No abstract available.
Sternotomy*

No abstract available.
Orchiopexy* ; Testis*

Island flaps have been widely used for the management of soft tissue defects in reconstructive surgery. The necrosis of the flap has been a catastrophe in clinical fields. It is well known that revascularization to the flap after ligation of its pedicle comes from the recipient bed and flap margins. The authors investigated the effects of the ischemic recipient bed on island flap survival after the ligation of its pedicle in the rats. One hundred and thirty inferior epigastric island flaps were divided into three groups (Group I, Group II, and Group III) according to the degree (0%,20%, and 60%) of interruption of contact of flap with the recipient bed, respectively. In Group I,the vascular pedicles were ligated before and on the 0, 2nd, 3rd, 4th and 5th days after flap elevation, and in Group II & III, the vascular pedicles were ligated on the 2nd, 3rd, 4th and 5th days after flap elevation. Flap survival was assessed on the 3rd day after pedicle ligation. Microangiographic studies were also performed on the 3rd day after pedicle ligation to study revascularization within the flap and the change of blood vessels around the flap margins. The results were as follows: 1. Flap survival was increased significantly in the flaps with pedicle ligation on the 4th and 5th postoperative days compared to those at the 2nd and 3rd postoperative days. 2. From the 3rd postoperative day, flap survival was not influenced significantly by the degree of limited bed contact and the date of pedicle ligation. 3. In spite of limited bed contact, the flap will likely survive with abundant revascularization from the flap margins. In conclusion, the flaps with limited bed contact were revascularized significantly from the flap margin by the 3rd postoperative day.
Animals ; Blood Vessels ; Ligation ; Necrosis ; Rats ; Surgical Flaps

No abstract available.
Humans ; Shoulder*

A 72-year-old woman developed pruritic erythematous patches on sun-exposed areas for 2 months following treatment with hydrochlorothiazide (Dichlozid) for hypertension. A phototest revealed a decreased minimal erythemal dose to UVA (MED(UVA)=2 J/cm²). A photopatch test with 0.5%, 1%, and 5% hydrochlorothiazide ointment revealed no response. Two weeks after discontinuation of hydrochlorothiazide, the skin lesions improved with complete loss of photosensitivity without any therapy. At that time, an oral provocation phototest with hydrochlorothiazide was performed and it showed a decreased MED to UVA (MED(UVA)=2 J/cm²).
Aged ; Dermatitis, Phototoxic* ; Female ; Humans ; Hydrochlorothiazide* ; Hypertension ; Skin

The key points of treatment of cryptotia are the elevation of invaginated ear helix and the correction of deformed cartilage. Prevention of stabilized cartilage contouring from returning to the previous state is also important. The authors carried cartilage plasty by modified Fukuda's method that several incisions are made along the crus, and then the crus is flattened using mattress suture in cases of mild cartilage deformity. In cases of severe cartilage deformity, the cartilage plasty by Onizuka method was carried. The cartilage graft from cavum on concha served as a splint for prevention of recurrence of cartilage deformities. We have repaired 13 cryptotic deformities in 9 patients with aesthetically satisfactory results using vertical incision at the superior crus of antihelix with mattress suture or cartilage graft from cavum of concha for cartilage correction.The correction of deformed cartilage by modified Fukida or Onizuka method is a good option for the treatment of cryptotia.
Cartilage ; Congenital Abnormalities ; Ear ; Humans ; Recurrence ; Splints ; Sutures ; Transplants

Cerebral aspergillosis is a rare condition that affects primarily the immunocompromised host. Most of cerebral aspergillosis is developed by hematogenous dissemination from extracranial foci, but aspergillosis of sino-nasal origin rarely affects the CNS. In case 1, wel symptom of tumor recurrence was unilateral numbness of the chin. A 65-year-old male was admitted because of paresthesia around the left chin and left lower lip. Neurologic examination revealed hypesthesia on the left side of chin, lower lip and buccal mucous mem-brane. Bone scan (Tc-99m MDP) showed focal hot uptakes on the left mandible and left first rib. Brain CT with bone window setting showed a focal osteolytic lesion in the bone marrow of the left mandibular canal without destruction of bone cortex. Both coronal T1 weighted image and axial T2 weighted image showed focal low signal intensities on the left ramus. The pathophysiologic mechanism could be understood by identification of the pathologic focus.
Aged ; Aspergillosis* ; Bone Marrow ; Brain ; Chin ; Humans ; Hypesthesia ; Immunocompromised Host ; Lip ; Male ; Mandible ; Neurologic Examination ; Paresthesia ; Recurrence ; Ribs

Toxoplasma gondii, an intracellular coccidian protozoan, is the causative agent of toxoplasmosis, a widespread infection affecting various birds and mammals including humans. In immunocompetent hosts, the infection is usually asymptomatic and benign. Toxoplasmosis is either congenital or acquired. In general prenatal therapy of congenital toxoplasmosis is beneficial in reducing the ncy of infant infection. Therapies are based primarily on spiramycin because of the relative lack of toxicity and high concentration achieved in the placenta. Clindamycin is the standard drug for chemoprophylaxis in newborn infants, and is directed at preventing the occurrence of retinochoroiditis as a late sequel to congenital infection. The standard treatment for acquired toxoplasmosis in both immunocompetent and immunodeficient patients is the synergistic combination of pyrimethamine and sulphonamides. Toxoplasmic encephalitis is tbe most common manifestation of acquired toxoplasmosis in immunocompromised patients and if not treated is fatal. However, because of toxicity, the therapeutic efficacy of pyrimethamine sulphonamide combinations may be seriously limited in immunodeficient patients. We have experienced a case of toxoplasmosis during the workup of habitual aborter. So we report this case with a brief review of literatures.
Birds ; Chemoprevention ; Clindamycin ; Encephalitis ; Humans ; Immunocompromised Host ; Infant ; Infant, Newborn ; Mammals ; Placenta ; Pyrimethamine ; Spiramycin ; Toxoplasma ; Toxoplasmosis* ; Toxoplasmosis, Congenital

Macrostomia is a relatively rare malformation. There have been many surgical methods for the correction of macrostomia. The old method, a simple straight line closure , did not include reconstruction of the orbicularis oris muscle. Postoperatively, a depressed scar and severe contraction on the cheek were found, especially with animation. As a result, many authors have known that reconstruction of the orbicularis oris muscle was very important to avoid a depressed scar for the correction of macrostomia. The tendency toward lateral displacement of the reconstructed commissure has been attributed to linear scar contraction, and Z-plasty is advocated to prevent this deformity. However, we found that the Z-plasty scar may be conspicuous when the patient smiles. So we performed reconstruction of the orbicularis oris muscle to avoid a depressed scar, and straight line closure to avoid a conspicuous scar. In order to prevent linear scar contracture due to straight line closure, we overcorrected the new commissure. We treated 6 cases of macrostomia form May 1, 1996 to April 30, 1999 using straight line closure and reconstruction of the orbicularis oris muscle. Periods of follow-up were from 12 months to 35 months, with an average of 20,2 months. Every patient was analyzed clinically by ordinary scale method and anthropometrically by the ratio of abnormal distances to normal distances between cheilion and crista philtri. In 3 clinical assessments : symmetry of the commissure was excellent: degree of the scar at rest was good: and degree of depression with animation was excellent. The anthropometrical ratio was 1:1.05. Despite the fact that the linear scars were perpendicular to the minimal skin tension lines, the scars were inconspicuous. The muscle repair provided reconstruction to the modiolus and gave a natural appearance to the commissure, however it did not seem to provide sufficient bulkiness around the commissure. The straight line skin closure and repair of the orbicularis oris muscle provide effective functional and aesthetic reconstruction.
Cheek ; Cicatrix ; Congenital Abnormalities ; Contracture ; Depression ; Follow-Up Studies ; Humans ; Macrostomia* ; Skin

PURPOSE: Central lucency of pelvic phleboliths is frequently observed on plain pelvic radiographs. When it is also present on noncontrast helical CT images, pelvic phleboliths may be easily diagnosed, with no suspicion of distal ureteral calculi. The objective of this study was to determine the frequency with which this phenome-non is seen on plain radiographs and noncontrast helical CT images. MATERIALS AND METHODS: During a recent two-year period we identified 70 patients with renal colic who under-went both abdomino-pelvic radiography and noncontrast helical CT scanning. Radiographs were obtained at 70 -85 kVp and 30 -40 mA; CT scans were preformed within one month of plain radiography with parameters of 120 kVp, 200 -220 mA, 5-mm collimation, and pitch of 1 -1.6, and using soft tissue and bone window settings. With regared to the central lucency of pelvic phleboliths, as seen on both on radiographs and CT im-ages, two experienced radiologists reached a consensus. RESULTS: Among the 70 patients, a total of 150 pelvic phleboliths was found. In all cases except one, pelvic radi-ography and noncontrast helical CT revealed the same number of phleboliths. The exception was a case in which one of two phleboliths demonstrated by CT was not seen on radiographs. Pelvic radiography revealed central lucency in 95 of these 150 phleboliths (63%), but noncontrast helical CT failed to depict a hypodense center in any phlebolith. CONCLUSION: Central lucency of pelvic phleboliths, as frequently seen on plain pelvic radiographs, was not revealed by routine noncontrast helical CT in any patient.The presence or absence of central lucency on these CT images cannot, therefore, be used to differentiate phleboliths from distal ureteral calculi.
Consensus ; Humans ; Radiography ; Renal Colic ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Ureteral Calculi