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*

Hughes-Stovin syndrome is an extremely rare entity. We present a case of a 42-year-old man, who developed deep vein and inferior vena cava (IVC) thrombosis, repeated internal bleeding and pulmonary artery aneurysms (PAAs). The patient presented with massive hemoptysis and with PAAs of a 2.5 cm maximum diameter. We describe the successful percutaneous transhepatic venous embolization of the PAAs due to occluded common vascular pathways to the pulmonary artery.
Adult ; Aneurysm* ; Hemoptysis ; Hemorrhage ; Humans ; Pulmonary Artery* ; Thrombosis ; Veins ; Vena Cava, Inferior

Pseudoaneurysm of splenic artery may arise from a vascular erosion by the inflammatory processes around the splenic artery, particularly in acute pancreatitis and chronic pancreatitis, which may cause rupture of pseudoaneurysm and life threatening hemorrhage. Collective experience with this massive hemorrhage is attended by a high mortality rate even with prompt therapy, and conservative management is associated with an almost 100 per cent of mortality rate. Identification of the bleeding site at laparotomy may be exceedingly difficult, which makes the preoperative detection of bleeding source desirable. Peripancreatic vascular lesions can be identified by angiography, and in selected cases the risk of urgent operation to control massive hemorrhage may be obviated by embolization. The authors have recently experienced a case of ruptured splenic artery pseudoaneurysm combined with a pancreatic pseudocyst in a 6 years old boy. A bolus enhanced CT scan and angiography were essential to confirm these complications of pancreatic pseudocyst. We managed this child successfully with an urgent procedure of transcatheter arterial embolization and another elective surgery of pancreatic pseudocyst.
Aneurysm, False* ; Angiography ; Child* ; Hemorrhage ; Humans ; Laparotomy ; Male ; Mortality ; Pancreatic Pseudocyst ; Pancreatitis ; Pancreatitis, Chronic ; Rupture ; Splenic Artery* ; Tomography, X-Ray Computed

STUDY DESIGN: Clinical and radiographic results of spine fracutre treated with pedicle screws and hooks were reviewed. OBJECTIVES: Evaluate the efficacy of tile pedicle screw and hook for thoracolumar bursting fracture. SUMMARY OF LITERATURE REVIEW: Despite of the mechanical advantage of the pedicle screw, the metal failure in short segment fusion has been reported. A biomechanical study showed additional laminar hook increased rotational strength. MATERIALS AND METHODS: Between 1994 and 1996, seventeen patients who had a Denis type B bursting fracture of the thoracolumbar spine were treated by posterior instrumentation with pedicle screws and laminar hooks and auterior interbody fusion after partial corpectomy. They have been followed for an average of 13.4 months. RESULTS: At last follow-up, radiographs showed successful fusion of the injured spinal segment in all patient. The subsidence of grafts which were used In anterior interbody fusion was an average of 0.76mm. There was a loss of 2.6 degrees on average in the correction of the kyphosis. No patients had screw breakage or loosening. CONCLUSIONS: We concluded that posterior fixation with screws and hooks, anterior decompression by partial corpectomy, and strut-grafting in patient who had a Denis type B bursting frafture of the thoracolumbar spine yielded good radiographic and functional results.
Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Spine* ; Transplants

No abstract available.

OBJECTIVE: Hyponatremia (Na<135 mEq/L) is associated with cerebral ischemia after subarachnoid hemorrhage (SAH) and the incidence was reported as 9-34% of treated cases of SAH. This study was undertaken to clarify the clinical factors of hyponatremia in ruptured intracranial aneurysms. METHODS: Total 170 consecutive patients with ruptured intracranial aneurysms were included in this study and the incidence and timing of hyponatremia were analyzed retrospectively. Clinical severity quantified by the Hunt and Hess grade and Fisher's grade at admission, location of ruptured aneurysm, presence of vasospasm, onset of hyponatremia, development of hydrocephalus and Glasgow Outcome Scale (GOS) were analyzed in patients with hyponatremia. RESULTS: Hyponatremia occurred in 32 (40.5%) of 79 patients with anterior cerebral artery (ACA) aneurysm group, in 18 (40.0%) of 45 patients with internal cerebral artery (ICA) aneurysm group and in nine (22.5%) of 40 patients with middle cerebral artery (MCA) aneurysm group. Hyponatremia occurred significantly more often in cases with vasospasm and hyrocephalus (p<0.05). Among vasospasm cases, hyponatremia was not associated with the location of aneurysm or hydrocepalus. Respective days of onset for symptomatic vasospasm and for hyponatremia were day 7.2+/-3.3 and day 9.9+/-5.5 following SAH (p<0.05). CONCLUSION: Hyponatremia occurred more frequently in patients with vasospasm and hydrocephalus. The onset of hyponatremia was delayed by 3 days following symptomatic vasospasm. Since careful observation for hyponatremia is required during therapy in patients with vasospasm.
Aneurysm ; Aneurysm, Ruptured ; Anterior Cerebral Artery ; Brain Ischemia ; Cerebral Arteries ; Glasgow Outcome Scale ; Humans ; Hydrocephalus ; Hyponatremia* ; Incidence ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Retrospective Studies ; Subarachnoid Hemorrhage

Spontaneous renal rupture with subcapsular renal hematoma is a rare disease entity. Hereby, we report a 60-year-old female who presented with abrupt right flank pain and was diagnosed as spontaneous renal rupture with subcapsular hematoma related to urinary tract infection and review related literatures.
Female ; Flank Pain ; Hematoma ; Humans ; Kidney ; Middle Aged ; Rare Diseases ; Rupture* ; Rupture, Spontaneous ; Urinary Tract Infections*

OBJECTIVE: Chlamydia trachomatis is one of the most common causative microorganisms in pelvic inflammatory disease. The symptom of Chlamydia infection is nearly absent or weak in many cases, but its complication is clinically very important because of tubal obstruction, infertility, tubal pregnancy, and recurrent pelvic inflammatory disease. This study was performed to investigate the prevalence rate and clinical characteristics of Chlamydia trachomatis. METHODS: From May, 2001 to April, 2002, in Daerim St. Mary's Hospital, OB-Gyn department, the 68 inpatients of pelvic inflammatory diseases and 607 outpatients of routine gynecologic examination were studied on history taking, physical examination, laboratory test, and polymerase chain reaction for the detection of Chlamydia trachomatis. RESULTS: The prevalence rate of Chlamydia trachomatis was 20.6% (14/68) in pelvic inflammatory disease and 8.6% (51/593) in routine gynecologic examination. As regarding the age distribution of Chlamydia trachomatis positive group was the largest portion in the twenties, and symptom-free group was about 40%. Chlamydia infection was related to the history of artificial abortion, and showed no significant difference in parity. Most common site of infection was uterine cervix, and mixed infection rate with other bacteria was 43.1%. The treatments were given medically in 58 cases, surgically in 6 cases, and laparoscopy in 1 case were performed. CONCLUSION: Although the prevalence rate of Chlamydia infection is high in sexually active age group and Chlamydia infection has a serious bad effect on reproduction, the disease detection is difficult because symptom is weak or absent, but it reveals good cure rate. Therefore the screening and treatment of Chlamydia trachomatis are necessary to decrease the prevalence and prevention of complication.
Age Distribution ; Bacteria ; Cervix Uteri ; Chlamydia Infections ; Chlamydia trachomatis* ; Chlamydia* ; Coinfection ; Fallopian Tube Diseases ; Female ; Humans ; Infertility ; Inpatients ; Laparoscopy ; Mass Screening ; Outpatients ; Parity ; Pelvic Inflammatory Disease ; Physical Examination ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy, Tubal ; Prevalence ; Reproduction

We reviewed the medical records of the 65 patients with stage 1 macular holes and evaluated the effect of prophylactic vitrectomy (34 patients)compared with observation only (31 patients).Mean follow up period was 38.2 and 27.7 months, respectively.88.3%of the patients of the vitrectomy group, and 87.1%of the patients of the observation group showed improved or same visual acuity.Postoperative complications were noted in 35.3%of the vitrectomy group, and lens nuclear sclerosis was the most frequent postoperative complication.Progression of stage 1 macular holes to the higher stage hole was noted in 5.9%of vitrectomy group, and 9.6%of the observation group.There was no statistical significance between two groups.And the prognosis of stage 1 macular hole is thought to be favorable.
Follow-Up Studies ; Humans ; Medical Records ; Prognosis ; Retinal Perforations* ; Sclerosis ; Vitrectomy*

STUDY DESIGN: Retrospective study. OBJECTIVES: To demonstrate the fusion rate, degree of subsidence and donor site morbidity of anterior cervical interbody fusion with autogenous bicortical iliac bone graft and anterior cervical locking plate. SUMMARY OF THE LITERATURE REVIEW: In anterior cervical discectomy and fusion with autogenous tricortical iliac bone graft, a large percentage of patients report chronic donor site pain. MATERIALS AND METHODS: Retrospective research was done for 39 patients who underwent anterior cervical interbody fusion with autogenous bicortical iliac bone graft, from January 2006 to July 2011, with a follow up period of longer than 1 year. Fusion rates and subsidece of the graft is estimated with radiographs. Neck pain and donor site pain was estimated with visual analogue scale (VAS) and dysfunction was estimated with the neck disability index (NDI). RESULTS: A 95% of patients who underwent anterior cervical interbody fusion with autogenous bicortical iliac bone graft revealed definitive fusion with little amount of subsidence. The mean VAS score was 0.7 on the donor site and the mean NDI score was 3.8 at the final visit. There was excellent clinical outcome without complication at the donor site or the recipient site. CONCLUSIONS: Anterior cervical interbody fusion with autogenous bicortical iliac bone graft showed high fusion rates and minimal subsidence with excellent clinical outcomes. Therefore, bicortical iliac bone graft is an effective operational procedure in anterior cervical interbody fusion.
Diskectomy ; Follow-Up Studies ; Humans ; Neck ; Neck Pain ; Retrospective Studies ; Tissue Donors ; Transplants