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.

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

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

No abstract available.

PURPOSE: Endobronchial tuberculosis and bronchogenic cancer are common causes of atelectasis or obstructive pneumonitis in Korea. Differntiation between endobronchial tuberculosis and bronchogenic carcinoma is important for the treatment and prognosis but it is sometimes difficult to differentiate these two lesions with radiologic examinations. The purpose of this study was to find the differential points between endobronchial tuberculosis and bronchogenic carcinoma associated with atelectasis or obstructive pneumonitis. MATERIALS AND METHODS: Forty patients in whom atelectasis or obstructive pneumonitis was detected on chest radiographs comprised the study. A definite mass opacity was not observed on chest radiographs in all patients. In these patients, the causes of obstruction were endobronchial tuberculosis (n=20) and bronchogenic cancer (n=20) which were microbiologically or pathologically confirmed. RESULTS: Double obstructive lesions were more frequently found in endobronchial tuberculosis (8/20) than in bronchogenic cancer (1/20). Multiple calcifications along the bronchial wall and severe distortion of bronchi were observed only in endobronchial tuberculosis (4/20) and associated low density mass at obstruction site was only observed in bronchogenic cancer (6/20). Bronchial dilatation (11/20) and parenchymal calcifications (14/20) distal to obstruction site, air containing bronchogram at post obstructive bronchus (14/20) were more frequently found in endobronchial tuberculosis. Contour bulging at obstruction site (14/20), and only mucus bronchogram at post obstructive bronchus (14/20) were more frequently found in bronchogenic carcinoma. CONCLUSION: In patients with atelectasis or obstructive pneumonitis, endobronchial tuberculosis is characterized by double obstructive lesion, multiple calcifications at the bronchial wall, and severe distortion of the bronchi. Endobronchial carcinoma is characterized by a low density mass at the obstructive site.
Bronchi ; Carcinoma, Bronchogenic* ; Dilatation ; Humans ; Korea ; Mucus ; Pneumonia* ; Prognosis ; Pulmonary Atelectasis* ; Radiography, Thoracic ; Tuberculosis*

No abstract available.
Burns* ; Congenital Abnormalities* ; Free Tissue Flaps*

Recurrent episode of meningitis in infants and children frequently constitute a frustrating and distressing, both in determination of course and treatment. The authors are reporting a infected case of congenital dermal sinus with dermoid cyst in the subarachnoid space of cauda equina and conus medullaris which was cured after complete removal of cyst and sinus tract.
Cauda Equina ; Child ; Conus Snail ; Dermoid Cyst ; Humans ; Infant ; Meningitis ; Spina Bifida Occulta* ; Subarachnoid Space