No abstract available.

The ideal breast reduction should create beautiful breasts with limited scars. Unfortunately, no surgeon has ever been able to produce such a result. Most recent breast reduction techniques tend to produce minimal breast scars and avoid the classic inverted-T incision. The vertical mammaplasty can be used in mild to moderate cases of breast reduction, producing consistently good, stable results with limited scars. This technique uses adjustable preoperative markings, an upper pedicle for the areola, and a central breast reduction with limited skin undermining. The shape of the breast is created by suturing of the gland and does not rely on the skin. The adjunctive use of liposuction in fatty breasts can be considered safe and efficient. We have performed reduction mammaplasty using the vertical mammaplasty technique in 12 patients. Overall number and extent of complications were small, and patient satisfaction was high for this procedures. The advantages of vertical mammaplasty technique compared with other methods are as follows ; 1. The markings are adjustable to nearly all patients. 2. Stable contours are produced because the gland is strongly sutured. 3. Few postoperative complications occur. 4. Limited scars(only vertical scars) are created 5. The procedure is easy to learn and perform.
Breast ; Cicatrix ; Female ; Humans ; Lipectomy ; Mammaplasty* ; Patient Satisfaction ; Postoperative Complications ; Skin

The purpose of this study is to present our experience of distraction osteogenesis procedure used to improve the functional and consmetic problems of two patients associated with Pierre-Robin sequence, which is an uncommon congenital disease in combination with micrognathia, glossoptosis, and respiratory obstruction. A female child of 42 months and a male infant of 4 months suffering from pneumonia, difficult breathing, cyanosis and insomnia were admitted. We performed temporary tongue to lip dhesion by modified Routledge method and bilateral mandibular distraction. After the operation, symptoms of insomnia and impaired breathing had improved. We found an extension of the mandibular length. In addition, the posterior airway space and lower face area were expanded in the cephalometric tracing and profilogram. We report that bilateral distraction provedure could be an effective and safe method for improving of impaired breathing and cosmetic problems of patients with Pierre-Robin sequence.
Child ; Cyanosis ; Female ; Humans ; Infant ; Lip ; Male ; Osteogenesis, Distraction ; Pneumonia ; Respiration ; Sleep Initiation and Maintenance Disorders ; Tongue

Utile recently, osteotomy & reposition surgery of prominent zygoma have been performed by means of a coronal incision or intraoral preauricular incision. But penalties are paid, such as scar, the possibility of facial nerve injury and long operative time. Reflecting on our past experiences of facial bone surgery, we developed an alternative approach. In our method, the protrusion in the cheekbone is corrected by performing an osteotomy and reposition method through intraoral incision only. During the past 3 years we have operated on 23 patients of malar prominences. The amount of the bone to be removed is determined on preoperative interview, physical examination and x-rays. Intraoral incision provide access to the zygomatic body and lateral orbital rim. After L-shaped osteotomy, two paralle vertical and one transverse osteotomies, at medical part of the zygomatic body, the midsegment is removed. Posterior portion of zygomatic arch was approached through medical aspect and was outfractured using curved osteotome. After completion of triple osteotomy, the movable zygomatic complex was reduced medially and fixed with miniplates and screws on the zygomaticomaxillary buttress. The patients were followed for 9.5 months with acceptable result and little complication. The author concludes that this technique is effective and safe method in reduction malarpalsty.
Cicatrix ; Facial Bones ; Facial Nerve Injuries ; Humans ; Operative Time ; Orbit ; Osteotomy ; Physical Examination ; Zygoma

No abstract available.
Cholelithiasis* ; Korea*

Intestinal capillariasis is caused by a small trichurid nematode, Capillaria philippinensis, which infects freshwater fish as intermediate hosts and subsequently fish eating birds as definitive hosts. It has occurred in areas such as the Philippines and Thailand where people eat raw fish. We report an imported case of intestinal capillariasis in a 31-year-old Korean man who lived in Saipan for ten years. He suffered from diarrhea with weight loss, abdominal distension, and pitting edema in the lower extremities for two years. He ate raw freshwater fish in the Saipan 2 years ago. The diagnosis was confirmed by jejunal biopsy. Flat mucosal surface without villi contained sections of numerous round worms with stichosome, larvae, and eggs which were identified as Capillaria philippinensis. The patient was successfully treated with albendazole.
Adult ; Albendazole ; Biopsy ; Birds ; Capillaria ; Diagnosis ; Diarrhea ; Eating ; Edema ; Eggs ; Fresh Water ; Humans ; Larva ; Lower Extremity ; Ovum ; Philippines ; Protein-Losing Enteropathies* ; Thailand ; Weight Loss

This study includes 40 patients of post-traumatic facial bone deformities to whom underwent realignment of zygomatic bone. In 13 cases, we modified the approach technique using limited exposure such as subciliary, intraoral and preauricular incisions instead of conventional wide exposure. Preoperative evaluation of deformity was done by using x-rays, photographs and detail communication with the patients. Through this limited exposure, osteotomy and repositioning of the zygoma were accomplished. There were no postoperative differences between wide and limited exposure, but limited exposure was more advantageous in terms of reduced operative time, transfusion, hospitalization and scaring. This approach was an effective method for the relatively simple tetrapod type-malunited fracture of zygoma without comminution.
Congenital Abnormalities ; Facial Bones ; Hospitalization ; Humans ; Operative Time ; Osteotomy ; Zygoma*

In the rat brain, global hypoxia cause a delayed neuronal degeneration that occurs hours to days after reoxygenation. It is generally thought that the ischemic damage is initiated by neurotoxicity mediated through glutamate receptors, particulary NMDA subtypes. Calcium entry through the NMDA receptor is responsible for the synaptic plasiticity and neuronal pathology. Degradation of MAP-2 and NF200, a major components of neuronal cytoskeleton, by Ca2+-dependent protease after NMDA receptor activation has been postulated in delayed neuronal damage. Changes of NR subunit 2B, MAP2 and NF200 in rat brain postsynaptic density[PSD] after hypoxic injury were investigated through immunoblot analyses. To understand the effect of Ca2+ influx through NMDA receptors on neuronal damage which is manifested by cytoskeletal disruption, morphological change was examined through immunohistochemistry and H & E staining. We found that immunoreactivity to NR2B antibody in the cerebral cortex PSD was up-regulated while MAP2 and NF200 was down-regulated at 30 hours after initial hypoxic insult. At this time, morphological changes of neuronal cells in hypoxic conditions were manifested as down-regulation of MAP2 and NF200 immunoreactivities, hyperchromatic condensation of cytoplasm and nucleus, homogenizing cell change, expansion of perineuronal space and dispersion of chromatin. From 3 days, NR2B, MAP2, NF200 were up-regulated simultaneously. On the other hand, morphological alterations in hypoxic neurons were progress further. Our present results suggests that Calcium influx through NR1/NR2B receptor channel is effective whithin 30 hours but ineffective from 30 hours. Delayed neuronal cell death triggered by Ca2+ influx through NR1/NR2B receptor channel within 30 hours, which may activate intracellular profeases. Proteolysis of cytoskeleton by activated protease leads to its abnormal reorganization and eventually damages normal function of cell membrane which causes neuronal cell death.
Animals ; Anoxia ; Brain ; Calcium ; Cell Death ; Cell Membrane ; Cerebral Cortex* ; Chromatin ; Cytoplasm ; Cytoskeleton* ; Down-Regulation ; Hand ; Immunohistochemistry ; N-Methylaspartate* ; Neurons ; Pathology ; Proteolysis ; Rats* ; Receptors, Glutamate ; Receptors, N-Methyl-D-Aspartate ; Up-Regulation*

No abstract available.
Replantation*

Transient cerebral ischemia was induced by bilateral common carotid artery ligation with reperfusion to understand its effect on the expression of NMDA receptor subunits 2A (NR2A), 2B (NR2B), and NF200 The changes of the expressions of NR2A, NR2B, and NF200 in cerebral postsynaptic density (PSD) were evaluated through immunoblot analyses. The expressions of NR2A and NF200 were markedly decreased until 18 hours after reperfusion, while that of NR2B was increased. The immunohistochemistry with NFIGO antibody showed that NF200 protein, which is a marker for neuronal damage, was also significantly decreased at this time point indicating neuronal damages, and the morphological damages of neuronal cells were evident by hyperchromatic condensation of nucleus, irregular cell membrane, displacement of nucleus, and chromatolysis of Nissl substances in toluidine blue stain. However, from 18 hours to 3 day after reperfusion, immunoblot analyses showed that NF200 was increased significantly, while the expression of NR2A were recovered to the control level and that of NR2B was returned to somewhat higher level than control. The NR1/NR2B-type receptor is known to have a longer offset decay time than NR1/NR2A-type ones, and to be more potent in Ca2 influxing. Therefore, our results suggest that, until 18 hours, neurons are damaged by overinflux of Ca2 through NR1/NR2B receptors which helps to degrade NF200 by Ca2 sensitive professes resulting in damages to intracellular transport. The fact that the expression of NF200 was increased even though the NR2A and NR2B are control level during 18 hours to 3 days after damage suggests that NMDA receptor subunits expressed at this time may not form functional receptors. The worsening of some neuronal damages after 3 days may indicate that an abnormal reorganization of elevated NF200 between 18 hours to 3 days further disturb intracellular transport and functions of cell membrane which cause cell death.
Animals ; Carotid Artery, Common ; Cell Death ; Cell Membrane ; Cerebral Cortex* ; Immunohistochemistry ; Ischemic Attack, Transient* ; Ligation ; N-Methylaspartate* ; Neurons ; Post-Synaptic Density ; Rats* ; Reperfusion ; Tolonium Chloride