The purpose of present study was to observe the radiographic finding and histologic response by Confocal Laser Scanning Microscopy(CLSM) on interface of the bone and titanium implant coated by chitosan. The tissue of rabbit tibiae to the surgical placement titanium implant coated by chitosan was examined at 3, 9 and 24 days postoperatively. The radiographic finding showed that surrounding bone density of implants was not significantly different compare with the bone on 3 and 9 days group. A large amount new bone was formed on 24 days group, the reason was osteconduction activity by chitosan. The CLSM analysis show that the surface coating by chitosan filled the gap between bone and implant on 3 days group and filled by mew born on 9 days group. On 24 days group, the bone and titanium surface was filled by lamella bone. This results indicated that this enhanced the initial stability of implant significantly and chitosan induced osseointegration around implant. CLSM allows the non-destrutive histo-tomography of bone biopsy as well as clinical practice. We conclude that CLSM allowed a good comprehension of the nature of bone-implant contact, avoiding artifacts due to the thickness of the specimen.
Artifacts ; Biopsy ; Bone Density ; Chitosan* ; Comprehension ; Microscopy, Confocal* ; Osseointegration ; Tibia ; Titanium*

We present a new method of suture bridge technique for medial row fixation using a modified Mason-Allen stitch instead of a horizontal mattress. Medial row configuration of the technique is composed of the simple stitch limb and the modified Mason-Allen stitch limb. The limbs are passed through the tendon by a shuttle relay. The simple stitch limb passes the cuff once and the modified Mason-Allen stitch limb passes three times which creates a rip stop that prevents tendon pull-out. In addition, the Mason-Allen suture bridge configuration is basically a knotless technique which has an advantage of reducing a possibility of strangulation of the rotator cuff tendon, impingement or irritation that may be caused by knot.
Arthroscopy/methods ; Humans ; Rotator Cuff/injuries/*surgery ; Suture Anchors ; *Suture Techniques

Although outcomes of neonatal cardiac surgery have dramatically improved in the last two decades, low body weight still constitutes an important risk factor for morbidity and mortality. In particular, cardiac surgery in neonates with very low birth weight (< or =1.5 kg) is carried out with greater risk because most organ systems are immature. We report here on a successful case of early one-stage total repair of coarctation of the aorta and a ventricular septal defect in a 1,480 gram neonate.
Aortic Coarctation ; Body Weight ; Heart Septal Defects, Ventricular ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight ; Risk Factors ; Thoracic Surgery

Benign osteoblastoma is an uncommon primary bone tumor, extremely rare in calvarium. We present a case of a 25-year-old female with an osteoblastoma of parietal bone which was totally resected. The authors discussed the clinical presentation, radiographic finding, differential diagnosis and management of the benign calvarial osteoblastoma with a review of the literature.
Adult ; Diagnosis, Differential ; Female ; Humans ; Osteoblastoma ; Parietal Bone ; Skull

Malignant growth of the small bowel accounts for approximately 1 to 3 percent of malignant tumors of the gastrointestinal tract. Leiomyosarcomas are the second most common primary tumor of the small bowel, their frequency being one-third to one-half of adenocarcinoma. The common clinical symptoms of leiomyosarcoma of the small intestine are hemorrhage and abdominal pain. Accurate diagnosis cannot be based on solely on the roentgenographic finding, although in certain situations the dignosis of leiomyosarcoma may be suggested strongly. We report a case of bleeding leiomyosarcoma located in the second portion of the duodenum which was first recognized by endoscopic examination and confirmed by explolaparotomy.
Abdominal Pain ; Adenocarcinoma ; Diagnosis ; Duodenum* ; Gastrointestinal Tract ; Hemorrhage ; Intestine, Small ; Leiomyosarcoma*

Actinomycoces is a gram positive, anaerobic, branching and non-acid fast bacterium which is a normal habitant of the skin, oral cavity, tonsil and gastrointestinal tract and its human infection is rare. Pelvic actinomycoses is frequently caused by Actinomycoces israel-ii. It is chronic, progressive, and more suppurative than granulomatous disease, and the symptoms are usually persistent and gradual, therefore the misdiagnosis and improper trea-tment are not uncommon. Actinomycoses is generally classified as cervicofacial, abdominal and thoracic type ac- cording to the site of the primary infection. Many actinomycotic pelvic infections in women used intrauterine device with long du- ration were reported, in contrast, others suggest that actinomycoces developed opportunistic infection irrespective of intrauterine device presence. We have experienced 4 cases of pelvic actinomycoses, one case with IUD(Lippes' loop) in a 47 year old woman, the other case with abdominal wall ctinomycoses in a 34 year old woman, the third case without IUD in a 41 year old woman, the fourth case with IUD(Cu-7) in a 37 year old woman and reported them with a review of literature.
Abdominal Wall ; Actinomycosis* ; Adult ; Diagnostic Errors ; Female ; Gastrointestinal Tract ; Humans ; Intrauterine Devices ; Middle Aged ; Mouth ; Opportunistic Infections ; Palatine Tonsil ; Pelvic Infection ; Skin

Cholesterol granuloma of the paranasal sinus is a rare condition. It is rarely diagnosed preoperatively, as correct diagnosis depends on its characteristic histological picture. It is currently thought that impaired drainage, hemorrhage and inadequate ventilation play significant roles in its pathogenesis. We have experienced a case of cholesterol granuloma that had developed in the frontal and the ethmoid sinuses, which was managed successfully by transnasal endoscopic marsupialization. We report this case with a literature review.
Cholesterol* ; Diagnosis ; Drainage ; Ethmoid Sinus* ; Frontal Sinus ; Granuloma* ; Hemorrhage ; Ventilation

PURPOSE: This study was conducted to evaluate the functional results of an anterior extrasphincteric anorectoplasty (AEA) guided by an illuminating intrarectal indicator, in which a transperineal positioning of the anal canal was performed without cutting the perineal sphincter muscle. METHODS: Point A which would be a anal orifice in future was designated 0.3 mm anterior to the anal dimpling site. A semicircular incision was made in the front of the anus. The flap, which included from the anal skin to the upper margin of the external anal sphincter, was everted posteriorly. A quarter of the frontal upper rim of the external anal sphincter was exposed, and the center of the uppermost portion was designated as point B. From point A toward point B, a spinal needle was inserted through the anal sphincter, and needle's tract was dilated under direct identification of the sphincter muscle by electronic stimulation. An illuminating intrarectal indicator with a laparoscopic light source was pushed through the distal stoma of a sigmoid colostomy toward its distal lumen so that the blind rectal pouch was perineally exposured. On the blind pouch, a cruciate incision was made, and it was anastomosed to the anus. RESULTS: From 1991 to 2000, 11 patients with imperforate anus of high and intermediate type were operated by our method. In one case, the urethral injury was found intraoperatively and was immediately repaired. One case of anal stenosis was improved after serial Hegar dilatation. The postoperative bowel function in the Kirwan's clinical assessment at 12 th month was grade I in 9 cases and grade II in 2 case. Conclusion: This AEA with an illuminating intrarectal indicator shows acceptable clinical results and could be considered to be an effective surgical option for anorectal malformations.
Anal Canal ; Anus, Imperforate ; Colon, Sigmoid ; Colostomy ; Constriction, Pathologic ; Dilatation ; Humans ; Needles ; Skin

BACKGROUND AND OBJECTIVES: Several prognostic factors are known to be related to the recovery of sudden sensorineural hearing loss (SSNHL). Recent studies have suggested that cardiovascular risk factors (CVRFs) are associated with the occurrence of SSNHL. However, the value of CVRFs as a predictor of recovery in patients with SSNHL has been rarely evaluated. We aim to evaluate the prognostic value of CVRFs in relation to hearing recovery of SSNHL. SUBJECTS AND METHOD: A total of 278 patients who were diagnosed and treated for SSNHL and who underwent blood sampling and follow-ups for more than 3 months were reviewed retrospectively. We reviewed CVRFs such as age, body mass index, blood pressure, cholesterol, smoking history, the presence of diabetes mellitus and other related underlying diseases. Patients were divided into three groups (low, medium, and high CVRF groups) according to the CVRF grades. Hearing thresholds were repeatedly measured on the initial visit, 1 week, 1 month and 3 months after treatment. Treatment outcome was analyzed by comparing hearing recovery rate and post-treatment audiometric changes among the three CVRF groups. RESULTS: Seventy (25.2%), 129 (46.4%) and 79 (28.4%) patients were included into the low, medium and high CVRF groups, respectively. The hearing threshold was significantly reduced at 3 months after treatment in all three groups (p<0.001). The hearing recovery rate of the low CVRF group was significantly higher than that of the medium and high CVRF group (p=0.011). On the last visit, the high CVRF group significantly showed more poor hearing improvement than the low CVRF group did (p=0.045). CONCLUSION: Our findings suggest that the presence of CVRFs may be a poor prognostic sign for hearing recovery in patients with SSNHL.
Blood Pressure ; Body Mass Index ; Cholesterol ; Diabetes Mellitus ; Follow-Up Studies ; Hearing Loss, Sensorineural* ; Hearing* ; Humans ; Methods ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking ; Treatment Outcome

BACKGROUND: Remarkable progress has recently been made in achieving successful early repair of congenital heart disease with using cardiopulmonary bypass in the neonatal period. The aim of this study is to evaluate our short-term outcomes for performing neonatal cardiac surgery under extracorporeal circulation. MATERIAL AND METHOD: Fifty five neonates underwent open heart surgery from February 2002 to December 2007. The mean ages and body weight was 13.5 days and 3.2 kg, respectively. The diagnoses of the patients were transposition of the great arteries (14), total anomalous pulmonary venous connection (7), large ventricular septal defect (VSD) (7), coarctation of the aorta with VSD (6), interrupted aortic arch (5) and others (16). RESULT: Six patients had difficulties being weaned from extracorporeal circulation. Four patients left the operating room with an open sternum. Low cardiac output syndrome and acute renal insufficiency were observed in 3 patients each, respectively. Post-operative complications were observed in 27 patients (49.1%). The postoperative mortality was 12.7% (7 patients); 5 patients experienced early hospital death and 2 experienced late death (2). CONCLUSION: In our hospital, early surgical repair with extracorporeal circulation in neonates was feasible with tolerable mortality. Further follow-up is required to establish the long-term survival and complications.
Acute Kidney Injury ; Aorta, Thoracic ; Aortic Coarctation ; Arteries ; Body Weight ; Cardiac Output, Low ; Cardiopulmonary Bypass ; Extracorporeal Circulation ; Follow-Up Studies ; Heart ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Infant, Newborn ; Operating Rooms ; Sternum ; Thoracic Surgery