A new balloon dissector, a modification of a Foley catheter, was devised and it can be used either as a dissector or a tissue expander. Since most operating time was spent in balloon manipulation (inflation/deflation), the duct for saline injection was made to be wider than the Foley catheter. As a result, the balloon could be inflated faster than before. In order to reduce the scar at the donor site, harvest of the sural nerve using endoscopic technique is currently applied, but utilization of this method is technically difficult and requires a long operating time. For these reasons, new our method of using a balloon dissector was devised. The balloon dissector can also be used for immediate intraoperative tissue expansion for the reconstruction of small skin defects without distortion. We have found that the advantages of using the new balloon dissector include a reduction in operating time, preservation of the perforating vessels, and primary closure with less tension. In addition, this simple and inexpensive instrument is cost-beneficial to patients.
Catheters ; Cicatrix ; Humans ; Skin ; Sural Nerve ; Tissue Donors ; Tissue Expansion ; Tissue Expansion Devices

Suction-assisted lipoplasty is now flrequently-performed pre cedure in plastic surgery, but it has several drawback including bleeding contour irregularity due to its traumatic nature. The recently introduced ultrasound-assisted lipoplasty (UAL) technique uses ultrasonic energy which has specificity in lower density tissue like fat tissue. Therefore, UAL can minimize these compli cations. We performed UAL in 21 patients from OCt. 1988 to Jun 1999. There were 17 females and 4 males, and patient age ranged from 18 to 52 years(average 40 years). A total of 58 areas were operated on for an averge of 28 areas per patient. We used a fivestage technique consisting of tumescent infiltration, ultrasonund treatment, emulsion suction, endermology, and postperative pressuregarment application. Total volume (fluid and fat) removed ranged from 200 to 4,050 cc(averge 1,750 cc) per patient and the lipocrit within the aspirate was 4-8%, which was significantly lower compared with traditional liposuction Residual emulsion was evacuated by endermology and pressuregarment was applied to all patients for postoperative 2-3 months. Pestoperative complications were seroma, induration, and paresthesia, but all these problems resolved spontaneously within a month. One patient required secondary UAL for correction of excess fat at the medial knee. We believe that UAL is a safe and excellent technology in liposuction because of reduced surgical bleeding and good contral of body contour.
Bezafibrate ; Cations ; Female ; Hemorrhage ; Humans ; Knee ; Lipectomy ; Male ; Paresthesia ; Sensitivity and Specificity ; Seroma ; Suction ; Surgery, Plastic ; Ultrasonics

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

We describe an unusual case of leptomenigeal carcinomatosis presented with bilateral blindness. A 67-year old male had been suffering from progressive blindness for the past 2 months. Initially, the symptom developed in the right eye but quickly spread to the left eye becoming bilateral with complete vision loss in a matter of weeks. He did not show any other focal neurological signs and did not have a history of malignancy. An examination of the cerebrospinal fluid revealed metastatic adenocarcinoma. As this case indicated, the patients of leptomeningal metastasis may present with acute or subacute blindness, even in the absence of other focal neurological deficits.
Adenocarcinoma ; Aged ; Blindness ; Carcinoma ; Cerebrospinal Fluid ; Humans ; Male ; Neoplasm Metastasis*

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

No abstract available.
Skull Base* ; Skull*

No abstract available.
Shoulder*

99m Tc-pyrophosphate was investigated for use as an indicator of intestinal infarction in intussusceptedbowel. Irreducible intussusceptions were created in 18 rabbits by surgery. 99mTc-pyrophosphate was then injectedintravenously 6-12, 18, 24 and 30-40 hours later for external scanning. In 15 of the rabbits, infaractiondeveloped with intussusception, and 13 of them demonstrated increased uptake of 99m Tc-pyrophosphate on externalinvivo scintiscans. The remained 2 of them showed no evidence of increased uptake. So false negative cases were2(sensitivity 86.7%). The 3 rabbits without infarction showed no increased uptake of radionuclide. Specimenscanning confirmed increased uptake of radionuclide in the infarcted segments. These observations suggest that 99mTc-pyrophosphate is a reliable indicator of the intestinal infarction that sometimes occures with intestinal intussusception.
Infarction ; Intussusception ; Rabbits ; Radionuclide Imaging ; Technetium Tc 99m Pyrophosphate

Mammary carcinoma was induced in rats by itravenous injection of N-methy-N-Nitrosourea. Microangiography was perfromed to evaluate the microvascular alterations in mammary carcinoma after irradiation. The tumors were givena single dose of 1.400 rads using Co-60 telethrapy unit with field size of 4 x 4 cm at 40 cm SSD. The dose ratewas 147.5 rads per minute. Microangiography was performed prior to irradiation and at one, two, and four weeksfollowing irradiation. The results are as follows: 1. Before irradiation, mammary carcinoma in rats tended to formlobules and the basic vasculature consisted of peripheral vascular pattern with central penetrating vessels. Theperipheral vascular pattern was always richer than that of the center. Irregular and tortuous vessles stretchedfrom the periphery into the center of lobule. 2. One week following irradiation, an increase in the number ofsmaller, tortuous vessels and decreased intervasular distance were obseved in the central portion of each lobule.This finding seems to be due to an improved filling of some previously existing but unfilled vessels. This maylead to improved metabolic changes and reoxygenation. 3. Later's changes of microvasculature after irradiation aretortuosity, irregularity, narrowing, abrupt tapering, fragmentation, and extravasation. These findings progressedafter a lapse of time. 4. The results can be considered as the microangiographic demonstration of the fact that reoxygenation after irradiation is mainly due to dilatation of the collapsed tumor vessels.
Animals ; Dilatation ; Microvessels ; Radiation Effects ; Rats ; Silver Sulfadiazine

No abstract available in English.
Methods ; Reference Values