No abstract available.

For many years, healing membranous bone fractures have been known to show a persistent lucency at the fracture interface. Radiographic follow-up has proven to be of little value as a guideline for healing of mandibular fractures. Recently, a fracture has been treated by rigid internal fixation by metallic plate and screws rather than closed reduction and wire fixation, we expected that some difference in the radiographic features of fracture healing. To investigate these questions we undertook a retrospective radiographic and clinical analysis of 33 followed patients with fractures of the body and angle of the mandible from 1993 to 1997. There were 26 male and 7 female patients ranging in age between 5 and 74 years, with an average of 29.7 years. All patients were managed by open reduction with metallic plates and screws. The length of follow-up ranged from 9 to 187 weeks. Total 81 radiographic follow-up films were obtained and divided into 3 grades according to the degree of radiolucency of fracture lines; grade 0 radiolucent fracture line and no evidence of fracture interface calcification, grade 1 decreased radiolucent area and evidence of fracture interface calcification, and grade 2 disappearance of fracture line.Until follow-up of 8 weeks, all of the radiographs showed grade 0. From 8 weeks to 16 weeks, 62.5 percent showed grade 0 and 37.5 percent showed grade 1. From 16 weeks to 48 weeks, 38.5 percent showed grade 1 and 61.5 percent showed grade 2. After follow-up of 48 weeks, all showed grade 2.In this study we have shown that the radiographic disappearance of mandibular fracture lines was usually accomplished by 48 weeks. We feel that radiographic union of the mandible is lagging well behind clinical union, but disapperance of the fracture line in rigidly fixated mandibular fracture was occurred earlier than healed by fibrous union. We propose that radiographic union of the mandible by approximately 1 year can be a guideline for the normal mandibular bone healing.
Female ; Follow-Up Studies* ; Fracture Healing ; Fractures, Bone ; Humans ; Male ; Mandible ; Mandibular Fractures* ; Retrospective Studies

Despite continually improving results of total hip arthroplasty, infection remains the major debilitating complication. The treatments of infected total hip arthroplasty were variable. but initially we removed infected implants and inserted antibiotic containing cemented spacer so called PRSTALAC to prevent scar contracture and disuse osteoporosis. After 6 weeks later, control of infection was clinically and radiologically determined, we inserted new prosthesis with cement. Three weeks postoperatively, patient began touch down standing exercise. We observed infected total hip patient in whom hip had been salvaged successfuily with twostage implantation using so called "" PROSTALAC "" which was made with Moore stem.
Arthroplasty, Replacement, Hip* ; Cicatrix ; Contracture ; Hip ; Humans ; Osteoporosis ; Prostheses and Implants ; Replantation*

To evaluate the effectiveness of intrauterine insemination (IUI) in the treatment of infertility, timed-intercourse and intrauterine insemination by husband in stimulated cycles with clomiphene citrate and gonadotropins were compared in a total of 105 cycles. Patients received 100 mg of clomiphene citrate daily for 5 days starting on day 3 of the menstrual cycle followed by hMG or FSH. Doses of exogenous gonadotropins were adjusted by the follicular development and concentrations of serum estradiol (E2). More than 3 follicles reaching >16 mm were present in the ovary, 5,000 IU of hCG was administered intramusculary. Patients received a maximum of three intercourse or IUI cycles for the treatment. Severe male (<10x106 motile sperm) or age factor (>39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. The overall clinical pregnancy rates were 17.1% per cycle (18/105) and 21.2% per patient (18/85). The pregnancy rates (per cycle) were 17.5% (l1/63) in intercourse and 16.7% (7/42) in IUI groups, respectively. IUI had no significant improvement in pregnancy rate compared with timed-intercourse. The multiple pregnancy rates were 11.1% (1 twin and 1 triplet). No patient developed ovarian hyperstimulation. Abortion rate was 28.6% (2/7) in IUI group only. The delivery and ongoing pregnancy rates were 15.2% per cycle (16/105) and 18.8% per patient (16/85). There were no differences in age, duration of infertility, follicle size and level of estradiol (E2) on the day of hCG injection in pregnant and non-pregnant groups. However, total doses of gonadotropins were higher in pregnant group than in non-pregnant group (p<0.01). Pregnancy rate was not affected by ovulatory status at the time of insemination. These results indicate that well timed-intercourse in stimulated cycles is as effective as IUI for infertile couples.
Abortion, Induced ; Age Factors ; Clomiphene* ; Estradiol ; Family Characteristics ; Female ; Gestational Sac ; Gonadotropins* ; Humans ; Infertility ; Insemination* ; Male ; Menstrual Cycle ; Ovary ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Multiple ; Spouses ; Ultrasonography

Frontometaphyseal dysplasia is an uncommon genetic syndrome affecting bone and connective tissue. This condition is characterized by the prominence of supraorbital ridges, hyperostosis of the skull, mandibular hypoplasia and malocclusion with antegonial notching, underdeveloped paranasal flaring of the long bone, and a widened iliac wing. Frontometaphyseal dysplasia has an X-linked dominant trait. Clinical manifestations are more severe in males and have extreme variability in females. We present an 11-year-old boy who had frontometaphyseal dysplasia with disfigured face due to bilaterally urinary tract malformation and chronic urinary tract infection. To improve facial appearance, his prominent supraorbital ridges were contoured by ostectomy and burring through bicoronal incision. Urologic operation was performed simultaneously. Histologically, resected bony specimen revealed bony tissue with normal trabecular pattern suggesting exostotic bone. The patient healed without any postoperative complications and he and his parents were satisfied with his final facial morphology.
Child ; Connective Tissue ; Female ; Humans ; Hyperostosis ; Male ; Malocclusion ; Parents ; Postoperative Complications ; Skull ; Urinary Tract ; Urinary Tract Infections

Restoration of anteroposterior projection of the zygomatic body and facial width are key elements in treatment of complex zygomatic fractures. Traditionally, it has been understood that for most fractures of the zygoma, three-point fixation of the zygomaticofrontal suture, inferior orbital rim, and zygomaticomaxillary buttress generally produces exact structural restoration. Recently, the importance of accurate reduction of the zygomatic arch through coronal incision has been favored in complex zygomatic fractures. Though coronal incision has the advantages of accurate reduction and fixation as a result of extensive exposure of the fractured area, this procedure also has many disadvantages including injury to the facial nerve, paresthesia, alopecia, scar formation, longer operating time, protracted hospitalization, etc. As well, there have been no objective data to prove the fact that four-point fixation through coronal incision is superior to traditional three-point fixation. From May, 1994 to December, 1998, the authors treated 45 patients by traditional three-point (n=20) and coronal four-point fixation (n=25) with random sampling. To assess the difference between the two methods the authors measured the axial angle of the zygoma, the axial angle of the zygomatic arch, and the degree of zygomatic arch inclination on submentovertex X-ray, and then analyzed the measurements by the paired T-test(p < 0.05). As a result, the axial angle of the zygoma and zygomatic arch assessed by anteroposterior projection, as well as the facial width showed no statistical difference between the two groups, respectively(p = 0.26, p = 0.18). Mean while, the degree of zygomatic arch inclination representing the local contour of the fractured zygomatic arch was statistically significant between the two groups(p < 0.05). Thus, the traditional three-point fixation method may be widely acceptable in treatment of complex zygomatic fractures with anterior three-point or zygomatic arch comminution.
Alopecia ; Cicatrix ; Facial Nerve ; Hospitalization ; Humans ; Orbit ; Paresthesia ; Sutures ; Zygoma ; Zygomatic Fractures

The effectiveness of intrauterine insemination (IUI) combined with controlled ovarian hyperstimulation (COH) in the treatment of infertility with various etiologies was compared in a total of 152 cycles. Patients received a maximum of three IUI cycles for the treatment. Severe male (<2 x 10(6)motile sperm) or age facto. (> 39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac was seen on ultrasound. The overall clinical pregnancy rate was 7.9% per cycle (12/152) and 9.7% per patient (12/124). The pregnancy rates were 0% in unstimulated natural (0/l8), 7.5% in CC (3/40), 8.2% in CC+hMG (4/49), 5.9% in GnRH-a ultrashort (1/17), 5.9% in GnRH-a long (1/17) and 27.3% in dual suppression cycles (3/11), respectively. The pregnancy rate was higher in dual suppression cycle than other stimulated cycles, but this was not significant. The multiple pregnancy rates were 25.0% (2 twins and 1 triplet). No patient developed ovarian hyperstimulation. Abortion rates were 66.7% in CC (2/3) and 100% in ultrashort cycles (1/1). The livebirth rate was 5.9% per cycle (9/152) and 7.3% per patient (9/124). There were no differences in age, duration of infertility, follicle size, total ampules of gonadotropins and days of stimulation between pregnant and non-pregnant groups. However, significant(P<0.05) differences were observed in the level of estradiol (E2) on the day of hCG injection (3,266.6+/-214.2 vs 2,202.7+/-139.4 pg/ml) and total motile sperm count (212.1+/-63.4 vs 105.1+/-9.9 x 10(6)) between pregnant group and non-pregnant group. These results suggest that lUl combined with successful ovarian stimulation tends to improve the chance of pregnancy as compared to lUl without COH and a total motile sperm count may be considered predictive of the success for pregnancy.
Abortion, Induced ; Estradiol ; Female ; Gestational Sac ; Gonadotropins ; Humans ; Infertility ; Insemination* ; Male ; Ovulation Induction ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Multiple ; Sperm Count ; Twins ; Ultrasonography

Adhesion formed between tendon and its sheath after repair often impairs functional recovery. There have been many attempts to reduce adhesion around a repaired tendon, but most results have been unsatisfactory or impractical in clinical application. Moreover, most attempts were focused on extrinsic tendon healing. whereas studies on the intrinsic tendon healing are sacrce in the literature. We have previously reported that fibrotic tendon adhesion after repair was decreased by decorin, a natural inhibitor of TGF-beta. Accordingly, the serial tensile strength was measured after complete tensection and repair of the tendon severance in order to confirm the effect of decorin inhibition of intrinsic healing capability. Forty White Leghorn chickens were subject to complete transection and repair of the third toe flexor digitorum profundus tendon in Zone II. In the experimental group, 0.5ml of diluted decorin(50microgram/ml) was injected around the repaired site, and the same volume of saline solution in the control group. Tendons were harvested at 1, 3, 5 and 7 weeks. The disrupting force of the repair site was analyzed using tensiometry(LLOYD LR 30K, U.K). The tensile strength of repaired tendon was similar in both groups for all postoperative periods. This indicates that intrinsic healing proceeds normally within the decorin group in spite of the blockade of TGF-betaactivity. Decorin, a natural inhibitor of TGF-beta, showed a significant inhibitory effect on reducing post-repair tendon adhesions, without disruption of intrinsic healing in the chicken flexor tendon injury model. Therefore, decorin is expected to be a useful agent for preventnion on tendon adhesion after the repair in clinical usage.
Chickens ; Decorin* ; Postoperative Period ; Sodium Chloride ; Tendon Injuries ; Tendons* ; Tensile Strength* ; Toes ; Transforming Growth Factor beta

Major concerns in cleft palate repair are improved speech results and adequate maxillary growth. In these respects, Furlow's double reversing Z-plasty which requires minimal hard palatal dissection and redirects palatal muscles to produce an overlapping muscle sling is theoretically optimal method to close the cleft palate. However, it often requires backcut around the maxillary tubercle even dissection around the pedicle on oral mucosal Z-plasty flap. Raw surface heals secondarily but leads to scarring within the soft palate. In the current study, IIpatients all had incomplete cleft palate and were operated double reversing Z-palatoplasty using intraoperative rapid mucosal expansion (IRME), from November, 1996 till July, 1997. With the IRME, we reduced the incidence of backcut or dissection on the oral mucosal flap. Only three patients need small backcut incision and two of these were closed primarily with V-Y fashion. To examine the histologic changes and expansion rate with the IRME, same procedures were performed to palatal mucosa of three cats. Expanded mucosal size was increased to 33.3% and histologically, change of mucosal architecture was not found except capillary dilatation. As a result, intraoperative mucosal expansion offers sufficient mucosal size, reduce incidence of backcut, therefore minimizes palatal scar formation. Balanced maxillofacial growth and normal occlusion are expected with this procedure.
Animals ; Capillaries ; Cats ; Cicatrix ; Cleft Palate ; Dilatation ; Humans ; Incidence ; Mucous Membrane ; Palatal Muscles ; Palate, Soft

No abstract available.
Drug Therapy, Combination* ; Ulcer*