No abstract available.
Child* ; Humans

No abstract available.

Traumatic implantation cyst of the conjunctiva has often been reported. We have observed two cases of conjunctival cyst following surgery of retinal detachment. A small vesicular lesion developed at the operation site of the conjunctiva about 5 weeks after the surgery. The cyst filled with clear fluid was located deep in the subconjunctival connective tissues. The wall of the cyst consisted of a few layers of epithelial cells very similar to the conjunctival epithelium and had not any direct connection with the overlying conjunctival epithelium. In order to prevent it a great care must be taken during surgery. A careful accurate apposition of the conjunctival wound will be required. An excessive and forceful retraction of the conjunctival flap for exposure of the operation field should be avoided. And also, an appropriate suture material (i.e. a round, tapered needle with smooth surfaced suture) seems to be necessary.
Conjunctiva ; Connective Tissue ; Epithelial Cells ; Epithelium ; Needles ; Retinal Detachment* ; Retinaldehyde* ; Sutures ; Wounds and Injuries

PURPOSE: This retrospective study was to determine the functional results of patients who were amputated of their fingertip between patients who were treated with replantation and patients who were treated with thenar flap. MATERIALS AND METHODS: From 2004 to 2007, we identified and operated 159 patients who were diagnosed with fingertip amputations. Of 159 patients, Eighty-two patients were treated by replantation (67 in men and 14 in women) and the mean age at the operation was 41 years (range, 15-68 years). Seventy-nine patients was treated with thenar flap(54 in men and 25 in women) and the mean age at the operation was 43 years(range, 21-70 years). We compared variables between two groups including, age, gender, diagnosis, duration of hospital admission, grip strength, two-point discrimination, Semmes Weinstein monofilament test, active range of motion (ROM) of the proximal and distal interphalangeal (PIP and DIP) joint, pain (or tenderness), paresthesia, cold intolerance, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and finger for activities of daily living (ADLs). RESULTS: The duration of admission was longer in Replantation group than in Thenar flap group(p=0.001). However, the grip strength (p=0.003) and Semmes Weinstein monofilament test (p=0.029) in the Replanation group were statistically superior to the Thenar flap group. The average DASH disability (p=0.003)/symptom score (p=0.007) and ADLs (p<0.001) in the Replantation group was statistically better. In addition, cold intoleranace test of Thenar flap group is worse than the Replantation group. CONCLUSION: This study demonstrate that fingertip replantation have demonstrated not only to obtain the best appearance but also to gain better functional outcome. However, it is impossible to perform replatation, the thenar flap can be limited alternative method for fingertip amputation in aspect of preservation of range of motion and hospitalization time.
Activities of Daily Living ; Amputation ; Arm ; Cold Temperature ; Discrimination (Psychology) ; Fingers ; Hand ; Hand Strength ; Hospitalization ; Humans ; Joints ; Male ; Paresthesia ; Surveys and Questionnaires ; Range of Motion, Articular ; Replantation ; Retrospective Studies ; Shoulder

A large osteoma arising from the ethmoid sinus produced exophthalmos and diplopia. The troublesome symptoms disappeared after surgical removal of the lesion. The osteoma was an ivory type.
Diplopia ; Ethmoid Sinus ; Exophthalmos ; Orbit* ; Osteoma*

PURPOSE: Free flaps from the great toe are an established method for reconstruction of absent or partially amputated thumbs. However, options differ as to which technique represents the ideal solution for each level of amputation. Various methods of distal thumb reconstruction have been proposed. We prefer to transplant the entire great toe nail complex with the almost all of the pulp rather than a portion of the nail. This paper reflects our experience in using the great toe mini wrap-around flap for distal thumb reconstruction. MATERIALS AND METHODS: In the period from October of 2005 to July of 2007, 9 patients were treated for traumatic thumb defects localized at the distal phalanx of the thumb. The patients included seven men and two women. The mean age was 44 years (range, 21~60) and the dominant right hand was involved in seven of nine patients. RESULTS: The transferred flaps have survived completely in all cases. The mean range of motion in the interphalangeal joints was 51o, with 73% of the normal uninjured opposite hands. The two-point discrimination was 10.5 mm (range, 5~13 mm). In Semmes-Weinstein monofilament test, the sensibility was 4.31 in 4 cases, 3.61 in 3 cases and 2.83 in 2 cases. The pinch power was 64% (range, 55~95%) of the opposite hand. All patients were satisfied with the appearance of the reconstructed thumb and felt comfortable at final follow-up. CONCLUSION: We have successfully reconstructed 9 cases of traumatic distal thumb defects using the mini wrap-around free flap. The mini wrap-around free flap in great toe is an excellent alternative method for distal thumb reconstruction in selected patients.
Amputation ; Discrimination (Psychology) ; Female ; Follow-Up Studies ; Free Tissue Flaps ; Hand ; Humans ; Joints ; Male ; Nails ; Range of Motion, Articular ; Thumb ; Toes ; Transplants

Intracanal separation of the rotary files is a serious concern in modern endodontic practice. The objective of this study was to compare the life span and fracture patterns of three NiTi rotary files in molar teeth. Mesiobuccal roots of upper molar (n = 150) and mesial roots of lower molar (n = 150) were divided into three groups and each group was prepared with Profile, ProTaper, and K3 respectively. Every file was used until separation and/or deterioration of the cutting blade was happened, and then the number of canals to separation and/or unwinding were recorded. Radiographs and Scanning electon microscope (SEM) photographs were taken to evaluate the patterns of separation. The results were as follows : 1. There were no significant differences in numbers of canals to separation and/or unwinding among the groups. 2. Comparing between flaring files, K3 showed significant lower numbers of canals to separation and/or unwinding (p < 0.05), and there was no significant difference between shaping files 3. Separations of instruments were occurred at the midpoint of curvatures within the canals. 4. In SEM observations, ductile fractures were seen in most of cases, characterized by shallow dimples. Additional researches is needed to provide a new guideline that informs the appropriate number of times to use NiTi files.
Molar* ; Tooth

We present the case of a 7 year-old child who underwent angioplasty with a stent for anastomosis site stenosis between a left subclavian artery free graft and the left main coronary artery in an arterial switch operation.
Angioplasty* ; Child* ; Constriction, Pathologic ; Coronary Vessels ; Humans ; Stents* ; Subclavian Artery ; Transplants ; Transposition of Great Vessels

The time course and magnitude of change in mean arterial pressure (MAP) and heart rate (HR) following a single rapid intravenous injection of 1ug/kg and 2ug/kg of sodium nitro prusside(SNP) were determined in 10 anesthetized patients. The results were as follows: 1) MAP began to decrease 15 seconds after both 1ug/kg and 2ug/kg of SNP and was maximal after 90 seconds with return toward control apparent by 3 minutes and complete after 5 to 6 minutes(Fig. 1). 2) The magnitude of decrease in MAP after SNP was dose related whereas onset and duration of blood pressure changes were not influenced by the SNP dose. 3) HR did not change significantly after either dose of SNP. SNP is a potent, rapid acting antihypertensive drug which produces arteriolar vasodilation and prevention of hypertension and is particularly important in patients with decreased myocardial reserve or intracranial pathology.
Arterial Pressure* ; Blood Pressure ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Injections, Intravenous ; Nitroprusside* ; Pathology ; Sodium* ; Vasodilation

BACKGROUND: Hemodynamic evaluation of the brain may be helpful for the identification of a risk of stroke in patients with middle cerebral artery (MCA) or internal carotid artery (ICA) steno-occlusive disease. The aim of this study was to evaluate the hemodynamic state in patients with steno-occlusive disease of ICA or MCA on the base of MRI/MRA and acetazolamide (ACZ)-challenged Tc-99m ECD brain perfusion SPECT findings. METHODS: An analysis of 68 patients who underwent MRI/MRA and ACZ-challenged Tc-99m ECD brain perfusion SPECT was performed. We divided these patients into two groups - MCA and ICA steno-occlusions. RESULTS: The cerebrovascular reserve (CVR) was impaired in 18 of 32 (56.3%) MCA disease patients (20 stenosis and 12 occlusions), and in 19 of 36 (52.8%) ICA disease patients (20 stenosis and 16 occlusion). The CVR was impaired in 22 of 28 (78.6%) occlusive patient, whereas in 15 of 40 (37.5%) stenotic patient (p< 0.01). The insular lesion was more commonly involved in the occlusion group (54%) than in the stenosis group (15%) (p< 0.01). CONCLUSIONS: There was no difference in CVR between MCA and ICA steno-occlusion groups. Incidence of impaired CVR was higher in occlusion group than stenosis group.
Acetazolamide ; Brain* ; Carotid Artery, Internal* ; Cerebral Infarction ; Constriction, Pathologic ; Hemodynamics ; Humans ; Incidence ; Middle Cerebral Artery* ; Perfusion* ; Stroke ; Tomography, Emission-Computed, Single-Photon*