No abstract available.
Tendon Transfer* ; Tendons*

No abstract available.
Free Tissue Flaps* ; Hand*

The nose has number of characteristics that make it unique when planning or reconstruction of surgical defects. The topography of nose is complex with multiple adjacent convex and concave surfaces that must be preserved. The free margins of the alar rims are mobile and easily distorted in case of inadequate planning. The skin over the lower one third of the nose id liss mobile and, therefore, cannot be easily recruited for closure of small defects. In addition, the texture and color of this skin are so unique that neither distant nor nearby skin can always provide a good match. Finally, the function of the nose must always be considered by preserving or replacing the bony and cartilaginous framework, mucosal linig, and never compromising a patent airway. The bilobed flap is particularly suited for reconstruction of small sized or medium sized nasal defects up to 1.5 cm in diameter. By definition, it is a double transposition flap and it is designed to move more skin over a longer distance than would be possible with a single transposition flap in the same location. On the lower one third of the nose where the skin is the least mobile, the bilobed flap allows the surgical site to be covered with nearby skin matched for color and texture and then allows for repair of that secondary defect with another well-matched flap whose donor site can finally be closed primarily. This flap also results in little or no distortion of the nose since the flap efficiently recruits skin from distant and more lax sites. While the standard design often results in tissue protrusions or pincushioning effect, improvements in the design are outlined herein to achieve the best results for defects of the nose.
Humans ; Nose ; Skin ; Tissue Donors

No abstract available.

Hypertrophic scarring is common in burn patients. The treatment of such scarring is difficult, and recurrence of the hypertrophic change after scar revision is not uncommon. It has been done intramarginal excision to diminish the chances of recurrent hypertrophic scarring. Core scars in the auricle are easily separated from auricular cartilage and overlying soft tissue because there is loose areolar tissue between them. We therefore reviewed our experience with core extirpation of post-burn hypertrophic scars in the auricle. Between June 14, 1991, and August 6, 1994, we excised 10 hypertrophic scars in the auricle in 5 burn patients. Core extirpations of hypertrophic scars were performed under local anesthesia with longitudinal incision along long axis of scars. The wounds were closed directly in one layer after marginal trimming. We observed that core extirpation yielded good results in post-burn hypertrophic scars in the auricles.
Anesthesia, Local ; Axis, Cervical Vertebra ; Burns ; Cicatrix ; Cicatrix, Hypertrophic* ; Ear Cartilage ; Humans ; Recurrence ; Wounds and Injuries

A secondary cleft lip nasal deformity can be corrected by many procedures including central lip tissue transfer, forked flap, nasal floor and alar base advancement, nasal skin flaps and composite graft. These procedures have been applied for many years, but each one has some conspicuous residual problems. We propose triple V-Y advancement flaps, which we have performed on 13 secondary cleft lip and nasal deformity patients over the past 6 years. The W-shaped triple reverse V-shaped incision easily exposed the alar cartilages. We made the advancement and rotation of the nasal skin flap to lengthen the columella and project the nasal tip. Postoperatively, the columella length and nasolabial angle were found to be increased by an average of 3.7 mm and 42 degrees, respectively. In lateral view, a relatively natural nasal line was achieved. The scar in the nasal tip posed few problems. This procedure should be useful for the correction of the secondary cleft lip nasal deformity.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Lip ; Skin ; Transplants

BACKGROUND: Allergic diseases are characterized by immediate - and late - phase reactions to various allergens by the selective activation of a subset of CD4 + T cells. In response to allergen, T cells isolated from atopic donors are biased to low levels of IFN - y and high levels of IL - 4, and vice versa by T cells from non - atopic donor. Objective : The aim of this study was to evaluate the patterns of IL - 4 and IFN - y production after Der p I stimulation and the effect on the cytokine production from T cells by budesonide, disodium cromoglycate and cyclosporin A in atopic and non - atopic individuals. MATERIAL AND METHOD: Seven Der p I specific atopic and 7 non - atopic individuals were selected. We decided the 50% inhibiting concentration of each immunomodulator by lymphocyte proliferation assay, and measured their effects on the cytokine production in vitro by intracellular IL - 4, IFN - y staining and flow cytometry. Results and CONCLUSION: There was significant difference on stimulation index ( SI ) of production of IFN - y as well as IL-4 after Der p I stimulation between atopic and non-atopic individuals ( IL - 4 ; 1.57 +/- 0.7 : 0.98 +/- 0.2, p = 0.026, IFN - r : 1.45 +/- 0.5 : 0.95 +/- 0.2, p = 0.048 ). The synthesis of IL - 4, and IFN - r were significantly inhibited after the stimulation of every immunomodulators in atopic individuals, DSCG couldnt inhibit IL - 4 and IFN - r in nonatopic individuals. There was no significant difference in the inhibiting effect of these immunomodulators in both of them.
Allergens ; Bias (Epidemiology) ; Budesonide ; Cromolyn Sodium ; Cyclosporine ; Dust* ; Flow Cytometry ; Humans ; Immunologic Factors ; Interferons* ; Interleukin-4 ; Lymphocytes ; Pyroglyphidae* ; T-Lymphocytes* ; Tissue Donors

No abstract available.
Amputation* ; Hand* ; Tendon Transfer* ; Tendons*

No abstract available.
Forehead*

No abstract available.