The relative merits of cartilage scoring versus suturing in techniques for correcting the prominent ear remains a subject of debate among leading plastic surgeons. We compared a variety of echniques for correcting the prominent ear in 72 rabbit ears using scoring, horizontal mattress sutures, and combination scoring and suturing. The ears were splinted with a right-angle fold for 3 postoperative weeks, and the animals were sacrificed after 8 weeks. Suturing techniques in combination with scoring maintained an angulation significantly closer to the desired 90 degrees than cartilage scoring or cartilage suturing only(p<0.05). Histological analysis demonstrated a significant increase in cartilage hyperplasia by suturing alone, whereas the other techniques achieved only mild to moderate increases. We recommend cartilage scoring and suturing through skin incision on severe degrees of prominent ear, and cartilage needle scoring and buried suturing through slit incision on mile-to-moderate degrees of prominent ear.
Animals ; Cartilage ; Ear* ; Hyperplasia ; Needles ; Rabbits* ; Skin ; Splints ; Sutures

Baboon syndrome is used to denote a systemic allergic contact dermititis with a characteristic color and distribution pattern. It is also referred to as mercury exanthem, because inhalation of mercury vapor usually causes the skiri lesion in a sensitized person. Diffuse pi,ikish erythema of the buttock, upper inner thigh, and axilla are characteristic features. We report a case of baboon syndrome developed after exposure to the smoke of a burning amulete a charm written on a piece of paper in a 12 year-old female. Mercury sensitivity was confirrned by a patch test. Atomic absorption by a spectrographic method and Scanning electron microscopy/energy dispersive for analysis X-ray detected mercury in the urine and the ed scraped pigments from the amulet, respectively.
Absorption ; Axilla ; Burns ; Buttocks ; Child ; Erythema ; Exanthema ; Female ; Humans ; Inhalation ; Papio* ; Patch Tests ; Smoke* ; Thigh

No abstract available.

No abstract available.
Nerve Regeneration*

Agminated lentigines may be defind as a circumscribed grouping of small pigmented macules arranged in a small or large group, often in a segmental pattern, each macule consisting of a lentiginous epidermal proliferation of melanocytes. We report five cases of agminated lentigines in otherwise healthy persons. Histologic exarnination of the pigmented lesion revealed findings consistent with lentigo simplex.
Humans ; Lentigo* ; Melanocytes

OBJECTIVE: This study was designed to investigate 1) sleep changes after antidepressant(dothiepin) treatment, and 2) sleep variables which seem to be associated with clinical response in the depressed patients. METHODS: The subjects consisted of 16 patients who fullfilled the criteria for major depression by the Diagnostic and Statistical Manual,(4th edition). Their sleep was recorded using polysomnography at the baseline and after one week and three weeks of dothiepin treatment. All subjects were further interviewed using Hamilton Rating Scale for Depression (HRSD) to rate the severity of their depression. High response to the drug was defined as a reduction of more than 50% of the HRSD score. Result : The results were as follows : 1) Depressed patients after dothiepin treatment showed more total sleep time(p=0.019), shorter sleep latency(p=0.05), less awake time(p=0.033), more sleep efficiency(p=0.018), more stage 2 sleep(p=0.002), less REM time(p=0.000), and longer REM sleep latency(p=0.004) than before treatment. 2) There were no differences in sleep variables between those who received 1 week and 3 weeks of dothiepin treatment except of th shortening of sleep latency after 3 weeks(p<0.05). 3) Depressive symptom scores on HRSD were reduced after 1 week and 3 weeks of dothiepin treatment as compared with the baseline. 4) High responers showed a tendency of increased wake time(p=0.054), while their stage 4 sleep decreased after 1 week of dothiepin treatment as compared with the low responders(p=0.0136). Conclusions : These results suggest that sleep of the depressed patients after dothiepin treatment tends to be nomalized and sleep chages seem to appear early in the treatment phase. In addition, clinical response might be associated with greater wake time at the baseline and lesser atage 4 sleep 1 week of dothiepin treatment.
Depression ; Dothiepin ; Humans ; Polysomnography ; Sleep, REM

A diagnosis of gout is often straightforward because gout has well known clinical presentations, laboratory analyses, and radiologic features. On the other hand, gout can mimic other diseases by showing a range of atypical clinical manifestations. This paper reports a 35-year-old male with no prior history of gout who developed tophaceous gout at his previously repaired Achilles tendon 11 years after surgery. He was initially misdiagnosed with cellulitis because of his atypical clinical features. This case is presented with a review of the relevant literature.

The authors have analyzed the factors influencing the outcome of the 168 patients with acute epidural hematoma who had been managed in our hospital for 3 years from July 1986 to June 1989. 1) Sex incidence showed that male patients were 4.8 times more commonly affected than females, and the most commonly affected age group was the 3rd decade. 2) The most common cause of injury was motor vehicle accidents. The patients with unknown cause of injury which probably suggested significant delay in starting the clinical managements had a higher mortality rate. 3) The most common site of hematoma was the FTP convexity(63.6%). The patients with diffuse hematoma in the fronto-temporo-parietal region had a high mortality and deteriorated level of consciousness. 4) Skull fractures were not seen only in 9.5% of the patients with acute epidural hematoma. 5) The main factors associated with the higher mortality rate were rapid development of hematoma, pupillary dilatation, low score in Glasgow Coma Scale on arrival, and more midline shifting on brain CT. 6) The patients with concomitant intracranial lesions had a high mortality rate(25.8%), and the patients with acute epidural hematoma alone had a low rate(2%), and the overall mortality rate of the patients with acute epidural hematoma was 11.3%.
Brain ; Consciousness ; Dilatation ; Female ; Glasgow Coma Scale ; Hematoma* ; Humans ; Incidence ; Male ; Mortality ; Motor Vehicles ; Skull Fractures

Rheumatoid nodules are the most common extra-articular presentations of rheumatoid arthritis. Although rheumatoid nodules can develop anywhere in the body, they develop most commonly in the subcutaneous region, where they are easily exposed to repetitive trauma or pressure. However, an infrascapular presentation has not yet been reported. We report a case of giant bilateral rheumatoid nodules that developed in the infrascapular area, complicating its distinction from elastofibroma dorsi on radiological examination.

BACKGROUND: Pachydermoperiostosis(PDP) is a rare genetic disease characterized by pachydermia, periostosis, arthralgia and finger clubbing. The pathogenesis of this disease is still unknown, but the concept that platelets and endothelial cells may play a major role in the developement of pachydermia is widely accepted nowadays, It is also suspected that several serum growth factors stimulate proliferation of soft tissue. OBJECTIVE: The purpose of this study was to investigate the pathogenesis of pachydermia in patients with pachydermoperiostosis through evaluating whether the fibroblasts from these patients have a higher proliferation rate than those from controls or whether the proliferation rate of those cells are affected by certain serum growth factors. METHOD: At first, we evaluated the proliferation rate of fibroblasts from patients and corntrols by the MTT colorimetric assay, and then the proliferation rate of fibroblasts from the prepuce of newborn infants under several conditions of media containing uncentrifuged patients serum, centrifuged patients serum, uncentrifuged control serum, or centrifuged control serum. RESULTS: The proliferation of fibroblasts from patients skin was slower than the control fibroblasts and fibroblasts derived from uninvolved skin of patients. The statistically significant highest proliferation rate was observed when fibroblasts were cultured in the uncentrifuged patients serum contained media and the order of proliferation was as follows: centrifuged patients serum, uncentrifuged control serum and centrifuged control serum condition at 20%, 10%, and 1% respectively. CONCLUSION: These results suggest that patients fibroblasts do not proliferate in vitro at a higher rate than control firoblasts. Fibroblasts in PDP may only play a role as target cells and certain serum factors are responsible for the pathogenesis of PDP.
Arthralgia ; Endothelial Cells ; Fibroblasts* ; Fingers ; Humans ; Infant, Newborn ; Intercellular Signaling Peptides and Proteins ; Osteoarthropathy, Primary Hypertrophic* ; Skin