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

No abstract available.
Pneumothorax* ; Thorax*

Since the term “facet syndrome” was introduced by Ghormley in 1933, arthropathy of the lumbar facet joint has long been recognized as an important source of low back pain, even sciatic pain. And facet joint injection has been helpful in the diagnosis and therapy for this facet syndrome. However, considering the possible complications such as infection, neurologic deficit and difficulty in locating the symptpmatic joint, and placebo effect, we have frequently doubted about clinical application of these procedures. This study is a retrospective review of 18 patients who got lumber facet joint injection for low back and leg pain with various previous indication that are not response to convential therapy for 2 months or more for therapeutic purpose. The response to facet joint injection was analyzed according to the entire spectrum of symptoms, physical findings, and X-ray findings. 13 or 15 patients with back pain with thigh or groin pain aggrevated by extension/rotation of trunk had successful response but patients with leg pain below the knee joint or pathology in the other structures in the spine got poor response. Strict diagnostic criteria through scoring system, provocation test, relief test and analysis of patient's signs and symptoms is needed to get higher degree of predictability and effectiveness of facet joint injection.
Back Pain ; Diagnosis ; Groin ; Humans ; Joints ; Knee Joint ; Leg ; Low Back Pain ; Neurologic Manifestations ; Pathology ; Placebo Effect ; Retrospective Studies ; Spine ; Thigh ; Zygapophyseal Joint

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.

No abstract available.
Esophageal Neoplasms*

To observe the change in the status of stresses according to three different postural angulation of an intervertebral disc with or without nucleus pulposus, 6 specimens of a 3-dimensional photoelastic model of the spine were made of epoxy. The nucleus pulposus portion was replaced with silicon in three models, and the three were made without silicon. Through axial application of a vertical compressive load of 8 kg, the peculiar patterns of the isochromatic fringes were observed. Stresses on the intervertebral disc were analyzed according to three different postural angulations of the intervertebral disc with the nucleus pulposus and without the nucleus pulposus. The results of these study are as follow: 1. In an erect neutral posture with the nucleus pulposus, the stress concentration was much increased at the posterior portion rather than at the anterior portion. Also, the high stress was concentrated at the medial and central portion. In an erect neutral posture without the nucleus pulposus, the stress concentration was much increased at the anterior portion rather than at the posterior portion and the stress distribution seemed to be locally concentrated. 2. In a maximal flexed posture, the stress concentration was much increased at the posterior portion rather than at the anterior portion. Comparing the presence of the nucleus pulposus with the absence of the nucleus pulposus, the stress concentration was lower at the anterior portion in the presence of the nucleus pulposus than in the absence of the nucleus pulposus. However, the stress distribution at the posterior portion was nearly same in the two groups. According to the analysis of the stress distribution diagram, as a whole, the stress pattern around the disc was evenly distributed. 3. In a maximal extended posture, the higher concentration of the stress distribution at the anterior and medial portion rather than in the posterior and lateral portion was observed. The stress concentration was higher in the presence of the nucleus pulposus than in the absence of the nucleus pulposus. 4. Comparing the maximal flexed posture with the erect neutral posture, the stress concentration in the flexed posture was much decreased in the posterior portion rather than in the erect neutral posture, and an even distribution of the stress pattern in the flexed posture was observed. 5. In the presence of the nucleus pulposus, at the anterior and posterior portion, the stress concentration in the flexed posture was much decreased compared with the extended posture. In the absence of the nucleus pulposus, at the anterior and posterior portion, the stress concentration in the extended posture was much decreased compared with the flexed posture.
Intervertebral Disc* ; Posture ; Silicon ; Spine

No abstract available.
Empyema*

Secondary bone grafting of the maxilla in the mixed transitional dentition stage has become a well accepted procedure in the surgical protocol for rehabilitation of patients with residual alveolar clefts. In our retrospective study we documented the excellent long term results obtained with iliac bone graft. For closure of alveolar cleft authors used combined corticocancellous bone of ilium with fibrin sealant on 54 children patients since 1994. The mean age of bone grafted patients was 6 years old. All patients were followed up from 6 to 48 months. Following exact assessment of the amount of bony defect was carried out through clinical and radiologic study including 3 demensional CT, sufficient amount of corticocancellous iliac bone onlay graft along the piriform aperture in addition to cancellous component inlay graft was carried out. Tooth eruption rate obtained from our method was 100%. In our studies, we experienced excellent results in terms of cleft closure, tooth eruption, bone incorporation and external nasal appearance.
Bone Transplantation ; Child ; Dentition, Mixed ; Fibrin Tissue Adhesive* ; Fibrin* ; Humans ; Ilium ; Inlays ; Maxilla ; Rehabilitation ; Retrospective Studies ; Tooth Eruption ; Transplants*

To evaluate the results and clinical impact of defecography in patients with anorectal diseases, 304 defecographic examinations from 304 patients were reviewed. The defecographic results were screened for the anorectal angle and perineal descent at rest, squeezing and during straining. Changes of rectal configuration and canal width during straining were reviewed. 304 patients had defecation problems such as terminal constipation, defecation defficulty, blood or mucus discharge, tenesmus, obstruction sensation etc. They were performed anorectal physical examination and anal manometry etc., and were later treated by operation and conservative management. Normal anorectal angle were measured to be 101°, 91°, 131°at rest, during squeezing and straining respectively. In the spastic pelvic floor syndrome, increase of anorectal angle less than 10 ° from rest to straining was observed. Incontinent patients had a larger anorectal angle (mean: 128°) at rest. 7.8cm of perineal descent was found in descending perineal syndrome in comparison to 4.0cm in normal. Normal anal canal width was measured 1.4cm only during straining but identified in incontinent patients at rest (mean:1.2cm). Abnormal rectal configuration was found in 254 defecographic examinations: rectoceles were observed in 235 cases and were associated with rectal prolapse in 115 cases, and rectal prolapses were found in 134 cases. In conclusion, the anorectal angle was valuable in evaluation of spastic pelvic floor syndrome and fecal incontinence. Degree of perineal descent was abnormally increased in descending perineal syndrome. In the cases of the rectoceles and rectal prolapses, defecography is helpful in preoperative evaluation of rectal wall change and postoperative follow up.
Anal Canal ; Constipation ; Defecation ; Defecography* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Manometry ; Mucus ; Muscle Spasticity ; Pelvic Floor ; Physical Examination ; Rectal Prolapse ; Rectocele ; Sensation