No abstract available.
Korea* ; Tuberculosis*

No abstract available.
Dexamethasone* ; Psychotic Disorders*

We performed tendon transfer with a microvascular free flap for recovery of handicapped function and reconstruction for the skin and soft tissue loss. We review the clinical data of 11 children who underwent these operation due to injured foot by pedestrian car accident from January, 1986 to June, l994. The mean age of patients was 5.6 years old (3-8). Five cases underwent tendon transfer and microvascular free flap simultaneously. Another 6 cases underwent operations separately. The time interval between tendon trasnfer and microvascular free flap was average 5.8 months (2-15 months). The duration between initial trauma and tendon transfer was average 9.6 months (2-21 months). The anterior tibial tendon was used in 6 cases. Among these, the technique of splitting the anterior tibial tendon was used in 5 cases. The posterior tibial tendon was used in 3 cases and the extensor digitorum longus tendon of the foot in 2 cases. Insertion sites of tendon transfer were the cuboid bone in 3 cases, the 3rd cuneiform bone in 3 cases, the 2nd cuneiform bone in I case, the base of 4th metatarsal bone in I case, and the remnant of the extensor hallucis longus in 3 cases. The duration of follow-up was average 29.9 months (12-102 months). The clinical results were analyzed by Srinivasan criteria. Nine cases were excellent and 2 cases were good. The postoperative complications were loosening of the tranferred tendon in 2 cases, plantar flexion contracture in l case, mild flat foot deformity in I case and hypertrophic scar in 2 cases. So we recommend the tendon transfer with a microvascular free flap in the case of injured foot of children combined with nerve injury and extensive loss of skin, soft tissue and tendon.
Child* ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Disabled Persons ; Flatfoot ; Follow-Up Studies ; Foot* ; Free Tissue Flaps* ; Humans ; Metatarsal Bones ; Postoperative Complications ; Skin ; Tarsal Bones ; Tendon Transfer* ; Tendons*

OBJECTIVES: To investigate the common causes of persistent septal deviation in revision septoplasty and to report the surgical techniques and results to correct them. METHODS: A total of 100 consecutive patients (86 males) who had revision septoplasty due to persistent septal deviation from 2008 and 2014 were included in the study. Their mean age was 35.6 years and the mean follow-up duration was 9.1 months. Presenting symptoms, sites of persistent septal deviation, techniques used to correct the deviation, and surgical results were reviewed. RESULTS: The mean interval between primary and revision surgery was 6.2 years. Forty-eight patients received revision septoplasty and 52 received revision septoplasty combined with rhinoplasty. Nasal obstruction was the most presenting symptom in almost all patients. The most common site of persistent septal deviation was middle septum (58%) followed by caudal septum (31%). Correcting techniques included further chondrotomy and excision of deviated portion in 76% and caudal batten graft in 39%. Rhinoscopic and endoscopic exams showed straight septum in 97% and 92 patients had subjective symptom improvement postoperatively. CONCLUSION: Middle septum and caudal septum were common sites of persistent deviation. Proper chondrotomy with excision of deviated middle septum and correction of the caudal deviation with batten graft are key maneuvers to treat persistent deviation.
Follow-Up Studies ; Humans ; Nasal Obstruction ; Rhinoplasty ; Transplants

PURPOSE: To evaluate 20% ethanol toxicity on the rabbit corneal epithelium, ethanol-treated rabbit corneas were examined with electron microscopy. METHODS: Rabbit corneas(24 eyes) were treated with 20% ethanol for 30 seconds, 1 minute, and 2 minutes by using LASEK(Laser Assisted Subepithelial Keratomileusis) instruments, and washed with sterile water. Zero time, 1, 3, 5 days after ethanol treatment, corneas were excised and examined with scanning and transmission electron microscopy. RESULTS: Widespread damage or disappearance of microvilli and local breaks of intercellular junction were observed. The changes were more severe in corneas with longer ethanol treament. In corneas with over 1 minute ethanol treatment, slough of superficial corneal epithelium was shown and increased with time. It was difficult to recognize microvilli or distinctive intercellular junction in corneas with 2 minute-treament. These pathologic changes persisted 5 days after ethanol-treatment. CONCLUSIONS: From these results, 30 seconds to 1 minute-ethanol treatment is recommended in corneal surgery to avoid severe, persisting damage of superficial corneal epithelium.
Cornea ; Epithelial Cells* ; Epithelium, Corneal ; Ethanol ; Intercellular Junctions ; Microscopy, Electron ; Microscopy, Electron, Transmission ; Microvilli ; Water

No abstract available.
Peripheral Nerves* ; Upper Extremity*

Acquired nasolacrimal duct obstruction may result from chronic infection, lacrimal stones, anatomical variations such as aberrant ethmoid cells, facial fractures, or complications following nasal surgery. In Korea, there has been no reported case of secondary nasolacrimal duct obstruction due to a retention cyst in the lacrimal sac. Recently, the authors encountered a 65-year-old female patient who presented with epiphora, was diagnosed with a lacrimal sac retention cyst, and was successfully treated with endoscopic marsupialization.

PURPOSE: We explored the possibility of DNA methylation as a mechanism of loss of type II collagen expression in dedifferentiating chondrocytes by culturing in monolayer. MATERIALS AND METHODS: Dedifferentiation was induced by low density subculturing primary porcine chondrocytes in vitro. The mRNA expression of Type I collagen, Type II collagen and DNA methyltransferase (DNMT) was measured by RT-PCR. Induction of redifferentiation in dedifferentiated chondrocytes was performed in 3-dimensional alginate bead culture system. As stimulating factors for reexpression of genes in dedifferentiated chondrocytes, 10 ng/ml TGF-beta1 and 5 micrometer 5-azacytidine were used. RESULTS: Type II collagen mRNAs was expressed strongly in freshly isolated cells but had decreased in monolayer cultured cells after 3 weeks up to 40%. In contrast, type I collagen expression was increased from 21 days and kept increasing during the 86 days of study. After treatment of 5 micrometer 5-azacytidine, fibroblast like morphology was changed to round shape such as traditional chondrocyte morphology at day 4. At day 10, type II collagen expression was increased by 5-azacytidine and TGF-beta1 marginally and also integrin beta1 expression was increased in all groups. RT-PCR analysis demonstrated that DNMT3A expression increased in dedifferentiating chondrocytes when compared with control cells for 40 days. CONCLUSION: Loss of type II collagen mRNA expression and increase of DNMT 3A expression were showed similar patterns during dedifferentiation. These results suggest that type II collagen gene expression may be influenced by DNA methylation. As stimulating factors, TGF-beta1 and 5-azacytidine have potential activity to increase the type II collagen expression in alginate culture system.
Antigens, CD29 ; Azacitidine ; Cells, Cultured ; Chondrocytes* ; Collagen Type I ; Collagen Type II* ; DNA Methylation* ; DNA* ; Fibroblasts ; Gene Expression ; RNA, Messenger ; Transforming Growth Factor beta1

PURPOSE: The purpose of this study is to evaluate the effectiveness of low-dose gabapentin for interdigital neuroma. MATERIALS AND METHODS: Between April 2000 and June 2003, 32 patients (39 feet) with interdigital neuroma were treated with using low-dose gabapentin. Two of the 32 patients were male, and thirty were female, and the average age was 47.4 years. The follow-up was 6 to 44months (mean 15.1 months). All cases were diagnosed by physical examination and ultrasonography or MRI. Low-dose gabapentin (300-600 mg) was prescribed and shoe modification was recommended. The patients were evaluated through questionnaire. RESULTS: Neuroma was found in twenty one cases at the third intermetatarsal space, and thirteen at the second intermetatarsal space. The sensitivity of ultrasonography was 96% and that of MRI was 79%. Overall satisfaction was rated as excellent or good by 18 cases (57%). Average pain relief ratio was 50.3%, and in 14 cases, more than 80% of pain relief was noted. Nine (28%) of 32 patients showed they had no activity restrictions, such as daily activities or work, whereas 8 (25%) had mild restrictions and 15 (47%) had major restrictions. Twelve of 15 patient with major restrictions had been treated operatively (neurectomy; 10 cases, decompression; 2 cases). One case had gastrointestinal problem. CONCLUSION: Low-dose gabapentin for interdigital neuroma was one of the effective conservative treatments. The operation may be preserved for patient with the persist symptoms, nevertheless the conservative treatments and use of low-dose gabapentin.
Decompression ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Neuroma* ; Physical Examination ; Shoes ; Ultrasonography

No abstract available.
Carpal Tunnel Syndrome*