BACKGROUND: Conventional correction of malunioned zygoma requires complete regional exposure through a bicoronal flap combined with a lower eyelid incision and an upper buccal sulcus incision. However, there are many potential complications following bicoronal incisions, such as infection, hematoma, alopecia, scarring and nerve injury. We have adopted a zygomaticofrontal suture osteotomy technique using transconjunctival incision with lateral paracanthal extension. We performed a retrospective review of clinical cases underwent correction of malunioned zygoma with the approach to evaluate outcomes following this method. METHODS: Between June 2009 and September 2015, corrective osteotomies were performed in 14 patients with malunioned zygoma by a single surgeon. All 14 patients received both upper gingivobuccal and transconjunctival incisions with lateral paracanthal extension. The mean interval from injury to operation was 16 months (range, 12 months to 4 years), and the mean follow-up was 1 year (range, 4 months to 3 years). RESULTS: Our surgical approach technique allowed excellent access to the infraorbital rim, orbital floor, zygomaticofrontal suture and anterior surface of the maxilla. Of the 14 patients, only 1 patient suffered a complication—oral wound dehiscence. Among the 6 patients who received infraorbital nerve decompression, numbness was gradually relieved in 4 patients. Two patients continued to experience persistent numbness. CONCLUSION: Transconjunctival incision with lateral paracanthal extension combined with upper gingivobuccal sulcus incision offers excellent exposure of the zygoma-orbit complex, and could be a valid alternative to the bicoronal approach for osteotomy of malunioned zygoma.
Alopecia ; Cicatrix ; Conjunctiva ; Decompression ; Eyelids ; Follow-Up Studies ; Hematoma ; Humans ; Hypesthesia ; Maxilla ; Methods ; Orbit ; Osteotomy* ; Retrospective Studies ; Sutures ; Wounds and Injuries ; Zygoma* ; Zygomatic Fractures

Some malignant melanoma cells regress spontaneously by terminal differentiation, and understanding the mechanisms of this spontaneous regression can contribute to the development of a new therapy not only for melanoma but also for other cancers. The signal transducing G protein is one component of the signaling pathways for the differentiation-inducing molecules such as alpha-melanocyte-stimulating hormone (alpha-MSH) and cAMP. To investigate the role of G proteins in the differentiation process, we analyzed the expression of various G proteins by quantitative Western blot and cAMP response in human malignant melanoma cell lines. SK-MEL-3 cells expressed the largest amount of stimulatory G protein alpha subunit (G(s) alpha) and the largest amount of inhibitory G protein alpha subunit (G(i) alpha) was expressed in Malme-3M cells among the 4 melanoma cell lines analyzed in this experiment. The SK-MEL-28 cells exhibited largest amount of alpha subunit of G(q) and the beta subunits. The cAMP formation by forskolin stimulation was largest in the Malme-3M. The amount of cAMP formation did not show any correlation with the expression of G(s) alpha nor that of G(i) alpha. The population doubling time was longest in Malme-3M cells. In this experiment, we found that the melanoma cells vary widely both in the expression of various G proteins and in cAMP production depending on the cell lines.
alpha-MSH ; Blotting, Western ; Cell Line* ; Colforsin ; GTP-Binding Protein alpha Subunits ; GTP-Binding Proteins* ; Humans* ; Melanoma*

BACKGROUND: Notified tuberculosis (TB) cases in Korea have not decreased over the last decade (2001-2010). METHODS: To clarify the reasons, we analyzed an annual report on notified tuberculosis patients and age-specific population drift in Korea. RESULTS: Compared to the age-specific notified TB cases between 2001 and 2010, distinctive features in notified TB cases and new cases increased markedly in people aged 45-54 years and in patients over 65 years old, whereas those between 15-34 years in 2010 decreased drastically. In particular, notified TB individuals over 65 years old occupied 29.6% of the cases in 2010, which was 1.5 times higher than that in 2001. The main reason not to decrease in notified TB patients for the last decade (2001-2010) was due to the increasing elderly population as well as the aging of baby boomers, which have a higher risk of TB development. CONCLUSION: Korea needs to pay attention to the older population in order to successfully decrease the burden of TB in the future.
Aged ; Aging ; Humans ; Korea ; Population Dynamics ; Population Growth ; Tuberculosis

There hundred and twenty five cases of meningitis, in infancy and childhood, consisting of 117 cases of purulent meningitis, 59 cases of aseptic meningitis and 149 cases of tuberculons meningitis, which were admitted to the wonju christian hospital between April 1966 and March 1976, were clinically observed and the following results were obtained. 1.Sex ratio was 2.0:1 in purulent meningitis, and aseptic meningitis and 1.9:1 in tuberculons meningitis. 2. The highest incidence in infancy was purulent meningitis (78.5%) and over 6 years was aseptic meningitis (44.1%) and under 6 years was tuberculous meningitis (71.6%). 3. The seosonal peak incidence was spring and summer for purulent meningitis and summer and winter for aseptic and tuberculer meningitis. 4. Fever was the most comon symptom followed by vomiting, headache, and unconsciousness in that order of frequency and the most common neurologic finding on admission was neck stiffness, kernig's sign, Burudzinsk's sign, etc in three meningitis. 5. Among preceding and associated chiseases, U.R.I. was the common(19.7%) in purulent ans aseptic meningitis (28.8%) and pulmonary tuberculous (24.8%) and miliary tuberculeus (16.1%) in tuberculous meningitis. 6. In C.S.F. examination on admissin day. Cell count were frequent 50~500/mm3 in aseptic meningitis (76.9%) and tuberculous meningitis (80.5%). Sugar levels under 40mg/dl showed 62.5% of cases of purulent meningitis, 76.6% of cases of tuberculous meningitis and 8.5% of cases of the aseptic meningitis. Protein levels were the most common in 100~500mg/dl in the purulent meningitis (61.5%) and the tuberculous meningitis (53%) and under 40mg/dl(54.2%) in the asephicmeningitis. 7. Known mortality rate was 64% for the purulent meningitis, 67.5% for the aseptic meningitis, and complications showed in 7.7% in the purulent meningitis 10% in the tuberculous meningitis.
Cell Count ; Fever ; Gangwon-do ; Headache ; Incidence ; Meningitis* ; Meningitis, Aseptic ; Mortality ; Neck ; Neurologic Manifestations ; Tuberculosis, Meningeal ; Unconsciousness ; Vomiting

Blue nevus of the uterine cervix is a rare benign pigmented lesion consisting of dermal melanocytes in the stroma. It is similar to those of common blue nevus of the skin. Most of these are clinically or colposcopically unsuspected and an incidental finding often found in hysterectomy specimens. The case here was incidentally found in surgical pieces after hysterectomy in 43-year-old women performed for leiomyoma. We report a case of blue nevus of the uterine cervix with a review of the literature.
Adult ; Cervix Uteri* ; Female ; Humans ; Hysterectomy ; Incidental Findings ; Leiomyoma ; Melanocytes ; Nevus, Blue* ; Skin

BACKGROUNDS/AIMS: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas has malignant potential. Predicting invasive IPMN has proven difficult and controversial. We tried to identify predictive factors for invasive IPMN. METHODS: Thirty six patients underwent resection for IPMN from February 2001 to July 2011. Clinicopathological features including demographic, imaging, microscopic, and serological findings were retrospectively reviewed. Receiver operating characteristic (ROC) curve analysis was used to analyze sensitivity and specificity of all possible cut-off values for the diameter of the main pancreatic duct and mass size predicting invasive IPMN. Student t-test, chi-square test, and logistic regression were used for univariate and multivariate analysis. RESULTS: The mean age was 63.5+/-8.4 years. Males were more commonly affected (58.3% vs 41.7%). Pancreaticoduodenectomy was performed in 55.6% of patients, distal pancreatectomy in 36.1%, and central pancreatic resection in 8.3%. Non-invasive IPMNs were present in 80.6% (n=29), whereas invasive IPMNs were present in 19.4% (n=7). In univariate analysis, tumor location (p=0.036), Kuroda classification (p=0.048), mural nodule (p=0.016), and main duct dilatation (> or =8 mm) (p=0.006) were statistically significant variables. ROC curve analysis showed that a value of 8 mm for the main duct dilatation and a value of 35 mm for the size of the mass lesion have 80% sensitivity and 75% specificity and 100% sensitivity and 82.6% specificity, respectively. However, in multivariate analysis, main ductal dilatation (> or =8 mm) was identified to be the only independent factor for invasive IPMN (p=0.049). CONCLUSIONS: Main duct dilatation appears to be a useful indicator for predicting invasive IPMN.
Dilatation ; Humans ; Logistic Models ; Male ; Mucins ; Multivariate Analysis ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Pancreaticoduodenectomy ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

No abstract available.
Pituitary Neoplasms* ; Thyrotropin*

OBJECTIVES: The goals of the study were to compare the middle ear (ME) volumes from both normal and lesioned ears, and these ME volumes were measured by a digital image processing computed tomography (CT) program in patients with unilateral chronic otitis media, and we wanted to compare the ME volumes of the lesioned ears by comparing the ME volumes obtained by tympanometry with those ME volumes measured by the digital image processing CT program. METHODS: Forty-four patients who had unilateral chronic otitis media (COM) and contralateral normal tympanic membranes (TM) and 100 subjects with normal TMs were included in the study. The normal volumes of the external auditory canal (EAC) were measured in the normal group. The tympanometric ME volumes in the ears with a perforated TM were calculated as the difference of the tympanometric volumes measured from the both ears in patients with unilateral COM. The CT ME volumes were measured by a digital image processing program. RESULTS: The tympanometric volumes of the EACs in the ears with normal TMs were 1.4+/-0.3 mL. There were no significant differences according to gender, age and the side of the face the ear was on. The tympanometric volumes of the EAC in the normal-side ear of the patients with unilateral COM showed no significant differences when compared with those from the normal group. The ME volumes of the intact ears, as measured by CT, showed significantly higher values than those ME volumes of the lesioned ears. The ME volumes of the lesioned ears, as measured by tympanometry, showed a strong, significant linear correlation with those ME volumes calculated by CT; however, the ME volumes of the lesioned ears, as measured by tympanometry (1.5+/-1.4 mL), were significantly larger than those ME volumes measured by CT (1.1+/-0.8 mL). CONCLUSION: Our results show that chronic otitis media causes reduced ME volumes compared to those ME volumes of the contralateral normal ears. Tympanometry can provide a valuable estimation of the ME volumes in chronic ears, although it tends to overestimate the ME volumes, and especially for the ears with a larger ME volume.
Acoustic Impedance Tests ; Aminocaproic Acids ; Ear ; Ear Canal ; Ear, Middle ; Humans ; Mastoid ; Otitis ; Otitis Media ; Tympanic Membrane

BACKGROUND AND OBJECTIVES: It has been reported that vibration applied either on the mastoid or the sternocleidomastoid (SCM) muscles induces nystagmus in patients after unilateral vestibular neuritis. The aims of the study were to characterize the vibration-induced nystagmus (VIN) in patients with various vestibular disorders and to compare the results of VIN to unilateral weakness in caloric test. MATERIALS AND METHODS:Fifthy-four patients with Meniere's disease, 58 patients with unilateral vestibular neuritis, 170 patients with migraine-associated dizziness, and 78 patients with chronic recurrent vestibulopathy were included. We recorded eye movements during unilateral 100-Hz vibration on the mastoids and SCM muscles. The bithermal caloric test was also performed. Abnormal criteria of VIN were slow-phase slow-phase velocity (SPV) at 4 all different conditions > or = 2degrees/s with the same directions or mean of SPV at vibration on both mastoids or both SCM muscles > or = 5degrees/s with the same directions. RESULTS: In Meniere's disease, 28 of 57 (49.1%) of patients show pathologic VIN, 21 of 57 (36.8%) show pathologic canal paresis. 14 of 57 (24.6%) show abnormalities in both tests, and 35 of 57 (61.4%) show any abnormalities in either test. In unilateral vestibular neuritis, 43 of 58 (77.6%) showed pathologic VIN, 58 of 58 (100%) show canal paresis. In migraine-associated dizziness, 48 of 170 (28.2%) showed pathologic VIN, 58 of 170 (18.8%) show canal paresis. 15 of 170 (8.8%) showed abnormalities in both tests, and 65 of 170 (38.2%) show any abnormalities in either test. In chronic recurrent vestibulopathy, 23 of 78 (29.5%) of patients show pathologic VIN and 17 of 78 (21.8%) show pathologic canal paresis. Seven of 78 (9.0%) showed abnormalities in both tests, and 33 of 78 (42.3%) show any abnormalities in either test. CONCLUSION: VIN test can increase the sensitivity in detecting vestibular imbalance in vestibular disorders when combined with caloric test.
Caloric Tests ; Dizziness ; Eye Movements ; Humans ; Mastoid ; Meniere Disease ; Muscles ; Paresis ; Vestibular Neuronitis ; Vibration

BACKGROUND AND OBJECTIVES: It has been reported that vibration applied either on the mastoid or on the sternocleidomastoid (SCM) muscles induces nystagmus in normal subjects. The aims of the study were to characterize the direction and velocity of slow-phase eye movement which is induced by vibration in normal subjects and to propose the mechanism of vibration-induced nystagmus (VIN) in normal subjects. MATERIALS AND METHOD: We recorded eye movements during unilateral 100-Hz vibration on the mastoid bone and SCM muscles in 56 normal subjects. The subjects were divided into 4 groups in ages (20s, 30s, 40s, 50~60s). The directions of VIN, the degree of maximal slow-phase eye velocities were analyzed according to age. Positive value means slow-phase velocity (SPV) to the right side. RESULTS: In 20s, vibration on right/left mastoids induced SPV of 1.2+/-2.0degrees/sec, 0+/-2.1degrees/sec and on right/left SCM muscles, 1.1+/-1.9degrees/sec, -1.2+/-2.5degrees/sec. In 30s, vibration on right/left mastoids induced SPV of 3.3+/-3.8degrees/sec, -0.3+/-1.4degrees/sec and on right/left SCM muscles, 2.8+/-4.2degrees/sec, -1.0+/-1.5degrees/sec. In 40s, vibration on right/left mastoids induced SPV of 0+/-1.7degrees/sec, -0.2+/-1.2degrees/sec and on right/left SCM muscles, 0+/-1.8degrees/sec, 0+/-1.0degrees/sec. In 50~60s, vibration on the right/left mastoids induced SPV of -1.3+/-1.3degrees/sec, 1.2+/-1.3degrees/sec and on right/left SCM muscles, -0.6+/-0.9degrees/sec, 0.9 +/-1.5degrees/sec. The directional preponderance of the slow-phase eye movement to the vibrated side was statistically significant in 20s and 30s, however, the preponderance of the slow-phase eye movement changed into the non-vibrated side in 50~60s. CONCLUSION: The proprioceptive input, changing major rotator from the inferior oblique muscle to the sternocleidomastoid muscles might explain the change of the directional preponderance of the slow-phase eye movements in normal subjects according to ages. Although this directional preponderance is not consistent in all age groups, it is still important in discriminating normal responses from abnormal responses which can be induced by vibration.
Eye Movements ; Humans ; Mastoid ; Muscles ; Vibration