No abstract available.
Goldenhar Syndrome*

No abstract available.
Scalp* ; Skin* ; Transplants*

Polydactyly is one of the most common congenital anomalies of the limb, however its surgical treatment varies from simple excision to reconstruction. The purpose of this study is to present out classification of polydactyly in which the type of surgery was concerned primarily. Two hundred and thirty five digits(134 fingers and 101 toes) in 188 patients were operated from 1980 to 1992. We divided the polydactyly into two types-the simple type, in which the extradigit arises from only one digit, and the complex type in which the extradigit connects more than two adjacent main digits. The simple type was subdivided into joint type(type I), in that the extradigit has its own joint in its origine; epiphyseal type(type II), the extradigit share common epiphysis with main digit; and hypoplastic type(type III), the extradigit is connected only by soft tissue to the main digit. The epiphyseal type(type II) was further divided into subtype A(type IIA), in that the origin seems to be directly derived from the epiphysis; and subtype B(type IIB), which resemble an osteochondroma. Type III and type IIB can be treated by simple excision, however the type I and type IIB can be treated by arthroplasty with or without osteotomy as well as excision of extradigit. Result of surgical treatment in 1 digit of the simple form, which siginifies the extradigit arising from only one digit, are good in 193 digits(91%), fair 14(6.6%), and poor 5(2.4%) after an average follow-up period of 20 months. Our principles in the surgical treatment of polydactyly was treatment according to the type, and early treatment.
Arthroplasty ; Classification ; Epiphyses ; Extremities ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Osteochondroma ; Osteotomy ; Polydactyly

No abstract available.
Facial Nerve* ; Paralysis* ; Transplants*

No abstract available.
Congenital Abnormalities*

Acardiac twinning affects 1 in 100 monozygotic twin pregnancies and 1 in 35,000 pregnancies overall. This condition is characterized by the absence or rudimentary development of fetal heart, and associated with various anomaly. The presence of an acardiac twin requires the normal (or "pump") twin to provide circulation for itself, as well as the acardiac sibling. The acardiac malformations are uniformly fatal in the affected twin, and mortality in the co-twin is as high as 55%. The principal perinatal problems associated with acardiac twinning are pump-twin congestive heart failure, maternal hydramnios, and preterm delivery. We recently experienced a case of acardius anceps associated with a normal male infant, so present with a brief review of the literature.
Fetal Heart ; Heart Failure ; Humans ; Infant ; Male ; Mortality ; Polyhydramnios ; Pregnancy ; Siblings ; Twins, Monozygotic

No abstract available.
Anemia, Megaloblastic* ; Humans ; Megaloblasts* ; Methotrexate*

Although a number of remedies like corticosteroids, retinoids, griseofulvin, PUVA, cyclosporine, antibiotics, dapsone, cyclophosphamide, surgery, methotrexate, radiation therapy, antimalarial drugs, psychotharapy and psychiatric medications have been used to treat lichen planus, there were no specific methods until now. We report herein an interesting case of lichen planus in which complete healing was achieved by griseofulvin administration. The patient was a 54-year-old male who for 3 months had variouly sized and shaped, flat-topped, scaly, violaceous papules and plaques on the whole of his body. We confirmed the patients disease as lichen planus by a histopathologic examination of a skin biopsy specimen and gave him 500mg ultramicronized griseofulvin daily in divided dosages. After 12 weeks of the medication nearly all of the skin lesions were regressed, and by 14 weeks all skin lesions had disappeared leaving hyperpigmentation. Up to now, l9 months after discontinuation of the medication, no recurrence of the disease has been noted.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Antimalarials ; Biopsy ; Cyclophosphamide ; Cyclosporine ; Dapsone ; Griseofulvin* ; Humans ; Hyperpigmentation ; Lichen Planus* ; Lichens* ; Male ; Methotrexate ; Middle Aged ; Recurrence ; Retinoids ; Skin

PURPOSE: This study evaluated the treatment effectiveness and proper radiation dose of helical tomotherapy (HT) in spine oligometastases from gastrointestinal cancers. MATERIALS AND METHODS: From 2006 to 2010, 20 gastrointestinal cancer patients were treated with HT for spine oligometastases (31 spine lesions). The gross tumor volume (GTV) was the tumor evident from magnetic resonance imaging images fused with simulation computed tomography images. Clinical target volume (CTV) encompassed involved vertebral bodies or dorsal elements. We assumed that the planning target volume was equal to the CTV. We assessed local control rate after HT for 31 spine metastases. Pain response was scored by using a numeric pain intensity scale (NPIS, from 0 to 10). RESULTS: Spine metastatic lesions were treated with median dose of 40 Gy (range, 24 to 51 Gy) and median 5 Gy per fraction (range, 2.5 to 8 Gy) to GTV with median 8 fractions (range, 3 to 20 fraction). Median biologically equivalent dose (BED, alpha/beta = 10 Gy) was 52 Gy10 (range, 37.5 to 76.8 Gy10) to GTV. Six month local control rate for spine metastasis was 90.3%. Overall infield failure rate was 15% and outfield failure rate was 75%. Most patients showed pain relief after HT (93.8%). Median local recurrence free survival was 3 months. BED over 57 Gy10 and oligometastases were identified as prognostic factors associated with improved local progression free survival (p = 0.012, p = 0.041). CONCLUSION: HT was capable of delivering higher BED to metastatic lesions in close proximity of the spinal cord. Spine metastases from gastrointestinal tumors were sensitive to high dose radiation, and BED (alpha/beta = 10 Gy) higher than 57 Gy10 could improve local control.
Disease-Free Survival ; Gastrointestinal Neoplasms ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Radiotherapy, Intensity-Modulated ; Recurrence ; Spinal Cord ; Spine ; Treatment Outcome ; Tumor Burden

The acute respiratory distress syndrome (ARDS) is a disorder of diffuse lung injury secondary to a wide variety of clinical insults including sepsis. It is manifested by impaired oxygenation, pulmonary edema, decreased static and dynamic compliance of lung, and increased airway resistance. Reduced lung compliance together with increased airway resistance is a hallmark of the syndrome and has generally been considered as the primary abnormality of lung mechanics. The study was designed to reproduce an ARDS condition in an animal model with acute lung injury and to determine whether these changes are reversed by inhalation of aerosolized bronchodilator such as salbutamol or nicorandil. Six adult mongrel dogs were exposed to intravenous oleic acid (0.08 ml/kg) mixed into a same amount of pure enthanol. We defined a condition of PaO2 less than 60 mmHg in FiO2 0.6 as an acute diffuse lung injury. Lung mechanics were deteriorated after oleic acid injection, from 27.33+/-2.73 to 17.50+/-.47 cmH2O/l/sec in compliance and from 14.55+/-.46 to 26.33+/-.02 ml/cmH2O in airway resistance. Salbutamol or Nicorandil inhalation significantly improved lung compliance to 30.57+/-11.30 or 36.33+/-.00 cmH2O/l/sec and airway resistance to 16.77+/-.47 or 19.55+/-.45 ml/cmH2O. From above data, we carefully concluded that compromized lung mechanics in adult respiratory distress syndrome could be effectively managed by inhalation of aerolized bronchodilator.
Acute Lung Injury ; Adult* ; Airway Resistance ; Albuterol ; Animals ; Compliance ; Dogs ; Humans ; Inhalation* ; Lung Compliance ; Lung Injury ; Lung* ; Mechanics* ; Models, Animal ; Nicorandil ; Oleic Acid ; Oxygen ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult ; Sepsis