The basic criteria of facial reconstruction with the flap are consisted of easy and wide applicability, good color and texture matching to the face and reliable anatomical basis. On these points, the submental island flap is superior to other regional flaps such as tissue expansion technique and free flaps It is based on the submental vessels branching from the facial vessels located at the medial groove of submandibular gland. Its pedicle has a reliable course along the inferior border of mandible with a constant distance and its perforator(s) is (are) located at the submental area around the anterior belly of digastric muscle. We report on its use in 4 cases of facial resurfacing on the cheek, the preauricular area and the nose in arteriovenous malformation and malignant skin cancer patients. The mylohyoid and anterior belly of digastric muscles could be included within the flap and the reverse submental island flap was also useful for obtaining the wide rotation of arc. The mean follow-up period was 8.3 months and the results were satisfactory to the patients. The submental island flap is reliable flap for facial resurfacing because of its good color and texture, acceptable donor scars, and thin, flexible flap. The flap also can incorperate with the skin, the muscle, and the bone in case of complicated facial defects. The long vascular pedicle also enables a wide applicability of the flap And also it can be used as a free flap, expanded flap and reverse island flap for the facial resurfacing.
Arteriovenous Malformations ; Cheek ; Cicatrix ; Follow-Up Studies ; Free Tissue Flaps ; Humans ; Mandible ; Muscles ; Nose ; Skin ; Skin Neoplasms ; Submandibular Gland ; Tissue Donors ; Tissue Expansion

No abstract available.
Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Trichosporon*

No abstract available.
Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Trichosporon*

BACKGROUND: Alopecia areata is replete with data from studies using variuos therapeutic approaches, none of which is clearly superior to another. OBJECTIVE: This study was designed to evaluate the therapeutic effect of cryotherapy in alopecia areata. METHODS: Thirty three patents with AA(M:13, F:20) well conduted in this study, precluding 3 patients with the moderate and extensive lesions. Cryotherapy using a cotton swab dipped with liquid nitrogen was applied to the involved areas, repeated with 2 times of freeze thaw cycle of two seconds. In 13 cases of AA multiplex, the lesions were divided into two groups, each of which was undertaken cryotherapy and intralesional injection of triamcinolone(3mg/ml) for evaluation of their respeetive effects. The treatment was done weekly method of 1 to 11 times, Th therapeutic response was determined as the regrowth of terminal hairs on the treated area(s) at 12 Weeks. RESULTS: Of the 33 patients with AA, the overall responders were 22(66.7%). There seemed good response rates of 70.0 % in females, 71.4 % in AA multiplex and 72.2 % in third decade as well as 72.4 % in those with lower than 1 year of duration. The remarkable resionse had 3-4 times in treatment numbers. There were no untoward side effects in patients except mild erythema. In the 13 patients treated with both modalities, cryotherapy had a slightly higher esaonse than triamcinolone therapy (69.2% vs 61.5%, p>0.05 by x-test). CONCLUSION: The effect of cryotherapy therapy in AA patients is not less than the intralesional therapy of triamcinolone. In addition, cryotherapy may be recommendec as the new, safe therapeutic modality.
Alopecia Areata* ; Alopecia* ; Cryotherapy* ; Erythema ; Female ; Hair ; Humans ; Injections, Intralesional ; Nitrogen* ; Triamcinolone

There are some effective methods for removing layers of skin to improve aging face and dermatologic defects : chemabrasion (chemical peeling), dermabrasion(surgical removal), laserabrasion. Chemabrasion, generally performed with a chemical solution, is most useful for removal of fine facial wrinkles and abnormal pigmentation. The application of chemical caustics, especially TCA (trichloroacetic acid), is known to be an effective and is now commonly practiced to improve the surface of the facial skin that has been blemished by pigmentation, wrinkles, solar damage and certain scars. Trichloroacetic acid is a colorless melting crystal and derivatives of acetic acid which das protein precipitating properties. It has specific odor but there is not systemic toxic effect like a phenol. It has heavy caustic effect on skin and mucosa and cause the coagulation necrosis of the skin and therefore, it must be handled carefully and stored in the proper condition. Especially, moderate to high concentrated TCA solution must be treated by well-trained persons. A 46-year-old woman visited a private clinic for removal of fine wrinkles around the lip. She was refered to our department because of acute upper lip coagulation necrosis which was caused by injection of 35% TCA solution mistaken for lidocaine, which was supposed to be used for anesthesia. At her arrival, cental half of upper lip showed severe coagulation necrosis. The lesion was well discriminated in a few days, then debridement and immediate reconstruction was done using an Abbe flap. Chemical peeling is a relatively effective procedure for improvement of aging skin lesion in a lower cost with a short time operation, if the practitioner has much experience and optimal indication is properly selected. But not so as, side effect and complication may be often ocurred in a mistake and as a result irreversible scars are remained. We experienced a rare case of upper lip necrosis which was caused by TCA injection mistaked for lidocaine in a private clinic and so, We report this case with the results of experiment of rabbit model which was observation of macroscopic and microscopic changes of the abdominal skin of the rabbit injected with serially diluted TCA solution.
Acetic Acid ; Aging ; Anesthesia ; Caustics ; Cicatrix ; Debridement ; Female ; Freezing ; Humans ; Lidocaine ; Lip* ; Middle Aged ; Mucous Membrane ; Necrosis* ; Odors ; Phenol ; Pigmentation ; Skin ; Trichloroacetic Acid

BACKGROUND: The aim of this study is to define the cardioprotective effects (functional and metabolic) of newly developed DelNido cardioplegic solution (containing plasma solution, mannitol, magnesium and lidocaine). MATERIAL AND METHOD: This study assessed the function of rat hearts after itermittent infusion of DelNido cardioplegia with different preserving methods(Air or Icebox) for 2hours and perfusing the hearts on a Langendorff apparatus. Heart rate, left ventricular developed pressure (LVDP) and coronary flow, were measured at pre-ischemic, post-reperfusion 15min, 30min and 45min. Coronary flow was standardized to dry heart weight. Each weight was weighted to calculate water content. Creatine kinase-MB isoenzyme release was measured and ultrastructural assessment was done with electron microscopes. DelNido group was better than St, Thomas group and Icebox group was better than Room-air group. CONCLUSION: DelNido cardioplegia have better myocardial protective effects than St. Thomas cardioplegia when they were preserved in the Room-air. But we can not tell the difference between Delnido cardiplegia with Air preserving method and St. Thomas cardioplegia with Icebox.
Animals ; Cardioplegic Solutions ; Creatine ; Heart ; Heart Arrest, Induced* ; Heart Rate ; Magnesium ; Mannitol ; Plasma ; Rats ; Water

No abstract available.
Cholangitis, Sclerosing*

No abstract available.
Barium* ; Colon* ; Humans ; Neoplasm Metastasis*

No abstract available.
Orbit*

Lymphangiectasia(acquired lymphangioma) is characterized clinically by the presence of a circumscribed eruption of thin-walled, translucent vesicles which closely resemble frog spawn in appearance. This rare disorder may arise as a result of acquired lymphatic obstruction secondary to surgery, irradiation, chronic recurrent infection, chronic scarring, or trauma. Herein, we report a case of atypical lymphangiectasia at the site of an abdominal scar in a 70-year-old female. She developed a dark red-colored, pedunculated papule, 2 years after a total abdominal hysterectomy and post-operative irradiation for carcinoma of the uterine cervix. Histopatholgical findings showed multiple irregularly shaped cystic dilatated cells lined by a single layer of endothelium in the dermis. Immunohistochemical staining with factor VIII-related antigen showed negative results. A lymphangiogram showed signs of acquired lymphatic obstruction.
Aged ; Cervix Uteri ; Cicatrix* ; Dermis ; Endothelium ; Female ; Humans ; Hysterectomy ; von Willebrand Factor