The purpose of this study is to introduce the patients with bilateral cleft lip nose have lots of distinctive anatomical features such as short columella, inferior displacement of the medial crura of alar cartilage, lowering of the alar dome, flattened tip of the nose, widened nostril sill and prominent vestibular skin web. Although millard, Kaplan and Wray have introduced columellar lengthening by fork flap, it was difficult to achieve satisfying results without reconstructing the nasal skeletal framework of the cleft lip nose deformity for their anatomical distinctiveness. We have performed rhinoplasty on 7 patients with bilateral cleft lip nose from January. 1995 to August. 1997, using onlay calvarial bone graft and suture suspension technique. Operation was performed on basic anatomical structure, skeletal framework using outer table of calvarial bone pushed into the nasal tip area and suspension suture was applied to the framework with anteroinferior projection of nasal tip projection vector by cantilever effect of the calvarial bone which carried out nearly normal anatomical nasal structure. We have obtained satisfying results without complication in all seven cases. In conclusion the method which authors have used shows several advantages. First, it was possible to obtain the substantial skin lengthening in anterior and inferior direction by "Tent-Pole effect" in which creating bony structure projected into nasal tip and traction suturing of the deformed alar cartilages. Secondly, columellar lengthening and close to normal nostril shape was obtained and thirdly, re-deformation of corrected structure was prevented. An expected problem in above method is resorption of grafted calvarial bone which expected to maintain its position under influence of alternation and reformation by reaction between chondroblast and chondroclast results in fibrous tissue replacement, yet long term follow up is necessary for futher evaluation.
Cartilage ; Chondrocytes ; Cleft Lip* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Inlays ; Nose* ; Rhinoplasty ; Skin ; Sutures* ; Traction ; Transplants*

No abstract available.

PURPOSE: To assess the MR findings of Tolosa-Hunt syndrome and to evaluat differential point of cavernous sinus lesions. MATERIALS AND METHODS: Eleven cases of Tolosa-Hunt syndrome were evaluated by MRI with specific regard to the shape of cavernous sinus, signal intensity, and pattern of enhancement. Other associated findings were also anlaysed. RESULTS: Two patients had normal MR features of the cavernous sinus. When compared with the contralateral normal cavernous sinus, the involved cavernous sinus was enlarged in six of the nine patients. The outer dural margin was convex and bulged laterally in 6 cases, flat in 2 cases, and concave in 1 case. Of the nine patients, five had iso-signal intensity and four had low signal intensity relative to gray matter on short TR/short TE. Three had isosignal intensity and 6 were not detectale on long TR/short and long TE pulse sequence. Contrast enhancement was seen in 8 cases ;7 cases showed homogeneous enhancement, 1 case heterogeneous enhancement. CONCLUSION: In the appropriate clinical setting of painful ophthalmoplegia, MR findings of cavernous sinus abnormality that consist of iso to low signal intensity on short TR/short TE images and isointense or undetectale mass on long TR/short TE or long TR/Iong TE images may suggest the dignosis of Tolosa-Hunt syndrome.
Cavernous Sinus ; Humans ; Magnetic Resonance Imaging ; Ophthalmoplegia ; Tolosa-Hunt Syndrome*

A total of 4757 apparently healthy aged persons over 65 years of age was surveyed for geriatric hypertension. A single blood pressure measurement was taken in the sitting position. Mean systolic blood pressure rose significantly with age in female but didn't in male and mean diastolic blood pressure didn't change with age in both sex. The prevalence of pure systolic hypertension, i.e., a systolic blood pressure greater than or equal to 160 mmhg and a diastolic blood pressure less than 95mmhg, increased with age. The prevalence was slighty lower for female than it was for male, being 7.0% for female and 8.0% for male. The prevalence of classical hypertension-defined as diastolic blood pressure greater than or equal to 95mmhg - was 42.7% for female and 48.2% for male and it rose with age in female. The prevalence of both pure systolic and classical hypertension was 49.7% for female and 56.1% for male.
Blood Pressure ; Epidemiologic Studies* ; Female ; Humans ; Hypertension* ; Korea* ; Male ; Prevalence

This study was executed to measure the shear bond strength of Panavia EX and Panavia 21 when the Ni-Cr-Be alloy castings were cemented to the enamel surfaces with these cements. The cast metsl plates of Ni-Cr-Be alloy were sandblasted and cemented to acid etched enamel surface with Panavia EX or Panavia 21. Their shear bond strength were measured with Instron Universal Testing machine. Within the limits of this study, following conclusions were withgdrawn. 1. The mean shear bond strength were 26.85.7Mpa, in Panavia EX and 28.35.2Mpa, in Panavia 21. 2. t-Test revealed no statistical significance between two groups(.05 level) 3. Macroscopically, bond failures were revealed compound fracture at metal and enamel interfaces, in cases of both cements, as the cement attached partly on both metal and enamel surface.
Adhesives* ; Alloys* ; Dental Enamel* ; Fractures, Open

Meningioma is the most common primary intracranial neoplasm that originates from the meningothelial cells. It occurs mainly in adults, and has a female preponderance. It is classically classified into three main types: meningotheliomatous or syncytial type, fibrous or fibroblastic type, and transitional type. Transforming growth factor alpha(TGF-alpha) was known as a neoplastic transformer found in the neoplastic tissue of the brain rather than in normal tissue in the neoplastic tissue, the expression of the TGF-alpha was more intense in the malignant rather than benign tumor, but the expression of the TGF-alpha on the meningioma was not reported. Transforming growth factor-beta (TGF-beta) was known as a peptide which is involved in the proliferation of the mesenchymal cells and the other many physiologic processes. Tumor necrosis factor(TNF) has a selective necrotic action of the neoplastic cells without influence on normal tissues. Epidermal growth factor (EGF) and epidermal growth factor receptor(EGR) have a control effect on cellular proliferation and differentiation and the expression of the EGR in breast cancer has a reverse correlation to the expression of the estrogen receptor(ER). The meningioma is the most common host tumor of breast cancer among the intracranial neoplasm, so, presence of some estrogen receptors in the meningioma is suspected. The correlation of the estrogen receptor expression to EGR expression in the meningioma is the concern of this study. Therefore, the authors have observed the meningioma on the basis of the expression of the ER, TGF-alpha, TGF-beta, TNF-beta, EGF and EGR according to the immunohistochemical stain and polymerase chain reaction(PCR), and the results obtained were as follows. The expressions of the TGF-alpha, TGF-beta were weakly positive in 4 out of 25 examined cases, and the expressions of the EGF and EGR, were more intensely positive in 2 out of 25 examined cases, especially in the vascular wall and perivascular area. TNF-beta expression was weakly positive to focal area only in one case of the meningotheliomatous type. The ER expression was weakly positive to focal areas. The subtypes of meningioma expressing positivity were meningotheliomatous and transitional type, which wer not related to tumor aggressiveness or poor prognosis. In conclusion, ER,EGF-alpha, TGF-beta, TNF-beta, EGF and EGR were experssed in the meningionma, and it is suspected that these factors may be involved in the tumorigenesis or "host" tumor action rather than in tumor aggressiveness.
Adult ; Brain ; Brain Neoplasms ; Breast Neoplasms ; Carcinogenesis ; Cell Proliferation ; Epidermal Growth Factor ; Estrogens ; Female ; Fibroblasts ; Humans ; Lymphotoxin-alpha ; Meningioma* ; Necrosis ; Polymerase Chain Reaction* ; Prognosis ; Receptors, Estrogen ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Transforming Growth Factors

PURPOSE: To understand the morphologic and molecular changes in carcinogen-induced breast tissues, DMBA (10-dimethy1-1,2 benzanthracene) was administrated in Sprague- Dawley female rats. MATERIALS AND METHODS: At 50 days of age, all experimental rats were given 20 mg DMBA by gastric intubation. Until the seventh week after DMBA administration, six rats were sacrificed every week, thereafter all tumors found during 20 weeks were removed every week. The morphologic changes were evaluated in routinely processed sections stained with H-E and with anti-smooth muscle actin antibody. Mutation of Ha-ras codons 12 and 61 was examined by ARMS (amplification refractory mutation system) method in frozen tissues. RESULTS: The epithelial cell proliferation of terminal end buds began 2 weeks after DMBA treatment and progressed to the 6th week, resulting in microscopic malignant tumor in one of the 7th weeks rats. The tumors were developed in 43 of 62 rats (69.4%); 8 benign lesions in 4 rats and 72 malignant tumors in 39 rats. Mutations in the 12th and 61th codon of Ha-ras gene were respectively found in 29.7% and 2.7% of preneoplastic breasts, 25% in benign lesions, 2.6% and 31.6% of malignant tumors. CONCLUSION: DMBA treatment in rats induced epithelial proliferation, then benign and malignant tumors through Ha-ras gene mutation, especially in codon 61 leading to cancer.
9,10-Dimethyl-1,2-benzanthracene* ; Actins ; Animals ; Arm ; Breast ; Codon ; Epithelial Cells ; Female ; Genes, ras ; Humans ; Intubation ; Rats*

A central vacuum scavenger modified by the authors, was used to control the atmospheric contamination of the operating room by anesthetic gases and vapours. Air pollution was monitored by measuring the concentrations of halothane vapour in the air of the operating room with the gas chromatograph. Under endotrachal intubation, the semi-colsed circle absorber system was used for anesthetic administration and maintained with 0.8~1.2% Halothane. Total gas flow rates were 4 liter/min with 50% oxygen in nitrous oxide for daily work. Air sampling was taken early in the morning at 10cm high from the floor before anesthesia. After daily work, they were also done at 10cm, 120cm, and 140cm high from the floor and at the corridor of the operating room. We investigated the differences of halothane concentration according to each sits by the changing central vacuum pressure. Results are followings: The atmospheric halothane concentration of the operating room before anesthesia were 0.27+/-0.12, 0.22+/-0.11 and 0.15+/-0.06 ppm.The atmospheric halothane concentration of the operating room after daily work were 7.94 +/- 1.30 ppm without the active central vacuum pressure.The atmospheric halothane concentration of the operating room after daily work were 1.41 +/-0.48ppm of 20mmHg of central vacuum pressure.The tmospheric halothane concentration of the operating room after daily work were 0.49+/-0.18ppm of 40mmHg of central vacuum pressure. The atmospheric halothane concentrations at the corridor of the operating room after daily work were 1.09+/-0.19, 0.77+/-0.11n and 0.36+/-0.17ppm when each vacuum pressure was 0mmHg, 20mmHg and 40mmHg. A significant reduction (p<0.01) in atmospheric halothane concentration of the operation room was obtained by the use of the central vacuum pressure with the scavenger. The higher the vacuum pressure, the greater reduction of the operating room air pollution was observed.
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid ; Air Pollution* ; Anesthesia ; Anesthetics, Inhalation ; Halothane* ; Intubation ; Nitrous Oxide ; Operating Rooms* ; Oxygen ; Vacuum*

We analyzed 20 cases of traumatic carotid cavernous fistula(CCF) during the recent 10 years The results are summarized as follows: 1) In 18 cases(90%), the clinical symptoms & signs of CCF occurred within 2 months after trauma. 2) The sites of fistulae were common in horizontal segment(40%) and at the junction(30%) between horizontal segment and posterior ascending segment of cavernous portion of internal carotid artery. 3) The main draining veins of CCF were the superior ophthalmic vein(90%) and the inferior petrosal sinus(70%). 4) The methods of treatment were occlusion of fistula with balloon(9 cases), occlusion of cavernous ICA with balloon(2 cases), ligation of cervical ICA with Poppen's clamp(4 cases) and trapping(2 cases). Two patients were not treated and another patient was healed spontaneously. 5) The frequency and severity of complication was significantly decreased in cases treated by detachable balloon occlusion than by direct cervical ICA ligation or trapping procedures. 6) The procedure using the self-sealed goldvalve balloon was simple, but had a risk of premature separation and premature deflation.
Balloon Occlusion ; Carotid Artery, Internal ; Fistula* ; Humans ; Ligation ; Veins

The authors retrospectively analized the radiographs and medical records of 135 consecutive patients who underwent minimaly invasive spinal surgery from January, 1990 to December, 1994 at our institution. Among these, 72 patients have had chemonucleolysis and others percutaneous automated lumbar discectomy(PALD). The success rate was similar in both groups, ie, 75% in chemonucleolysis and 74.6% in PALD by Macnab's criteria. The higher success rate could be obtained in 1) younger age below 30, 2) predominant sciatica than lower back pain, 3) eccentric bulged disc with minimal degeneration, 4) abscent or minimal neurologic deficits. In conclusion, provided patients are carefully screened, minimal invasive spinal surgery is more preferable over conventional surgery, providing a safe and effective therapeutic alternative to many patients suffering from herniated lumbar disc.
Diskectomy* ; Humans ; Intervertebral Disc Chemolysis* ; Low Back Pain ; Medical Records ; Neurologic Manifestations ; Retrospective Studies ; Sciatica