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.
Calcium Carbonate* ; Calcium* ; Humans ; Renal Dialysis*

No abstract available.
Brassica* ; Ear*

The molecular mechanisms that regulate glossal muscle cell cycle and terminal differentiation remain largely unknown. To determine which cyclins, cyclin dependent kinases (CDKs), cyclin dependent kinase inhibitors (CKIs) are important for glossal cell proliferation, we have examined expression of cyclins CDKs, CKIs during normal glossal muscle development in the rat. All cyclins, CDKs, and KIP/CIP family of CKIs were highly expressed during fetal glossal muscle development, then they decreased at different rates after birth. While the mRNAs of cyclin Dl, D3, E , A, and B decreased gradually in glossal muscle during all stages of development, the protein levels of these cyclins decreased differently in tongue during pre- and postnatal development. While the functionally active formed of cyclin Dl, cyclin D3 and E proteins were observed until 7 days after birth, cyclin A and B proteins were decreased more slowly. While the CDK4, CDK6, CDK2, cdc2, and proliferating cell nuclear antigen (PCNA) proteins were higllly present during fetal glossal muscle development and gradually decreased during postnatal development. Particularly, cdc2 levels decreased markedly after birth. Immunohistochemical data for PCNA was consistent with Western blotting data for PCNA temporally and spatially. The mRNA and protein levels of p21, p27, and p57 were high, then their levels changed differently during glossal development. While the mRNA levels of p21 and p57 decreased gradually, the mRNA level of p27 did not change during glossal development. While the protein levels of p21 and p57 in tongue decreased markedly after birth, the protein levels of p27 increased slightly after birth, then decreased at adulthood. These findings suggest that the all cyclins and CDKs observed are involved in glossal muscle cell cycle, and reduction of cyclins and CDKs and induction of p21 are associated with the withdrawal of glossal muscle cell cycle after birth.
Animals ; Blotting, Western ; Cell Proliferation ; Cyclin A ; Cyclin D3 ; Cyclin-Dependent Kinases* ; Cyclins* ; Humans ; Muscle Cells ; Muscle Development ; Parturition ; Phosphotransferases* ; Proliferating Cell Nuclear Antigen ; Rats* ; RNA, Messenger ; Tongue

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

Debonding of cement-femoral stem interface has been suggested as a initial focus of loosening mechanism in many previous studies of cemented total hip replacement. The purpose of this study was to investigate the effect of debonding of cement-femoral stem interface to the cement-bone inter- face by using three-dimensional non-linear finite element analysis. Three cases of partial debonded, full debonded, and full bonded cement-bone interface were modelled with partial bonding of distal 70mm from the tip of femoral stem. Each situation was studied under loading simulating one-leg stanced gait of 68kg patient. The results showed that under partial and full debonded cement-stem interface conditions the peak von Mises stress (3.1 MPa) were observed at the cement of cement-bone interface just under the calcar of proximal medial of femur, and sudden high peak stresses (3.5 MPa) were developed at the distal tip of femoral stem at the lateral bone-cement interface in all 3 cases of bonding. The stresses were transfered very little to the cement of upper lateral bone-cement interface in partial and full debonded cases. Once partial or full debonded cement-femoral stem interface occured, 3 times higher stress concentration were developed on the cement of proximal medial cement-bone interface than full bonded interface, and these could cause loosening of cemented total hip replacement. Clinically, preservation of more rigid cement-femoral stem interface may be important factor to prevent loosening of femoral stem.
Arthroplasty, Replacement, Hip ; Femur ; Finite Element Analysis* ; Gait ; Humans

Morphological characteristics of human embryos of Carnegie stage 17 were described. The crown rump length of these embryos were 11.7-13.6mm. These embryos were characterized externally by ventrally directed nasal pits, 6 distinct auricular hillocks, finger rays in the hand plate, digital plate at the lower limb bud, herniation of a part of midgut through umbilical cord, and internally by the partial fusion of ventral and dorsal pancreas, prominent nasal sac which is not open to primitive oral cavity, formation of segmental and some subsegmental bronchial buds, branching of metanephrotic pelvis, crescent-shaped lens cavity, and imminent semicircular ducts.
Crown-Rump Length ; Embryonic Structures* ; Fingers ; Hand ; Humans* ; Lower Extremity ; Mouth ; Pancreas ; Pelvis ; Semicircular Ducts ; Umbilical Cord

No abstract available.
Congenital Abnormalities* ; Fingers* ; Plastics*

The depth of wound level is as important as the level of the tendon injury itself. And the timing of the operative procedure is an important factor. As a rule, tendons injured outside of the flexor sheath yield much better results than those injured within the sheath. The nutritional supply of the flexor tendons is not completely understood. Many elaborate studies have outilned the vascular anatomy of these tendons, and not all authors are in agreement. It is now clear that synovial fluid within the sheath supplies nutrition to the tendon much as synovial fluid in a joint supports cartilage. With this in mind, the present study was designed to determine the effect of exposing tendons for varying periods of time on the viability of the tendon and sequential morphological changes. The results are as follows: 1. Twelve hours after tendon sheath removal, collagen fibrillar dissociation and irregular surface of the tendon sheath were noted on the chicken flexor tendons by electronmicroscopy. 2. Superficial tenocyte necrosis was created after 24 hours of tendon exposure. 3. At 3 days, inflammatory cell infiltration and thickening of the outer synovial layer were noted. After 7 days, fibrosis of the degenerated tendon started from the exposed surface. 4. The fibrous connective tissue and new blood vessel infiltration into the tendon were progressed after 7 days. From these morphological results, any interference with the synovial environment leads to a regressive change of the flexor tendons immediately. It is suggested that delayed primary wound covering procedure within three days an after exposed tendon injury is ideal, and it should by done at least 7 days after tendon exposure.
Blood Vessels ; Cartilage ; Chickens ; Collagen ; Connective Tissue ; Equipment and Supplies ; Fibrosis ; Joints ; Necrosis ; Surgical Procedures, Operative ; Synovial Fluid ; Tendon Injuries ; Tendons ; Wounds and Injuries

Osteogenesis imperfecta is a rare affection characterized by fragility of the bones, blue sclerae, and deafness, less freqently by hypermobility of the joints. The etiology is unknown, but it appears to be a mesenchymal defect. A case of osteogenesis imperfecta(tarda form). in a 8 ycar old girl, is presented with a review of the literatures. The chief complaints were bowing deformities of the right upper arm and both lower extremities, stunted growth, blue sclerae, dental defects, weakness of the muscles and pigeon breast. X-Ray showed multiple malunited fractures of the right humerus, both femurs, and bilaterally of tibiae and fibulae.
Arm ; Breast ; Columbidae ; Congenital Abnormalities ; Deafness ; Female ; Femur ; Fibula ; Fractures, Malunited ; Growth Disorders ; Humans ; Humerus ; Joints ; Lower Extremity ; Muscles ; Osteogenesis Imperfecta ; Osteogenesis ; Sclera ; Tibia