The blow-out fracture can be reconstructed by various autogeneous and alloplastic material. Particulate, nonresorbable hydroxyapatite is currently one of the choice of implant material available for reconstruction of blow-out fracture. Hydroxyapatite is radiopaque ceramic, physically and chemically similar to enamel and cortical bone. It is a biomaterial derived from natural corals to use as a bone graft substitute. And we looked into the clinical usefulness of 2 type of hydroxyapatite with their advantages and disadvantages in reconstruction of blow-out fracture. 183 patients with blow-out fracture who underwent surgical reconstruction with two types of hydroxyapatite from March 1933 to July 1977 have been analyzed the results of surgical reconstructions, and have been followed up for more than a year. And the condition of formerly inserted hydroxyapatite was observed in the patients who needed 2nd surgical reconstruction due to the enophthalmos. The disadvantages of hydroxyapatite are fragility, size and contour limitations. In spite of these demerits, hydroxyapatite can be one of the prospective materials to reconstruct orbital floor. Through the clinical experiences for 5 years, we have not found any of complications of exposure, infection, and foreign body reaction. Low rates of diplopia, limitation of ocular movement, and enophtalmos was observed. Hydroxyapatite was well adherent to adjacent orbital bone in most patients who needed secondary reconstruction for enopthalmos. In conclusion, our study shows that the availability of hydroxyapattite in reconstruction of blow-out fracture is recommendable, with low complication rates. Hydroxyapatite important appears to be well tolerated, and provides useful alloplastic prosthesis with few problems in reconstruction of blow-out fracture.
Anthozoa ; Ceramics ; Dental Enamel ; Diplopia ; Durapatite* ; Enophthalmos ; Foreign-Body Reaction ; Humans ; Orbit* ; Orbital Fractures* ; Prostheses and Implants ; Transplants

A 4-year-old boy has had a solitary sclerotic depressed plaque on the right anterior chest since birth. The histopathologic findings are consistent with morphea profunda: thickening, hyalinization, and homogenization of collagen bundles in the dermis and subcutaneous tissues, admixture with a prominent lymphocytic and plasma cell infiltrate, and sweat glands en-trapped between the thickened collagen bundles. We report a case of congenital solitary morphea profunda.
Child, Preschool ; Collagen ; Dermis ; Humans ; Hyalin ; Male ; Parturition ; Plasma Cells ; Scleroderma, Localized* ; Subcutaneous Tissue ; Sweat Glands ; Thorax

The basic technique for total reconstruction of the microtia was established by Tanzer, who utilized autologous rib cartilages for constructing the auricular framework. In order to decrease the number of surgical stages and to achieve maximal convolution, we employed a surgical procedure with simultaneous three layered costal cartilage grafting for the high profiled auricle, concha formation and lobule rotation. However, we performed ear elevation as an additional procedure for some patients who had decreased helical height due to absorption of cartilage framework or postoperative trauma and who had wanted to wear the spectacles or to have more natural appearance of auriculocephalic sulcus. From August 1988 to October 1997 we had performed surgeries for the ear elevation of 58 patients in 177 patients with total ear reconstruction, using various elevation methods; skin graft, local flap, and local with costal cartilage block. When the ear elevation was performed with skin graft, postoperative contraction of the grafted skin was inevitable. In cases with two skin flaps, it was difficult to stabilize and maintain the correct projection of the constructed ear. So we elevated the reconstructed ear by utilizing a costal cartilage block, two skin flaps to cover the posterior region and skin graft. We conclude that the local flap with costal cartilage block is one of the most favorable methods in ear elevation which can maintain the adequate projection and make natural looking auriculocephalic sulcus.
Absorption ; Cartilage ; Ear* ; Eyeglasses ; Humans ; Ribs ; Skin ; Transplants

The double eyelid operation is one of the most common cosmetic surgery performed in orientals, and there are numerous studies about surgical procedures of that. In the case of appropriate candidates, the non-incision technique makes excellent cosmetic results, with the advantages of shorter operating time, less morbidity, less pain, no scarring and easy revision of shape. But, usually the non-incision technique is recommended in the cases with thin upper eyelid, small amount of orbital fat, less redundant skin of upper eyelid and in whom a wide fold is not desired so on. Therefore, the disadvantages of this method are that it cannot be applied to all patients. The postoperative complications are disappearance or faded fold, formation of cyst or lumps, asymmetry etc. and the incidence of these complications is slightly higher than those of the incisional method. In this study, the double eyelid operation using the continuous buried suture method was performed in 210 patients for formation of double eyelid from Jan. 1993 to Dec. 1995. In conclusion very good results can be obtained by the continuous buried suture method even in the cases of puffy upper eyelid. This method can make a double eyelid shape in the fashion the patient wants and can be a new indication for correction of unilateral double eyelid. This method is safe, satisfactory and take shorter postoperative recovery time and it can reduce the incidence of postoperative complications.
Cicatrix ; Eyelids* ; Humans ; Incidence ; Orbit ; Postoperative Complications ; Skin ; Surgery, Plastic ; Sutures*

Microgenia is that the mental protuberance is small state because of symphysis did not developed properly while occlusion and size of mandible are normal. One or two-step sliding advancement genioplasty is mainly performed to make good aesthetic harmony with face, but in slight or moderate degree of microgenia patients who do not want general anesthesia or osteotomy, the multiporous high-density polyethylene(Medpor(R)) can be used. It is easy to carve and bend, and has a variety of size and shape to fit the contour of the chin anatomy. Under the local anesthesia. a vertical incision which can preserve mentalis muscle is made about 2 cm at inferior labial sulcus along inferior frenulum in the jaw midline. Subperiosteal dissection is performed to make a pocket. Seperated Medpor(R)s are inserted in each side and reassembled into one in the midline. To minimize bone erosion, implant has to be placed on the inferior side of mandible edge and fixed with screw. Bandage compression was applied for 3 days and antibiotics was treated for 7 days postoperatively. This technique has a small incision, easy procedure and faster recovery. During the follow-up period, there were no specific complications and patients were all satisfied to their result.
Anesthesia, General ; Anesthesia, Local ; Anti-Bacterial Agents ; Bandages ; Chin ; Follow-Up Studies ; Genioplasty ; Humans ; Jaw ; Mandible ; Mandibular Prosthesis Implantation ; Muscles ; Osteotomy ; Polyethylene

The antiphospholipid antibody syndrome is an acquired multisystemic disorder characterized by persistent elevated antiphospholipid antibodies and/or hypercoagulation in veins or arteries, or both. The clinical manifestations of the antiphospholipid antibody syodrome are recurrent thrombosis, fetal loss, thrcenbocytopenia, and various cutaneous lesions. Skin lesions are the first sign of this syndrome in 41% of patients and systemic thrombosis develops in 40% of them. Livedo reticularis is the most common cutaneous finding of the antiphosphotipid antibody syndrome. Although vasculitis has not been frequently noted in antiphospholipid antibody syndrome, some vasculitis such as polyarteritis nodosa, giant cell arteritis, and other nonspecific vasculitides have been found in association with antiphospholipid antibody syndrome. We present a male patient with typical manifestations of leukocytoclastic vasculitis with deep vein thrombosis and positive antiphospholipid antibodies. It suggests that a case of antiphospholipid antibody syndorme was accompanied with cutaneous leukocytoclastic vasculitis.
Antibodies, Antiphospholipid* ; Antiphospholipid Syndrome ; Arteries ; Giant Cell Arteritis ; Humans ; Livedo Reticularis ; Male ; Polyarteritis Nodosa ; Skin ; Thrombosis ; Vasculitis* ; Vasculitis, Leukocytoclastic, Cutaneous ; Veins ; Venous Thrombosis

No abstract available.
Endometriosis* ; Female

We built the hypothesis that the hypertrophic callus formation is mediated by beta-endorphin that stimulates secretion of GH and increase circulation growth factor activity in head injury patient. We classified 4 groups such as 5 normal person(control), group I;5 patients with only fracture, group II;5 patients with fracture and head injury, group III; 5 patients with only head injury, group IV. We obtained the samples of serum from each group at 0, 2, 4, 6, 8 weeks after trauma and assessed the serum level of GH, GHRH, somatostatin. The serum level of GH was statisticallyu higher in group III, IV than group I, II. There was not significant difference in serum level of GHRH. The serum level of somatostatin was higher in group II, III, IV than group I, but there was no statistical significance in each group. GH has a important role in hypertrophic callus formation in severe head injury patients, but there was no evidence that the mechanism is mediated by beta-EndorphinGHRH & somatostatin-GH-GF-1, beta-FGF axis. There may be a another mechanism in increasing GH that was stimulated by beta-endorphin in thalamus and lateral ventricle, and it should be necessary for further evaluation of it.
Axis, Cervical Vertebra ; beta-Endorphin ; Bony Callus ; Craniocerebral Trauma* ; Head* ; Humans ; Lateral Ventricles ; Somatostatin ; Thalamus

Tegafur [1-(tetrahydro-2-furyl)-5-fluorouracil], the prodrug of 5-fluorouracil, is an anticancer agent. Several cutaneous reactions have been reported following systemic 5-fluorouracil for the treatment of malignancies. We report a patient with marked inflammation of the actinic keratosis following the use of tegafur for stomach carcinoma. The side-effect with 5-fluorouracil was beneficial as most actinic keratosis cleared following the inflammatory reaction. Dermatologists and oncologists should be aware of this potential side-effect, not only because it may become more prevalent but, most importantly, because it is not an allergic reaction to 5-fluorouracil but a dose-dependent response, and the chemotherapy may be continued in most patients.
Actins* ; Drug Therapy ; Fluorouracil* ; Humans ; Hypersensitivity ; Inflammation ; Keratosis, Actinic* ; Stomach ; Tegafur

Plexiform neurofibroma is considered a pathognomic of Von Recklinghousen's disease, which involves the deep and large nerve trunk. These are large irregular nerve fascicles which result from an increase in endoneural matrix within individual nerve facicles, without an increased number of nerve fibers. We experenced a case of Von Recklinghausen's disease in a 24 year-old male who had variable cutaneous skeletal, and CNS lesions. He presented multiple neurofibromas, cafe-au-lait spots, and axillary freckles as common cutaneous lesions of NF-I and giant pigmentation, sacral hypertrichosis, and plexiform neurofibroma as unusual cutaneous lesions. Also he had a scoliosis, bowing deformity of the humerous and wedging deformity of the body of the 5th cervical spine as a skeletal manifestation and cortical calcification in the occipital area as a CNS manifestation.
Cafe-au-Lait Spots ; Congenital Abnormalities ; Humans ; Hypertrichosis ; Male ; Melanosis ; Nerve Fibers ; Neurofibroma, Plexiform* ; Neurofibromatoses ; Neurofibromatosis 1 ; Pigmentation* ; Scoliosis ; Spine ; Young Adult