From May, 1971 to June, 1984, we performed extensive saucerization on the chronic osteomyelitis of long bones eradicating all pathologic foci; not only sequestra but sclerotic involocurum and necrotic original cortex embeded by new bone, which was different from the conventional methods such as sequestrectomy or guttering in its extensiveness. Clinical analysis on the base of radiologic evaluation after saucerization was done on the 16 patients; for average 5 years of follow-up. The results obtained were as follows; 1. The angulatory deformity of the long bones after pathologic fracture complicated by the chronic osteomyelitis was not corrected satisfactorily due to the bony sclerosis or hyperostosis at the fracture site, especially in cases of posterior or medial angulation. 2. The recurrence was closely related to the persisting non-sequestered original cortical lesion after incomplete saucerization, which was embeded by the new bone. So to prevent the recurrence the non-sequestered original cortical lesion must be removed completely. 3. The cortical defect after saucerization was restored completely in patients under the age of 14, but which was not the way in patients over the age of 16.
Congenital Abnormalities ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Hyperostosis ; Osteomyelitis ; Recurrence ; Sclerosis

No abstract available.
Pressure Ulcer*

In evaluation of head trauma, simple skull examinations have been almost routinely requested in emergency room, regardless of historical, physical or neurologic findings, for fear of an unexpected fracture and medicolegal problem. Considering the low yield rate of positive radiologic findings for skull fracture and poor correlation of skull fracture with intracranial sequelae, simple skull examinations in head trauma patients, especially in those with minor trauma, is overutilized without reasonable clinical criteria of application. A retrospective review of 1,101 patients was performed to evaluate the efficacy of simple skull examination at the point of diagnosis and treatment, and to predict the risk for skull fracture and significant intracranial sequelae by clinical findings. Eighty-six patients(7.8%) had skull fractures including two basilar fractures and 12 depressed fractures. 116 patients(10.5%) had significant intracranial sequelae and 62 of these had skull fractures. Of 1,101 patients, 237 had the clinical findings of "high-yield" features and 70 of these had skull fractures and 99 had intracranial sequelae, so high-yield fractures are very indicative for the skull fracture and intracramal sequelae. Only in nine patients(0.08%0 the managements were altered after simple skull examination in that two with basilar fractures were treated with antibiotics and seven with depressed fractures were undergone neurosurgical precedures. Patients who were not admitted nor required further study or treatment because of minor head traumadidn't have any skull fractures or intracranial sequelae in our series, and 62 of 116 patients with intracranial sequelae showed normal skull findings indicating that normal findings can create false sense of security.
Anti-Bacterial Agents ; Craniocerebral Trauma* ; Diagnosis ; Emergency Service, Hospital ; Head* ; Humans ; Neurologic Manifestations ; Retrospective Studies ; Skull Fractures ; Skull*

Insulin autoimmune syndrome (IAS) includes fasting or reactive hypoglycemia, hyperinsulinemia and the presence of insulin-binding antibodies in patients who have never been exposed to exogenous insulin. This report concems a 29-year-old male patient with Graves disease who had history of having taken methimazole for two months, without any consequence, 6 months previously. However, when methimazole was administered again for three weeks, the patient suffered hypoglycemia during the next fourth week. He denied history of diabetes mellitus (DM), of taking any oral hypoglycemic agent or of having received insulin injection. Laboratory data showed total serum insulin level > 300 pu/mL, C-peptide reactivity (CPR) 8.0ng/mL and insulin antibody 89%. After stopping methimazole, he was treated with radioiodine (131I). There was no episode of hypoglycemic attack during 8 months of follow-up.
Adult ; Antibodies ; C-Peptide ; Diabetes Mellitus ; Fasting ; Follow-Up Studies ; Graves Disease* ; Humans ; Hyperinsulinism ; Hypoglycemia ; Insulin ; Male ; Methimazole

Closed internal degloving is a significant soft-tissue injury associated with a trauma that results in a tear of the subcutaneous tissue away from the underlying fascia. Although the diagnosis of Morel-Lavallee lesion (MLL) is routinely based on clinical and radiological examinations, in one-third of the cases, there is a possibility that clinicians may fail to diagnose MLL due to its inconsistent clinical manifestations. Additionally, it often involves initial skin bruising due to underlying soft-tissue injury. We present two cases of delayed MLL without a fracture treated using percutaneous drainage and sclerotherapy. Our cases demonstrated successful treatment with a minimally invasive percutaneous approach. The potential advantage of using a percutaneous technique is to preserve the subdermal arterial plexus, which is the only remaining blood supply to the skin in the area of the lesion. Maintaining this blood supply may result in healthier skin at the time of any open procedure.
Diagnosis ; Drainage* ; Fascia ; Sclerotherapy* ; Skin ; Subcutaneous Tissue ; Tears

OBJECTIVE: To observe the capability of fertilization and embryo development including blastocyst formation of the oocytes in simple media after thawing of the cryopreserved cumulus-free mouse oocytes by vitrification method. METHODS: Oocytes were collected from 5 to 6 weeks old ICR female mice, and were denuded from the cumulus cells by 0.1% hyaluronidase. Recovered mature oocytes in study group were cryopreserved by vitrification method using EM grid for 5~7 days. In brief, oocytes were exposed in dPBS containing 1.5 M EG and 5.5 M EG+1 M sucrose for 2.5 minutes and 20 seconds each, and then executed vitrification by plunging in LN2 after loading on EM grid. Thawing treated by exposure of 1, 0.5, 0.25 and 0.125 M sucrose solution for 2.5 minutes each in order and used for experiments. Spermatozoa aspirated form the epididymis of 12 weeks old ICR male mice were used for insemination after capacitation. T6 media containing 0.4% BSA were used for fertilization and development. RESULTS: Survival and fertilization rates after thawing were 76.9% and 79.6% respectively. Fertilization rate was lower (p<0.005) than that of control group (92.9%). There was no difference in embryo developmental rates from 2-cell to morula, however, the blastocyst formation rate and mean cell numbers of blastocysts in study group (63.3%, 58.9+/-9.2) were lower compared with those of control group (76.1%, 63.5+/-8.9). CONCLUSION: Vitrification is an effective method for mouse mature oocyte cryopreservation with high survival and fertilization rate after thawing. And in simple media, fertilization rates and embryo development of frozen-thawed mouse oocytes are satisfactory.
Animals ; Blastocyst ; Cell Count ; Cryopreservation ; Cumulus Cells ; Embryonic Development* ; Embryonic Structures* ; Epididymis ; Female ; Fertilization ; Fertilization in Vitro* ; Humans ; Hyaluronoglucosaminidase ; Insemination ; Male ; Mice* ; Morula ; Oocytes* ; Pregnancy ; Spermatozoa ; Sucrose ; Vitrification*

A retrospective study was made for 12 penetrating keratoplasties (9 patients) for corneal opacity due to severe corneal alkali burn from January 1987 to December 1991 at St. Mary's Hospital, Catholic University Medical College. 5 eyes which received penetrating keratoplasty within a year after alkali burn have never improved in visual acuity, but 3 out of 7 eyes which received penetrating keratoplasty after a year obtained improved visual acuity during the follow up period of 6 months After keratoplasty, the corrected visual acuity of 11 out of the 12 transplants (91.7%) were temporary improved in comparision with the preoperative levels. But 3 eyes (27.2%) have kept improved visual acuity during the follow up period of 6 months. The relationship between preoperative corneal scarring type according to Kinoshita and Manabe's classification and postoperative corneal transparency was reviewed; 3 among 6 eyes with scarring type A have kept clear cornea, but all of 6 eyes with scarring type B were noted to have .opaque cornea during the follow up period of 6 months.
Alkalies* ; Burns* ; Cicatrix ; Classification ; Cornea ; Corneal Opacity ; Corneal Transplantation ; Follow-Up Studies ; Keratoplasty, Penetrating* ; Retrospective Studies ; Visual Acuity

Anesthesia for the patients with mediastinal mass may be associated with significant respiratory and cardiovaacular complications due to compression of traeheobronchial trees, the pulmonary artery, heart and superior vena cava The authors present a case of a 6-year-old girl with a large mediastinal tumor located in anterior and superior mediaetinum. Preoperatively, the patient was asymptomatic and anesthesia was induced and maintained uneventfully. Operative finding was that 8 X 14 cm sized hemangioma was extended superiorly over thoracic outlet, posteriorly aorta and SVC, medially pericardium and right hilum and inferiorly right upper lung and pleura. Because difficulties in removal of the hemangioma were expected, exploratory thoracotomy was discontinued. On emergence, as soon as the patient was extubated due to irritability, the patient became cyanotic and was noticed bulging mass on right supraclavicular area, Intubation was attempted and during direct laryngoscopy, anesthesiologist also noticed a bulging mass in right oral cavity. Postoperatively, the patients airway was kept with endotracheal tube, but cyanosis appeared on the face and skin over the chest, but not below the abdomen. Bulging mass on right supraclavicular area, distension of neck vein and conjunctival edema were noticed only when the patient was crying or suctioned. Symptoms improved by deep sedation. We assumed that enlargement of hemangioma due to increased central blood volume occasionally compressed tracheobronchial tree and sup. vena cava when patient was irritable, crying and coughing. On 11th postoperative day, patient was transferred to the another hospital for the better treatment with endotracheal intubation.
Abdomen ; Airway Obstruction* ; Anesthesia ; Aorta ; Blood Volume ; Child ; Cough ; Crying ; Cyanosis ; Deep Sedation ; Edema ; Female ; Heart ; Hemangioma ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Lung ; Mouth ; Neck ; Pericardium ; Pleura ; Pulmonary Artery ; Skin ; Suction ; Thoracotomy ; Thorax ; Veins ; Vena Cava, Superior

Face-lift operations have been performed to correct the stigma of aging of the lower face, and its techniques have been modified to obtain more favorable results. However, the lack of significant improvements in the appearance of nasolabial folds has been a problem in face-lift procedures, requiring surgeons to perform ancillary procedures such as fat strip, dermofat, and superficial musculoaponeurotic system (SMAS) grafting to address the issue. In this report, we describe a subcision technique using a wire scalpel or a thread as an ancillary procedure to a face-lift operation to improve the appearance of nasolabial folds. The procedure is simple, safe, easy, and effective with minimal complications.
Aging ; Nasolabial Fold ; Rhytidoplasty ; Transplants

Anterior frontal hairline incisions have been used for subcutaneous forehead lifts, reduction foreheadplasty, endoscopic forehead lifts in patients with long foreheads. However, the resulting visible hairline scar has been a major concern. To obtain a more aesthetic scar, different types of incisions have been used. Since 2005, we have been using 30~45degrees anteriorly beveled incisions 4~5 mm behind the anterior frontal hairline when performing subcutaneous forehead lifts. In the present study, 32 patients who underwent subcutaneous forehead lifts and could be followed up for more than 6 months were evaluated for the incisional scars. Using a questionnaire, all the patients were interviewed regarding their postoperative hairstyle changes and reaction to the scars from the subcutaneous forehead lifts. Their responses with respect to the scars were as follows: less than expected, 30 patients; equal as expected, 2 patients; worse than expected, no patients. The surgeon's evaluation of scar visibility was as follows: barely visible (scar and alopecia were not seen or barely seen), 19 patients; minimally visible (a fine scar was seen), 12 patients; markedly visible (a wide scar or alopecia was seen), 1 patient. Except 1 patient, all other patients did not change their hairstyles permanently to camouflage their scars. Therefore, the 30~45degrees anteriorly beveled incision 4~5 mm behind the anterior frontal hairline was demonstrated to result in an aesthetically acceptable scar.
Alopecia ; Cicatrix ; Forehead ; Humans ; Surveys and Questionnaires