Primary treatment of cleft palate should result in an intact palate with separation of the oral and nasal cavities. However, the published reports of large series indicate that palatal fistula present in operated cleft palate of a small but significant groups of patients. Even in the best hands, a palatal fistula of the operated cleft palate may reoccur postoperatively. Various methods of repair including local mucosal flaps have been employed to date, but fistula repair is extremely difficult because the operative field is limited by scar formation around the palatal fistula, making wound healing unsatisfactory. In such cases, a tongue flap is commonly indicated. From May of 1991 to May of 1996, among 19 patients with palatal fistula in operated cleft palate, 11 patients were operated by anteriorly-based tongue flap. All patients were followed up for at least 6 months, with mean follow up of 18 months. Among 12 cases of 11 patients included in this study, 11 flaps survived and did not recur during follow up periods. One complication was seen in the first case. In this case, there was a flap detachment from the recipient site on the 3rd postoperative day, but he was treated successfully at a subsequent operation. There have been no problems with feeding and communication until the pedicle is cut, and no patient experienced problems either with alteration in speech or with disturbance of taste sensation following surgery. In conclusion, this study shows that the anteriorly-based tongue flap is a safe and reliable technique for closure of large palatal fistula.
Cicatrix ; Cleft Palate ; Fistula* ; Follow-Up Studies ; Hand ; Humans ; Nasal Cavity ; Palate ; Sensation ; Tongue* ; Wound Healing

The microform cleft lip is the mildest expression of cleft lip and nose deformity, but it has no specific definition, classification, and few methods have been reported for its correction. It is characterized by deformity of the nostril, skin striae of the upper lip, notching of peaked Cupid's bow, deformity of the vermilion, and anomaly of the upper lateral incisior and alveolar ridge on the affected region. Sixty-three microform cleft lip patients were operated on between Dec. 1993 and Sep. 1998 in our department(29 males and 34 females). The age of the patients ranged from 5 months to 30 years(Mean 9 years). We classified and treated the microform cleft lip as follows: Class I: Cleft lip nose with very slight lip deformity Class II: Minimal lip deformity without vermilion notching Class III: Mild lip deformity with slight vermilion notching. The goals in the correction of a microform cleft lip are to obtain an esthetically pleasing upper lip and nose, and to reestablish muscle continuity for improved function. To attain these goals, we used the above classification and satisfactory results were obtained by treating the microform cleft according to the classification.
Alveolar Process ; Classification* ; Cleft Lip* ; Congenital Abnormalities ; Humans ; Lip ; Male ; Microfilming* ; Nose ; Skin

BACKGROUND: Transforming growth factor (TGF)- has a large variety of biological functions, including the modulation of inflammation and the immune system, and is presumed to play important roles in repairing wounds and reducing scarring. The objective of this study is to examine the effects of TGF-1 on healing wounds and reducing scarring. We have also analysed the ability of the hemagglutinating virus of Japan (HVJ) liposome mediated antisense oligodeoxynucleotides (ODNs) to specifically inhibit wound-induced expressions of TGF-1 proteins and mRNA in the rat skin. METHODS: Skin wounds were created on the backs of 80 anesthetized rats. The first group of wounds, as the controls, was unmanipulated. The second group of wounds, as positive controls or an excessive scarring model, was injected with TGF-1 subcutaneously. The third group of wounds was injected with anti-TGF-1 antibody subcutaneously. The fourth group of wounds was injected with HVJ liposome mediated antisense ODNs for TGF-1 subcutaneously. The wounds of all groups were bisected and analysed histologically 5, 10, 15, 30, and 50 days after the wounds were made. RESULTS: All control wounds (TGF-1 or no injection) healed with scarring, whereas the wounds treated with the antibody or antisense ODNs healed with less scar formation compared to the control group. The wounds treated with the antibody or antisense ODNs had fewer macrophages, less collagen and fibronectin contents than the other wounds. Northern blotting and in situ hybridization analysis showed that wound sites treated with HVJ liposome mediated antisense ODNs for TGF-1 exhibited decreased levels of TGF-1 mRNA after injury. CONCLUSIONS: These findings suggest an important new approach to controlling scarring in normal wound healing, complementing the practice of adding exogenous growth factors to chronic wounds in the attempt to inhibit collagen deposition.
Animals ; Blotting, Northern ; Cicatrix* ; Collagen ; Complement System Proteins ; Fibronectins ; Genetic Therapy* ; Immune System ; In Situ Hybridization ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Liposomes ; Macrophages ; Oligodeoxyribonucleotides ; Oligoribonucleotides ; Rats ; RNA, Messenger ; Sendai virus ; Skin ; Transforming Growth Factor beta ; Transforming Growth Factors ; Wound Healing ; Wounds and Injuries

Isoproterenol (ISO), a beta agonist, causes hyperpolarization of coronary smooth muscle cells via an increase in K+ conductance. This hyperpolarization may cause the coronary vasorelaxation by decreasing the cytoplasmic Ca2+ concentration. It is well known that the activation of beta adrenoreceptors stimulates the adenylate cyclase activity, and the resulting K+ channel phosphorylation by cAMP-dependent protein kinase may be responsible for ISO-induced increase in K+ channel activity. However, it is not clear whether the increase in K+ channel activity by ISO is exclusively due to the activation of adenylate cyclase or not. In this research, the effect of ISO on the isometric tension and the mechanism of ISO-induced K+ channel activation were investigated in various patch clamp conditions. The summarized results are as follows. ISO- and pinacidil induced vasorelaxation was significantly inhibited by the application of TEA or by increasing the external K+ concentration. In the whole cell clamp mode, application of ISO increased K+ outward current, and this effect was completely eliminated by propranolol. In the cell-attached patch, application of ISO or forskolin increased Ca(2+)-activated K+ channel activity. Application of ISO to the bath in the outside-out patches or GTP in the inside-out patches stimulated Ca(2+)-activated K+ channels. From the above results, both A-kinase dependent channel phosphorylation and direct GTP-binding protein mediated effect might be responsible for the the activation of Ca(2+)-activated K+ channel by ISO in rabbit coronary smooth muscle cells. And this K+ channel activation also contributes to the ISO-induced vasorelaxation.
Animal ; Calcium/*metabolism ; Coronary Vessels/*drug effects/physiology ; Cyclic AMP-Dependent Protein Kinases/physiology ; Female ; GTP-Binding Proteins/physiology ; Isoproterenol/*pharmacology ; Male ; Muscle, Smooth, Vascular/*drug effects/physiology ; Potassium Channels/*drug effects ; Rabbits ; Support, Non-U.S. Gov't ; Vasodilation/drug effects

With the class of 2000, the College of Medicine at Korea University instituted a revised curriculum. The new revision combined the traditional, and discipline-oriented, curriculums into a newly integrated curriculum. The purpose of this study is to identify the problems of the newly introduced integrated lectures, and how to find ways to improve this curriculum. Overloaded lecture hours and content, insufficient functional integration between disciplines, unstructured handout, deficiency in reference material and lack of motivation were identified as problems for students. Most of the participants urged a more effective collaboration between the faculty members of individual disciplines. Basic and clinical disciplines must be integrated as thoroughly as possible to improve and stabilize the new curriculum. Also, overall lecture time should be diminished, thereby allowing students to actively pursue their own learning.
Cooperative Behavior ; Curriculum ; Humans ; Korea* ; Learning ; Lectures* ; Motivation

No Abstract Available.
Forehead*

No abstract available.
Adhesives* ; Cyanoacrylates* ; Fracture Fixation*

PURPOSE: The purpose of this study were to investigate the self-reported quality of life and family burden and to examine the factors associated with the quality of life in patients with cancer. METHODS: 216 patients participated in the cross-sectional study. The European Group of Research and Treatment of Cancer Quality of life Questionnaire (EORTC QLQ-C30) and the Family Burden Scale were sent by mail to 2,000 cancer patients. Two hundred and sixteen patients answered the questionnaire. The stepwise multiple regression was conducted to analyze predictors of overall quality of life. RESULTS: All subscales of EORTC QLQ-C30 were significantly correlated with family burden. The regression analysis of patients with cancer revealed some variables as significant predictors; performance, perceived severity, family burden, time since diagnosis, and sex. CONCLUSION: The results offer a number of recommendations for future research and nursing practice focused on primary care for patients with cancer and their family for improving quality of life.
Cross-Sectional Studies ; Diagnosis ; Humans ; Nursing ; Postal Service ; Primary Health Care ; Quality of Life* ; Surveys and Questionnaires

PURPOSE: Since 2000, the Korea University Medical College has conducted Comprehensive Basic Medical Sciences Examination as a summative test. Summative assessment must be dependable in that it meets the highest standards of reliability and validity. The purpose of this study were to examine the validity and reliability of Comprehensive Basic Medical Sciences Examination and to improve the quality of the examination. METHODS: The subject of this study was the examination materials and scores of the test. We conducted exploratory factor analysis to testify validity. Cronbach alpha coefficient was used to examine the reliability. RESULTS: Only one factor was extracted from exploratory factor analysis. Its eigen value was 4.61 and it explained 65.93% of total variance. We could infer the extracted factor as an ability of basic medical sciences knowledge. The reliability coefficient of the test was ranged from 0.45 to 0.74. Of the total 335 item, overall acceptable items were 206(58.0%); the range of difficulty was 0.21~1.00 and discriminative indices were higher than 0.20. CONCLUSION: We confirmed the Comprehensive Basic Medical Sciences Examination in 2000 met the relative highest standards of reliability and validity. Item analysis could be of help to improve the quality of examination
Korea ; Psychometrics* ; Reproducibility of Results

Cleft lip and palate is the most common deformity among the facial congenital anomalies. And although many research and studies of operative methods haute been performed, the actual measurement of length of alar flaring have not been reported in cleft lip and palate. For this, authors chose the length of alas rim and nostril sill, which are an objective parameter, to measure the complete and incomplete cleft lip before the remedy and it was proven by a numerical value that compare to the normal part, the length was elongated. Also we found elongation of the cleft side alar rim in which patients had been operated by triangular flap method. We propose two surgical operative methods of the correction of lengthened alar rim; 1 partial resection of the elongated alar rim. 2. conversion of ala into nostril floor (Millard II operation) We conclude that this study is more accurate correction of the nasal deformity by measuring and understanding the length of alar rim in cleft lip and palate patients.
Cleft Lip* ; Congenital Abnormalities ; Humans ; Palate