No abstract available.
Animals ; Rats* ; Wounds and Injuries*

BACKGROUND: Pertechnetate ( Tc) has been widely employed for thyroid imaging. While pertechnetate and radioiodide have usually similar results in identifying thyroid nodules, occasionally differences have been noted. We intended to observe that the thyroid nodules which appeared to be hot on pertechnetate and to compare them with the images by radioiodide. METHODS: 'I scan was performed to thirty-eight cases (mean age: 48.9 +/- 13.2) presenting as hot nodule on Tc scan. Thyroid function test and pathologic diagnosis were obtained in all patients. RESULTS: Of the 38 patients, 24 had euthyroidism, 13 had hyperthyroidism, and 1 had hypothyroidism. Thirty patients had adenomatous goiter, 4 papillary carcinoma, 3 Hashimotos thyroiditis, and 1 had HQrthle cell tumor. 28 of 38 patients showed similar images, but the remaining 10 patients(26.3%) revealed discordant images on Tc and 131I scan. Among the concordant cases, 23 had adenomatous goiter, 3 had papillary carcinoma, and 2 had Hashimotos thyroiditis. Among the discordant cases, 7 had adenomatous goiter, 1 had papillary carcinoma, 1 had Hashimotos thyroiditis, and 1 had HQrthle cell tumor. The incidence of malignancy was 10.7% of concordant cases, and 20% of discordant cases and was revealed statistically insignificant (p>0.05). CONCLUSION: We observed higher incidence of malignancy in patients presenting hot nodules on 99mTc scan than ever reported. Fine needle aspiration should be performed to all patients with hot nodules and the 'I scan would not be recommended for further diagnostic study.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Goiter ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Sodium Pertechnetate Tc 99m ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Nodule ; Thyroiditis

Neurocristopathy is characterized as having a common origin in aberrant neural crest development. Congenital central hypoventilation syndrome (Ondine's curse) is characterized by marked depression of respiratory drive during sleep and normal ventilation while awake because of no response to both hypercapnea and hypoxia. The girl was full-term, weighing 3020 grams. The girl had poor respiratory effort at birth, but improved with oxygen supply and stimulation. abdominal distention and calcification were noted. During laparotomy transitional zone was found at distal jejunum; a jejunostomy was constructed. Numerous attempts at extubation failed because of apnea. The results of an apnea work-up, including brain sonography, echocardiogram, were normal. The girl died of sepsis at 37 days of age. para-aortic ganglioneuroblastoma was found on autopsy. We experienced a newborn with congenital central hypoventilation syndrome, Hirschsprung's disease and congenital ganglioneuroblastoma representative of neurocristopathy.
Anoxia ; Apnea ; Autopsy ; Brain ; Depression ; Female ; Ganglioneuroblastoma* ; Hirschsprung Disease* ; Humans ; Hypoventilation* ; Infant, Newborn* ; Jejunostomy ; Jejunum ; Laparotomy ; Neural Crest ; Oxygen ; Parturition ; Sepsis ; Ventilation

No abstract available.
Lymphoma, Large-Cell, Anaplastic*

The extensive knowledge of accurate anatomical morphology and acceptable proportion of the eyelid and orbit should be needed for plastic surgeons. The normal morphological and functional values of eyelids and orbits are variable according to races, sex and ages, and there are a few articles concerning them in Korea yet. The author measured eigt items of morphological and functional values of eyelids in Koreans and statistically analyzed them in 498 individuals including 234 males and 264 females. We divided them into nine age-related groups and measured the values. Especially, we subdivided 10 to 19 year-old group into three subgroup concretely because most of the values in the 10 to 19 year-old group reach the peak level of growth. The mean values in adults were recorded as follows: The horizontal dimension of the palpebral fissure was 27.0 +/- 1.8 mm in males and 26.8 +/- 1,7 mm in females and the vertical dimension of the palpebral fissure was 8.0 +/- 1.0 mm in female. The slant of the palpebral fissure was 7.9 +/- 2.4 degrees in males and 8.8 +/- 2.3 degrees in females and the height of the opened upper eyelid was 12.4 +/- 2.4 mm in males and 12.0 +/- 1.9 mm in females. The height of double fold in closed eye was 6.6 mm in males and 6.5 mm in femals and the intercanthal distance was 38.4 +/- 3.0 mm in males and 38.2 +/- 2.8 mm in females. The interpupillary distance was 64.6 +/- 2.9 mm in males and 63.6 +/- 2.9 mm in females. A double fold was seen in 36.1% of Korean. The average height of the double fold in closed eye was about 6.5 mm. The epicanthus present in 58.6% of Korean eyes and the most commom type was epicantus tarsalis. The growth of eyelids reached the peak level at teenager in a great portion. After the peak level, the changing pattern of eyelids could be divided into 3 groups; the first one was increasing more, the second was stationary, and the third was decreasing gradually. The peak levle of growth reached at 10 to 13-year-old in the vertical dimension of the palpebral fissure, at 14 to 16-year-old in the intercanthal distance, at 17 to 19-year-old in the horizontal dimension of the palpebral fissure.
Adolescent ; Adult ; Continental Population Groups ; Eyelids* ; Female ; Humans ; Korea ; Male ; Orbit* ; Vertical Dimension ; Young Adult

Endoscopic technique have become very popular in plastic and reconstructive surgery. They have provided advantages over previously closed techniques by minimizing scars, soft tissue manipulation and access with excellent visualization and magnification. More than twenty cases of facial bone surgery were performed over the past 3 years by endoscopic assistance. Our series consist of 3 cases of frontal bone contouring, 1 zygoma contouring, 3 fracture of zygoma, 9 fracture of orbit, 4 rhinoplasty for deviated nose. To accomplish this technique, a rigid 4 mm, 30 degree down angled endoscope was used. The frontal bone or zygomatic arch is approached endoscopically through two or three small incisions on the temporoparietal scalp. All endoscopic instrument are then manipulated through these incisions. The approach for zygoma complex, maxilla and mandible needs intraoral incision. Recontouring by a power bur and osteotomy using a small saw are done with endoscopic visual assistance. Rigid fixation requires an additional small incision over the plate for trocar method. The other technique was same with routine standard rhinoplasty procedures. The duration of follow-up ranged 3 months to 27 months. The postoperative course were satisfactory with fewer complication than conventional technique. The extra-time need for the endoscopic procedures was about 1 hour Endoscopically assisted facial bone recontouring, osteotomy and plate fixation can be performed with adequate visualization and direct manipulation of all facial bone. Complications usually associated with extensive incisions and pool visualization may be avoided. This technique may prove to be ideal for aesthetic surgery for facia skeleton with smaller scars and less morbidity.
Cicatrix ; Endoscopes ; Facial Bones ; Follow-Up Studies ; Frontal Bone ; Mandible ; Maxilla ; Nose ; Orbit ; Osteotomy ; Plastics ; Rhinoplasty ; Scalp ; Skeleton ; Surgical Instruments ; Zygoma

It is difficult to treat the complete cleft lip because of wide cleft and malaligned alveolar process, outward rotation of greater(medial) alveolar segment, and severe nasal deformity. Lip adhesion without presurgical orthopedic appliance was performed on 8 consecutive infants with unilateral complete cleft of the primary palate before denfinitive lip repair with Millard I procedure. Among 8 patients, 6 patients had complete unilateral cleft lip with alveolar cleft only and 2 patients were accompanied with complete cleft palate. All patients had more than a 10-mm-wide lip cleft with alveolar arch discrepancy. Lip adhesions were performed at 1-2 months of age and definitive repair was done at 5-6 months of age. Lip adhesions were performed by Randall's method and cheiloplasty was done by Millard I technique. Satisfactory results of lip and nose were obtained aesthetically in 8 cases after an average follow-up of 32 months. The vertical height of the medial and lateral lip segment were a symmetric appearance, while the vermilion tubercle, philtrum, and Cupid's bow were natural. Disadvantages included increased operating time and the sacrifice of same-lip tissue. In conclusion, preliminary lip adhesion can have better functional, esthetic and emotional results since the disadvantages are minor compared to the advantages.
Alveolar Process ; Cleft Lip* ; Cleft Palate ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Infant ; Lip* ; Nose ; Orthopedics ; Palate

BACKGROUND: Recently technetium-99m sestamibi (99mTc MIBI), which dose not require withdrawal of thyroid hormone, has been used for imaging of thyroid carcinoma. The aim of this study was to determine the clinical usefulness of Tc MIBI scintigraphy after total thyroidectomy for thyroid carcinoma. The results were compared with those of standard 131I scintigraphy. METHODS: One hundred twelve patients with a median age of 44 years (range, 14-76 years) were included in the study. After optimal endogenous thyroid stimulating hormone stimulation (>50 mIU/mL), whole body scintigraphy using 4 mCi of 'I and 20 mCi of Tc sestamibi were done simultaneously. Concomitantly serum thyroglobulin and anti-thyroglobulin antibody levels were checked. If abnormal findings on any of the scintigraphic methods or high levels of thyroglobulin (> 10ng/mL) were detected, diagnostic imaging studies were done to confirm the existence of the disease. And high dose (150-200 mCi) 'I was administered as therapy and then whole body scans were performed again after the therapy. The presence or absence of thyroid cancer was established by pathologic, radiologic, and/or high dose I scan findings. RESULTS: In 11 patients, Tc MIBI scan revealed positive accumulations which were not found on 131I scan, of whom 6 had elevated thyroglobulin levels. In these cases, 5 cases were interpreted to have normal thyroid remnant and 6 cases showed pathologic findings (2 lung, 1 lymph node, 1 lung and lymph node, 1 local recurrent cancer, and 1 false positive accumulation of 99mTc MIBI). Metastasis or residual cancer were confirmed histologically in 1 and radiologically in 4 cases. Negative 99mTc MIBI scans, despite of positive I scans, occurred in 9 patients, of whom 2 had abnormal thyroglobulin levels. Seven cases were interpreted to have thyroid remnant, 2 cases were confirmed to have lung metastasis, and another one was misinterpreted due to breast shadow. CONCLUSION: In conclusion, these results suggest that 99mTc MIBI scan may have similar sensitivity and specificity for the detection of residual or metastatic differentiated thyroid carcinoma. The 99mTc MIBI scan, especially in cases of negative 131I scan despite of abnormal thyroglobulin levels, can be used as a very useful complementary diagnostic tool.
Breast ; Diagnostic Imaging ; Follow-Up Studies* ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Radionuclide Imaging* ; Sensitivity and Specificity ; Technetium Tc 99m Sestamibi ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyrotropin ; Whole Body Imaging

From May 1988 to January 1997 authors had experienced 13 cases of recurred blepharoptosis. Previous operative procedures were frontalis muscle suspension in 10 cases and levator resection in 3 cases. Follow up period ranged from 11 months to 9 years. We have treated recurred blepharoptosis using frontalis myofascial flap, orbicularis oculi muscle flap and levator resection in accordance with the postoperative levator function and degree of ptosis of patient and considering previous operative technique. The results were that 12 patients have gained the levator excursion over 7 mm and reduced the height difference between both palpebral fissures less than 2 mm after reoperation (good in 6 cases and satisfactory in 6 cases). From these results we might conclude that the frontalis myofascial flap technique is a good secondary blepharoptosis operation for patient with less than 2 mm of levator function, orbicularis oculimuscle flap technique with 2-4 mm of levator function, levator resection with over than 4 mm of levator function. The expert technique and experience are also important factor for the treatment of recurred blepharoptosis.
Blepharoptosis* ; Follow-Up Studies ; Humans ; Reoperation ; Surgical Procedures, Operative

PURPOSE: To verify the usefulness of left portal vein angle (LPVA) on CT scan in the diagnosis of liver cirrhosis and to compare its diagnostic value with that of caudate to right lobe ratio (C/RL ratio). MATERIALS AND METHODS: LPVA, an angle formed by a vertical line and a line connecting the center of the vertebral body to the umbilical point of the left portal vein, and C/RL ratio were measured on CT scans of 100 cirrhotic and 100 normal livers. Diagnostic values of LPVA and C/RL ratio were compared statistically. RESULTS: The mean of LPVA was 18.9 degrees(SD; 7.6) for normal livers and 25.8 degreesSD; 8.4) for cirrhotic livers (P<0.001). The mean of C/RL ratio was 0.47(SD; 1.10) for normal livers and 0.58(SD;0.14) for cirrhotic livers (P<0.001). When LPVA was greater than 30 degreesliver cirrhosis was diagnosed with 36% sensitivity and 92% specificity. When C/RL ratio was greater than 0.60, the diagnose of liver cirrhosis was with 41% sensitivity and 90% specificity. There was no significant difference of the diagnostic accuracy between LPVA and C/R L ratio in ROC analysis. CONCLUSION: Both LPVA and C/RL ratio are useful diagnostic indices of liver cirrhosis on CTscan. LPVA is more convenient to measure than C/RL ratio.
Diagnosis* ; Fibrosis ; Liver Cirrhosis* ; Liver* ; Portal Vein* ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed