No abstract available.
Diagnosis, Differential*

PURPOSE: For the correction of ptosis with very poor levator function, frontalis sling operation with various materials has been used. The purpose of this study was to evaluate the effect of the modified Crawford technique using preserved fascia lata. METHODS: The photographs and charts of 46 patients who underwent frontalis sling operation using preserved fascia lata from June 2001 to February 2004 at our hospital were retrospectively reviewed. The eyelid crease approach was used with the suturing of the sling material directly to the tarsus. RESULTS: The patients were 27 males and 19 females. There were 20 (44%) unilateral cases and 26 (56%) bilateral cases. The age of the patients ranged from 1 to 65 years at the time of surgery, with an average age of 8.3 years. The success rate was 93% (43/46 patients) for a mean postoperative follow-up of 9 months (range 4~26 months). The complications consisted of one case of overcorrection and 2 cases of undercorrection. Knot exposure occurred in 2 cases. CONCLUSIONS: The modified Crawford technique using preserved fascia lata appears to be an effective treatment for severe ptosis. The lid crease formation provides good cosmetic results and the direct suturing of the preserved fascia lata to the tarsus prevents its migration.
Ankle ; Blepharoptosis ; Eyelids ; Fascia Lata* ; Fascia* ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies

PURPOSE: The purpose of this study is to develop three-dimensional computerized anthropometry(3DCA) and to compare its reliability and accuracy 3DCA with manual anthropometry(MA) for measurement of lips and nasal deformities in unilateral cleft lips and palate(UCLP) patients. METHODS: Samples were consisted of six UCLP patients whose facial plaster models were available immediately before and 3 months after the cleft lip surgery. MA of the facial plaster models was carried out using an electronic caliper. In 3DCA, three-dimensional auto- measuring program was used to digitize landmarks and to measure three-dimensional virtual facial models (3DVFM), which was generated with a laser scanner and 3D virtual modeling program. Intraclass correlation coefficients(ICC) were calculated to evaluate reliability and reproducibility of the variables in both methods, and Wilcoxon's signed rank test was done to investigate the difference in values of the same variables of facial models of each patient between two methods. RESULTS: All ICC values were higher than 0.8, so both methods could be considered reliable. Although most variables showed statistical differences between two methods(p<0.05), differences between mean values were very small and could be considered not significant in clinical situation. CONCLUSION: In clinical situation, 3DCA can be an objective, reliable and accurate tool for evaluation of lips and nasal deformities in the cleft patients.
Cleft Lip ; Congenital Abnormalities ; Electronics ; Electrons ; Humans ; Lip

No abstract available.
Fistula* ; Stomach* ; Tuberculosis*

It has been reported that the number of patients with hypertension increases yearly, and this imposes many anesthetic problems during surgery. The etiology of essential hypertension is unknown, but it affects primarily the brain, heart and kidney. The main causes of mortality due to hypertension are cerebrovascular accident, congestive heart failure, myocardial infarction and uremia. For the better anesthetic management of patients wuth hypertension, it is essential to clearly understand the pathophysiologic changes and hemodynamic patterns of hypertension. Because of the controversy regarding the appropriateness of preoperative treatment of hypertension, this article will evaluate the effect of preoperative antihypertensive medication on blood pressure during anesthesia of hypertensive patients. Patients with hypertension were divided into two groups, one group consisting of ll patients, who received antihypertensive medication in the preoperative period, and the other group, consisting of 11 patients, who did not received antihypertensive medication for the control of high blood pressure preoperatively. Changes of arterial blood pressure during anesthesia were analyzed, and data were compared between the two groups. The results were as follows: The patient who receivecd antihypertensisve medication for preoperative anesthetic management showed the same arterial blood pressure fluctuation during general anesthesia, as the patients who had not received antihypertensive medication (p < 0. 05). In the treated group, the blood pressure and heart rate changes during preinduction and intubation showed significant increase compared to the ward's values, but did not show a significant increase during operation annd recovery. In the nontreated group, the results showed similar changes with the treated group. It may be suggested from the above observation that the preoperative control of hypertension dose not affect the changes of blood pressure in the perioperative period.
Anesthesia* ; Anesthesia, General ; Arterial Pressure ; Blood Pressure* ; Brain ; Heart Failure ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Hypertension ; Intubation ; Kidney ; Mortality ; Myocardial Infarction ; Perioperative Period ; Preoperative Period ; Stroke ; Uremia

The vertebral artery is infrequently injured because it lies deep in the neck, surrounded for the most part by bony foramina. Vertebral artery injuries are caused by penetrating traumas, blunt traumas and iatrogenic injuries. Sequela of vertebral artery injury include arteriovenous (AV) fistulae, and pseudoaneurysms may appear months after injury. Angiography is currently the gold standard for evaluating vascular injuries, such as vertebral artery injuries, and can be therapeutic. A vertebral artery fistula can also be treated by operative ligation. We experienced a rare case of a vertebro-jugular AV fistula secondary to a cervical stab wound. In this case, the patient was successfully treated by coil embolization and glue injection during angiography, which was confirmed by a postangiograpy operation.
Adhesives ; Aneurysm, False ; Angiography ; Arteriovenous Fistula* ; Embolization, Therapeutic ; Fistula ; Humans ; Ligation ; Neck ; Vascular System Injuries ; Vertebral Artery ; Wounds, Stab

BACKGROUND AND OBJECTIVES: To report our experience of colon interposition without thoracic inlet widening for the management of esophageal stricture. SUBJECTS AND METHOD: Between 2005 and 2012, five patients underwent esophageal replacement using colon graft. Clinical data, such as surgical techniques including thoracic inlet widening, surgical outcomes, and patient's age and gender were retrospectively analyzed. The follow-up period ranged from 10 months to 5 years. RESULTS: All five patients had corrosive esophageal stricture and underwent colon interposition without thoracic inlet widening; four underwent pharyngocologastrostomy and one total laryngopharyngectomy and pharyngocologastrostomy. No major complications, such as aspiration, dysphagia, reflux, or swallowing disorder developed during the postoperative long term follow-up. CONCLUSION: A colon graft without enlargement of the thoracic inlet is an excellent esophageal substitute for patients with an esophageal corrosive stricture. Further surgical experience and more long-term follow-up data are required to produce more precise and statistically meaningful results.
Bays* ; Colon* ; Constriction, Pathologic ; Deglutition Disorders ; Esophageal Stenosis* ; Follow-Up Studies ; Humans ; Retrospective Studies ; Transplants

PURPOSE: The purpose of this study is to evaluate the early results and occurrence of complications of cementless total hip arthroplasty (THA) using an alumina-on-alumina articulation with a minimum follow up period of three years. MATERIALS AND METHODS: We prospectively followed 108 patients (121 hips) who underwent cementless THA using an alumina-on-alumina articulation. The mean age of the patients was 50.7 years (range, 20-80 years) and mean the follow up period was 48 months (range, 36-60 months). Preoperative diagnoses included osteonecrosis of the femoral head in 90 hips; secondary osteoarthritis due to hip dysplasia in 24 hips; secondary osteoarthritis after acetabular fracture in four hips; acute femoral neck fracture in three hips. Clinical evaluation was performed using Harris hip score (HHS) and radiographic evaluation was performed in terms of the fixation of components and the prevalence of osteolysis. In addition, we observed complications, including the occurrence of sound or fracture of the alumina head or liner. RESULTS: Mean HHS improved from 62.4 points to 94 points at final follow-up. Thigh discomfort was found in six hips and mild inguinal discomfort was found in eight hips. Both had disappeared within one year after operation. A clicking sound was detected in two patients. One hip had become dislocated and an alumina liner fracture had occurred in one hip. Loosening of component or osteolysis was not observed in any hip. The radiographic wear was not measurable. CONCLUSION: Early results of cementless THA using an alumina-on-alumina articulation were favorable, with osseointegration of the components and absence of periprosthetic osteolysis. However, longer-term follow up for a hip clicking sound and fracture of an alumina fracture are necessary.
Aluminum Oxide ; Arthroplasty ; Femoral Neck Fractures ; Follow-Up Studies ; Head ; Hip ; Humans ; Osseointegration ; Osteoarthritis ; Osteolysis ; Osteonecrosis ; Prevalence ; Prospective Studies ; Tacrine ; Thigh ; Ursidae

Purpose: Verifying a reliable predictor of the progression of vertebral deformity in patients with acute osteoporotic fractures of the lumbar spine may be useful. A qualitative analysis of the muscle near the spine was performed using magnetic resonance imaging (MRI), and its correlation with a spinal deformity was determined under the hypothesis that the causes of the kyphotic deformity are associated with muscle reduction in the multifidus and erector spinae. Materials and Methods: The study was performed in a retrospective manner using the electronic medical records of patients who presented to the author’s institution between January 2007 and March 2018, and were diagnosed with an acute lumbar fracture. The fat infiltration rates of the multifidus and erector spinae were measured using MRI taken at the time of injury, and the mean value was defined as the total fat infiltration rate (TFI). Based on lateral radiographs of the lumbar spine at the one-year follow-up, the loss of height of the vertebral body, the kyphotic angle and the wedge angle were measured. The statistical significance was confirmed by calculating the Pearson correlation coefficient. Results: One hundred twenty-nine patients, of which 30 were male and 99 were female, were examined. The mean age was 71.28 years. The mean T-score was - 3.53±0.79 g/cm2 , and the mean fat infiltration was 15.20%±11.99%. TFI was positively correlated with age (R=0.373, p<0.001), compression rate (R=0.369, p<0.001), and Cobb’s angle (R=0.386, p<0.001) after a one year follow-up, but negatively correlated with the BMD score (R= - 0.252, p=0.004). As the fracture progressed to the lower lumbar level, the compression rate (R= - 0191, p=0.030) and wedge angle (R= - 0.428, p<0.001) at the time of injury tended to decrease. Conclusion In patients with osteoporotic vertebral fractures, the fat infiltration rate may be an important predictor of conservative treatment. The prognosis of patients with a high-fat infiltration rate should be explained during patient education, and the patients must be monitored closely through short-term outpatient follow-up.

We found an error in our published article. Author name should be corrected.