No abstract available.
Follow-Up Studies* ; Magnetic Resonance Imaging* ; Radiculopathy*

A multitude of methods for correction of the residual cleft lip nose deformity have been developed. Inspite of the development it appears that no one procedure has achieved satisfactory results. In addition, the appropriate timing for surgical correction still remains unsettled. The philtrum plays a keyhole in the appearance of the upper lip and nostril sill. But the formation of philtrum with muscle flap or conchal cartilage have been resulted in a unsatisfactory aesthetic outcome. We performed 26 cases of the correction of unilateral cleft lip nose deformity between May 1993 and September 1996, and we always used autogenous palmaris longus tendon for reconstruction of philtral column and nostril sill augmentation. Palmaris longus tendon creates a more definite philtral unit comparing to other materials which have been used and it is easy to harvest and transfer and it does not affect normal function of the hand. And we followed up all patients and confirmed that disappearance of newly formed philtrum is rare. In conclusion, this study shows that autogenous palmaris longus tendon is a useful material for reconstruction of philtral column.
Cartilage ; Cleft Lip* ; Congenital Abnormalities* ; Hand ; Humans ; Lip ; Nose* ; Tendons*

In double eyelid operation, if the eyes have too little fat and soft tissue, or if the orbital fat were removed too much in the operation, the double eyelid crease is too high. And the supra-tarsal recess becomes hollow and the adhesion of eyelid crease occurs even in orbital septum and levator muscle. Secondary double eyelid operation in response to these problem needs to correct the height of eyelid crease or the supra-tarsal depression by releasing the inadequately high eyelid fold and preventing re-adhesion. Moreover, in case the muscle and scar tissue are bulged below the incision line, the height of double eyelid should be appropriately lowered, the adhesion should be released, and the bulky lower flap should be flattened. In case the adjacent tissue (e.g., preaponeurotic fat) was excessively removed during the primary double eyelid operation, free-fat graft or dermis-fat graft has been done to correct supra-tarsal depression and re-adhesion. These graft materials are extracted from a distant donor site. Even if the adjacent tissue was not sufficient, we made the superiorly based local flap or graft of pre-tarsal scar-muscle tissue obtained after thinning the bulky lower flap. In these cases, the fibrous muscle flap or graft compensated tissue depletion with a proper mass around the double eyelid crease and help prevent re-adhesion. Of the 1225 patients with high placement of supra-tarsal fold with bulky lower skin flap, we used pretarsal fibro-muscular flap in 914 patients and pretarsal fibro-muscular graft in treating 311 patients from November 1997 to October 2005. And we eventually found that the operation was successful in making a natural eye shape and preventing re-adhesion with no requirement of a distant donor site. We found that the pretarsal fibro-muscular flap or graft were effective in reducing the operative time and lowering the risk of post-operative infection, preventing the re-adhesion, correcting the supratarsal depression and making a natural eye shape with a slender eyelid line.
Cicatrix ; Depression ; Eyelids ; Humans ; Operative Time ; Orbit ; Skin ; Tissue Donors ; Transplants

BACKGROUND: Aging is associated with increased cardiovascular risk and firmly established as a risk factor for the development of atherosclerosis. However the exact mechanism of age-related damage to the arterial wall and its relation to the atherosclerotic process are not well known.The endothelium plays an important role for the regulation of vascular tone and the endothelial function is impaired in the presence of risk factors early in the process of atherosclerosis. Assessment of endothelial function appears to be a valuable tool for the diagnosing and therapeutic monitoring of coronary artery disease. Anti-oxidants are known to improve endothelial dysfunction in atherosclerosis patients. The aim of this study was, (1) to evaluate the endothelial function in elderly, (2) to investigate whether vitamin C administration has benefit on the endothelial function in elderly. METHODS: The endothelial function was estimated using venous occlusion plethysmography(VOP) in 7 elderly and 7 young healthy volunteers. The strain guage was connected to plethysmograph to record the forearm volume change. A rapid cuff inflator was used to inflate the arm cuff to 40 mmHg instantaneuosly thus occluding venous return from the forearm. The measurement of forearm volume change was repeated for 7 times each stage. The change of the forearm blood flow(FBF) was measured with the acetylcholine infusion through brachial artery and also with intra-arterial vitamin C. RESULTS: Endothelium-dependent vasodilatation was significantly impaired in the elderly group compared to the young group(321 +/-17% in elderly group vs 509 +/-81%, mean+/-SEM) Forearm blood flow response to acetylcholine was significantly enhanced with inraarterial infusion of vitamin C in elderly group(321+/-17% in elderly group vs 78% in vitamin C) Coinfusion of L-NMMA, an inhibitor of nitric oxide synthase, blunted forearm blood flow response to acetylcholine. CONCLUSIONS: Even though the mechanisms leading to drpressed endothelial function in elderly remains to be elucidated, our study shows that vitamin C result in demonstrable improvement by a mechanism that is probably related to antioxidant activity.
Acetylcholine ; Aged* ; Aging ; Arm ; Ascorbic Acid* ; Atherosclerosis ; Brachial Artery ; Coronary Artery Disease ; Endothelium ; Forearm ; Healthy Volunteers ; Humans ; Nitric Oxide Synthase ; omega-N-Methylarginine ; Risk Factors ; Vasodilation* ; Vitamins*

No abstract available.
Diagnosis* ; Endoscopy*

Double eyelid operation is one of the most common cosmetic surgery in orientals. Among this, the non-incision technique has been usually performed in the patient with thin upper eyelid, lesser amounts of orbital fat, less redundant skin of upper eyelid, and so on. A non-incision technique make a more smooth and natural double eyelid. The merit comes from short operating time, short recovery time, less morbidity and inconspicuous scarring, Therefore, when we decide double eyelid operation on a patient who has a congenital unilateral double eyelid, we correct the aesthetic deformity in appearance caused by an unnatural asymetric upper lid which is not double eyelid using a non-incision technique. This study includes 255 patients to whom underwent double eyelid operation of unilateral double eyelid by non-incision techniques from 1990 to 1995, ranged in age 19 to 55years and follow-up period ranged from 2 months to 2 years. Two methods of non-incision technique were used in this study. One is single stitch method and the other is continuous buried suture method. The former was used in 176 patients(70.2% ) who are young with thin upper lid and the latter was used in 79 patients( 29.8% ) with redundant or puffy upper lid. Most of the patients were satisfied with smooth and symmetric appearance. We concluded that non-incision technique can be a good surgery method of correcting unilateral double eyelid. And we had good results using the continuous buried suture method in the case of puffy upper eyelid.
Cicatrix ; Congenital Abnormalities ; Eyelids* ; Follow-Up Studies ; Humans ; Orbit ; Skin ; Surgery, Plastic ; Sutures

OBJECTIVE: The nitric oxide synthases(NOS) are a group of isoenzymes that convert L-arginine to L-citrulline and generate nitric oxide(NO). The constitutive form of NOS is present in endothelium, adrenal gland, brain, and platelets, while the inducible form of NOS is present in macrophages, hepatocytes, vascular smooth muscle cell and endothelial cells. To determine whether NO has a role in anterior pituitary cell function, immunohistochemistry and molecular techniques were used to study NOS expression in rat pituitary gland. MATERIALS AND METHODS: We treated the rats with two NOS inhibitors: N-mono-methyl amine(NMMA), which is an inhibitor of NOS activity, and aminoguanidine, which a selective inhibitor of the inducible NOS isoform and two NO donors; sodium nitroprusside(SNP), s-nitro-acetyl-penicillamine(SNAP) as well as L-arginine. Rat growth hormone was measured in the serum using radioimmunoassay and NOS producing cells in the anterior lobe of the pituitary was detected by immunohistochemical stains. Also mRNA was extracted from the pituitary and performed RT-PCR using inducible NOS primer. RESULTS: Serum growth hormone levels were increased significantly by administration of NOS inhibitors, such as NMMA and aminoguanidine. Immunohistochemical stains for neuronal and inducible NOS showed strong positivity in the folliculostellate cells and weak positivity in the anterior pituitary cells in the control and various experimental groups. RT-PCR in inducible NOS showed more brighter band in the 222 base pairs in the aminoguanidine treated group than normal control group. CONCLUSION: These data suggest that pituitary NOS may play a pivotal role in the control of growth hormone secretion.
Adrenal Glands ; Animals ; Arginine ; Base Pairing ; Brain ; Coloring Agents ; Endothelial Cells ; Endothelium ; Growth Hormone ; Hepatocytes ; Humans ; Immunohistochemistry ; Isoenzymes ; Macrophages ; Muscle, Smooth, Vascular ; Neurons ; Nitric Oxide Synthase* ; Nitric Oxide* ; Pituitary Gland ; Pituitary Gland, Anterior* ; Radioimmunoassay ; Rats* ; RNA, Messenger ; Sodium ; Tissue Donors

Systemic chemotherapy is the cornerstone of treatment for patients with advanced gastric cancer. The combination of fluoropyrimidine and platinum is the most widely used first-line treatment worldwide. In patients with HER2-positive gastric cancer, the combination of trastuzumab (an anti-HER2 monoclonal antibody) and chemotherapy is the standard-of-care. Second-line chemotherapy can also prolong patients' survival after progression; treatment options include cytotoxic chemotherapy (paclitaxel, docetaxel or irinotecan) and/or ramucirumab (an anti-VEGFR2 monoclonal antibody). A number of new targeted-agents are currently being studied, and more personalized approaches will be realized in the near future.
Drug Therapy ; Humans ; Neoplasm Metastasis ; Platinum ; Stomach Neoplasms* ; Trastuzumab

Systemic chemotherapy is the cornerstone of treatment for patients with advanced gastric cancer. The combination of fluoropyrimidine and platinum is the most widely used first-line treatment worldwide. In patients with HER2-positive gastric cancer, the combination of trastuzumab (an anti-HER2 monoclonal antibody) and chemotherapy is the standard-of-care. Second-line chemotherapy can also prolong patients' survival after progression; treatment options include cytotoxic chemotherapy (paclitaxel, docetaxel or irinotecan) and/or ramucirumab (an anti-VEGFR2 monoclonal antibody). A number of new targeted-agents are currently being studied, and more personalized approaches will be realized in the near future.
Drug Therapy ; Humans ; Neoplasm Metastasis ; Platinum ; Stomach Neoplasms* ; Trastuzumab

BACKGROUND: The diagnosis of atypical mucosal lesions by performing hematoxylin-eosin staining is too subjective, and it is also subject to considerable inter-observer variation. There is a need for reliable immunohistochemical markers that can give reproducible results and that are not subject to individual interpretation. METHODS: We reviewed a total of 199 cases of gastric biopsy specimens, which were all diagnosed as atypical mucosal lesions, and 124 cases of the adenocarcinomas specimens had been classified from category 1 (C1) to C5 according to the Vienna classification. We also examined the immunohistochemical expressions of the glucose transporter GLUT1 and the p53 protein in the gastric biopsy specimens to determine if they were useful markers for differentiatial diagnosis under the Vienna classifications. RESULTS: None of the specimens in categories C1 to C3 showed GLUT1 expression, but 10.1% of the C4 specimens and 25.0% of the C5 specimens were GLUT1-positive (p<0.05). The expression of p53 was undetectable in the C1 specimens, but this was expressed in 2.9% of the C2 specimens, 15.6% of the C3 specimens, 37.8% of the C4 specimens, and 65.3% of the C5 specimens (p<0.05). CONCLUSIONS: The Vienna classification is very applicable to the gastric biopsy specimens of the atypical mucosal lesions, and the GLUT1 and p53 expressions are candidates as highly useful markers to differentiate the Vienna C4 lesions from the C3 and C5 lesions.
Adenocarcinoma ; Biopsy* ; Classification ; Diagnosis ; Glucose Transport Proteins, Facilitative ; Glucose Transporter Type 1 ; Observer Variation ; Stomach ; Tumor Suppressor Protein p53