No abstract available.
Lower Extremity* ; Melanoma*

No abstract available.
Forearm* ; Free Tissue Flaps*

The recent development of microsurgical tissue transfer has enabled any defect in any area to be reconstructed with free flaps. However, the need for a more functional and thinner flap has been raised due to bullkiness of the flap and donorsite morbidity. For better functional and aesthetic results, various perforator flaps excluding muscles or adjacent subcutaneous tissue have been recently reported. We report 44 cases of perforating artery pedicled flaps from April 1995 to August 1998, including 21 cases of anterolateral thigh flap, 12 cases of gluteal artery perforator flap, 4 cases of posterior interosseous flap, and 7 cases of paraumbilical perforator flap for various soft tissue defects. Even though marginal necrosis of flap occurred in 9 cases, complete healing without significant problem was possible. The advantages of perforator flaps are as follows: 1. It is possible to obtain a relatively thin fasciocutaneous flap, but still with sufficient volume 2. Donor site morbidity was reduced without damage of main artery. 3. In spite of diverse vascular pattern of the perforator, the location of perforating arteries can be Detected with relative ease and mapped preoperatively with an ultrasound Doppler. The need of meticulous and tedious dissection could be a sole disadvantage of these flaps. This report describes the clinical experience with a perforator-based flap, anticpating applications of many other types of perforator flap in the future.
Arteries* ; Free Tissue Flaps ; Humans ; Muscles ; Necrosis ; Perforator Flap ; Subcutaneous Tissue ; Surgical Flaps* ; Thigh ; Tissue Donors ; Ultrasonography

No abstract available.
Adult* ; Child* ; Humans ; Palatine Tonsil*

The orbitozygomatic area occupies a key anatomic position in midface, is prone to injury, and plays a prominent role in facial aesthetics. So the facial appearance including orbital shape can be altered by complications of orbitozygomatic fractures. Most possible initial complications include blindness, hyphema, retinal detatchment, and paralysis or entrapment of extraocular muscles. Long term sequelaes include infraorbital nerve dysfunction, loss of malar projection, enophthalmos, and dystopia. Accurate anatomic reduction and rigid fixation is essential for management of orbitozygomatic fractures to minimize those late sequelaes. Conventional fixation devices to fix displaced fracture of facial bone are interosseous wire and miniplate. But interosseous wirings are unstable for primary bone healing and time consuming. Miniplates have great deal in rigid fixation but their high profile and palpability are the main complaints in many patients, especially in orbital rim area. In this article, we reviewed the 30 cases of zygomamaxilla complex fractures with orbital rim fracture fixed with microplates, and discussed the stability of microplate and superiorities in final aesthetics result. The use of microplates in these area permits enough stability of fracture segment with ease of procedures and superiorities in final results without any palpability.
Blindness ; Enophthalmos ; Esthetics ; Facial Bones ; Humans ; Hyphema ; Muscles ; Orbit* ; Paralysis ; Retinaldehyde

By animal experiments in rat, it has been known that Interleukin-6 (IL-6) is secreted from renal mesangial celle and is an autocrine growth factor for the proliferation of mesangial cells. According to these facts, several studies have been tried for its clinical usefulness by measuring their serum or urinary IL-6 in glomerulonephritis patients with mesangial proliferation. The authors measured urinary IL-6 levels by Interleukin-6 [123I] RIA kit (Amersham Co. UK) in 11 patients with minimal change nephrotic syndrome, in 3 patients with mesangial proliferative glomerulonephritis (MesPGN), in 3 patients with IgA nephropathy, in 9 patients with Henoch-Schonlein purpura nephritis (HSPN) in 2 patients with membranoproliferative glomerulonephritis (MPGN), and in 12 normal healthy children as a control group. The results obtained were summarized as follows: 1) There was no significant differences of urinary IL-6 levels between minimal change nephrotic syndrome patient group and normal control group (p=0.73). The level of urinary IL-6 was increased significantly in HSPN group compared to in normal control group, statistically (p=0.045). Also there were same results in the glomerulonephritis patients with mesangial proliferation in its histopathologic findings such as IgA nephropathy, MesPGN, MPGN. 2) There was a positive correlation between the degree of mesangial proliferation and the urinary IL-6 level. In conclusion, the urinary IL-6 level reflects the glomerular mesangial proliferation and could be useful as a predictive indicator for evaluation of its clinical course in patient with mesangial proliferative glomerulonephritis.
Animal Experimentation ; Animals ; Child* ; Glomerulonephritis* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Humans ; Interleukin-6* ; Interleukins* ; Mesangial Cells ; Nephritis ; Nephrosis, Lipoid ; Purpura, Schoenlein-Henoch ; Rats

No abstract available.
Osteomyelitis* ; Skull Base* ; Skull*

In this study, effects of incision of retrodiscal tissue and unilateral occlusal reduction on temporomandibular joint of rabbit were investigated. Twenty-seven adult New Zealand White Rabbits, weighing over 3.5kg, were utilized in this study. Temporomandibular joint surgery was performed in left temporomandibular joint of 24 rabbits to displace disc anteriorly through incising the retrodiscal tissue 1-2mm posterior to the disc. They were divided into two groups: twelve were left untreated after surgery, occlusal reduction was performed on left posterior teeth every 2 weeks in the other twelve rabbits. The remaining three served as the control group. The sample were sacrificed by 8, 12, and 16 weeks after surgery. Histologic examinations were performed after sacrificing them. The results were as follows: 1. Histologic findings which were manifested by flat articular fossa, broad articular surface, generalized recession of articular cartilage and sclerosis of subchondral bone were observed. These findings were similar to internal derangement. 2. In the rabbits untreated after surgery, thin cartilagenous layer and necrotic tissue were observed in 8 weeks group, calcifying cartilagenous layer was observed in 12 weeks group, and cartilagenous layer on anterior portion was observed in 16 weeks group. So, it showed gradual healing pattern into the normal tissue except displaced disc. 3. Occlusal trauma after surgery resulted in generalized recession of upper and lower articular surface. Necrosis and vertical split on condylar process of mandible were observed in 8 weeks group. Osteoclasts, exposure of subchondral bone due to erosion on upper and lower articular surface, and degenerative changes on retrodiscal tissue were observed in 16 weeks group. So, it showed continuous progress pattern of osteoarthrosis.
Adult ; Cartilage, Articular ; Humans ; Mandible ; Necrosis ; Osteoarthritis ; Osteoclasts ; Rabbits ; Sclerosis ; Temporomandibular Joint* ; Tooth

No abstract available.
Clubfoot*

The spine is the most common site of metastatic cancer in the skeletal system. Managment of the lesion site due to the relation of the spinal cord or nerve root and post-operative treatment present coplicated and difficult problems. One hundred and ninety-three cases of metastatic cancer of the spine were seen and treated during the 5 year period from January 1981 to December 1985 in the Department of Orthopedic Surgery, Severance Hospital Yonsei University, College of Medicine in Seoul, Korea. This study was based on the clinical symtoms, radiological studies, laboratory studies, and tissue pathology of selected cases. Most of cases were treated by chemotherapy, radiation therapy, and hormonal therapy in selected terminal cases. In cases of intractable pain and neurological deficit, surgical intervention is advocated for relief of pain and to improve nursing care and daily activity. Unfortunately in Korea most patients and families refuse surgical intervention, the main reason being that surgery can not cure the disease itself. The results of the study lead us to conclude that; The incidende of spinal metastasis was 31.8% of the metastatic lesions of all skeletal systems, and was almost equally distributed in males and females l. 14: l. The primary site of the tumor was in decreasing order lung (25.9%), breast(9.8%), cervix of the uterus(6.7%), stomach(5.7%), liver(5.3%), kidney(3.7%), thyroid(3.7%), prostate(2.6%), bladder(2.6%), rectum(2.0%), ovary(1.0%), pancreas(1.0%), skin(1.0%), colon(0.5%), larynx(0.5%), and unknown origins (27.5 %). The peak age of the patient was the 7th decade in males and the 6th decade in females. The prominent clinical symtom was diffuse back pain (79.0%) which was characteristically worse in a resting position especially at night. The most significant laboratory finding was an elevated serum alkaline phosphatase in 28% of the cases. The predilection site of metastasis was the thoraco-lumbar junction. Diagnostically a whole body bone scan was more sensitive than a plain film.
Alkaline Phosphatase ; Back Pain ; Cervix Uteri ; Drug Therapy ; Female ; Humans ; Korea ; Lung ; Male ; Neoplasm Metastasis ; Nursing Care ; Orthopedics ; Pain, Intractable ; Pathology ; Seoul ; Spinal Cord ; Spine