No abstract available.
Spondylolisthesis*

Various surgical methods have been used to reconstruct severe soft tissue defects of the finger with exposed critical structures such as tendon, bone, and nerve. Some of these methods include rotation flap, cross finger flap, or regional flap similar to neurovascular island flap. However, there were often difficult situations where a flap could not be applied depending on the remaining surrounding tissue, injured area, and size of defect. As a result, free flap or distant flap may become necessary. However, distant flaps often cause stiffness of the finger joints since the hands need to be immobilized for a long time, while standard free flaps may be too thick to cover the finger and cause problems such as morbidities of the donor site. Since May, 1997, at Anam Hospital, we have performed reconstruction on 6 patients with soft tissue defect using a thin, flexible medial plantar septo-cutaneous free flap similar to the volar aspect of the finger in anatomical characteristics of the skin and subcutaneous tissue covering. The vessels used for this flap were superficial branches of medial division of the medial plantar artery and vena comitantes, or the subcutaneous veins. The mean size of the flaps was 2.75cm x 4.25cm. Primary repair or split-thickness skin graft was performed on the donor site depending on the size. All the flaps survived without significant complications, except one case of venous insufficiency. The composition of the transferred flaps was good with the recovery of pain, touch and temperature sensation. A free medial plantar septo-cutaneous flap has several advantages, e.g., it is small in comparison with other standard free flaps, having two draining venous pathways, good color and texture, and a good recovery of protective sensation. This flap can be used for the reconstruction of soft tissue defect on the heel and foot, as well as the volar aspect of fingers.
Arteries ; Finger Joint ; Fingers ; Foot ; Free Tissue Flaps* ; Hand ; Heel ; Humans ; Sensation ; Skin ; Subcutaneous Tissue ; Tendons ; Tissue Donors ; Transplants ; Veins ; Venous Insufficiency

No abstract available.
Tretinoin*

BACKGROUND: Histamine, released from mast cells in atheromatous plaque, has been known to cause cardiac ischemia or sudden cardiac death in atherosclerosis patient. Previous reports have suggested that histamine induced coronary vasoconstriction was due to increase in IP(3) and DAG, which induce release of Ca2+ from SR and increase the Ca2+ sensitivity of contractile element via activation of PKC. Recently, it was reported that application of histamine cause depolarization of intestinal smooth muscle, which may contribute to histamine-induced contraction via augmenting Ca2+ influx through activation of Ca2+ channels. However, the underyling mechanism of histamine-induced depolarization and its contribution to the magnitude of coronary vasoconstriction are still uncertain. METHOD: To elucidate the underlying mechanism of Ca2+ influx change during histamine-induced vasoconstriction, we examined the effect of Ca2+ channel antagonist and PKC blocker on histamine-induced contractions, and then measured the effect of PKC antagonist on whole cell K+ current using patch clamping method in rabbit coronary smooth muscle cells. RESULTS: Application of histamine induced phasic and tonic constraction of coronary rings via activation of H(1) receptors. Pretreatment of Ca2+ channel antagonist (nifedipine, 1 microM) or PKC blockers (10 nM staurosporine and 10 microM Go6976) markedly inhibited histamine-induced tonic contraction, which suggest that the magnitude of tonic contraction depend on the Ca2+ influx. Application of 4-AP, a blocker of voltage-dependent K+ channels, increased resting tone of coronary rings, and combined treatment of nifedipine blocked this 4-AP induced increase of resting tone. Application of active analoge of DAG (1,2-DiC(8)) significantly inhibited the activity of voltage-dependent K+ current in single smooth muscle cell, meanwhile the inactive analogue of DAG (1,3-DiC(8)) has no apparent effect on the activity of voltage-dependent K+ current. Furthermore, pretreatment of calphostin C (1 microM), a blocker of PKC, diminished the 1,2-DiC(8)-induced inhibition of K+ current. CONCLUSION: PKC dependent inhibition of voltage-dependent K+ current may be responsible for the maintaining of histamine-induced tonic contraction in rabbit coronary artery.
Atherosclerosis ; Constriction ; Coronary Vessels* ; Death, Sudden, Cardiac ; Histamine ; Humans ; Ischemia ; Mast Cells ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Nifedipine ; Protein Kinase C ; Staurosporine ; Vasoconstriction

A choroid detachment occurs most commonly after surgical operation for cataract, glaucoma, and retinal detachment. It is fairly characteristic for postoperative choroidal edema to be accompanied by hypotonia and a shallow anterior chamber. We have recently experienced 3 cases of choroid detachment after cataract operation, and acase of choroid detachment combined with retinal detachment after trabeculectomy. They were also accompanied by hypotonia and shallow anterior chamber, but had not would leakage. Among 4 cases, a case of choroid detachment was performed suprachoroidal tapping, the remaining were treated with prednisolone, cycloplegics, and pressure dressing. They were not of consequence and subsided without being noticed. A brief review of relating literatures was described.
Anterior Chamber ; Bandages ; Cataract ; Choroid* ; Edema ; Glaucoma ; Muscle Hypotonia ; Mydriatics ; Prednisolone ; Retinal Detachment ; Trabeculectomy

No abstract available.
Hematoma*

No abstract available.
Lasers, Gas*

No abstract available.

The increasingly successful results of hair restoration surgery in the last years have developed the interest and the confidence of patients and it is the most frequently performed esthetic surgery among male patients. Currently, various kinds of techniques for hair restoration surgery including hair transplantation, scalp reduction, and scalp flaps are performed in our clinic. Among these, hair transplantation is the basic and the most popular procedure, which can be performed not only by itself but also in conjunction with other procedures. 123 consecutive cases of hair transplantations were peformed from Jan. 1995 to Feb. 1996 for male pattern baldness, traumatic alopecia, and female pattern baldness under out patient base. The authors introduced a new classification for male pattern baldness, which are the type M, O, C, U, M-O, and C-O after alphabet to make simple and easy for clinical application. The ancillary procedures were scalp reduction, preauricular flap, and scalp expansion. An ellipsis of hair bearing scalp taken from the occipital area was sliced into slit-, mega-, mini-, and micro-grafts. The survival rate of the grafts was over 90% with minimal complications. This hair transplantation technique enabled us to achieve a good density and more natural looking hair with avoidance of cobble stoning and apparent scar.
Alopecia* ; Cicatrix ; Classification ; Hair* ; Humans ; Male* ; Scalp ; Surgery, Plastic ; Survival Rate ; Transplants

Of 127 consecutive cases of relatively fresh rhegmatogenous retinal detachment, posterior vitreous detachments and their relation to type of retinal perforation were studied using a contact lens or Hruby lens and a biomicroscope for stereoscopic examination of the vitreous cavity and the fundus of the eve. Analysing 127 cases, the authors found a complets posterior vitreous detachment with collapse in 58 cases and a simple total pcsterior vitreous detachment in 69 cases. And posterior vitreous detachment was an indispensable factor for rhegmatogenous retinal detachment. The topographical site of election, however, varies with the type of perforation. Arrow-head tears occur preferentially in the upper half of the retina, particulaly with a predilection for the equatorial zone. Amog 26 horse-shoe shaped tears, 25tears were found in the upper half of the fundus and only one in the lower half. The horse-shoe shaped tears were always accompanied with total posterior vitreous detachment with collapse. In the series of 127 rhegmatogenous retinal detachment, 100 round holes were detected; 48 holes were found in the eyes wth total posterior vitreous detachment with collapse and 52 holes in the eye with simple total posterior vitreous detachment. The distribution of these perforations in the retina is of interest. The teares distributed almost equally in all quadrants. The vast majority occurred in the peripheral retina at equator or anterior to the equator and holes at juxtapapillary and intermedial areas are extremly rare. The authorse are of the opinion, that total posterior vitreous detachment with collapse, is one of the predisposing factors to lead to a horse-shoe shaped tear. In this type of vitreous detachment, the solid vitreous in the upper part is found only antereioly next to the vitreous base. In event of trauma and sudden movement of the eyeball, vitreoretinal adhesion, which located in the upper part of peripheral fundus may be pulled anteriorly and tangentially from the internal surface of the retina and so the base of the operculum deflects toward the ora serrata. The ascension phenomenon of the solid vitreous may also lead tc the formation of retinal tears in th elower part of the fundus. The convexity of the tear is always turned toward the optic nerve, and the concavity face the ora. The appearance of these rents may suggest that they not only are formed by a tearing process of a forward direction due to adhesion of the retina to the vitreous but also depend upon the typical network of retinal fibers. On the other hand, in simple total posterior vitreous detachment, a round hole of en occurrs in the equator as well as in macular, juxta papillary and intermedial region, because the solidification power of the formed vitreous operates as a force on the vitreoretinal adhesion toward the center of the eyeball.
Causality ; Hand ; Optic Nerve ; Retina ; Retinal Detachment ; Retinal Perforations* ; Retinaldehyde* ; Vitreous Detachment*