantly decreased 12 months after surgery. Most of the changes in visual acuity and central macular thickness took place during the first 3 months. The only parameter which was significantly correlated with final visual acuity was preoperative visual acuity (0.635) (p < 0.001). CONCLUSIONS: Visual acuity and central macular thickness improved 12 months months after vitrectomy in patients with idiopathic ERM. Preoperative visual acuity had a significant correlation with final visual acuity.
Epiretinal Membrane ; Follow-Up Studies ; Humans ; Hypogonadism ; Mitochondrial Diseases ; Ophthalmoplegia ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy

BACKGROUND AND OBJECTIVES: Middle ear barotrauma is a damage of the ear resulting from the pressure difference between the middle ear and the atmospheric environment. We investigated the effects of chewing gum and administering the systemic decongestant in hyperbaric oxygen therapy. MATERIALS AND METHOD: We investigated the cases of the middle ear barotrauma which came from hyperbaric oxygen therapy for finger replantation. We studied 81 patients without E-tube dysfunction. They were divided into three groups: the non-treated patients, the patients chewing gums and receiving high-pressure treatment, and the patients receiving the systemic decongestant. We investigated the patients for symptoms, otoscopic findings, tympanometry, and PTA. Otoscopic findings were classified by modified Teed classification. RESULTS: In the first group, 36 of 60 (60%) ears had otologic symptoms, 37 of 60 (62%) ears were above the grade 1, 31 of 60 (52%) ears were B or C type in tympanometry and 20 of 60 (33%) ears were above 20dB in AB gap (air-bone gap). In the second group, 23 of 60 (38%) ears had the otologic symptom, 26 of 60 (43%) ears were above the grade 1, 19 of 60 (32%) ears were the B or C type and 10 of 60 (17%) ears were above 20dB in AB gap. In the third group, 18 of 42 (43%) ears had the otologic symptoms, 19 of 42 (45%) ears were above the grade 1, 15 of 42 (36%) ears were the B or C type and 7 of 42 (17%) ears were above 20dB in the AB gap. CONCLUSION: The second group was better than the first group with regard to otologic symptom, otoscopic findings, tympanometry, PTA, and showed statistical significance. On the other hand, the third group was effective but did not show statistical significance.
Acoustic Impedance Tests ; Barotrauma* ; Chewing Gum ; Classification ; Ear ; Ear, Middle* ; Fingers ; Hand ; Humans ; Hyperbaric Oxygenation* ; Replantation

Background: This study aimed to retrospectively assess results of intracranial meningioma surgerywith or without intraoperative neuromonitoring (IONM) in a single institution. Methods: Two cohorts (a historical cohort and a monitoring cohort) were collected for the analy-sis. Before IONM was introduced, a total of 107 patients underwent intracranial meningioma operation without IONM from January 2000 to December 2008 by one neurosurgeon (historical cohort). After IONM was introduced, a total of 99 patients with intracranial meningioma were operated under IONM between November 2018 and February 2023 by two neurosurgeons (monitoring cohort). A retrospective comparison was made on the complications from meningioma surgery between the two groups. Results: In the monitoring cohort, warning signals of motor evoked potential (MEPs) or so-matosensory evoked potential (SSEPs) were alarmed in 10 patients. Two of these 10 patients aborted the operation and eight of these 10 patients with warning signals underwent tumor resection. Of these eight patients, five showed postoperative morbidity. Five of 89 patients without warning signals developed neurological deficits. In the historical cohort, 14 of 107 patients showed postoperative morbidity or mortality. Conclusion Even after successful resection of intracranial meningiomas prior to the advent ofIONM, integration of MEPs and SSEPs monitoring yielded valuable insights for surgical teams during operative procedures.

Gastric bezoars are collection of indigestible material in the stomach, and these can be classified into five broad categories: phytobezoar, trichobezoar, pharmacobezoar, lactobezoar and miscellaneous materials such as sand, stone and concrete (gypsum). The treatment of gastric bezoars has recently changed from surgical management to such nonsurgical interventions as enzymatic dissolution, nasogastric suctioning and endoscopic removal by polypectomy snare and basket. Up to the present, electrohydraulic lithotripsy has been a well established method for the treatment of urinary and hepatobiliary stones. We report here on a patient who had a huge gastric bezoar that was formed by the ingestion of gypsum, and this was treated with endoscopic electrohydraulic lithotripsy.
Bezoars* ; Calcium Sulfate* ; Eating* ; Endoscopy ; Humans ; Lithotripsy* ; Silicon Dioxide ; SNARE Proteins ; Stomach ; Suction

PURPOSE: The purpose of this study was to assess the clinician satisfaction of a newly introduced around-the-clock radiology coverage system for the emergency department. MATERIALS AND METHODS: Seventeen emergency physicians (8 board certified physicians, 9 residents) were invited to fill out a survey pertaining to the newly introduced radiology coverage system for the emergency department. The questionnaire included 10 questions covering three major topics. The first topic related to the around-the-clock radiology coverage by two full-time radiology residents. The second topic focused on the preliminary interpretations of radiology residents. The last topic included the interpretation assistance system by board-certified radiologists. The answers to each question were assessed using a scoring system of 1 to 5. RESULTS: The mean satisfaction score of the around-the-clock radiology coverage system by the two full-time radiology residents was 4.6 (range 3-5). The mean score for the preliminary interpretation system by the radiology residents was 4.8 (range 4-5). The score for the reliability of the preliminary versus the final interpretations was 4.1 (range 4-5). Lastly, the mean score for the interpretation assistance system by board-certified radiologists was 4.9 (range 4-5). CONCLUSION: The results of this study indicate a high satisfaction rating among clinicians' of the new around-the-clock radiology coverage system for the emergency department.
Emergencies ; Emergency Service, Hospital ; Surveys and Questionnaires

Protein S is found in two forms in plasma; as free and functionally active protein S, and complexed to C4b-binding protein. Patients with nephrotic syndrome are at risk for arterial and venous thrombosis at various localizations, and acquired protein S deficiency due to the selective urinary loss of the free form may be a risk factor for the development of thromboembolic complications. We report a case of cerebral arterial thrombosis associated with decreased level of free protein S antigen (44%) in a 39-year-old female patient with nephrotic syndrome.
Adult ; Case Report ; Female ; Human ; Intracranial Embolism and Thrombosis/*etiology ; Nephrotic Syndrome/*complications ; Protein S Deficiency/*complications

Retrocaval ureter is a congenital venous anomaly, in which the ureter passes behind and is compassed by inferior vena cava. We experienced a case of multiple urothelial cell carcinoma in retrocaval ureter in 68 years old male. He was treated with transurethral resection of bladder tumor and right nephroureterectomy with bladder cuff excision.
Aged ; Carcinoma, Transitional Cell ; Humans ; Male ; Retrocaval Ureter* ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms ; Vena Cava, Inferior