Schematic of mean thickness distribution on the lateral aspect of the canine frontal sinus as an experimental model of sinus surgery / 대한해부학회지

The dog frontal sinus may represent an alternative model dental implant research; its topographical resemblance to the maxillary sinus renders it a potentially favorable experimental environment. The aim of this study was thus to elucidate the anatomical configuration of the canine frontal sinus and histological characteristics, and to determine whether it could be a new canine experimental model for dental implant research. Twenty-four sides of canine frontal bones were harvested. The distance from the nasion to the emerging point of the lateral aspect of the canine frontal sinus was measured with the aid of Lucion software. The thicknesses of the canine frontal sinus wall were measured, and the two specimens stained with hematoxylin and eosin. The mean distance from the nasion to the emerging point of the lateral aspect of the canine frontal sinus was 16.0 mm. The mean thicknesses of the canine frontal bone at 3, 6, 9, 12, and 15 mm lateral to the midsagittal plane were 2.3, 2.7, 3.2, 3.8, and 3.7 mm, respectively. The canine frontal sinus was lined with pseudostratified ciliated columnar epithelium. These data suggest that the canine frontal sinus is a suitable alternative to the canine maxillary sinus as a model for studying various sinus augmentation protocols.

Metastasis via Peritumoral Lymphatic Dilation in Oral Squamous Cell Carcinoma / 대한악안면성형재건외과학회지

PURPOSE: Nodal metastasis is the main prognostic factor in the patients with oral squamous cell carcinoma (OSCC). We investigated the association between tumor-associated lymphatics and OSCC characteristics. METHODS: Thirty-four specimens were used for the immunohistochemical staining with the antibody for vascular endothelial growth factor (VEGF)-C, VEGF-D, VEGF receptor (VEGFR)-3, phosphorylated VEGFR-3, D2-40, and matrix metallproteinases (MMPs). We observed the distribution of the lymphangiogenic factors and quantified the degree of expression. We determined lymphatic vessel density (LVD) and lymphatic vessel dilatation with D2-40 immunostaining. We assessed the association of LVD or lymphatic vessel dilatation with tumor progression or tumor differentiation. RESULTS: OSCC cells expressed lymphangiogenic ligands. Lymphangiogenic receptor, VEGFR-3, was expressed and activated in some tumor cells as well as in tumor-associated endothelial cells. LVD was not associated with tumor size or nodal status, but lymphatic vessel dilatation was higher in tumors with nodal metastasis, and also higher in poorly differentiated tumors. In stromal area of OSCC, MMP-1 and MMP-10 were up-regulated and the basement membrane of tumor-associated endothelial cells was destroyed by these collagenases. CONCLUSION: In the primary tumors with nodal metastasis, especially in poorly differentiated OSCC, tumor cells invaded the dilated lymphatic vessels via ruptured sites. MMP-1 and MMP-10 are important in the lysis of the glycocalyx inside the tumor-associated lymphatic endothelial cells.

Recurrent Herpes-Stomatitis Mimicking Acute Necrotizing Ulcerative Gingivitis

Gene Expression for Lymphangiogenic Factors in Oral Mucosal Squamous Cell Carcinoma

The Effect of Heparin Binding Epidermal Growth Factor on the Hypertrophy / Hyperplasia of Human Bladder Smooth Muscle

PUROPOSE: The bladder outlet obstruction (BOO) causes a bladder hypertrophy and/or hyperplasia with time. Heparin binding epidermal growth factor like growth factor (HB-EGF) is a potent mitogen for bladder smooth muscle cell (BMSC), causing significant cellular hypertrophy. Few studies have evaluated the effect of HB-EGF on bladder hypertrophy or hyperplasia. We studied to evaluated the effect of HB-EGF on the hypertrophy or hyperplasia of human BSMC and fibroblast. MATERIAL AND METHODS: To evaluate the change of expression of HB-EGF mRNA of human BMSC under a constant stimuli of 40cm-H20 pressure during 0, 1, 3 and 5 hours, RT-PCR was perfromed. The human BMSC and bladder fibroblasts with the addition of the recombinant HB-EGF 25ng/ml were performed 3H-thymidine and 3H-leucine incorporation assay for DNA and protein production, respectively. RESULTS: The expression of HB-EGF mRNA in BMSC under a constant stimuli of 40cm-H20 pressure was up-regulated with time (p<0.05). The optimal concentration of HB-EGF was 25ng/ml. The 3H-Lecine and 3H-thymidine activity in both human BSMC and fibroblast were significantly increased in addition of 25ng/ml of HB-EGF (p<0.05 and p<0.05, respectively). CONCLUSIONS: Constant hydrostatic pressure induces the expression of HB-EGF in human BSMC. Subsequently HB-EGF induces hypertrophy and hyperplasia of human BSMC and fibroblast in vitro. Our data support that HB-EGF is one of relevant BOO-induced growth factors.

Severe Hypercapnia during Cardiopulmonary Bypass due to Carbon Dioxide Insufflation: A case report / 대한마취과학회지

Air embolization is a potential danger during open heart surgery. To prevent air embolization in incompletely deaired cardiac chambers, flooding of the surgical fields with carbon dioxide (CO2) is used during cardiopulmonary bypass. CO2 flooding may be more useful in de-airing for patients undergoing minimally invasive cardiac surgery. We experienced an episode of sudden, severe hypercapnia and respiratory acidosis in a 51-year-old female patient during hypothermic cardiopulmonary bypass for minimally invasive mitral valve replacement. During hypercapnia, hemodynamic and BIS data were stable except for a slight increase in mean arterial pressure. After ruling out other causes of hypercapnia such as oxygenator failure and malignant hyperthermia, severe hypercapnia disappeared gradually after the cessation of CO2 flooding in the surgical field. No neurologic or cardiopulmonary complications were noted after the operation. We concluded that frequent or continuous CO2 monitoring may be required during CO2 insufflation at surgical fields to prevent hypercapnic complications in minimally invasive cardiac surgery.

Comparison of the Efficacy between Risperidone and Quetiapine in Elderly Patients with Delirium

OBJECTIVES: Many studies showed that risperidone and olanzapine in the treatment of delirium were similar to haloperidol, in side effects were superior to that. Quetiapine is frequently used in delirious patients. However, the studies of quetiapine in the treatment of delirium are very few. This study was designed to compare the efficacy of risperidone and quetiapine in elderly patients with delirium. METHODS: We divided 2 groups (risperidone and quetiapine) of elderly patients with delirium. We compared the two groups of elderly patients with delirium by Korean Version of Delirium Rating Scale (K-DRS) and Korean Mini-Mental State Examination (K-MMSE) at baseline and 1 week later. RESULTS: Our results showed that risperidone and quetiapine were efficacious in the treatment of elderly patients with delirium according to using K-DRS and K-MMSE. There were no significant differences in the degree of effects in both drugs. CONCLUSION: We compared the efficacy of risperidone and quetiapine in the treatment of delirium. Quetiapine was as efficacious as risperidone in the treatment of the elderly patients with delirium. In future, the sample size need to be increased in the studies of delirium. And the evaluation of long-term side effects related to quetiapine need to be performed.

Immunohistochemical study on expression patterns of tumor growth related factors in salivary gland tumors

Restoration of mandibular continuity using mandibular transport distractor guided by reconstruction plate

Comparison of Thiopental Sodium and Ketamine Induction on Emergence Agitation after Desflurane Anesthesia in Children undergoing a Tonsillectomy / 대한마취과학회지

BACKGROUNDs: It is widely known that desflurane provides fast emergence but with a high incidence of emergence agitation. This study was designed to investigate the emergence agitation resulting from thiopental or ketamine induction with desflurane anesthesia for pediatric patients. METHODS: Forty patients, aged 3-8 years, scheduled for a tonsillectomy or a tonsillectomy and adenoidectomy were randomly allocated into two groups. Anesthesia was induced using 5 mg/kg thiopental sodium (Group T patients) or 2 mg/kg ketamine (Group K patients), and was maintained using O2-N2O-desflurane. The recovery time and incidence of emergence agitation were assessed. RESULTS: The incidence of emergence agitation was less in patients in the ketamine induction group. There were no differences in the recovery time and reported side effects. CONCLUSIONS: We conclude that ketamine induction provides less emergence agitation when compared to thiopental induction for desflurane anesthesia for a pediatric tonsillectomy or a tonsillectomy and adenoidectomy without delayed recovery.

Mid-term Results and Complications of Posterior Intravaginal Slingplasty for Patients with Uterine and Vaginal Vault Prolapse / 대한비뇨기과학회지

PURPOSE: Only a few reports have been published describing the mid-term results of posterior intravaginal slingplasty(IVS). We analyzed the efficacy and complications of this procedure. MATERIALS AND METHODS: We analyzed the treatment outcomes of 95 patients who underwent posterior IVS due to uterine(n=59) and vaginal vault(n=36) prolapse. The degrees of prolapse were classified according to pelvic organ prolapse quantification(POPQ) of the International Continence Society(ICS), and posterior IVS was conducted for cases above stage 2. Polypropylene tape was used for all 95 patients. On the postoperative evaluation, stage 0 was regarded as a complete remission, stage 1 as an improvement and above stage 2 as a failure. RESULTS: Among the patients operated on for uterine and vaginal vault prolapse, 48(81.4%) and 30(83.3%) patients were cured, and 8(13.6%) and 6(16.7%) patientsshowed improvement, and 3(5.1%) and 0(0%) patients showed failure, respectively. The mean hospitalization was 3.3 and 3.8 days, the mean operative time was 37.4 and 36.7 minutes, and the mean bleeding volume was 91 and 102ml in the uterine prolapse group and the vaginal vault prolapse group, respectively. The mean follow-up time was 27.3 months(2-40). Identified complications were tape erosion in 9 cases(9.5%), hemorrhage that needed transfusion in 3 cases(3.2%), and recurrent prolapse in 3 cases(3.2%). CONCLUSIONS: Posterior IVS proved to be a highly effective therapeutic method for uterine and vaginal vault prolapse, with a low surgical risk and less discomfort to the patients. Tape erosion was a relative frequent complication of this operation.

Removal of foreign body in the lateral pharyngeal space via transtonsillar approach

Lateral pharyngeal space is one of potential fascial planes of head and neck, that may become involved by various pathological processes, such as infection, inflammation and neoplasm. The calcified stylohyoid ligament with styloid process is also located in this space, so this space is more acquainted with Eagle's syndrome in oral and maxillofacial field. During the mandibular transbuccal fixation procedures of 29-year old female patient who had right condylar neck and left parasymphysis fracture, we had lost one 10.0 mm miniscrew. After confirming the location of the lost miniscrew from different angled plain skull radiographies, we tried to find it in the lateral pharyngeal space via transtonsillar approach at the time of plate removal operation. This case report is aimed to share our valuable experience of the effective approach way to the lateral pharyngeal space, which has many advantages, such as short operative time, minimal bleeding, fast post-operative recovery, and less morbidity. The related literature is also reviewed.

Pneumothorax during Ventriculoperitoneal Shunt Operation: A case report / 대한마취과학회지

Ventriculoperitoneal shunts are currently believed to be a safe standard therapy for hydrocephalus. However, these procedures have been associated with many complications such as infections, ascites, abdominal visceral perforation, and hydrothorax etc. We report an extremely rare complication during a right ventriculoperitoneal shunting for a 70-year male patient. The patient developed tachycardia, hypoxemia, hypercapnia, and an increased airway pressure after inserting the shunt device into the peritoneal cavity. The emergency chest X-ray revealed a right pneumothorax, which was relieved by chest tube air drainage.

A Case of Neurogenic Bladder and Erectile Dysfunction due to Decompression Sickness / 대한남성과학회지

Decompression sickness is a disease caused by nitrogen bubbles in the tissues of divers who move too rapidly from environments of higher to those of lower atmospheric pressures. Nitrogen breathed in air under pressure dissolves in tissue fluids. When ambient pressure is reduced too rapidly, nitrogen goes out of solution faster than it can be circulated to the lungs for expiration. Gaseous nitrogen then accumulates in the joint spaces and peripheral circulation, impairing tissue oxygenation. We report a case of patient who experiencedneurogenic bladder and erectile dysfunction after decompression sickness. To our knowledge, this is the first case of neurogenic bladder and erectile dysfunction due to decompression sickness in the Korean literature.

Acute Urinary Retention due to Urethral Foreign Bodies

A 54-year-old man presented to the emergency department with a chief complaint of suprapubic pain and inability to void for 1 day after self insertion of urethral foreign bodies. These foreign bodies were two beans self inserted compulsively into the urethra by the patient. On physical examination, two materials of oval shape in the bulbous urethra were palpable. Retrograde urethrogram showed a complete obstruction in the bulbous urethra. When possible, endoscopic removal should be used for urethral foreign bodies. However the beans of our case required surgical retrieval. We present a case of foreign bodies in the urethra with brief review of literature. To our knowledge, this is the first case of acute urinary retention due to beans in Korean literature.

Xanthogranulomatous Cystitis Presenting as a Urachal Carcinoma / 대한비뇨기과학회지

Xanthogranulomatous cystitis (XC) is a very rare benign chronic inflammatory disease of unclear etiology. Herein is reported the case of a 46-year-old woman who presented with a painless lower abdominal palpable mass. According to the cystoscopic, ultrasonographic and enhanced computed tomographic (CT) findings, a urachal carcinoma could be suggested. Partial cystectomy was performed as the presence of a urachal carcinoma could not be ruled out. There was no recurrence of the XC more than 12 months after the partial cystectomy.

Xanthogranulomatous Cystitis Presenting as a Urachal Carcinoma / 대한비뇨기과학회지

Xanthogranulomatous cystitis (XC) is a very rare benign chronic inflammatory disease of unclear etiology. Herein is reported the case of a 46-year-old woman who presented with a painless lower abdominal palpable mass. According to the cystoscopic, ultrasonographic and enhanced computed tomographic (CT) findings, a urachal carcinoma could be suggested. Partial cystectomy was performed as the presence of a urachal carcinoma could not be ruled out. There was no recurrence of the XC more than 12 months after the partial cystectomy.

Surgically assisted rapid maxillary expansion and orthognathic treatments: report of 2 cases

Implant-supported prosthesis placed in the distraction-augmented alveolar bones: review of 2 cases

Predicting Factors of Discontinuation of medication after Cognitive Behavioral Therapy for Panic Disorder

OBJECTIVE: The authors experienced that cognitive begavioral therapy(CBT) could replace medication for controlling panic attacks and anticipatory anxiety symptoms. The objective of this study was finding out predicting factors of discontinuation of medication after CBT for patients with panic disorder. METHOD: A hundred forty-eight patients who met DSM-IV criteria for panic disorder with or without agoraphobia for at least 3 months had completed 12 weekly sessions of Panic Control Therapy(CT ; Barlow et al). Eighty-one patients who could discontinue medication and sixty-seven patients who could not discontinue medication were measured with several scales as the pre- and post-treatment assessment. The scales were Beck Depression Inventory(BDI), Clinical Global Impression(CGI), Spiellberger State Anxiety Inventory(STAI-state), Anxiety Sensitivity Index(ASI), Body Sensation Questionnaire(BSQ), Panic Belief Questionnaire(PBQ), Agoraphobic Cognition Questionnaire(ACQ), Fear Questionnaire(FG), Toronto Alexithymia Scale(TAS). RESULTS: At the pre-treatment assessment, the scores of BDI, CGI, STAI-state, ACQ, BSQ were higher in the patients who could discontinue medication than in the patients who could not discontinue medication(t=-2.68, t=-4.88, t=-3.07, t=-3.68, t=-3.35, p<0.01). CONCLUSION: Patients with panic disorder who were less depressed, less anxious, less agoraphobic and who had less negative cognitions for the bodily sensation and who had higher scores in the therapist's assessment could discontinue their medications.