No abstract available.

Many operative techniques for the repair of cleft lip nasal deformities have been reported. However, the situation with regard to nasal deformity is less satisfactorily understood than lip deformity, in which we have experienced significant improvement led by enhanced understanding of the total anatomic deformity of the primary cleft lip and the consequent refinement of surgical techniques. Our purposes in tip plasty are the restoration of nasal tip symmetry and correction of the obtuse angle of the cleft side nostril. Additionally, an inconspicuous scar is one of the merits of our method. The alar cartilage war exposed through both the alar rim and transcolumella incision, and then interalar loose connective tissue based superiorly was dissected and elevated. Cleft side alar cartilage was cross-hatched(Lipsett technique) on the deformed dome and relocated superomedially by a 4-0 vicryl fixation suture. The elevated intera1ar loose areolar tissue was used for augmentation of the alar dome. Conchal cartilage graft on cleft side dome and septoplasty were carried out in cases of specific necessity. We have performed this procedure in 19 patients, aged between 15 to 19. Average follow-up period was one year. Results have been rated good to excellent by patients and surgeons. There has been no recurrence of this deformity.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Connective Tissue ; Follow-Up Studies ; Humans ; Lip ; Polyglactin 910 ; Recurrence ; Sutures ; Transplants

Arteriovenous malformation of the pancreas is a rare disease, and it is manifested by gastrointestinal bleeding and/or portal hypertension. Surgery is definitely the treatment of choice at the early stage of the disease, and a transcatheter embolization is an alternative treatment for the control of bleeding and if the lesion is surgically inaccessible. We describe a 62-year-old man who had refractory ascites and esophageal variceal bleeding caused by a pancreatic arteriovenous malformation associated with portal hypertension; this was successfully treated by a transjugular intrahepatic portosytemic shunt.
Arteriovenous Malformations* ; Ascites ; Esophageal and Gastric Varices ; Hemorrhage ; Humans ; Hypertension, Portal* ; Middle Aged ; Pancreas ; Portasystemic Shunt, Surgical* ; Rare Diseases

No abstract available.
Thoracic Surgery, Video-Assisted*

No abstract available.
Pneumothorax* ; Thorax*

The aim in arthrodesis of ankle is to gain a painless, normal walking gait of destroyed ankle joint caused by various origins. Despite more than 30 different fusion techniques have been described in the literature, but the results were not always satisfactory. Blair introduced tibial sliding graft, rectangular hone block donated at distal tibia, to the neck of talus. His method has advantages of a normal apperance of the foot, no shortening, and the weight bearing thrust on normal tissue. The purpose of this study was to compare the ankle arthrodesis according to surgical procedures & introduce the method which could produce excellent results for ankle arthrodesis. We reviewed 23 patients(24 cases) undergone ankle arthrodesis from Jan. 1989 to Dec. 1996 in Kyung Hee Medical Center. Male were twelve(13 cases) and female were eleven. Mean age was 42.6(l8-75)years. The Blair fusion method was used in ten cases. Iliac bone graft followed by internal fixation using Steinmann pin in 4 cases, using cancellous screw in I case, and using both Steinmann pin and staple in 1 case, while tibiotalar coaptation without bone graft followed by internal fixation using Steinmann pin in 3 cases, using staple in 1 case, and using cancellous screw in 1 case. In 3 cases, arthroscopic abrasion and cancellous screw was used. The mean duration of follow-up was 46(6-99) inonths. Time to union was average l4.6(8-23) weeks in Blair fusion and 17.5(8-40) weeks in other methods. Delayed union was observed in three cases, but no case was found in Blair fusion. Pain was ohserved in 5 cases, 3 in Blair fusion and 2 in other methods. Nonunion or pseudoarthrosis was not ohserved. On the clinical criteria for Boston Childrens Hospital ankle-scoring system, we ohserved nineteen excellent and five good cases. The difference in results according to fusion method was not ohserved. The results in tibiopedal motion using cineroentgenography were seven good and three fair cases in Blair, while two good, ten fair and two poor in other methods. By using Blair fusion, we expect early bony union and better clinical results.
Ankle Joint ; Ankle* ; Arthrodesis* ; Child ; Female ; Follow-Up Studies ; Foot ; Gait ; Humans ; Male ; Neck ; Pseudarthrosis ; Talus ; Tibia ; Transplants ; Walking ; Weight-Bearing

To observe the change in the status of stresses according to size of the meniscus, a 3-dimensional photoelasticity model of the knee joint was made of epoxy. Three kinds of meniscus models were made of rubber. Through the axial application of a vertical compressive load of 8kg equivalent to the joint reaction of 3,000N in the human knee joint, the peculiar patterns of the isochromatic fringes were observed and stresses around the knee joint were analyzed according to the size of the defect in the medial meniscus. Even distribution of the photoelasticity fringe patterns were observed in the normal knee joint model with both menisci intact. Stress concentration was increased at the margin of the medial side of the knee joint model with the medial menicus removed partially in about 30-50% of its central portion. In addition, the magnitude of stresses were also noted as increased in the lateral part of this type model. In the knee joint model with nearly all of the medial meniscus removed, strssess were concentrated markedly in the central portion of the knee joint just outside of both tibial spines. Stress was increased in its magnitude according to the size of the defect of the meniscus, and was focalized after menisectomy. In the model for partial menisectomy, the maximum stress concentration point of the removed side migrated to the margin of the same side of the joint. But in the model of total menisectomy, maximum stress concentration points of both side were more centralized. Not only an increment of stresses in magnitude but also centralization of the maximum stress concentration point in its location could contribute to the degenerative process of the knee joint after menisectomy. In addition, articular cartilage can be easily damaged with a relatively small amount of external force.
Cartilage, Articular ; Humans ; Joints ; Knee ; Knee Joint ; Menisci, Tibial ; Rubber ; Spine

Epidemilologic information about various syndromes in low back pain has been regarded by Vert Mooney as one of the important sources for establishing prognosis and providing a rationale for therapy. Several risk factors about low back pain and injuries were analyzed through a questionnaire filled out by 172 athletes of various kind of sports including students and professional players. The following results were obtained. 1. Types of sports were associated with the incidence of low back injuries and gymnastics were included in high risk groups (p<0.01). 2. Career is also associated with the incidence of low back injuries (p<0.05). 3. Pain pattern, such as anterior element pain or posterior element pain is also associated with the particular type of sport(p<0.001). 4. Over-use has been suspected as a main cause of sports injury in 37.8% of athletes. Neglect of warming-up, psychologic attitudes and chronic accumulation of micro-trauma have been also suspected (p<0.001). 5. Management of pain was expected to be received from physiotherapists by 34.2%, from coaches or fellow sportsmen by 24.6%, from an acupuncturist by 17.5%, from doctors by 9.7%, and from trainers by 14% of athletes. However 66.7% of the professional players wanted to receive management of pain from trainers (p<0.001).
Athletes ; Athletic Injuries ; Back Injuries ; Epidemiologic Studies ; Gymnastics ; Humans ; Incidence ; Low Back Pain ; Physical Therapists ; Prognosis ; Risk Factors ; Sports

To assess the influence of diabetes mellitus on the healing of segmental defect of rat, a defect measuring 5mm was made at right sciatic nerve in thirty-three adult female Wistar rats(control group:17, diabetic group:16). To induce diabetes in rats, Streptozotocin(50mg/kg body weight) was injected into tail vein after dissolution in saline solution. Both proximal and distal nerve ends were connected with 9mm long silicone tube, and the tube was filled with 10µl collagen(Vitrogen 100) solution. Two and 4 weeks after the operation, electromyographic study(latency period and amplitude) and histologic examination(the number of myelinated axon, non-neuronal cell, and vessel at mid-chamber level, the mid-chamber cross-sectional area) after toluidine blue staining were carried out. From the results, we concluded that diabetes mellitus retarded the healing process of segmental defect of sciatic nerve in rat. And we might suggest that if we meet this situation in clinical practice, we have to consider some supportive measures to overcome the bad effect of diabetes mellitus on the healing of nerve defect.
Adult ; Animals ; Axons ; Diabetes Mellitus ; Female ; Humans ; Myelin Sheath ; Rats ; Sciatic Nerve ; Silicon ; Silicones ; Sodium Chloride ; Tail ; Tolonium Chloride ; Veins

No abstract available.
Emphysema*