Animals ; Bicuspid ; Calcium Phosphates ; Dogs ; Humans ; Light ; Mandible ; Microscopy ; Osteogenesis ; Young Adult

Adult ; Animals ; Bacteria ; Bicuspid ; Corrosion ; Dental Implants ; Dogs ; Hardness ; Humans ; Osseointegration ; Osteogenesis ; Osteogenesis, Distraction ; Titanium

Distraction osteogenesis (DO) is a surgical method of bone formation that involves an osteotomy and sequential stretching of the healing callus by gradual movement and subsequent remodeling. DO is used to correct facial asymmetry, such as in patients with hemifacial microsomia, maxillary or mandibular retrusion, cleft lip and palate, alveolar defects, and craniofacial deficiency. It is accomplished with the aid of a distraction device, which is secured with screws placed directly into bone, for a predetermined length of time. Hemifacial microsomia is characterized by unilateral facial hypoplasia, often with unilateral shortening of the mandible and subsequent malocclusion. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, tilted occlusal plane, and short mandible. Early treatment is necessary to avoid subsequent impaired midfacial growth. The standard treatment of these malformations consists of the application of bone grafts, which can lead to unpredictable growth. The new bone-lengthening procedure represents a limited surgical intervention and opens up a new perspective for treatment, especially in younger children with severe deformities. This report describes a case of hemifacial microsomia (Type-II left-sided hemifacial microsomia). The patient, a 10-year-old child, visited our clinic for facial asymmetry correction. He had a hypoplastic mandible, displaced ear lobe, 10 mm canting on the right side, and malocclusion. We planned DO to lengthen the left mandible in conjunction with a Le Fort I osteotomy for decanting and then perform a right intraoral vertical ramus osteotomy (IVRO). Progressive distraction at a rate of 0.5 mm/12 hours was initiated 7 days postoperatively. The duration of DO was 17 days. The consolidation period was 3 months. Satisfactory results were obtained in our case, indicating that DO can be used successfully for functional, aesthetic reconstruction of the mandible. We report a case involving DO in conjunction with orthognathic surgery for correcting mandibular hypoplasia with a review of the literature.
Bony Callus ; Child ; Cleft Lip ; Congenital Abnormalities ; Dental Occlusion ; Ear ; Facial Asymmetry ; Goldenhar Syndrome* ; Humans ; Malocclusion ; Mandible ; Maxilla ; Orthognathic Surgery ; Osteogenesis ; Osteogenesis, Distraction* ; Osteotomy ; Palate ; Retrognathia ; Transplants

Malnutrition in patients with liver disease is common. Consequently, percutaneous endoscopic gastrostomy may be needed for the correction of malnutrition. Percutaneous endoscopic gastrostomy is rarely performed in patients with liver cirrhosis because of the presence of varices and coagulation abnormalities. However, if careful insertion technique along with thorough clinical assessment is undertaken, percutaneous endoscopic gastrostomy may be successfully performed in patients with liver cirrhosis. Here, we report successful application of percutaneous endoscopic gastrostomy in a patient with liver cirrhosis accompanied by both gastric and esophageal varices.
Aged ; *Endoscopy ; *Enteral Nutrition ; Esophageal and Gastric Varices/*complications ; Gastrostomy/*methods ; Humans ; Liver Cirrhosis/complications/*therapy ; Male

BACKGROUND/AIMS: Although the majority of patients with Mallory-Weiss syndrome (MWS) have a benign course, MWS patients with recurrent bleeding have an unfavorable outcome and require intensive care. Therefore, this study was carried out to identify the risk factors for recurrent bleeding in MWS patients. METHODS: The medical records of patients with MWS between January 1999 and December 2003, were reviewed retrospectively. Demographics, initial clinical and laboratory parameters, and endoscopic findings of the patients with and without recurrent bleeding were compared and the potential risk factors predicting recurrent bleeding in MWS were evaluated. RESULTS: A total of one hundred and fifty-nine patients (22 women, 137 men, mean age 48.1 years old) were enrolled in the study. Recurrent bleeding was observed in 17 patients (10.7%). Those patients with recurrent bleeding showed higher frequency for the presence of shock at initial manifestation, combined liver cirrhosis and endoscopic findings of active bleeding, lower hemoglobin level and platelet count, higher amount of transfusions and epinephrine-mixed fluid injections, and longer hospital stay than those patients without recurrent bleeding. Significant risk factors predicting the recurrent bleeding in MWS were the presence of shock at initial manifestation (OR 3.71, 95% CI 1.07-14.90) and the evidence of active bleeding on endoscopic examination (OR 9.89, 95% CI 1.88-51.98) on multivariate analysis. CONCLUSIONS: Intensive care with close monitoring is required for the patients with shock on initial manifestation or with evidence of active bleeding on endoscopic examinations since these are independent risk factors predicting the recurrent bleeding in MWS patients.
Female ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Male ; Mallory-Weiss Syndrome/*complications/pathology/therapy ; Middle Aged ; Recurrence

Ascaris lumbricoides is the most common intestinal parasite in less-developed countries as well as in areas with poor sanitation. Highly motile mature worms may enter the ampulla of Vater and migrate to the bile or pancreatic ducts causing cholangitis, biliary stones, cholecystitis, pancreatitis and a liver abscess. The incidence of pancreatitis due to biliary ascariasis is relatively common in endemic areas, but only a few cases have been reported in Korea since 1990. A 68-year-old woman was admitted with a sudden onset of epigastric pain. She was diagnosed with acute pancreatits due to ascaris based on computed tomography, the ampulla-impacted state of the worm and an elevated serum amylase level. The patient recovered without complications after the ascaris had been extracted using grasp forceps during endoscopy. The patient also received antihelminthic therapy. We report this case with a review of the relevant literatures.
Aged ; Ampulla of Vater ; Amylases ; Ascariasis ; Ascaris lumbricoides ; Ascaris* ; Bile ; Cholangitis ; Cholecystitis ; Common Bile Duct* ; Developing Countries ; Endoscopy ; Female ; Hand Strength ; Humans ; Incidence ; Korea ; Liver Abscess ; Pancreatic Ducts ; Pancreatitis* ; Parasites ; Sanitation ; Surgical Instruments

PURPOSE: It is now well recognized that reperfusion of ischemic tissues initiates a complex series of reactions that can paradoxically injure tissues. Apoptosis occurs in select cell populations during morphologic development and during cellular injury, including oxygen radical exposure, ischemia-reperfusion, and sepsis. Thus, in this study, we examined relation of the melatonin effect to the injection time and the dose, and role of melatonin in apoptosis. METHODS: Intestinal ischemia-reperfusion injury was induced in rats by clamping the superior mesenteric artery for 30 minutes. After reperfusion injury for 30 minutes, the experimental group was administered melatonin (10 mg/kg) intraperitoneally and the control group received saline and ethanol. At 30 minutes, 60 minutes, and 90 minutes, 1) pulmonary histological assessments (interstitial PMNs/10HPFs and lung (alveolar) injury score), 2) alveolar microvascular permeability assessments (wet-weignt to dry-weight ratio and lipid peroxidation activity, malondialdehyde, MDA), and 3) western blotting assessments (p53, p21, Bax, and bcl-2) were made. For comparison, long- time (60-minute) reperfusion and double- dosage melatonin (20 mg/kg) were also studied. RESULTS: The lung injury score was 1.00+/-0 in the melatonin group at 90 minutes and 3.28+/-0.30 in the saline group (p<0.01). The number of sequestered neutrophils was significantly higher in the control group at 90 minutes (34.38+/-16.76/10 HPFs) than in the melatonin-treated group (5.63+/-2.73/10 HPFs; p<0.01). In the melatonin group at 90 minutes, the wet-weight to dry-weight ratio was 4.69+/-0.16, and in the saline group, the ratio was 4.78+/-0.17 (p>0.05). A marked difference was found between the ischemia-reperfusion control group and the experimental group at 90 minutes regarding lipid peroxidation activity (Malondialdehyde, 16.45+/-0.19 micrometer vs 10.93+/-0.11 micrometer, p<0.01). In the melatonin group, p21 expressions were found to be much more than in the control group. But, p53, bcl-2, and Bax expressions were found to be in the control group. CONCLUSION: Melatonin injection within 60 min after reperfusion may promote recovery of reperfusion injury, but double-dose melatonin injection was inefficacious. Also, melatonin inhibit apoptosis by p21 expression.
Animals ; Apoptosis ; Blotting, Western ; Capillary Permeability ; Constriction ; Ethanol ; Intestines* ; Lipid Peroxidation ; Lung ; Lung Injury ; Malondialdehyde ; Melatonin* ; Mesenteric Artery, Superior ; Neutrophils ; Oxygen ; Rats ; Reperfusion ; Reperfusion Injury ; Sepsis

We report a patient with an unusual manifestation of Trichophyton rubrum infection. A 75-year-old male presented an erythematous patch with painless crusted and non-crusted nodules on the left elbow which had persisted for 5 weeks. Histologic findings of the erythematous nodule showed epidermal hyperplasia and granulomatous change in the lower dermis. Trichophyton rubrum was isolated on the fungus culture of the biopsy specimen. The patient was treated with itraconazole (100mg/day) for 8 weeks, resulting in the clearing of the skin lesion and there has been no recurrence of any skin lesion over a 3-month' follow-up period.
Aged ; Biopsy ; Dermis ; Elbow ; Follow-Up Studies ; Fungi ; Granuloma* ; Humans ; Hyperplasia ; Itraconazole ; Male ; Recurrence ; Skin ; Trichophyton*

BACKGROUND: Pilomatricoma is a rare benign follicular tumor in Orientals. OBJECTIVE: Clinical and histopathological features of the tumor were analyzed. METHODS: The medical records and histopathological slides of 19 tumors from 17 patients with pilomatricoma were studied. RESULTS: The morphology of the tumors were divided into 3 groups :1) elevated, uniform nodules(16 cases), 2) elevated, multilobulated nodules(2 cases), and 3) non-elevated, uniform nodules (1 case). Histologically, the tumors were composed of shadow cells, transitional cells, basaloid cells and squamous cells. Changes of the stroma within the tumors and the stroma overlying the tumors included vascular dilatation, RBC engorgement and infiltration of inflammatory cells. Changes of the epidermis overlying the tumors were found in 14 cases and included hyperkeratosis(14 cases), follicular plugging(2 cases), epidermis invagination(5 cases) and acanthosis nigricans-like change(3 cases). CONCLUSION: Clinically, pilomatricomas manifested as either a solitary nodule or two nodules. Histologically, several tumors showed palisading of basaloid cells, retraction spaces, lymphoid follicles and acanthosis nigricans-liike epidermal changes in addition to the classic features of pilomatricoma.
Dilatation ; Epidermis ; Humans ; Medical Records ; Pilomatrixoma*

Cribier and Grosshans(1995) reported two cases of tumor of the follicular infundibulum(TFI) arising in nevus sebaceus for the first time. In 1961 Mehregan and Butler described a new benign adnexal neoplasm, which they called tumor of the follicular infundi4ulurn." Since then few observations have been published. The majority of the lesions are solitary. They appeared in adults, predominantly in wornen, on the face, arm, and neck. Histopathologically, the unique feature is a benign hyperplastic lesion that extends from the follicular infundibuluni. as an epithelial plate either with underlying elastic fiber network in TFI or without underlying elastic fiber network in TFI like change. A 52-year-old man has haf a solitary, well-defined, hairless, verrucous plaque on his right supra auricular area for about 10 years. It has seerned to increase gradually in size over the last year. The histologic findings shwed a plate-like growth of epithelial cells in the upper dermis extending parallel to the epidermis with multiple connections at the lower margin of the epidermis. The peripheral cell layer of ttie tumor plate showed palisading, and centrally located cells were pale staining. Many hair follicl s, mature sebaceous glands, ectopic apocrine glands, and inflammatory cell infiltrations were present in the dermis. However, there was no elastic fiber network beneath the epithelial cell plate. We believe our case is the first to be reported in Korea as TFI-like change in nevus sebaceus.
Adult ; Apocrine Glands ; Arm ; Dermis ; Elastic Tissue ; Epidermis ; Epithelial Cells ; Hair ; Humans ; Korea ; Middle Aged ; Neck ; Nevus* ; Sebaceous Glands