Though proper management of hand burns in children is provided, hypertrophic scars frequently cause various hand deformities or functional disturbances in growing hands. When correction principles have not been observed for the long term, contraction of the skin, tendon and joints has a serious influence on hand deformities and bone change occur in growing children and second, to determine when is the proper operative time to minimize hand deformities and recurrences. We reviewed 107 hands in 103 admitted pediatric patients who had postburn hands deformities by scar contracture. The analysis of severity of hand deformities was evaluated by assessment of our hospital scale. According to these data, we performed the operations and compared the final results. The results were as follows: The types of burn hand deformities among 107 involved hands of 103 patients included flexion contracture (39.3%), syndactyly (29.9%), extension contracture (10.3%), Boutonniere deformity (9.3%), claw hand deformity (5.6%), severe hypertrophic scar (3.7%), swan neck deformity (0.9%), and loss of digit (1.9%) etc. On 98 preoperative x-ray examinations, bone changes were common, including angular deformity (19.4%), epiphyseal plate loss(18.4%), osteoporosis (17.3%), bony erosion (17.3%), joint change (15.3%), and ankylosis (9.2%). Thus, early correction of postburn hand deformities is imperative in pediatric patients, even though there is a greater chance of secondary operation due to immature scars. All patients were operated on by our proposed protocol and postoperative results showed greatly improved finger joint motion than before. We concluded that early correction of Grade III to V postburn hand deformities is mandatory in rapidly growing pediatric patients.
Animals ; Ankylosis ; Burns* ; Child* ; Cicatrix* ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Finger Joint ; Growth Plate ; Hand Deformities* ; Hand* ; Hoof and Claw ; Humans ; Joints ; Neck ; Operative Time ; Osteoporosis ; Recurrence ; Skin ; Syndactyly ; Tendons

The surgical correction of postburn nose and lips deformities still remains a difficult task domain to be done by plastic surgery. Consequently, the performance of autogenous cartilage graft and ear cartilage graft to maintain a better philtral form were found to raise the problem of a defect in the unnatural form due to consecutive tension in the region. Recently, focus had been placed on composite graft, including auricular cartilage, to obtain a unique dimple in the philtrum, and concurrently with this, part of its natural form has been acknowledged. However, composite graft on scar beds with poor circulation on the recipient site dose not represent safe survival, has increased risk allotment, which laeds to difficult application. From Jan. 1992 to Dec. 1998, the authors have experienced auricular composite graft in 15 patients who had a defect on the philtrum due to postburn scar contractures. As types of this operation, in method I, the subcutaneous pocket is made at the midline of the upper lip. The next step is cartilage insertion into subcutaneous tissue. The cartilage graft is fixed to be overlying skin by the bolus sutures. In Method II, the recipient site is excavated by some excision of the soft tissue in the central upper lip after scar tissue excision. The obtained auricular skin composite graft is placed and fixed to the philtral area. In Method III the auricular skin composite graft is harvested, and 2 or more 2mm-sized multiple holes are made along the midline of cartilage. Then composite graft is fixed to the defects of philtrum. The elongated portion of the distal tip of cartilage is embedded into the vermilion tubercle for sprouting and fullness. The most effective method was Method III, which enhanced the survival of auricular cartilage graft and its overlying skin, by trimming the margin of grafts, and enhancement of the connecting vessels through fenestrated holes of cartilage between the recipient site and composite graft. The authors hereby report the results of the present study along with study findings based on literature surveys.
Burns* ; Cartilage ; Cicatrix* ; Congenital Abnormalities ; Contracture ; Ear Cartilage ; Humans ; Lip ; Nose ; Skin ; Subcutaneous Tissue ; Surgery, Plastic ; Sutures ; Transplants*

No abstract available.
Pneumocephalus*

Aneurysm of the pulmonary artery is a rate entity. A neonate was seen with cyanosis and tachypnea. There was a grade 4/6 systolic murmur along the left sternal border. The chest X-ray showed a round mass shadow in the left parahilar region. Echocardiogram showed large Ventricular Septal Defect and mild Pulmonary Stenosis. The cardiac angiogram showed giant aneurysm of pulmonary artery. Surgical intervention was advised. However, the patient was discharged against operative plan. And the patient died two weeks later.
Aneurysm* ; Cyanosis ; Heart Septal Defects, Ventricular* ; Humans ; Infant, Newborn ; Pulmonary Artery ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Tachypnea ; Thorax

Complicated hepatic microabscess secondary to ascending cholangitis following ERCP (Endoscopic retrograde cholangiopancreatogram) is rare, and needs to be differentiated from other microabscesses, metastasis or Caroli's disease. We experienced a case of hepatic microabscess associated with septic cholangitis following ERCP. Cholangiogram showed multiple sac-like abscess pockets with characteristic biliary communication, and CT scan revealed multiple low attenuated lesions. At the resolving stage of chotangitic microabscess, CT scan showed partial rim enhancement of the abscesses and disproportional dilatation of intrahepatic ducts. The residual parenchymal enhancement surrounding the resolved microabscess pockets and dilatated biliary ducts, however, remained even after clinical recovery.
Abscess ; Caroli Disease ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis* ; Dilatation ; Neoplasm Metastasis ; Tomography, X-Ray Computed

No abstract available.
Humans

For many years permanent soft denture liners has been widely used in dental practice directly or indirectly because of its function in absorbing and distributing the impact force. However, it reveals problems such as lack of permanency and decreased bond strength in long term use. The purpose of this study is to measure the bond strength and failure between denture base resin and several permanent liners. Lucitone 199 was used as denture base resin with soft acrylic liners (Triad, Tokuso Rebase) and silicone elastomers (Tokuyama, Ufi Gel C) bonded to measure the tensile strength before and after thermocycling. The thermocycling was done in 2000 cycles at 5degrees C, 26degrees C and 55degrees C and the measured tensile strength values before and after thermocycling were compared. The mode of failure was investigated in the separated specimens. The results are as follows. 1. As to tensile strength, the strongest material is Tokuso Rebase followed by Triad, Tokuyama, Ufi Gel C in before thermocycling and the order of Triad, Tokuso Rebase, Tokuyama, Ufi Gel C in after thermocycling state. There was significant difference between the values of Triad, Tokuso Rebase and Tokuyama, Ufi Gel C(p<0.05). 2. As to degree of displacement, Ufi Gel C showed most displacement with or without thermocycling treatment and also the difference was significant with the other materials(p<0.05). 3. As to comparisons before and after thermocycling, Tokuso Rebase and Tokuyama showed significant difference in bond strength, whereas Triad and Tokuso Rebase showed significant difference in the degree of displacement(p<0.05). 4. In debonded specimens, Triad and Ufi Gel C showed adhesion failure and Tokuyama showed cohesion failure. Both failures were observed in Tokuso Rebase with adhesion failure up to 70%. The results of this study showed that degree of bond strength between permanent soft denture liner and denture base resin were variable. There was a significant difference between soft acrylics and silicone elastomers with regard to bond strength. Further research in improving bond strength of widely used silicone elastomers and in developing the method of measuring bond strength between denture base resin and the lining materials is needed.
Denture Bases* ; Denture Liners* ; Dentures* ; Silicone Elastomers ; Tensile Strength

Adolescence is the period in which physical, mental and social maturation occurs and it is an important transit stage, changing from childhood to adulthood. This is a period in which important changes occur physically such as rapid growth in height and weight gain but significant differences in growth may occur for the same age. Therfore, the degree of sexual maturation may be an important indicator in evaluating growth in adolescence. Six thousand five hundred and eighty six male and female students from grade 4 to senior high from Seoul, district town and countryside were evaluated for sexual maturity using Tanner staging, weight, height and body mass index and compared for growth. There was a rapid growth in height of 6.7cm in boys between the ages of 11 and 14 years and 6.3 cm in height for girls between the ages of 10 and 12 years, showing earlier growth in height for girls. Growth in height according to sexual maturation showed the greatest growth during stages 2~3 for boys and girls. Boys grew an average of 18.94 cm and girls an average of 18.03 cm in height during the whole sexual maturation period. There was an increase of 5.5 kg in weight for boys during the same age as for growth in height, that is between 11 and 14 years of age. In girls, an average weight gain of 5.1 kg occurred between 11 and 13 years of age, slightly later than that of growth in height. Rapid gain in weight occurred during Tanner stages 2~3 for girls. Total gain of 20.70 kg for boys occurred during the whole sexual maturation period while girls gained total 19.73 kg. Body mass index increased gradually during the whole adolescent period. It was greater in boys during the ages of 9 and 12 years and greater in girls the age of 13 years and again in boys after 17 years of age. During the whole maturation period, boys gained 3.24 and girls, 4.05 of body mass index showing more gain in girls. Height, weight and body mass index showed normal variations during the sexual maturation index showed normal variations during the sexual maturation period and the results may bring an increased understanding that adolescent physical growth was closely related to sexual maturation.
Adolescent* ; Body Mass Index ; Female ; Humans ; Male ; Seoul ; Sexual Maturation* ; Weight Gain

One case of congenital cutis aplasia is presented. The defect involved includes full-thickness skin defect of scalp and cranium. The patient was treated with debridement of dirty necrosed crust which covered exposed dura mater and with double opposing rotation flap including pericranium for bone regeneration. The donor site was covered with skin graft from right thigh. During operation, the superficial temporal artery was found to be short and weak. And after operation, the margin of flap were congested and finally necrotized. The necrotic wound was treated with conservative management. The vascular impairment is thought to be main course of congenital cutis aplasia. So we conclude that the treatment of choice is conservative management or careful flap surgery for coverage of defect area.
Bone Regeneration ; Debridement ; Dura Mater ; Estrogens, Conjugated (USP) ; Humans ; Scalp ; Skin ; Skull ; Temporal Arteries ; Thigh ; Tissue Donors ; Transplants ; Wounds and Injuries

Localized fibrous mesothelioma of the liver is very rare benign tumor. It usually manifest large palpable hepatic mass in right upper quadrant area, and the prognosis is excellent by surgical resection. Contrast enhanced CT scan shows well defined hyperattenuating mass and celiac anglogram shows hypervascular mass. Recently we experienced 1 case of localized fibrous mesothelioma of the liver, and we report CT and anglographic findings of this tumor.
Liver* ; Prognosis ; Solitary Fibrous Tumor, Pleural* ; Tomography, X-Ray Computed