The osteoplasties of maxilla and mandible as the craniomaxillofacial surgery is popular and markedly developed in technically. In traditional osteoplasty, we have been use the mechanical saw, burr, cutting bar which is big sized instrument to transmit the energies to the saw or burr tips. So it is technically difficult to use such big instrument in narrow operative field Recently, the development of laser technology makes wider influence in the medical field. So, the laser is applying to high energy-using osteotomy in addition to hemangioma, tatoo, laserbrasion, hypertrophic scar and endoscopic surgery. The objective of the present study is to evaluate the extent of damage of bone and subsequent healing between the conventional mechnical saw osteotomies and the ND-YAG laser used osteotomies on the rabbit mandible angles by the histologic examination. Fifteen New Zealand white rabbits were used for the study. After exposure of rabbit's mandibular angle, one side of mandible angles were osteomized used by Nd-YAG laser and the other by the saw randomly. We compared the extent of damage and healing of laser and saw osteotomies at immediate, 2 week, 4 week, 3 months, 6 months postoperatively. The result revealed that, in two weeks after operation, the one of damaged bone was looks wider in laser osteotomies sites than by conventional mechanical saw osteotomies sites, but there is not remarkable differences between the laser and saw used group after 4 weeks, and we believe that it is possibility to use alser in craniomaxillofacial field saftly in near future.
Cicatrix, Hypertrophic ; Hemangioma ; Lasers, Solid-State* ; Mandible ; Maxilla ; Osteotomy ; Rabbits

Microvascular endothelial cells were purely isolated from human fetal skin using magnetic particles. The principle of this technique is based on the selective binding of the lectin Ulex europaeus I (UEA I) to the endothelial cell surface via fucose residues. Initially UEA I was covalently bound to tosyl-activated magnetic polydisperse polymer particles (Dynabeads) and then the UEA I-coated beads were collected using a magnetic particle concentrator (MPC). Endothelial cells were isolated by extracting microvascular segments from trypsin-treated fetal skin tissue and were purified by sieving with nylon mesh and by 35% Percoll gradient centrifugation. For further purification, the obtained cells were incubated with UEA I-coated Dynabeads. The endothelial cells bound to the Dynabeads were collected using MPC. This is a simple and reproducible technique for isolating a pure population of microvascular endothelium from the fetal skin.
Cells, Cultured ; Endothelium, Vascular/*cytology ; Factor VIII/analysis ; Female ; Fetus ; Human ; Intercellular Adhesion Molecule-1/analysis ; Pregnancy ; Skin/blood supply ; Support, Non-U.S. Gov't ; Vascular Cell Adhesion Molecule-1/analysis

The evaluation of pigmentary skin lesions by clinical doctors has been based on subjective and qualitative judgements. Observations have mostly relied on visual inspection, making the effects of treatment difficult to evaluate with any precision. For this reason there is a real need for an objective method to evaluate prognosis after treatment. Recent scientific measurements such as reflectance spectrophotometry and reflectance colorimetry have provided accurate quantitative color information about skin lesions, but these techniques are costly and difficult to apply in the clinical field. The purpose of this study was to develop a simple and cost-effective way of evaluating treatment results. We have developed a software program using the L*a*b* color coordinate system to quantify the effect of treatment and have successfully demonstrated its clinical usefulness. Our method compares the relative color difference between normal skin and skin lesions before and after treatment, instead of measuring the absolute color of skin lesions. The accuracy of our quantitative color analysis was confirmed by the simulated images of hemangioma and ota nevus. Clinical efficacy was also confirmed through a blind test involving 3 clinicians who were asked to grade the treatment effects of 13 cases of hemangioma and 7 cases of ota nevus. These subjective clinical grades correlated well with the treatment results obtained using the proposed color analysis system (Correlation coefficient = 0.84).
Color* ; Female ; Hemangioma/therapy ; Hemangioma/pathology ; Human ; Nevus of Ota/therapy ; Nevus of Ota/pathology ; Outcome Assessment (Health Care)/methods* ; Pigmentation Disorders/therapy* ; Pigmentation Disorders/pathology* ; Skin Neoplasms/therapy ; Skin Neoplasms/pathology ; Skin Pigmentation* ; Software*

Epidermal cysts slowly growing, intradermal or subcutaneous tumors that usually cease growing after having reached 1 to 5 cm in diameter. We report a case of giant epidermal cyst on the scapular region with the appearance of well delineated huge mass measured 19×17×14cm in size. Its clinical and surgical management are illustrated.
Epidermal Cyst

BACKGROUND: Coverage of defects of the pretibial area remains a challenge for surgeons. The difficulty comes from the limited mobility and availability of the overlying skin and soft tissue. We applied variable pedicled perforator flaps to overcome the disadvantages of local flaps and free flaps on the pretibial area. METHODS: Eight patients who had the defects in the anterior tibial area were enrolled. Retrospective data were obtained on patient demographics, cause, defect location, defect size, flap dimension, originating artery, pedicle length, pedicle rotation, complication, and postoperative result. The raw surface created following the flap elevation was covered with a split thickness skin graft. RESULTS: Posterior tibial artery-based perforator flaps were used in five cases and peroneal artery-based perforator flaps in three cases. The mean age was 54.3 and the mean period of follow-up was 6 months. The average size of the flaps was 63.8 cm2, with a range of 18 to 135 cm2. There were no major complications. No patients had any newly developed functional deficit of the lower leg. CONCLUSIONS: We suggest that pedicled perforator flaps can be an alternative treatment modality for covering pretibial defects as a simple, safe and versatile procedure.
Arteries ; Demography ; Follow-Up Studies ; Free Tissue Flaps ; Humans ; Leg ; Perforator Flap ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin ; Surgical Flaps

STUDY DESIGN: The authors retrospectively analysed the recovery of clinical symptoms after surgical treatment of lumbar HIVD. OBJECTIVES: To investigate the incidence of clinical symptoms, the recovery rate and time after surgical treatment and the difference between L4-5 and L5-S1 lesion. SUMMARY OF LITERATURE REVIEW: There are many reports concerning the clinical result of surgical treatment for the HIVD. They usually describe the result as excellent, good, fair and poor. We can't get any information about the recovery rate and recovery time of each clinical symptom from the reports . MATERIALS AND METHODS: Thirty-eight patients were treated by one level open discectomy from march 1991 to december 1995, The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR and severity of radiating pain were periodically followed up on the predesigned protocol. RESULTS: In preoperative examination, SLR was positive in 82%, motor deficit in 76%, sensory deficit in 74%, DTR change in 50%, and radiating pain in 100%. The recovery rate of SLR was 96.8%, motor deficit ; 93.6%, sensory deficit ,78.6%, DTR change ; 21% and radiating pain ,84.2%. The average recovery time of SLR was 3.4 months, motor deficit ; 1.9 months, sensory deficit ; 5.3 months, DTR change ; 4.1 months and radiating pain ; 3.2 months. Motor and sensory deficit was more frequent in L4-5 lesion but DTR change was usually noted in L5-S1 lesion. The recovery rate and time showed no great difference between the two level. CONCLUSIONS: The recovery rate was higher in SLR, motor deficit and radiating pain rather than sensory deficit and DTR change. The recovery time was fastest in radiating pain but variable nature was noted in sensory deficit. Above results may be helpful to explain the prognosis of the lumbar HIVD.
Diskectomy ; Humans ; Incidence ; Prognosis ; Retrospective Studies

In the treatment of meniscal injury of the knee joint, it has been known that the result of partial meniscectomy to prevent degenerative change of the knee joint after meniscectomy. However the result of lateral discoid meniscectomy is controversial between partial and total meniscectomy. In the treatment of lateral discoid meniscal injury, Fujikawa and Dickhaut reported the better results with partial meniscectomy than total resection, but Ikeuchi and Kobayashi reported the better results with total meniscectomy. The purpose of this paper is to compare the results of arthroscopic partial and total meniscectomy. Five hundred ninety-five patients with meniscal injury was treated by meniscectomy between January, 1983 and December, 1994 at the department of orthopaedic surgery, Soonchunhyang Univ. Hospital. 119 patients of all were done lateral discoid meniscectomy had no other combined findings. Wr wrre able to follow up 42 patients(44 cases) of 84 patients with interview and/or questionnaire. WR analysed the 44 cases and summarized the results as follow: 1) A discoid lateral meniscus was presented in 20.0% of all meniscal resection. 2) Postoperative click sound was presented in 7 cases of 25 cases(28.0%) with partial meniscectomy and in 5 cases of 19 cases(26.3%) with total meniscectomy. Giving way was presented in 2 cases(8.0%), 1 case(5.3%) and Locking in 1 case(4.0%), 0case(0.0%) respectively. 3) In the post operative. Pain, no pain and mild pain were presented in 88.0% of partial meniscectomy and in 94.8% of total meniscectomy. 4) In the degree of activity level, “same before symptoms was developed(no symptom)”. was presented in 84.0% of partial meniscectomy and in 84.2% of total meniscectomy. 5) In the return to work, all patients returned to original job with/without limitation. 6) In the knee rating scale of Ikeuch, excellent or good was presented 72.0% of partial meniscectomy and in 89.5% of total meniscectomy. 7) Roentgenologic degenerative changes were more presented after total than partial meniscectomy. We concluded that the total meniscectomy is better than the partial meniscectomy in the symptom and functional results, but long term follow up secondary degenerative change must be followed.
Arthroscopes ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Menisci, Tibial ; Return to Work

Cell migration is essential for many important biological events, including embryonic development, wound healing, inflammatory response, and tumor metastasis. As a result of endothelial cell migration, angiogenesis is very important factor in embryogenesis, wound healing, tumor development and flap survival. Angiogenesis is dependent on endothelial cell proliferation, migration and motility is one of the most essential for many important biological events. The speed of cell migration is regulated by extension, attachment, detachment of cell membrane and adhesiveness of cell to extracellular matrix. Growth factors such as FGF, TGF, VEGF is well known to play a major roles in the migration of endothealial cells. This study was designed to compare the motilities of human dermal microvascular endothelial cell(HDMEC) in growth factors such as bFGF, TGF-beta1 and VEGF. The motility of cultured HDMEC was compared using a video-microscopy system that was developed in combination with a self-designed CO2 mini- incubator. To determine migration speed, cells were viewed with a 4 phase-contrast lens and video recored. Images were captured using a color CCD camera and saved in 8-bit full-color mode. Experimental groups were divided into four groups: group I(with a Control, HDMEC only), group II(HDMEC with bFGF), group III (HDMEC with TGF-beta1), group IV(HDMEC with VEGF). At the concentration of 1ng/ml(bFGF), 1ng/ml(TGF-beta1), and 10ng/ml(VEGF) as the most effective dose for cell migration through preliminary study, the speed of migration are 8.736+/-0.948micrometer/hr, 9.869+/-1.904micrometer/ hr, 10.293+/-1.612micrometer/hr, respectively. These data shows that groups with growth factor accelerate the HDMEC migration than a control group, and the VEGF is most effective growth factor in the HDMEC migration than bFGF and TGF-beta1.
Adhesiveness ; Cell Membrane ; Cell Movement ; Embryonic Development ; Endothelial Cells* ; Extracellular Matrix ; Female ; Humans* ; Incubators ; Intercellular Signaling Peptides and Proteins* ; Neoplasm Metastasis ; Pregnancy ; Transforming Growth Factor beta1 ; Vascular Endothelial Growth Factor A ; Wound Healing

Eaton and Littler's ligament reconstruction is used to treat carpometacarpal instability of the thumb using the flexor carpi radialis tendon. This procedure involves a reconstruction of the deep anterior oblique ligament in patients with post-traumatic prearthritic unstable joints. According to a recent paper, the dorsoradial ligament as well as the deep anterior oblique ligament plays an important role in stabilizing the trapeziometacarpal joint. We report three cases of post-traumatic instability in a prearthritic thumb that was treated with Eaton and Littler's reconstruction using the flexor carpi radialis tendon.
Carpometacarpal Joints ; Humans ; Joints ; Ligaments ; Tendons ; Thumb

PURPOSE: The effects of local injection of TGF-beta1 on the normal patellar tendon and the characteristics of remaining tendon after the partial resection of hypertrophic one were investigated. MATERIALS AND METHODS: TGF-beta1 was injected into the right patellar tendon of mature rats weekly for 3 weeks. Histological study, biomechanical analysis and the transmission electron microscopic evaluation were done. Half of hypertrophic tendon was resected at 4 weeks after the last injection and the same analyses were RESULTS: TGF-beta1 treated tendon increased in cross sectional area but decreased significantly in maximum tensile stress. The hypertrophic tissue was mainly composed of small collagen fibrils. After the partial resection of hypertrophic tendon, there was no significant difference in maximum tensile stress between remaining and control tendons. There were relatively larger collagen fibrils in the remaining tendon tissue than in non-resected hypertrophic one. CONCLUSION: Local injection of TGF-beta1 induced the hypertrophy of normal tendon. After the partial resection of hypertrophic tendon, the remaining one showed the more similar biomechanical properties to normal one.
Animals ; Collagen ; Hypertrophy* ; Patellar Ligament* ; Rats* ; Tendons ; Transforming Growth Factor beta1*