No abstract available.
Paraffin* ; Silicones*

No abstract available.
Hemangioma* ; Ligation*

In 1999 Kayikcioglu and his colleagues invented the oblique nerve coaptation technique which increases coaptation surface and proved that their technique is superior to conventional vertical coaptation technique. This method is useful but it is not fit for a clinical application because the sciatic nerve was cut obliquely and repaired immediately in their experiment. In that case, we couldn't exclude the possibility of the improved effect by increased orientation of nerve fiber. Using different nerves we could exclude the effect by orientation improvement and prove the superiority of the oblique nerve coaptation technique in functional restoration. Ten Sprague-Dawley rats were used. The tibial nerve and the peroneal nerve were cut randomly to 30 degree and 90 degree on each side. The distal stump of the tibial nerve and the proximal stump of the peroneal nerve were repaired with 10-0 nylon under microscopic view. 12 weeks after nerve coaptation, nerve conduction velocity of extensor digitorum longus muscle, moist weight and histological analysis of extensor digitorum longus muscle, and myelinated axonal count and histological analysis of peroneal nerve were investigated. The results showed the nerves of oblique coaptation(30 degree transection angle) group are more regenerated than those of vertical coaptation(90 degree transection angle) group and nerve conduction velocity and moist weight of extensor digitorum longus muscle are also increased in oblique coaptation group. From these results we came to a conclusion that the oblique nerve coaptation technique is superior to the conventional technique and may be helpful in innervated free flap or nerve graft.
Axons ; Free Tissue Flaps ; Myelin Sheath ; Nerve Fibers ; Neural Conduction ; Nylons ; Peroneal Nerve ; Rats, Sprague-Dawley ; Sciatic Nerve ; Tibial Nerve ; Transplants

Transverse rectus abdominis musculocutaneous (TRAM) flap is one of the best flap in breast reconstruction. Even though many trials have been attempted to increase the rate of the flap survival, the necrosis of distal flap area due to vascular compromise is troublesome. The aim of this study was to evaluate the effect of prostaglandin E1(PGE1), surgical delay and the combined procedure on TRAM flap survival rate in vascular compromised rat by diabetes. Left inferior epigastric vessel pedicled TRAM flaps(5.0 x 2.5 cm) were elevated in 40 Sprague-Dawley rats. In control group(N=10), there was no procedure before the flap elevation. In surgical delay group(N=10), the left superior epigastric vessels and the contralateral rectus perforators were ligated 2 weeks before the flap elevation. In PGE1 injection group(N=10), PGE1(0.5microgram) was given intraperitoneally for 2 weeks before the flap elevation daily. In combined procedure group(N=10), the same surgical delay and injection of PGE1 were done simultaneously. On the seventh postoperative day, we evaluated and compared the flap survival rates, the vessel distribution status through Microfil casts, the vessel area rates by histomorphometric analysis in each group. The results were as follows 1) The mean percentages of surviving flap areas of surgical delay group(73.41+/- 10.43%), PGE1 injection group(68.95 +/- 7.13%) and combined procedure group(79.39 +/- 13.44%) were greater than that of control group(44.85 +/- 18.08%) with a statistical significance(p< 0.05). 2) The vessel distributions of each procedure group were more abundant than those of control group in Microfil casts. 3) The mean percentages of vessel areas of surgical delay group(2.74 +/- 0.23%), PGE1 injection group(2.58 +/- 0.49%) and combined procedure group(3.15+/- 0.25) were greater than that of control group(1.24 +/- 0.40%) with a statistical significance(p< 0.05). The results indicated that PGE1 injection or surgical delay procedure could be used to increase the TRAM flap survival area in diabetic condition and the effect of PGE1 was comparable to that of surgical delay procedure. But, the synergistic effect of surgical delay and PGE1 injection was not observed statistically.
Alprostadil* ; Animals ; Female ; Mammaplasty ; Myocutaneous Flap* ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; Rectus Abdominis* ; Silicone Elastomers ; Survival Rate

MRSA strains cause serious nosocomial infections. The rate of MRSA among Staphylococcus aureus isolated in Korea is about 70 - 80%. The treatment for MRSA infection is vancomycin. But vancomycin has several side effects and its therapeutic rate is 60 - 75%. Therefore the disinfectants play an important role in preventing and treating MRSA infection. In this study, 44 MRSA isolates were obtained from Wonkwang University Hospital, and examined for the efficacy of disinfectants commonly used in hospital. The tested disinfectants were chlorohexidine (Hibitan(R)), H2O2, tego, Gentian Violet, potadine, chlorohexidine gluconate (Microshield(R)), boric acid, alcohol, zepanon, acetic acid, and combinations of these disinfectants. MRSA studied were killed after exposure to chlorohexidine gluconate (Microshield (R)), alcohol, zepanon, alcohol+potadine, and alcohol+Gentian Violet within 30 seconds. But, tego, boric acid, and Gentian Violet+acetic acid could not kill MRSA after 30 minutes. Agar dilution minimal inhibitory concentration test was done with cephalothin, ciprofloxacin, clindamycin, erythromycin, fusidic acid, gentamicin, mupirocin, oxacillin, penicillin G, rifampin, tetracycline, and vancomycin. We found that bactericidal activity of vancomycin, fusidic acid, and mupirocin were good. In conclusion, this study provided useful information: 75% alcohol is the best disinfectant for wound dressing, 4% chlorohexidine gluconate(Microshield(R)) is useful for hand washing, and zepanon is useful for ward cleansing. Vancomycin-resistant Staphylococcus aureus was not found in our study.
Acetic Acid ; Agar ; Anti-Bacterial Agents* ; Bandages ; Cephalothin ; Ciprofloxacin ; Clindamycin ; Cross Infection ; Disinfectants* ; Erythromycin ; Fusidic Acid ; Gentamicins ; Gentian Violet ; Gentiana ; Hand Disinfection ; Korea ; Methicillin-Resistant Staphylococcus aureus* ; Mupirocin ; Oxacillin ; Penicillin G ; Rifampin ; Staphylococcus aureus ; Tetracycline ; Vancomycin ; Viola ; Wounds and Injuries

Reconstruction of a finger-pulp defect is one of the most difficult procedures. The reasons are that the identical donor tissue is not easy to obtain and the reducing the donor site morbidity is not easy to achieve. Particularly, reconstruction of multiple digit pulp defect is more difficult. We propose toe partial pulp free flaps for the replacement of defects of multiple fingertip. It can provide identical color matching to donor defect, and cut down the morbidity of donor site. The 33 digits of 15 patients were treated with this method. The donor sites were medial aspect of the second toe or third toe and lateral aspect of big toe. The neurovascular pedicles were composed of medial plantar digital artery, medial plantar digital nerve, and superficial plantar vein of the second toe, third toe or big toe. All flaps were survived. The average of static two-point discrimination was 5.9 mm. Primary closure of donor sites was possible in all cases. Toe partial pulp free flaps has many advantages in multiple digit reconstruction. It can provide excellent color and texture matching, excellent sensory recovery. It avoids long term immobilization. Vascular anatomy was so consistent that vessels were easily dissected. Primary closure of donor site was possible. However, there were some restrictions. The flap could not be applied to a large defect, and to patients with vascular disease and old age. It also required skillful technique in anastomosis of pedicle. In conclusion, we consider that toe partial-pulp free flaps are useful method to reconstruct the defects of multiple fingertips.
Arteries ; Discrimination (Psychology) ; Free Tissue Flaps* ; Humans ; Immobilization ; Tissue Donors ; Toes* ; Vascular Diseases ; Veins

The purpose of this study was to analyze the fate of intercalated bone graft and the satisfaction of patients with brachymetatarsia of the 4th toe on the clinical results after one-stage lengthening with autogenous iliac bone graft. In last 6 years, 30 feet in 17 patients with brachymetatarsia were corrected with one-stage operation that was composed of Z-plasty of skin, extensor tendon and intercalated iliac bone graft, which appeared as ball-and- socket figure at the metatarsophalangeal joint. The length of harvested iliac bone graft was 18 mm in average(14 -23 mm) and there was bone resorption about 1.1 mm(0.1- 3.0), (7.1%) postoperatively. Postoperative digital fluoroscopy showed 83%(25/30) new joint(pseudojoint) formation of intercalated iliac bone grafts between proximal phalangeal bone and metatarsal bone. The objective functional evaluation with AOFAS scale was 89.4 in average(80 - 100) and subjective satisfaction on the aesthetic aspect was also high. There was no neurovascular impairment nor recurrence of brachymetatarsia even after one-stage lengthening with intercalated iliac bone graft.
Bone Resorption ; Fluoroscopy ; Foot ; Humans ; Metatarsal Bones ; Metatarsophalangeal Joint ; Recurrence ; Skin ; Tendons ; Toes ; Transplants*

In Asian double eyelid surgery, there have been two approaches to form a suprapalpebral fold: the buried suture (nonincision) method and the full external incision method. Usually excessive fat tissue in upper eyelid has been removed by using a full external incision method, or 2 to 3 partial incisions with buried suture method. The full external incision method is more invasive than the buried suture method, which is not suitable for patients with excessive orbital fat. From March 1999 to January 2002, we have introduced the single 5 mm-partial incision method to 216 patients. This method is applied to patients who have excessive amount of orbital fat or those who do not have excessive orbital fat but which must be removed for better result. These patients have bulging supra-crease areas when we form suprapalpebral folds with a curved wire loop preoperatively. Excessive orbital fat was removed through a single 5 mm incision in the middle of designed eyelid crease and tarso-dermal suture was performed. At another 2 to 3 points, through skin stab punctures by using 18 gauge needle, full-thickness eyelid tarso-dermal sutures were done. Pretarsal and preseptal orbicularis muscles were preserved. If muscles were removed, that could result in thinning of the overlying skin and could make suprapalpebral fold unnatural. This method has several advantages. First, we could perform the operations safely in patients who have excessive fat tissue, without a full external incision. Second,fat tissue can be removed almost totally by a single 5 mm-partial incision. Third, we can minimize the scar formation, and the possibility of complications, and make healing process and operation time shorter compared to the full incision technique. However a very delicate technique is required in this method. In patients who have a thick orbital septum, a superiorly located fat pad, and a bleeding tendency, exposure of fat tissue could be difficult and injury of levator muscle aponeurosis is possible. The complications of this method are the possibility of disappearing of the crease with the lapse of time(3 percents), and suture granuloma formation(less than 1 percent). In conclusion, patients who have excessive fat tissue in upper eyelid don't have to proceed a full incision, and can have more excellent results with this single 5 mm-partial incision method.
Adipose Tissue ; Asian Continental Ancestry Group ; Cicatrix ; Eyelids* ; Granuloma ; Hemorrhage ; Humans ; Muscles ; Needles ; Orbit ; Punctures ; Skin ; Sutures

The formation of pretarsal fold without modification of the medial canthal folds may produce eyes with rounder and narrower palpebral fissures. In the last 6 years, the authors performed double eyelidplasty in 16 patients with Oriental eyelids and type III medial epicanthal fold. In 9 patients, simple double eyelidplasty was performed and in 7 patients double eyelidplasty combined with Z-epicanthoplasty were performed. The aesthetic and functional outcomes, and overall patient satisfaction were followed up in 15 patients up to 5 years. In group of double eyelidplasty only, results were equivalent to Good selectively in only 4 patients who had relatively long preoperative palpebral fissure. The epifolds were sustaining in all patients. Remaining patients showed Fair or Poor results. In group of double eyelidplasty combined with Z-epicanthoplasty, all patients showed Good or Excellent results except one who had defective scar maturation. To achieve apparent aesthetic enhancement and beautiful looking eyes with lengthy palpebral fissure in patients with Type III or IV medial canthal epifold, epicanthoplasty should be combined with double eyelidplasty. It achieves apparent aesthetic enhancement by eliminating the medial epicanthal fold and opening the lacrimal lake widely leaving minimal scar and natural supratarsal skin fold line in a single stage operation.
Cicatrix ; Eyelids ; Humans ; Lakes ; Patient Satisfaction ; Skin

Cleft of the lip and palate is one of the most common congenital anomalies. Considerable epidemiologic work has been done in different parts of the world. The predisposing cause of these anomalies are multifactorial. Heredity, environment, nutrition and infection have been reported to be the predisposing cause. The aim of this study is to examine clinical aspect of cleft lip and palate by investigating nine items such as incidence, type of cleft, associated anomaly and familial history in last 10 years. From 1991 to 2000, clinical analysis of patients with cleft lip and palate was carried out in Dong-A university hospital. Eight hundred ninety-five patients were operated during that period and we investigated clinical aspect through chart review retrospectively. The result of clinical analysis were as follows. Of the 895 patients, 24% had cleft lip only, 44% had cleft lip and palate and 32% had cleft palate only. In cases of cleft lip with or without cleft palate, the most commonly affected side was the left(55%). Cleft lip and cleft lip with palate were more frequent in the male patients, while cleft palate were more frequent in the female patients. Associated anomalies were present in 8.5% of cases. A positive familial history was found in 5% of cases. 75 of 895 mothers(8.4%) had a history of disease and 98 of 895 mothers(11%) had a history of taking drugs during the first trimester. The significant percentage of patients(48%) was the first baby. Maternal age of affected children was most frequently in the range of 25 to 29. The operation was performed most frequently while the baby was 3 to 5 months old in cleft lip patients and 6 months to 1 year old in cleft palate.
Child ; Cleft Lip* ; Cleft Palate ; Female ; Heredity ; Humans ; Incidence ; Infant ; Lip ; Male ; Maternal Age ; Palate* ; Pregnancy ; Pregnancy Trimester, First ; Retrospective Studies