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.
Spleen*

PURPOSE: Many investigators suggested that changes in hormonal environment in the postmenopausal women functionally or histologically effect the clitoris and vagina. We investigated the mechanism of female se xual dysfunction occurring in the decreased hormonal status, and aimed to establish and experimental base for the hormone replacement in postmenopausal women to correct sexual dysfunction. MATERIALS AND METHODS: Twenty mature female New Zealand white rabbits were randomly divided into three groups; control group, oophorectomy group, estrogen replacement group after oophorectomy. Nitric oxide synthase (NOS) activity and the degree of expression of neuronal NOS (nNOS) and endothelial NOS (eNOS), collagen content in clitoral tissues were analysed. RESULTS: nNOS and eNOS were significantly increased in the oohporectomized group while decreased in the estrogen replacement group (p<0.01). NOS activity showed the similar pattern of change (p<0.05). Oophorectomy induced a significant increase in collagen content, while the ratio of smooth muscle content was increased significantly after the estrogen replacement (p<0.01). CONCLUSIONS: Estrogen deficiency induces collagen synthesis and decreases the content of smooth muscle in clitoris, resulting in a structural relaxation difficulty. We believe that NOS becomes more active to improve the relaxation difficulty and that hormone replacement helps to restore the normal state of smooth muscle relaxation. Considering these findings, we suggest that estrogen down-regulates NOS and its activity.
Clitoris* ; Collagen ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Muscle, Smooth ; Neurons ; Nitric Oxide Synthase ; Ovariectomy ; Rabbits ; Relaxation ; Research Personnel ; Vagina

OBJECTIVE: To assess the effect of recombinant human leukemia inhibitory factor on in vitro development of 1-cell ICR mouse embryo. MATERIALS AND METHOD: ICR mice were superovulated with PMSG/hCG and 1-cell stage mouse embryos were recruited. 1-cell mouse embryo were cocultured on human oviductal cells in a CO2 incubator (coculture group) and were cultured on 0.4% BSA+HTF media (control group). And anti-hLIF Ab was added the cocultured group in a different concentration (1pg, 10pg, 100pg, 1ng) and developmental rate was compaired to the control group, and rhLIF was added to the preincubated 0.4% BSA+HTF media in a different concentration (2000U, 1000U, 100U, 10U) and its developmental rate was compaired to group which was cultured on 0.4% BSA+HTF media only. RESULT: 1. The cleavage rate of 2-cell mouse embryo co-cultured with human tubal epithelial cell was significantly higher than that of cultured with media alone (HTF with 0.4% BSA) (p<0.05). 2. When LIF antibody was added to the medium with human tubal epitherlial cell, the mouse embryo could not cleave more than 2-cell in 1 ng of LIF antibody, and less than 1 ng, the cleavage rate was lower than cultured without LIF antibody group(p<0.05). 3. Two cell blocked ICR mouse embryos were developed into four cells under LIF(p<0.05), but no further development was observed. CONCLUSIONS: These results shows that LIF enhances the development of preimplantation embryo, and when rhLIF is applicated in vitro, it has positive effects on the development of early mouse embryo and can help overcoming the two-cell block.
Animals ; Blastocyst* ; Coculture Techniques* ; Embryonic Structures ; Epithelial Cells ; Humans ; Incubators ; Leukemia Inhibitory Factor* ; Leukemia* ; Mice ; Mice, Inbred ICR ; Oviducts

Purpose: We report the clinical outcomes of Korean patients who were diagnosed with orbital malignancies and underwent orbital exenteration. Methods: We retrospectively reviewed the tumor origins, histopathological diagnoses, local/regional recurrences, distant metastases, surgical margin clearances, overall and event-free survivals, and adjuvant chemotherapy or radiation therapy statuses of 14 patients who underwent orbital exenteration in our center from February 2009 to March 2020. Results: We enrolled seven men and seven women of mean age at the time of exenteration of 68 years (range, 37 to 80 years). The mean follow-up period was 44.6 months (range, 10 to 133 months). Most tumors had arisen in the eyelid (seven cases, 50.0%). The most common pathological diagnosis was malignant melanoma (five cases, 35.7%). We observed no local or regional recurrence after exenteration, but distant metastases developed in seven cases, of which four were malignant melanomas (80% of all melanomas). Positive surgical margins were observed in six cases (42.9%). The distant metastasis rate was 42.9%; the overall survival rate was 60%. The 1-year overall survival rate was 100%, the 2-year survival rate was 81.8%, and the 5-year survival rate was 56.1%. The 1-year event-free survival (EFS) rate was 100%, the 2-year EFS rate was 72.7%, and the 5-year EFS rate was 49.9%. Nine patients received adjuvant radiation or chemotherapy and six patients received combined chemoradiation. Conclusions Patients underwent orbital exenteration to treat orbital malignancies and received postoperative chemotherapy and/or radiation exhibited differences in clinical outcomes and survival rates depending on the tumor type.

Mutations within the SCN5A gene, which encodes the α-subunit 5 (NaV1.5) of the voltage-gated Na+ channel, have been linked to three distinct cardiac arrhythmia disorders: long QT syndrome type 3, Brugada syndrome (BrS), and cardiac conduction disorder. In this study, we have identified novel missense mutations (p.A385T/R504T) within SCN5A in a patient exhibiting overlap arrhythmia phenotypes. This study aims to elucidate the functional consequences of SCN5A mutants (p.A385T/R504T) to understand the clinical phenotypes. Whole-cell patch-clamp technique was used to analyze the NaV1.5 current (INa) in HEK293 cells transfected with the wild-type and mutant SCN5A with or without SCN1B co-expression. The amplitude of INa was not altered in mutant SCN5A (p.A385T/R504T) alone. Furthermore, a rightward shift of the voltage-dependent inactivation and faster recovery from inactivation was observed, suggesting a gain-of-function state. Intriguingly, the coexpression of SCN1B with p.A385T/R504T revealed significant reduction of INa and slower recovery from inactivation, consistent with the loss-of-function in Na+ channels. The SCN1B dependent reduction of INa was also observed in a single mutation p.R504T, but p.A385T co-expressed with SCN1B showed no reduction. In contrast, the slower recovery from inactivation with SCN1B was observed in A385T while not in R504T. The expression of SCN1B is indispensable for the electrophysiological phenotype of BrS with the novel double mutations; p.A385T and p.R504T contributed to the slower recovery from inactivation and reduced current density of NaV1.5, respectively.

No abstract available.
Atrioventricular Block

Arthroscopic synovectomy is a widely-used method to treat septic knee arthritis. To date, many authors have reported minimal complications related to arthroscopic treatment, especially vascular injuries. A three-dimensional computed tomography angiography revealed a pseudoaneurysm that arise from the popliteal artery near the arthroscopic site in septic arthritis patients with atherosclerosis and neurofibromatosis. A careful arthroscopic procedure via the posteromedial or posterolateral portal is recommended for the prevention of this complication. We, therefore, recommend close observation after arthroscopic procedure, despite the occurrence of complications; nonetheless, early diagnosis and treatment are important. We report a case of pseudoaneurysm of the popliteal artery with a complicating arthroscopic synovectomy in septic arthritis with literature review.
Aneurysm, False ; Angiography ; Arthritis ; Arthritis, Infectious ; Arthroscopy ; Atherosclerosis ; Debridement ; Early Diagnosis ; Humans ; Knee ; Methods ; Neurofibromatoses ; Popliteal Artery ; Vascular System Injuries

Biomaterial surfaces can be characterized by their chemical, morphologic, and electrical surface features. The adhesion and proliferation of different types of mammarian cells on various surfaces depends on polymer surface characteristics like water wettability and charge. In clinical aspect, bone to bone cement interface loosening has been one of the causes of failure of the prosthetic implantation. In this study, the bone cement was, thus, modified by mixing a monomer with amino group, which is a positively charged chemical group, to improve cellular adhesion and proliferation and to decrease bone to bone cement interface loosening. To incorporate amino-charged groups in the bone cement, we used dimethylaminoethyl- metacrylate (DAEMA) as a adding material. As experimental materials, CMW1 bone cement (control) and CMW1 mixed with monomer containing 1mol% dimethylaminoethylmetacrylate (DMA1) and CMW1 mixed with monomer containing 3mo1% dimethylaminoethylmetacrylate (DMA3) were used. To estimate the wettability of surface of bone cement, water contact angle was measured using contact angle goniometer and water absorption was measured using the disc samples. Osteoblasts were isolated from neonatal, Spraque-Dawley rat calvaria. After 3 culturing passages, the osteoblasts were plated on the cement disks, which are placed in a 24-well tissue-culture plate, at a density of 1 X 10 (5) cells/cm. After culturing for 2, 6, 24, and 48 hours, the number of attached cells on each cement discs were counted and cell morphologies were examined with scanning electron microscope (SEM). No significant difference in the water contact angle (63-64degrees) is statistically found between 3 groups (P>0.05). The water absorbencies of DMA1 (3.61+/-0.28%) and DMA3 (6.70+/-0.56%) were higher than that of the control (2.59+/-0.21%). Diametral tensile strength were decreased at DMA1 and DMA3 groups in comparing with control and that of DMA3 was smallest (P< 0.05). After culturing 2 hrs, the cell areas of control group was 158.1+/-64.2mm (2), while those of DMA1 and DMA3 were 280.4+/-102.2 and 665+/-209.8mm (3) and the shape factor of control was 0.391+/-0.184, while those of DMA1 and DMA3 were 0.179+/-0.056 and 0.274+0.144, respectively. The osteoblasts that cultured on the DMA1 and DMA3 cement discs were well spread and flattened than control cement discs at each culturing periods. Attached cell number on DMA1 and DMA3 cement plates were increased than that of control cement disc (P<0.05). There is, however, no significant difference between DMA1 and DMA3 (P>0.05) at each culturing period. In summary, well spread osteoblasts and increased attachment and growth of them were observed, when they were plated on the amino-charged cement discs. The histocompatibility of the amino-charged cements may increase the attachment between bone and cement. However, mechanical strength may decrease due to higher water absorbency. The author will further study to find the material that is cytocompatible and that does not lead to deteriorate mechanical properties.
Absorption ; Animals ; Bone Cements* ; Cell Count ; Histocompatibility ; Osteoblasts* ; Polymers ; Rats ; Skull ; Tensile Strength ; Water ; Wettability

Epinephrine is used with lidocaine to provide bloodless surgical field and to prolong the action of local anesthetics. But epinephrine also has many adverse reactions, such as agitation, restlessness, headache, tachycardia, hypertension, and some significantly more dangerous conditions including myocardial ischemia, ventricular arrhythmia, cerebral hemorrhage and pulmonary edema, cardiac arrest, etc. We have experienced epinephrine-induced acute pulmonary edema due to submucosal intranasal application of epinephrine soaked gauze during septoplasty. The patient was successfully treated in intensive care unit with positive pressure ventilation, diuretics, and inotropic support. He was extubated after 5 hours and discharged after 7 days without any complications.
Anesthetics, Local ; Arrhythmias, Cardiac ; Cerebral Hemorrhage ; Dihydroergotamine ; Diuretics ; Epinephrine ; Headache ; Heart Arrest ; Humans ; Hypertension ; Intensive Care Units ; Lidocaine ; Myocardial Ischemia ; Positive-Pressure Respiration ; Psychomotor Agitation ; Pulmonary Edema* ; Tachycardia