No abstract available.
Adolescent* ; Epidemiologic Studies* ; Humans ; Temporomandibular Joint*

No abstract available.
Hypopharyngeal Neoplasms*

Benign portal vein thrombosis (PVT) is a challenging complication of an otherwise successful liver transplantation. PVT is caused by various conditions and results in pathologic hemodynamics of hepatofugal diversion of porto-mesenteric blood flow. Thus, adequate restoration of portal blood flow to the liver graft is a major concern when trying to achieve successful liver transplantation in patients with PVT. This letter describes the surgical view point of PVT in liver transplantation.
Hemodynamics ; Humans ; Liver ; Liver Cirrhosis ; Liver Transplantation ; Portal Vein ; Thrombosis ; Transplants

Adenosine deaminase (adenosine aminohydrolase, AL)A), which catalyzes the deamination of adenosine to yield inosine and amrnonia, was assayed in human penile foreskin. The skin tissue was separated into two layers; epidermis and dermis. They were sliced with scissors into gel state, 4 volumes of 0.05M phosphate buffer solution were added and the tissue homogenized. After centrifugation at 4,000xg for 5 minutes, the supernatant was used as an enzyme solution. ADA activity was measured according to the method f Giuseppe" ADA was found to be present in both layers (epidermis; 0.24 OD/mg protein, dermis; 0.19 OD/mg protein) with slightly higher activity in the epidermis. As in earlier reports, it was found that ADA in the skin showed nearly even activity in the pH range of 5.0-8.0. Considering the significance of ADA in immunological function, the presence of ADA in the skin suggests that the tissue may participate in the immune function.
Adenosine Deaminase* ; Adenosine* ; Centrifugation ; Deamination ; Dermis ; Epidermis ; Foreskin ; Humans* ; Hydrogen-Ion Concentration ; Inosine ; Skin*

BACKGROUND: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation (rSO2). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. METHODS: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. RESULTS: The increments of the rSO2 on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The rSO2 on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. CONCLUSIONS: We observed an increment of the rSO2 on the block side from the baseline; however, the rSO2 on the non-block side decreased.
Blood Pressure ; Blood Volume ; Ear ; Heart Rate ; Horner Syndrome ; Humans ; Lidocaine ; Oxygen ; Spectrum Analysis ; Stellate Ganglion

No abstract available.
Forearm*

Ilizarov technique has been successfully applied to limb lengthening for several decade, one of its main drawback is, however, long application of external fixator over 6 months. To lessen this time, simultaneous intramedullary fixation which convert later to static fixation by insertion of interlocking screws has been proposed. The indication for surgical limb lengthening includes familial short stature below the 3rd percentile. We compared the results of thirteen tibial lengthening with Ilizarov method to that of eleven hybrid methods. The hybrid system is composed of an unreamed AO intramedullary nail (IM) and ring fixator. Once the lengthening is completed, distal interlocking screws were inserted. In the group who were treated by hybrid system, the mean lengthening of tibia was 7.1cm (range, 6.3-9.5), the mean of external fixation period 7 months (range, 5-9), the mean healing index 1.2 month/cm (range, 1.1-1.4). On the other hand, the mean lengthening of tibia was 7.5cm (range, 5-10.3), the mean of external fixation period 9.8 months (range, 6-15), the mean healing index 1.4 month/cm (range, 1.1-1.8) in the group treated by Ilizarov method. Mean follow-up period was 23 months (range 14-47). There was no rotational or angular deformities and no loss of lengthening in the hybrid group. However we experienced three cases of angular deformity at the distraction site during lengthening in Ilizarov group. There was no deep infection in both groups. In the hybrid group we found several advantages such as no deformity, no loss of lengthening, and less scar by early removal of fixator, but some disadvantages such as need of subsequent procedures and limitation in intramedullary nailing.
Cicatrix ; Congenital Abnormalities ; External Fixators ; Extremities ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Hand ; Ilizarov Technique* ; Tibia

Genu recurvatum deformity of the knee can be due to the deformity of the bone of the proximal end of the tibia or to the changes in the soft tissues, or both. The causes of acquired genu recurvatum include trauma, wire traction of the tibia, operative procedures involving the proximal tibial physis, Osgood-Schlatter's disease, osteomyelitis and prolonged immobilization. The most frequent symptoms of genu recurvatum are weakness, pain and instability of the knee, genu valgus, and shortening of the affected lower extremity. Operative treatment consists of tibial osteotomy and soft tissue procedures performed on the capsule and ligaments, and recently percutaneous corticotomy of the proximal tibia and gradual correction by the Ilizarov external fixator became one of the treatment modalities. From Nov. 1990 to June 1993, the authors have performed gradual correction by the Ilizarov external fixator in 6 patients of genu recurvatum and the results were as follows. 1. The mean age was 14 years ranging from 11 to 21. And there were 2 males and 4 females. 2. In the past history, there were ipsilateral femur fractures in 5 cases in which 4 cases were treated with skeletal pin traction on the proximal tibia, and one case had ipsilateral open tibiofibular fracture. 3. After Ilizarov external fixation, proximal tibial corticotomy just inferior to the tibial tuberosity were performed in all 6 cases. 4. The follow up period was 19 months in average. 5. The results were evaluated according to a scoring system that was suggested by Lecuire et al.: 2 cases were excellent, 3 cases were good and 1 case was fair. 6. Ilizarov gradual correction was very effective not only in the treatment of genu recurvatum but also in the concurrent correction of limb length inequality and mechanical axis deviation of the lower extermity.
Congenital Abnormalities ; External Fixators ; Extremities ; Female ; Femur ; Follow-Up Studies ; Humans ; Immobilization ; Knee ; Ligaments ; Lower Extremity ; Male ; Osteomyelitis ; Osteotomy ; Socioeconomic Factors ; Surgical Procedures, Operative ; Tibia ; Traction

PURPOSE: Healey divided segment IV of the live as the 'superior portion (IVa) ' and the 'inferior portion (IVb) '. On the contrary, Couinaud suggested that there was no useful purpose in dividing segment IV because of several reasons. Our goal is to evaluate the safety of the 'isolated IVb (inferior) resection of the liver' via performing the dissection of cadavers. METHODS: There were ten total cadavers. Cadaver dissection proceeded with respect to the Glissonian pedicle, the portal vein and the bile duct, respectively. The total number of Glissonian pedicles at segment IV was measured. The distance between the origins of the IVa and IVb branches was measured. Additional pedicles that were known to exist at segment IVa were also evaluated. RESULTS: The mean number of Glissonian pedicles in segment IV, IVa, and IVb was 5 (+/-1.3), 1.6 (+/-7), and 3.4 (+/-0.9), respectively. The mean distance between the origins of the IVa and IVb branches was 5.6 mm (+/-3.9 mm). Two of 10 cases had a very short distance between the origins that were considered as having common origin. Additional pedicles were identified at the Lt. main Glissonian pedicle in all the cases (8 cases: 1 each, 2 cases: 2 each). CONCLUSION: Considering the possible existence of a common origin of segment IVa and IVb Glissonian pedicles, there is the risk that the segment IVa will be injured during 'iso lated IVb resection'. Inevitable ligation of the additional pedicle of segment IVa from the Lt. main Glissonian pedicle can be made during the 'isolated IVb resection'. Therefore, we think that 'isolated IVb resection of the liver' can be safe only when the surgeon divides the branches of segment IVb with meticulous preservation of the IVa branches.
Bile Ducts ; Cadaver* ; Hepatectomy ; Ligation ; Portal Vein

PURPOSE: Most liver surgeons perform a right hepatic resection for a hepatocellular carcinoma (HCC) for the complete mobilization of the right lobe of liver, via the conventional approach, prior to a parenchymal transection. However, in selected patients, with a massive hepatoma that has invaded to the diaphragm, the conventional mobilization of the liver prior to a parenchymal transection may be very difficult and result in excessive bleeding. The feasibility of an 'anterior approach' was evaluated by analyzing of the clinical result of the surgical treatment for a massive hepatoma with diaphragmatic invasion. METHODS: Between November, 2001 and November, 2002, six patients underwent a major right hepatic resection, using an anterior approach, for a HCC that had invaded or was adhered to the diaphragm, preventing the easy mobilization of the right lobe of the liver. RESULTS: There was no hospital mortality among six patients. A massive transfusion, followed by massive bleeding, was performed in four patients, but no post-operative liver failure occurred. CONCLUSION: These cases, performed via an anterior approach, had massive bleeding, but no hospital mortality or post- operative liver failure was observed. If the patients had undergone the procedure via the conventional approach, much more bleeding would have been expected. An 'anterior approach' is a safe and effective option in selected patients with a massive hepatoma and diaphragmatic invasion.
Carcinoma, Hepatocellular* ; Diaphragm ; Hemorrhage ; Hospital Mortality ; Humans ; Liver ; Liver Failure