No abstract available.
Adenoma*

No abstract available.
Cleft Palate* ; Muscles* ; Palate, Soft*

No abstract available.
Fistula*

PURPOSE: The purpose of this study is to evaluate the incidence and the degree of peritumoral edema on MRI in meningioma and to correlate other MR findings with the edema. MATERIALS AND METHODS: MR images of 35 patients with histologically-confirmeal meningioma were retrospectively reviewed. We analyzed the MR findings with special attention to the presence or absence and degree of edema. The edema was graded as absent, mild (extending less than 1 cm from outer margin of mass), moderate (1 to 3cm with mild mass effect), and severe (more than 3cm with marked mass effect). We also evaluated size and margin of the tumor, heterogeneity of mass signal, enhancement pattern and dural enhancement of the masses. In 24 patients with cerebral angiography, cerebral vascularity on angiogram was correlated with MR findings. Statistic correlation analysis was done using SAS ver 6.04. RESULTS: Twenty-five of 35 cases (72%) had edema; mild in 11 cases, moderate in 10 cases, and severe in 4 cases. Heterogeneous signal intensity of mass (<0.001), heterogeneous enhancement of mass (<0.001), mass size (<0.001), location (<0.001), and vascularity on angiography (<0.05) were well correlated with edema, while mass margin (>0.05), dural enhancement (>0.05), and histologic type (>0.05) were not correlated with edema. CONCLUSION: In meningioma, moderate to severe peritumoral edema occurred in 41% (14/35). The edema was correlated with heterogeneous enhancement, size, location, heterogeneous signal intensity and vascularity of the mass on angiography.
Angiography ; Cerebral Angiography ; Edema* ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Meningioma* ; Population Characteristics ; Retrospective Studies

The TRAM flap provides the safe creation of a durable, soft, natural-appearing breast mound and has thus become the most popular method of breast reconstruction. On the other hand, the rectus muscle can be used as a good donor site for a flap reconstruction in trauma or osteomyelitis cases on the lower extremity. The abdominal sequelae, including abdominal wall dysfunction after free rectus muscle transfer, was evaluated. Thirty-seven patients underwent free TRAM (n=29) or rectus abdominis muscular free flap(n = 8) operations between 1994 and 1997. In harvesting of the TRAM flap, a muscle-splitting technique was used and thus one-quarter of the muscle was preserved. In rectus muscular free flap, the entire width of the rectus abdominis muscle was harvested. Among the 37 patients, 26 patients (20 free TRAM flap and 6 rectus muscular free flap) were studied, for they were followed up postoperatively for at least 6 months and had provided preoperative data of abdominal strength. Cosmetic results of the abdomem were appraised by four independent judges on photographs taken of 26 patients. The global appearance of the abdomen was rated as "natural" in 75%. The scar on the umbilicus and lower abdomen was rated as acceptable or not visible in 65%. The replies to questionnaires were analyzed Patient self-assessment showed general satisfaction. In 24 of 26 answers, they said they would recommend the operation to others, and 70% of the patients found their abdominal strength and sports ability the same or improved. Thirty percent of the patients complained that back pain developed or became aggravated after surgery. Abdominal muscular strength was tested both preoperatively and 6 months to 1 year period after surgery according to Lacote. The abdominal wall function was impaired, especially in the upper rectus and external oblique muscle. In conclusion even though the abdominal sequelae after free TRAM or rectus muscular free flap reconstruction should not be urderestimated, no problem of clinical significance was encountered, and patients showed a high degree of satisfaction with the operation
Abdomen ; Abdominal Wall ; Back Pain ; Breast ; Cicatrix ; Female ; Free Tissue Flaps* ; Hand ; Humans ; Lower Extremity ; Mammaplasty ; Osteomyelitis ; Surveys and Questionnaires ; Rectus Abdominis* ; Self-Assessment ; Sports ; Tissue Donors ; Umbilicus

No abstract available.
Diagnosis* ; Humans

No abstract available.
Child* ; Humans ; Urinary Tract Infections* ; Urinary Tract*

In the case of crush injury, the failure rate of replantation of free tissue transfer is high. Recently, the freezing of intact and repaired microarteries has been known to relieve spasm without inducing thrombosis in vivo. Therefore, the author thought that the vascular freezing of crushed vein showing only unrecognized endothelial damage after adequate debridement of a damaged vessel can also relieve spasm without inducing thrombosis and improve the patency rate of microvascular anastomosis. In this study, the process of vascular freezing was investigated in veins with acutely damaged endothelium using ethly chloride in a rat model. Two experiments were performed in 30 Sprague-Dawley rats, weighing about 250 gm. In the first experiment, a new crush model was established on the femoral vein of the rats. The degree of vessel injury was evaluated as crush energy. The proper crush energy was determined only by the endothelial damage without inducing thrombosis(0.037 J). In the second experiment, femoral veins were crushed with the energy of 0.037 J on the left side and then frozen after inflicted crush injury with the same energy on the right side. The gross and pathologic findings and patency rates were observed at postoperative day 2, 10 and 30. Patency in both the crushed and crush-freezing group was 100%. Pathlolgic findings in the crush-freezing group were more severe loss of the intima and most parts of the media, as well as cellular depopulation of the media when compared to the crushed group. Microthrombi adherent to the wall were demonstrated in several crush-freezing specimens, but the crush-freezing group showed relief of crush-induced vasopasm and endothelial regeneration. In conclusion, the freezing of microveins with acute endothelial damage relieves spasm without inducing thrombosis. Therefore, this study presents the posslbility of clinical application of vascular freezing in a case of crush injury requiring microvascualr anastomosis.
Animals ; Debridement ; Endothelium* ; Femoral Vein* ; Freezing* ; Models, Animal ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Replantation ; Spasm ; Thrombosis ; Veins

CT scans of 23 patients with gallbladder carcinoma were retropectively reviewed to determine the incidence of lymphatic spread and to access the pattern of regional lymph node metastases. The lymphatic spread were noted in 74%(17/23). The involved patterns of regional lymph node metastases were nodes of porta hepatis 65%, portocaval nodes 41%, superior pancreaticoduodenal nodes 47%, posterior pancreaticoduodenal nodes 59%, nodes around the celiac trunk 35%, nodes around the superior mesenteric artery 29% and paraaortic nodes 35%. The findings suggested that the pattern of regional lumph node metastases in gallbladder carcinoma occurred along the normal lymphatic pathway of the gallbladder.
Gallbladder* ; Humans ; Incidence ; Lymph Nodes* ; Mesenteric Artery, Superior ; Neoplasm Metastasis* ; Tomography, X-Ray Computed*

CT scans of 23 patients with gallbladder carcinoma were retropectively reviewed to determine the incidence of lymphatic spread and to access the pattern of regional lymph node metastases. The lymphatic spread were noted in 74%(17/23). The involved patterns of regional lymph node metastases were nodes of porta hepatis 65%, portocaval nodes 41%, superior pancreaticoduodenal nodes 47%, posterior pancreaticoduodenal nodes 59%, nodes around the celiac trunk 35%, nodes around the superior mesenteric artery 29% and paraaortic nodes 35%. The findings suggested that the pattern of regional lumph node metastases in gallbladder carcinoma occurred along the normal lymphatic pathway of the gallbladder.
Gallbladder* ; Humans ; Incidence ; Lymph Nodes* ; Mesenteric Artery, Superior ; Neoplasm Metastasis* ; Tomography, X-Ray Computed*