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

Ectopic lacrimal gland denotes a lacrimal gland which is located anywhere other than its normal site, lacrimal fossa, and it can occur in places like conjunctiva, cornea, lid, nasal mucosa, and orbit. It is a rare congenital anomaly and needs to be differentiated form other tumors. The literature contains few reports of ectopic lacrimal gland. We experienced a case of a 28-year-old Korean man who presented with an ectopic lacrimal gland with duct at temporal aspect of bulbar conjunctiva. The glandular tissue was excised and was histopathologically confirmed as such. We report it with reviews of the literature concerned.
Adult ; Conjunctiva ; Cornea ; Humans ; Lacrimal Apparatus* ; Nasal Mucosa ; Orbit

OBJECTIVE: To explore the clinical value of postoperative follow-up examination of F-wave and H-reflex in patients with lumbosacral radiculopathy and to clarify optimal timing of follow-up examination. METHOD: The subjects were 17 patients with unilateral lumbosacral radiculopathy caused by disc herniation. In patients with the L5 radiculopathy, F-waves were obtained from extensor digitorum brevis and six parameters including minimal latency per height were used. In patients with the S1 radiculopathy, H-reflexes were obtained from gastrocnemius and amplitude and minimal latency were used as parameters. These parameters were evaluated preoperatively and postoperatively at week 1, 3, 6. These changes of the parameters and clinical findings were related. RESULTS: The parameters of peroneal F-wave and tibial H-reflex showed significant improvement at 3 weeks and 6 weeks after surgery. The improvements of these parameters were not related with clinical improvement at 1 week after operation, but these were significantly related with improvement of pain and muscle weakness at 3 weeks after operation. CONCLUSION: These findings suggested that follow-up examination of F-wave and H-reflex were valuable for objective assessment of lumbosacral radiculopathy after operation and the optimal timing for follow-up study was 3 weeks after operation.
Follow-Up Studies* ; H-Reflex* ; Humans ; Muscle Weakness ; Radiculopathy*

No abstract available.
Animals ; Lymphocyte Subsets* ; Lymphocytes* ; Rats*

Amblyopia and strabismus are common in eyes of prematurity and the need for early detection of amblyopia and amblyogenic factors is widely recognized. So, we performed refraction in premature infants at the 6 months of age to evaluate the incidence and degree of myopia and the changes of refractive errors according to the development, disease course and photocoagulation therapy of retinopathy of prematurity[ROP]. It is the purpose of this study to evaluate the effectiveness of MTI[medical Technology, Inc]photoscreener by comparing the sensitivity and specificity between refractive errors determined by manifest photorefraction and cycloplegic photorefraction in 6-month-old premature infants in Sung-Ae General Hospital. Pass or fail screening data from photograph of 32 non-dilated and dilated premature infant were calculated by two masked observers, compared with the results of cycloplegic retinoscopy, and the statical analysis was carried out. In the cases of cycloplegic photorefraction, Ten eyes of myopia, 4 eyes of emetropia, and 50 eyes of hyperopia were found, and 21 eyes of astigmatism above 1.5D were also detected. Overall statistical analysis of sensitivity and specificity rate were 71.7% and 69.5%in manifest photorefraction, 87.5% and of 75%in cycloplegic photorefraction, respectively. In non-cycloplegic photorefraction, sensitivity of myopia and hyperopia were 92.8%, 65%, but in cycloplegic photorefraction, sensitivity of myopia and hyperopia were 75%, 100%, respectively. The outcomes of our study suggest that MTI photoscreener in cycloplegic photorefraction was more reliable than non-cycloplegic photorefraction. Myopia under 1D turned to hyperopia in cycloplegic photorefraction, so the sensitivity of that was not to be reliable, but the sensitivity of hyperopia was high. Thus, the authors can readily recommand this cycloplegic photorefraction in uncooperable infants to evalute the refractive error conveniently.
Amblyopia ; Astigmatism ; Hospitals, General ; Humans ; Hyperopia ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Light Coagulation ; Masks ; Mass Screening ; Myopia ; Refractive Errors ; Retinoscopy ; Sensitivity and Specificity ; Strabismus

Repetitive nerve stimulation (RNS) test was systematically performed in proximal and distal muscles of 142 cases with myasthenia gravis (MG) and 45 norrnal controls and then analyzed qualitatively. Diagnostic sensitivity was 75% based on abnorrnal decremental response in at least one muscle. The sensitivity increased from 56% in ocular MG to 96% in type Iib MG according to severity of disease. Higher diagnostic yield was noted in the orbiculans oculi in ocular MG and in the trapezius in gereralized MG. RNS test on proximal muscle showed a higher positive rate than that on distal muscles. When distal muscle testing was negative, there was an additional increase of 24% in proximal muscle testing. The posttetanic exhaustion (PTE) enhanced diagnostic sensitivitY as much as 8% in generalized MG. The posttetanic facilitation(PTF) and PTE were observed in 50% and 38% of generalized MG and were most prominent in MG with moderate severity. Five patterns on RNS findings were classified according to test paramcters. The most common response was the pattern which showed normal arnplitude of compound muscle action potential, decremental response at low rate stimulation, and PTF without PTE.
Action Potentials ; Muscles ; Myasthenia Gravis* ; Superficial Back Muscles

No abstract available.
Liposarcoma, Myxoid*

No abstract available.
Animals ; Burns* ; Lymphocyte Subsets* ; Lymphocytes* ; Mice* ; Spleen* ; Thymus Gland*

Computed tomography can be diagnostic with orbital fractures, because it provides detailed visualization of anatomical relationship on both the bones and soft tissues of the orbits. By identifying a group of patient at high risk for enophthalmos and persistent diplopia, we were able to decise the indication of operation. From January 1991 to December 1996, the authors reviewed of 106 consecutive patients(118 eyes)with orbital fractures proven by computed tomography respectively. Among them, 13 patients were repaired surgically. The results were as follows. Orbital fractures occurred most frequently between the ages of 21 and 40 years of men, and the most common cause of those was traffic accident. The incidence of orbital fracture was higher on the left side of orbit. In single wall fractures, the most common involved wall was medial wall, followed by inferior, superior and lateral wall in order. In combined wall fractures, medial and inferior wall fractures were most common. The associated symptoms and signs of orbital fracture were periorbital swelling, lid laceration, diplopia, and enophthalmos in turn. Subciliary approach was used for repair of the fracture. The surgical intervention was done within 2 weeks.
Accidents, Traffic ; Diplopia ; Enophthalmos ; Humans ; Incidence ; Lacerations ; Male ; Orbit* ; Orbital Fractures*

No abstract available.