No Abstract available.
Diagnosis* ; Sleep Apnea, Obstructive*

Access to the craniofacial skeleton and skull base requires osteotomies. An adequate exposure of neoplasms occupying the skull base and the oral cavity and oropharynx, especially retromolar trigone, is very important for precise tumor ablation. The demonstration by Tessier of the capacity for large segments of bone to survive removal and replacement has enabled skull base tumor surgery to grow into a subspeciality. Through the refined craniofacial exposure osteotomies, the surgery is safer, the operation shorter, and the result better both oncologically and reconstructively. We experienced 24 cases of exposure osteotomies consisting of 12 cases transzygomatic approaches, 1 case tranglabellar osteotomy, 1 case lateral transmaxillary approach, 1 case Le Fort II & midline splitting, and 9 cases mandibulotomy. There was no significant complication except a local wound infection in transzygomatic approach and one case of minimal malocclusion after parasymphyseal mandibulotomy. The orthotopic bone graft and the rigid fixation enables the postoperative morbidity to decrease. It seems that the previously inaccessible craniofacial tumors can be treated through the various exposure osteotomies.
Malocclusion ; Mouth ; Oropharynx ; Osteotomy* ; Skeleton ; Skull Base ; Transplants ; Wound Infection

The elbow is the most frequent area of complaint in children and adolescent baseball players. The physical stresses associated with repetitive throwing create extra-ordinary forces, which may affect the normal osteochondral and soft tissue developmental process and are the important factors causing the decrease of competitive power and shortening of life as a baseball player in adolescents. We surveyed the 114 baseball players of middle & high school in Taegu in order to evaluate the prevalance of symptoms and radiologic findings of the elbow and correlation of these findings to career & position of the baseball game. The results were as follows. 1. Of 114 players, 83 were non-pitchers and 31 were pitchers. The mean career was 3.8 years (7 months to 6 years). 2. The 77 players (67.7%) had the pain on their elbow during or after daily exercise. Other clinical symptoms were locking (30.7%), limitation of motion (18.4%), swelling (16.6%) and clicks on motion (10.5%). 3. On the radiogram of the elbow, hypertrophy or separation of medial epicondyle were seen in 34% of players, loose bodies in 17%, hypertrophy of the humerus in 12% and cystic change of the capitellum in 11%. 4. The mean career of symptomatic players was 4.4 years but non-symptomatics was 2.7 years. The mean career of players who had abnormal radiologic findings was 5.1 years but 3.1 years in players who had no abnormal radiologic fingings. 5. Symptoms and pathologic changes were more common in the elbow of pitcher' s group due to throwing frequency & pitching style. 6. Among the 77 players who had any kinds of problem of the elbow, 49 players of them had no experience of visiting hospital. 7. To prevent these injuries of the elbow, the following recommendations were made. First, restrict the number of innings pitched per game. Second, avoid throwing the curve ball in this age group. Third, ensue an adequate warm up period before exercise or rest after games. Fourth, inform parents and coaches of possible harmful nature of excessive throwing.
Adolescent* ; Baseball* ; Child ; Daegu ; Elbow* ; Humans ; Humerus ; Hypertrophy ; Parents

We developed Extor pins for Extor external fixator, it made of stainless steel and applied it clinically to manage open fractures and chronic osteomyelitis from December, 1993 to January, 1995. The main aim of present study is to compare the mechanical strength and biocompatibillity between Extor pins and AO Schanz pins, and to determine the safety and possibility of clinical use. We performed the biomechanical test for bending, tension, and shearing of pin itself using universal testing machine (LR5OK) and pullout test in cadeveric cortical femur to determine the bone holding power. There was no significant difference between Extor and AO Schanz pin (p>0.05). Clinically, the incidence of pin site infection, pin lossening, radiological rarefaction, and pathological change were not different significantly (p>0.05). Although Extor pins are somewhat different from AO Shanz pins in material and design characteristics, we can find the safety and possibility of clinical use of Extor pins made in Korea.
External Fixators* ; Femur ; Fractures, Open ; Incidence ; Korea ; Osteomyelitis ; Stainless Steel

Achilles tendon is the most powerful and the biggest tendon of the body and its rupture is frequently sports-related. Many authors reported the effects of mobilization, electricity, ultrasound and various drugs as factors influencing the injured tendon. We studied the effects of early passive mobilization after firm suture using plantaris tendon as tension suture material and reinforcing membrane on the repair of a ruptured Achilles tendon. From March 1992 to December 1995, twenty-two operations on the Achilles tendon were carried out in our hospital. 1. Fourteen patients were male and eight patients were female. The mean patient age was 38 years, ranging from 13 to 68 years. Average follow-up periods was 2 years and 7 months, ranging from 12 months to 3 years and 8 months. 2. The rupture site was 4.7cm proximal to the tendon insertion into the calcaneus on average. 3. We performed the operations with end to end suture technique. After approximation of the ruptured ends of the tendon with a No. 5 Ethibond tension suture using a modified Kessler stitch, placed plantaris tendon in a fascial needle and pass it circumferentially and distal plantaris tendon is fanned out and tacked over the repair. 4. Postoperative treatment was done as following protocol Short leg cast was done with equinus position for initial 3 weeks, and then cast was removed, hydrotherapy and passive exercises was employed. About 6 weeks after operation when the foot can be brought to right angle, a reverse 90degrees ankle stop short leg brace was applied for additional 6 weeks and partial weight bearing was aUowed. 5. Follow-up results were classified according to the Arner-Lindholm scale. We had 16 excellent results and 6 satisfactory results. After rigid suture it may be possible to introduce a regimen of progressive isometric stimulation and protected loading and streching combined with removable orthosis. Such early exercises are likely to improve the rate of rehabilitation over plaster immobilization.
Achilles Tendon* ; Ankle ; Braces ; Calcaneus ; Electricity ; Exercise ; Female ; Follow-Up Studies ; Foot ; Humans ; Hydrotherapy ; Immobilization ; Leg ; Male ; Membranes ; Needles ; Orthotic Devices ; Rehabilitation ; Rupture* ; Suture Techniques ; Sutures ; Tendons ; Ultrasonography ; Weight-Bearing

STUDY OBJECTIVES: To identify the value of symptoms in head trauma patients with alert mental status requiring a head CT scan. METHODS: A retrospective study was performed at an emergency center over 8 months period. Patients(age > or = 7) were enrolled if they presented with a Glasgow Coma Scale score of 15 and underwent head CT after head trauma. The symptoms and signs were recorded in the entry forms prior to head CT The symptoms found in the patients with normal CT were compared with those in abnormal CT showing intracranial injuries. RESULTS: Among the 168 patients, traumatic intracranial abnormality was identified in 34(20.2%) by CT. Skull fracture was idendified in 8(4.8%) in normal CT, 17(10.1%) in abnormal CT group by simple X-ray and CT. In the normal CT group without skull fracture, 65(52.0%) had headache, 61(48.8%) had loss of consciousness( LOC), 43(34.4%) had vomiting, 24(19.2%) had nausea, 7(5.6%) had dizziness. In the abnormal CT group without skull fracture, 14(77.8%) had heacache, 9(50.0%) had LOC, 9(50.0%) had vomiting, 2(11.1%) had nausea, 2(11.1%) had dizziness. The patients with headache were significantly more common in the abnormal CT group. CONCLUSION: A head CT is required in alert head trauma patients with any symptoms and signs of intracranial injuries, especially with headache.
Craniocerebral Trauma* ; Dizziness ; Emergencies ; Glasgow Coma Scale ; Head* ; Headache ; Humans ; Nausea ; Retrospective Studies ; Skull Fractures ; Tomography, X-Ray Computed ; Vomiting

No abstract available.
Free Tissue Flaps* ; Head* ; Neck*

No abstract available.
Free Tissue Flaps* ; Mouth* ; Oropharynx* ; Rectus Abdominis*

Isoniazid (INH), a hydrazide of isonicotinic acid, has been used for more than 30 years for the treatment of tuberculosis and is one of the most effective anti-tuberculous agents so far. In spite of the widespread use of INH, very few accidental or suicidal poisonings have been reported, Acute INH intoxication is characterized by hyperpyrexia, respiratory distress, coma seizure, metabolic acisosis, hyperglycemia and acetonuria Especially metabolic acidosis is not corrected by alkali therapy in which usual dose of bicarbonate supply, and seizure attacks also has not controlled by common anti-epileptic drugs, so it needed a large quantity of intravenous pyridoxine and diazepam infusion. This report describes an adult who ingested large amount of INH with the intent of suicide and was presented with the fatal status epilepticus and severe metabolic acidosis.
Acidosis ; Adult ; Alkalies ; Coma ; Diazepam ; Humans ; Hyperglycemia ; Isoniazid* ; Isonicotinic Acids ; Ketosis ; Poisoning ; Pyridoxine ; Seizures ; Status Epilepticus ; Suicide ; Tuberculosis

Bony defect is one of the most common problems in craniomaxillofacial surgery. Although aurogenous bone graft is the best choice for the treatment of bone defect, it provides many problems such as donor site morbidity, irregular absorption, and limited amount of harvest. To overcome the shortcomings of autogenous bone graft many bone substitutes have been introduced. The ideal bone substitution is to have characteristics such as cheap, easy to obtain, rapid fusion to recipient bone, hard structure, long maintenance of shape and volume, low infection rate, and low exposure rate. Among those bone substitutes which have been widely used we chose lyophilized cartilage allograft because of low antigenecity, low resorption rate, easiness of carving and ling term preservation. From August 1993 to August 1997, 66 patients had been performed craniomaxillofacial reconstruction with lyophilized cartilage allograft. Orbital wall reconstruction and correction of enophthalmos were 24, correction of cleft lip and nose deformity were 19, temporal augmentations were 7, and others 16. Complications such as infection, exposure were not common. And partially removed cartilage was proved some calcification. Radiologic follow-up presented well positioned lyophilized cartilage allograft. Two radiologic works revealed haziness of bone density at the site of cartilage allograft. This suggests the ossification of lyophilized cartilage allograft. Together with liw infection rate, low exposure rate, and good framework for osteoconduction, lyophilized cartilage allograft are regarded as one of the good bone substitutes.
Absorption ; Allografts* ; Bone Density ; Bone Regeneration ; Bone Substitutes ; Cartilage* ; Cleft Lip ; Congenital Abnormalities ; Enophthalmos ; Follow-Up Studies ; Humans ; Nose ; Orbit ; Tissue Donors ; Transplants