Muscle transplanation surgery is presently widely accepted as a good precedure not only for cosmetic, but also for functional results, a concept to which Marina's observations on the absence of fixed and predetermined functions in the nuclei and associated tracts of the oculomotor system give great support; however, not everyone is in agreement with this concept. This paper report one case in which the total transplantation of the vertical rectus muscles midway between their insertions and the insertion of the lateral rectus muscle were carried out, in addition recession of the medial rectus muscle and resection of the paralyzed lateral rectus muscle. Our case have been followed up during 8 months to rule out late complications, aspecially ocular movement and diplopia. No late complications, however, have been found up to remaining underaction of the right superior and inferior oblique muscles and also medial rectus muscle. The eyes were straight with abduction of the right eye up to 40 prism diopters. Binocular vision was present and there was no diplopia. The cosmetic result was excellent.
Diplopia ; Muscles ; Paralysis* ; Vision, Binocular

The effect of IDU and cryocautery in the treatment of Herpes Simplex Keratitis was presented. The cryoapplicator was a model of Krwawlcz probe (2 mm in diameter) which was refrigerated in a mixture of dry ice and methyl alcohol. The applicator was appJied on the lesions 7 seconds each and antibiotics and atropine solutions were instilled. A good result was experienced in the treatment of several cases of dendritic kenititis by freezing the corneal lesions by means of cryoappJicator, which had not been responded to IDU therapy speedy. The deep neovascularization of the cornea in a case of stromal keratitis was disappeared after cryocautery for the treatment of the superficial corneal ulcers.
Anti-Bacterial Agents ; Atropine ; Cornea ; Dry Ice ; Freezing ; Herpes Simplex* ; Keratitis ; Keratitis, Herpetic* ; Methanol ; Ulcer

Animals ; Bone Regeneration ; Control Groups ; Durapatite ; Eosine Yellowish-(YS) ; Granulation Tissue ; Hematoxylin ; Immunohistochemistry ; Osteocalcin ; Osteoclasts ; Osteogenesis ; Osteonectin ; Rats ; Skull ; Transforming Growth Factor beta ; Transplants

No Abstract Available.
Case-Control Studies*

PURPOSE: To report a rare case of lymphocytic hypophysitis in a 31-year-old woman who presented with gradually progressive bilateral visual loss during the third trimester of pregnancy. METHODS: Ophthalmologic examination revealed best corrected visual acuity of 0.02 OD and counting fingers at 20 cm OS. Pupil examination revealed no relative afferent pupillary defect in either eye and intraocular pressure was normal in both eyes. A visual field test revealed nearly total visual defect sparing superotemporal area OD and total defect OS. An MRI of the head was performed. RESULTS: At the time of transsphenoidal surgery following the patient's delivery, a frozen biopsy of the lesion revealed diffuse lymphocytic infilteration and fibrosis of the pituitary gland consistent with the diagnosis of lymphocytic hypophysitis. Postoperatively the patient was treated for hypopituitarism. At 5 weeks postoperative, her best corrected visual acuity was 1.0 OU, and visual field defects resolved in both eyes. On follow-up by telephone for postoperative 7 months, the patient remained visually asymptomatic. CONCLUSIONS: The clinical presentation of lymphocytic hypophysitis may mimic pituitary adenoma, lymphoma, germinoma, and histiocytosis. The diagnosis should be suspected in any pregnant or postpartum patient with an intrasellar or suprasellar mass.
Adult ; Biopsy ; Diagnosis ; Female ; Fibrosis ; Fingers ; Follow-Up Studies ; Germinoma ; Head ; Histiocytosis ; Humans ; Hypopituitarism ; Intraocular Pressure ; Lymphoma ; Magnetic Resonance Imaging ; Pituitary Gland ; Pituitary Neoplasms ; Postpartum Period ; Pregnancy Trimester, Third ; Pregnancy* ; Pupil ; Pupil Disorders ; Telephone ; Visual Acuity ; Visual Field Tests ; Visual Fields

No abstract available.
Bilirubin* ; Infant, Newborn ; Jaundice, Neonatal*

Proliferative scarring in the form of keloids and hypertrophic scars continues to be a clinical problem for some patients. The lack of an animal model for such scarring has been an obstacle to studying the biology and effective therapy of these entities. Consequently we created an accurate reproductive animal model to systematically study them. Human proliferative scars were explanted into flaps based on isolated vascular pedicles in congenitally rats. We compared the procollagen type III peptide levels of proliferative scar tissue before and after explanting. The procollagen type III peptide levels of explanted proliferative scar tissue remained increased as before explanting. Histological analysis of the explanted proliferative scar tissue revealed that all explants retained their original histotypic character even after 1 year. We could also retain the volume of implanted proliferative scar for 1 year and studied in vitro cellular proliferation. Fibroblast cultures from explanted scars demonstrated less aggressive growth characteristic than those from original surgical specimens. The advantages of this animal model are as follows: 1. The explants retain their histotypical character for a long period. 2. Placement of the explants outside the dorsum of a nude rat makes serial observation and measurement easier. 3. Agents under test can be injected into the explants through a catheter inserted into a single pedicle of island flap without the possibility of spreading systematically.
Animals* ; Biology ; Catheters ; Cell Proliferation ; Cicatrix* ; Cicatrix, Hypertrophic ; Collagen Type III ; Fibroblasts ; Humans ; Keloid ; Models, Animal* ; Rats ; Rats, Nude

Although sacrococcygeal mass is rare and usually found in infants or children, adolescent or adult patients with protruding mass in sacrococcygeal region occasionally come to us simply for a cosmetic problem. In this situation, even though there is no definite neurological deficit, it should be evaluated whether or not the underlying bony pathology or dural defect exists. Few cases about the sacrococcygeal mass have been reported in adults. We reviewed our cases including preoperative evaluation methods and postoperative diagnosis. From March, 1993 to February, 1997, we experienced 6 adult patients with sacrococcygeal mass and no neurological abnormality. Preoperative evaluation were made by plain X-ray, myelogram, computed tomography(CT), and magnetic resonance imaging (MRI), as needed. Postoperative diagnoses were 2 meningoceles, 2 lipomyelomeningoceles, 1 desmoid tumor, and 1 teratoma. From our experiences, CT or MRI is essential to evaluate the sacrococcygeal mass preoperatively. These methods can visualize the precise anatomic location and extent of the mass, its relation to the spinal cord, and associated bony abnormalities. MRI is superior to CT, especially in defining the nature of the mass and involvement of the spinal cord. Conclusively, even a simple mass in the sacrococcygeal region in adults needs MRI or CT evaluation, and MRI is the most valuable method of evaluating the mass preoperatively and provides important information to establish a treatment plan.
Adolescent ; Adult* ; Child ; Diagnosis ; Fibromatosis, Aggressive ; Humans ; Infant ; Magnetic Resonance Imaging ; Meningocele ; Pathology ; Sacrococcygeal Region* ; Spinal Cord ; Teratoma

To repair bony defects with transplanted bone in the body, fresh autogenous bone is undoubtly. A retrospective study was made of a consecutive patient who underwent mandibular reconstruction with PMCB and allogeneic mandibular crib in November 1996. Free autogenous iliac bone in the form of particulate cancellous bone and marrow was densely packed into the allogenous mandibular crib that was adapted to bridge the mandibular discontinuity defect. Freeze dried allogenous mandibular bone was traded by Wonkwang bone bank. Freeze dried allogenous mandibular bone was used as allogeneic crib carrying the PMCB. This case was undergone successful healing with the formation of a continuous bony union with the remaining mandible. The rate of resorption was assessed by sequeal panoramic radiographs, that is, a day of postoperative period, 3 months of postoperative period, 6 months of postoperative period, 12 months of postoperative period. The mean horizontal dimension of the mandibular defect was 58mm and the mean vertical dimension of the reconstructed segments was 30mm. The bony height reconstructed segments retained about 78% of the bony height of a 1-year period. We estimated that autogenous PMCB grafts and allogenous crib grafts were the most successful and esthetic grafts in mandibular discontinuity reconstruction.
Bone Banks ; Bone Marrow ; Humans ; Infant Equipment ; Mandible* ; Mandibular Reconstruction* ; Postoperative Period ; Retrospective Studies ; Transplants ; Vertical Dimension

Healing is an intricate, interdependent process that involves complex interactions between cells, the microcellular environment, biochemical mediators and extracellular matrix molecules. The goals of wound healing are to minimize bloods loss, to replace any defect with new tissue, and to restore an intact epithelial barrier as rapidly as possible. The rate of wound healing is limited by the available vascular supply and the rate of formation of new capillaries and matrix molecules, which are heavily influenced by locally-acting growth factors that affect proliferation, angiogenesis, chemotaxis, gene expression, proteinases, and protein production. We present a new method for wound control and treatment, the V.A.C (vacuum-assisted closure) technique. It places open-cell foam dressing into the wound cavity and applies subatmospheric pressure. The application of subatmospheric pressure accelerates the rate of wound healing by the foollowing two mechanisms: 1. Removal of excessive interstitial fluids, which decrease localized edema, reduce concentration of inhibitory factors, and increase local blood flow. 2. Transmission of mechanical forces to surrounding tissues with resultant deformation of the extracellular matrix and cells, which then increase protein and matrix synthesis as well as cell proliferation. We applied it to 17 patients: 1 Livedo vasculitis, 1 burned by flame 3 pressure sores, 1 extravasation injury, 1 wound infection, 2 wound disruption, and 8 diabetes mellitus feet. In the end, most of the remaining wounds were treated with a simple split-thickness skin graft and the results were encouraging. We concluded that the V.A.C technique may be an effective substitute to help promote wound healing. It could be especially helpful in chronic complicated wounds in aging or debilitated patients who can not tolerate aggressive surgical procedures.
Aging ; Bandages ; Burns ; Capillaries ; Cell Proliferation ; Chemotaxis ; Diabetes Mellitus ; Edema ; Extracellular Fluid ; Extracellular Matrix ; Foot ; Gene Expression ; Humans ; Intercellular Signaling Peptides and Proteins ; Peptide Hydrolases ; Pressure Ulcer ; Skin ; Transplants ; Vasculitis ; Wound Healing* ; Wound Infection ; Wounds and Injuries*