No abstract available.
Muscular Dystrophies*

The face and notably the lips are important structures not only of aestheticvalue but also for expression, vibrancy and vitality. Sometimes we are encountered with the functional and aesthtetic lip problems especially in the patients with mandibular prognathism, such as excessive vermilion exposure, lip incompetence and hyperactivity of mentalis muscle. The etiologic factors are usually related to excessive anterior facial height, secondary to the abnormal development of perioral muscle, salivary gland and the swelling of lymphatic gland. Sometimes orthognathic surgery (mandibular setback osteotomy) alone is not accepted regarding to aesthetic value, there is likely to be a corresponding interest in adjunctive procedures such as genioplasty and soft tissue procedures. This article urges the incorporation of reduction cheiloplasty. It is a relatively minor procedure that can be easily reproducible and yields excellent, predictatable results with few complications. We treated two patients who have excessive vermilion exposure and marked abnormal lip eversion using reduction cheiloplasty combined with mandibular setback osteotomy, followed by improved facial harmony and patients were pleased.
Genioplasty ; Humans ; Lip ; Orthognathic Surgery ; Osteotomy* ; Prognathism ; Salivary Glands

Between Jan. 1976 and May 1987, Sixteen supracondylar fractures of the femur were treated by interlocking nailing. Of the 16 cases, 7 cases were intercondylar, 12 cases were segmental fractures of the femur, 4 cases were open fractures in the type of wound. 1. The simple supracondylar fracture involving the distal 9cm of the femur can be treated by interlocking nailing which makes firm fixation and allows early ambulation. 2. If the supracondylar fracture is accompanied with intercondylar fracture, careful reduction and transcondylar fixation by means of tibial bolt or cancellous screws are essential before the insertion of the nail. 3. The shape of the bent nail must be depended on the type of the fracture. If the nail is to be inserted into the anterolateral aspect of the distal fragment, the degree of bending of the nail is 400cm, and posteromedial is 110cm in radius. 4. The authors made several sagittal holes the at dorsum of the nail. So the screw can be easily inserted to the nail perpendicularly or obliquely, when the insertion of the screw through the transverse holes is difficult. 5. Of the 15 cases treated by interlocking nailing, 5 cases were excellent, 4 cases were good, 2 cases were fair, 4 cases were failure by schatzker assessment.
Early Ambulation ; Femur ; Fractures, Open ; Radius ; Wounds and Injuries

No abstract available.
Granuloma* ; Subphrenic Abscess*

The degenerative arthritis following total menisectomy has led to consideration of the need for meniscal transplantation, this study evaluates the morphologic and histologic changes fol lowing fresh meniscal autograft and allograft in therabbits. Transplantation of the medial meniscus was carried out in two groups of 32 rabbits(autograft group=16 rabbits, allograft group=16 rabbits). The morphological and histological changes of the transplanted auto-and allografted menisci and the articular cartilage of the medial femoral and tibial condyle were observed at 2,4,6,8,10,12,22,28 weeks postoperatively. There were no significant differences between auto and allograft groups in gross appearance. Histologically, the fibrous adhesion was noted between grafted meniscus and joint capsule 2 weeks after operation, but complete healing was seen at the suture sites without rejection phenomenon at 6 weeks in both groups. There were prominent inflammatory reactions such as lymphocytes and inflammatory cells infiltration during early postoperative stages(2,4 weeks) only in the allograft group, and more prominent fibrotic reactions in the allograft group than auto-graft group. The results of this study suggest that meniscal allografts are able to adapt to the host tissues, survive within the joint environment, and provide a functional replacement for the removed meniscus, but further studies for graft-host immune response and a method to take the maintenance and deposits of graft must be needed to perform the meniscal allograft in human.
Allografts ; Autografts ; Cartilage, Articular ; Humans ; Joint Capsule ; Joints ; Knee Joint ; Knee ; Lymphocytes ; Menisci, Tibial ; Methods ; Osteoarthritis ; Rabbits ; Sutures ; Transplants

In spite of large volume of reports, surprisingly little information is avail-able about the function of the foot in standing and there are still many controversies about the exact proportion of the weight distributed in discrete areas of the foot. The purpose of this study is to evaluate about the exact proportion of the weight distribution in discrete areas of the foot through the photoelastic technique. In the results of this study according to the 10 regional division method, 4.4% of the total load of one foot was loaded on the toes(1 st toe, 2.2% ;2nd toe, 0.8%; lateral toes, 1.4%), 27.4% on the metatarsal area(lst metatarsal, 6.6%; 2nd metatarsal 8.7% ; lateral metatarsals, 12.5%), 8.6% on the midfoot(medial midfoot, 1.4%; lateral midfoot, 7.3%) and 59.2% on the heel(medial heel, 31.9%; lateral heel, 27.%), respectively. As in other reports, the toes played little role in weight bearing and the midfoot suggested the presence of the longitudinal arch. The metatarsal area received considerable amount of weight but the priority of the first metatarsal area was not demonstrable, rendering the presence of the transverse metatarsal arch doubtful. The heel received more than half of total weight given in one foot(p < 0.005). No significant difference was demonstrable between the dominant side and the nondominant side other than in midfoot.
Foot ; Heel ; Metatarsal Bones ; Methods ; Toes ; Weight-Bearing

Objective: Percutaneous vertebroplasty (VP) has been used for the safe treatment of osteoporotic compression fracture. However, cement leakage is the most common complication. To reduce the leakage of bone cement, we did the gelfoam embolization during VP. The purpose of this study is to compare the safety and feasibility of different two gelfoam embolization technique during VP. Methods: Total 127 patients (146 level) who had the thoracolumbar osteoporotic compression fracture were enrolled. Group A was treated by gelfoam-only technique and, Group B was treated by gelfoam with venography technique. We compared the incidence of bone cement leakage between two groups using post-operative computed tomography scan and X-ray. Results: Seventy-four patients (81 levels) were treated with gelfoam-only technique (A), and 53 patients (65 levels) were treated with gelfoam with venography technique (B). There were 22 leakages on group A, and 19 leakages on group B. There was no statistical significant difference between two groups (Chi-square test, p-value =0.958). Incidence of leakage to spinal canal was 11 levels in Group A, 3 levels in group B, and there was statistical significant difference (Fisher's exact test, p-value=0.027). Conclusion Complication induced by the bone cement leakage are the most careful point during VP. Gelfoam embolization with venography is very easy and safe method. Gelfoam with venography technique could make lower the incidence of cement leakage to spinal canal.

A successful prosthesis is difficult to produce without using the implants in the severely resorbed alveolar ridges and maxillofacial defects. This report describes clinical experience of the overdenture using O-ring attachment. Clinical results have revealed successful application for the O-ring attachment in the two edentulous patients and a partial maxillectomy patient.
Denture, Overlay ; Humans ; Prostheses and Implants ; Rehabilitation*

It remains a problem that successful revascularization and reperfusion after ischemia are associated with high systemic complication rates and severe local tissue injuries. With prolonged ischemia, there is damage to tissue from anoxia, but further injury may occur after reperfusion. The activation of leukocytes and endothelial cells during reperfusion causes neutrophil adhesion in capillaries, resulting in plugging and further ischemia, Alternativety, neutrophil adhesion to endothelium leads to the migration of neutrophil with local edema formation, hemorrhage and thrombosis. Some chemotactic and activating factors are needed to propel neutrophils to the site of local inflammation. The chief cytikines that induce a pro-adhesive state in endothelium are tumor necrosis factor-alpha(TNF-alpha), interleukin-1 beta(IL-1 beta) and endotoxin or lipopolysaccharide(LPS). Similarly, TNF-alpha,and to a lesser extent interleukin-8(IL-8), is the important stimulus that acts on neutrophils and other leukocytes to alter their adhesion. The purpose of this study was to evaluate the pathogenetic role of IL-8 after perfusion with CDl8 monoclonal antibody(CDl8 mAb), the blocking antibody of neutrophil adherence, on reperfusion injury in rat epigastric island skin flap. A 6 X 3 cm-sized island skin flap was made on the abdomen. The epigastric pedicle was occluded for six hours with ambient temperature. Fifteen minutes before reperfusion, the flap was perfused with saline and CDl8 mAb(1 mg/kg). For evaluation of IL-8 levels, tissue fluid and serum were obtained at 4, 8, 12 and 24 hours after reperfusion. IL-8 concentrations of the CDl8 mAb group in the tissue fluid were significantly decreased at 8, 12 and 24 hours compared to the control group(P > 0.01), but the difference between the two groups was not significant at 4 hours after reperfusion IL-8 concentrations of the CDl8 mAb group in the serum were significantly decreased over time compared to the control group(P > 0.05, p > 0.01). Form the above results, we concluded that blocking neutrophil adherence using CD18 mAb within the peak level of IL-8 at 4 hours after reperfusion may be a better method of reducing reperfusion injury to the island skin flap.
Abdomen ; Animals ; Anoxia ; Capillaries ; Edema ; Endothelial Cells ; Endothelium ; Hemorrhage ; Inflammation ; Interleukin-1 ; Interleukin-8* ; Ischemia ; Leukocytes ; Necrosis ; Neutrophils ; Perfusion ; Rats ; Reperfusion Injury* ; Reperfusion* ; Skin ; Thrombosis

The purpose of this study is to describe the magnetic resonance imaging (MR) findings of metastatic brain tumors with emphasis on the signal intensities of the lesion on MR. Thirty four patients with intracranial metastases were studies with MR imaging. The diagnosis was established on the basis of either brain biopsy or combination of brain MR findings and the presence of primary tumors. The primary tumors include lung cancer (n=18), breast cancer (n=3), stomach cancer (n=3), rectal cancer (n=1), renal cell carcinoma (n=1), hepatocellular carcinoma(n=1), ovarian cancer (n=1), thyroid cancer (n=1), melanoma (n=1) and unknown primary sites (n=4). The parenchymal lesions were solitary in 35% (12/34) and multiple in 65% (22/34). The size of the lesions was variable, ranging from several millimeters to 5cm in diameter. The corticomedullar junction of the cerebral heispheres was the most common location of the lesions (68%). The signal intensity of solid portion of the lesions was usually either isointense (44%) or hypointense (29%) on T1-weighted images, whereas it appeared in isointense (47%), hypointense (8%) or hyperintense (11%) on proton density-weighted or T2-weighted images. The remaining cases showed mixed signal intensities. The enhancement patterns were variable including nodular (<1cm) (6%), homogenous (19%), heterogeneous (10%), ring-like enhancement (22%) or mixed pattern(43%). The size of surrounding edema was larger than the tumor diameter in 76%. In conclusion, although there are no specific MR findings of intracranial metastasis except multiplicity, intracranial metastasis should be included in differential diagnosis with high priority, when a solitary mass showing isointensity on boty T1-and T2-weighted images with massive surrounding edema, especially in the corticomedullary junction of the cerebral hemispheres is encountered.
Biopsy ; Brain Neoplasms* ; Brain* ; Breast Neoplasms ; Carcinoma, Renal Cell ; Cerebrum ; Diagnosis ; Diagnosis, Differential ; Edema ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging ; Melanoma ; Neoplasm Metastasis ; Ovarian Neoplasms ; Protons ; Rectal Neoplasms ; Stomach Neoplasms ; Thyroid Neoplasms