Penile amputation is an unusual injury. There are several reports in the literature describing successful primary reanastomosis. We have an experience of a case of completely amputated penis that was reimplanted with the techniques of microvascular anastomosis of the dorsal arteries. The result was satisfactory for both urinary and sexual function. Herein we report this case with the review of the literatures.
Amputation ; Arteries ; Male ; Microsurgery ; Penis* ; Replantation*

No abstract available.
C-Peptide* ; Child* ; Diabetes Mellitus* ; Histocompatibility Testing* ; Humans ; Insulin* ; Islets of Langerhans*

No abstract available.
Forehead* ; Methylmethacrylate*

The Non-incision "double eyelid" operation reported by Mikamoto of Japan in 1896 has the advantage of shorter operating time, less morbidity and minimal scarring thus more natural final appearance. Incidence complications of this procedure such as disappearance of the fold, asymmetry, and inclusion cyst has been reported to be higher than the incision method and there has been reports of complication rates of up to 30%. The surgeon and the patient are most worried about the complete disappearance of the surgical palpebral fold. The complications of Non-Incision ""double eyelid"" operation was evaluated in 190 patients who were available for follow up of more than 1 year. Classification of the complications which required revision surgery was classified and evaluated. There were no major complications such as blindness, retrobulbar hematoma, and blepharoptosis. Total number of complications requiring reoperation: 24(100%). The most common reoperation procedure that we experienced was asymmetry which occurred in 10(42%) patients followed by lowering of the fold line and disappearance of the fold with 6(25%) cases each. All these patients were taken back to surgery and were corrected by Non-incision method with favorable results. Conclusively, 24 complications of Non-incision double eyelid procedure experienced in 190 patients. Disappearance of the palpebral fold was seen in 6 patients who were corrected by another Non-incision technique with excellent results. The complete disappearance of the fold was experienced in very few patients and correction of this complication was satisfactory. Thus, disappearance of the fold after Non-incision double eyelid procedure should not be termed by the patient or the surgeon with full under- standing of the procedure.
Blepharoplasty* ; Blepharoptosis ; Blindness ; Cicatrix ; Classification ; Eyelids ; Follow-Up Studies ; Hematoma ; Humans ; Incidence ; Japan ; Reoperation

No abstract available.
Anemia* ; Hypothyroidism*

The prevalence of renal disease continues to increase worldwide. When normal kidney is injured, the damaged renal tissue undergoes pathological and physiological events that lead to acute and chronic kidney diseases, which frequently progress to end stage renal failure. Current treatment of these renal pathologies includes dialysis, which is incapable of restoring full renal function. To address this issue, cell-based therapy has become a potential therapeutic option to treat renal pathologies. Recent development in cell therapy has demonstrated promising therapeutic outcomes, in terms of restoration of renal structure and function impaired by renal disease. This review focuses on the cell therapy approaches for the treatment of kidney diseases, including various cell sources used, as well recent advances made in preclinical and clinical studies.
Cell- and Tissue-Based Therapy/*methods ; Fetal Stem Cells/transplantation ; Humans ; Kidney/cytology ; Kidney Diseases/*therapy ; Pluripotent Stem Cells/transplantation ; Stem Cell Transplantation/methods

The reconstruction of the cheek area is a complex problem because the cheek is the most broad area of the face and is close to the aesthetically important region such as eyelids, nose, and mouth. The ultimate purpose of the cheek reconstruction is the restoration of the original shape and function, and establishment of the harmony with the adjacent structure in terms of color, nature and thickness. Various procedures such as skin graft, local flap, free flap, and local flap using skin expansion have been performed for cheek reconstruction. However, no golden principal or indication has been clarified to be imperative. Analyzing our clinical experiences of the cheek reconstruction, we intend to present a general guide of the cheek reconstruction and to assess the advantages and/or disadvantages of the operative methods. Between march of 1989 and August of 1999, we have experienced 154 cases of the cheek reconstruction. There were 52 males and 73 females, and their ages ranged from 3 to 89 years (mean 28.1 years). Preoperative diagnosis were post-burn deformity(n=74), Romberg disease (n=9), post-traumatic deformity(n=7), hemangioma(n=7), nevus(n=7), neurofibroma(n=5), hemifacial microsomia (n=3), lymphangioma(n=3), cancer(n=6), post-hemimandibulectomy(n=1), radical maxillectomy(n=1). The procedures were one stage cervicofacial flap(49 cases), cervicofacial flap following skin expansion(42 cases), local cheek flap (14 cases), deltocervicopectoral flap(2 cases), skin graft(29 cases), free flap(18 cases). Follow up period ranged from 3 to 72 months(mean 11.8 months). Advantages and disadvantages of each procedures were explained. The satisfaction rate was higher in one stage cervicofacial flap and free flap when assessed by both patients and surgeon. There were 3 cases of the ectropion of lower eylids, 4 cases of partial flap necrosis, and 1 case of exposure of tissue expander. The local flap is always the preferred method for the cheek reconstruction and the free flap is the treatment of choice for the cheek contour reconstruction. Selection of the most suitable flap is mandatory depending on the location and size of the defects.
Cheek* ; Diagnosis ; Ectropion ; Eyelids ; Facial Hemiatrophy ; Female ; Follow-Up Studies ; Free Tissue Flaps ; Goldenhar Syndrome ; Humans ; Male ; Mouth ; Necrosis ; Nose ; Skin ; Tissue Expansion Devices ; Transplants

The constricted ear was suggested by Tanzer for the purpose of obviating the confusion involving lop ear, cup ear and prominent ear as defect whose helix turns down, and scapha and fossa triangularis are narrowed. The constricted ear has a spectrum of severity and therefore, requires a graded surgical approach. Tanzer has described the degree of deformities of the constricted ear as falling into three groups. For the correction of constricted ear, there are numerous techniques but we have had difficulties in adopting these techniques in various type. We also describe the various constricted ear as the Tanzer's classification and adopted three methods to each type, banner flap(group I), concha cartilage graft (group II) and rib cartilage graft(group III) for reducing postoperative deformity and confusion in correcting the ear deformities. Constricted ear repairs must be individualized to accomodate each specific deformity. We corrected 22 cases of constricted ear in 20 patients using each optimal method described above according to the degree of deformities. Mild deformities need only reshaping and adjusting of existing tissues, moderate deformities need additional skin and severe deformities require a cartilage graft. For correction of constricted ear, accurate identification of the severity of deformity is essential. The results were satisfactory and we report our experience with relative literatures.
Cartilage ; Classification ; Congenital Abnormalities ; Ear* ; Humans ; Ribs ; Skin ; Transplants

Vitamin C acts as a antioxidants and as free radical scavengers in biological systems. The objective of this study was to examine whether the administration of vitamin C could improve the skin flap survival. Sprague-Dawley rats (n = 40) were divided into 4 groups (n = 10); normal saline, vitamin C 200 mg/day, vitamin C 500 mg/day, vitamin C 1000 mg/day were injected subcutaneously to each group (n = 10). A classic caudally based random flap (2 X 7 cm) was elevated on the dorsum of rats and then sutured to its normal position. On the 3rd, 7th, 14th days postoperatively each animal was evaluated for percentage area of flap survival by paper template technique, thereafter rats were sacrificed and we obtained tissue from the distal ends of the flap. Following is our results. 1) The experimental group treated with vitamin C revealed an increased rate of random pattern skin flap survival compared with the control group (p < 0.005). 2) There was correlation of vitamin C dosage with flap survival rate (Spearman's correlation coefficient = 0.971). 3) The biopsy of the control group showed extensive atrophy and necrosis. However, New capillary proliferation and collagen deposition were noted in the vitamin C 200 mg and 500mg treated group. In the vitamin 1000 mg group, microscopic findings were very alike compared with normal rat skin texture. Finally, we concluded that the Vitamin C supplement increases survival rate of random pattern flap in rat skin flap model, and flap survival is correlated with vitamin C dosage.
Animals ; Antioxidants ; Ascorbic Acid* ; Atrophy ; Biopsy ; Capillaries ; Collagen ; Free Radical Scavengers ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; Skin ; Survival Rate ; Vitamins*

PURPOSE: To assess the comparative growth of the four long bones of the lower extremities after the tibial shaft fractures in children. MATERIALS AND METHODS: Thirty-eight children (age, 8.2+/-2.6) with tibial shaft fractures treated with a closed reduction and a long leg cast were enrolled in this study. The mean follow-up was 54.4 months (range, 24-96). The medical records and Bell-Thompson images were retrospectively reviewed. RESULTS: The clinical results were excellent in all cases. The fractured tibia showed overgrowth (4.4+/-3.3 mm) compared with the contralateral side. The ipsilateral femur showed mild over-growth (0.9 mm+/-3.7), and the final leg length discrepancy was 5.3 mm+/-5.4. Four ipsilateral femurs showed overgrowth >10 mm. Gender, the level of the fractures and associated fibular fractures did not affect the overgrowth of the fractured tibia (p>0.05). However, age might affect the amount of overgrowth (p=0.005). CONCLUSION: Tibial shaft fractures in children treated with a long leg cast showed variable overgrowth. The final leg length discrepancy was influenced by the overgrowth of the ipsilateral femur as well as by overgrowth of the tibia.
Child* ; Femur ; Follow-Up Studies ; Humans ; Leg ; Lower Extremity ; Medical Records ; Retrospective Studies ; Tibia