No Abstract Available.
Humans ; Poliomyelitis*

The orbital floor fracture of trapdoor subtype is a pure orbital fracture, linear in form and hinged medially, which allows herniation of orbital fat and ocular muscles and then entraps these contents. The goals of the reconstruction of the orbital fracture are to restore the continuity and to avoid a relapse the orbital tissue. If the reconstruction is incomplete, it may result in enophthalmos with diplopia. The indications for surgical reconstruction are the imitation of ocular muscles, the persisting diplopia, enophthalmos, large size of bony defect. There are no uniformly guidelines for the materials for orbital reconstruction. The ideal material should be biocompatible, non-carcinogenic, easily kept in position and free of any potential for disease transmission. Among the materials, the absorbable mesh is used for the orbital reconstruction recently. We used the 0.8mm thickness absorbable mesh in 11 patients with orbital floor trapdoor fracture. The displaced bony fragment was reducted and the absorbable mesh was inserted below the reducted fragment. The absorbable mesh was fixated with absorbable screw, so the mesh can support the bony fragment with cantilever effect. The results were satisfactory and no significant problem was not happened during the follow up period. Absorbable meshes are gradually resorbed and the scar that formed after resorption provides the support of the globe. Our results suggest that the orbital floor trapdoor fracture with small to moderate defects is the advisable indication of orbital reconstruction with absorbable mesh.
Cicatrix ; Diplopia ; Enophthalmos ; Follow-Up Studies ; Humans ; Muscles ; Orbit* ; Orbital Fractures ; Recurrence

Deficiency of upper lip tissue is a difficult problem in cleft lip repair. Various kinds of operation technique such as triangular flap and Millard method has been developed. but, when the severe vertical tissue deficiency is present, there are limitations in making a symmetric lip contour. We defined the short lateral lip when the vertical distance from alar base to the imaginary peak of cupid bow pont is less than vertical distance from alar base to noncleft cupid bow peak. Rareoperation techniques to solve the short lateral lip has been suggested until nowadays. So, we classified the short lateral lip as mild, moderate and severe cases. And we tried the following 3 methods for correction of short lateral lip. In mild cases, we used the C-flap and small triangular flap which can lengthen the short lateral lip about 2 to 3 mm just above the white line. And the moderate cases, it can corrected with lattis method. For the lengthening of very short lateral lip in cleft side, full thickness skin from the posterior auricular area is grafted onto the redrapped muscle of cleft side muscle bulge.
Cleft Lip* ; Lip* ; Skin ; Transplants

Despite on-going efforts to control malaria, the rate of malaria has not decreased throughout the world. It was believed that endemic malaria had been eradicated in Korea since the end of the 1970s, however it reemerged from 1993 and has been increasing ever since. Besides endemic malaria, imported malaria is also increasing in Korea as the number of overseas travellers and foreign workers increases. We discovered malaria in a two-year-old child who visited Sierra Leone with his missionary father. The patient contracted malaria despite chemo-prophylaxis with chloroquine and was diagnosed as falciparum malaria by blood smear examination and IFAT. He successfully recovered after administraion of quinine and clindamycin without complication. However, the malaria did not respond quickly to chloroqine and Fansidar but a drug resistence test was not performed.
Child* ; Chloroquine ; Clindamycin ; Fathers ; Humans ; Korea ; Malaria* ; Missions and Missionaries ; Quinine ; Sierra Leone

Axillary osmidrosis is caused by excessive secretion of apocrine sweat gland and can cause extreme difficulty in social activities. The surgical removal of apocrine glands has been thought as an effective method. But this classical treatment results in many complications such as scarring, hematoma, skin necrosis and these complications have not been solved yet. Recently radiofrequency surgery as a minimally invasive technique is used for the treatment of snoring, benign prostate hypertrophy, hepatoma, reduction of masseter muscle and gastrocnemius muscle. From June, 2004 to March, 2005, 10 patients with axillary osmidrosis were treated by radiofrequency thermal ablation(PMC-1000). The generator was set to level 6-8 and the duration of time was 1.0 seconds. The maximum number of treatment sessions were two. The mean postoperative follow-up period was about average 6 month ranged from 2 to 9 month. The skin necrosis was developed in 2 patients. All patients were satisfied or partially satisfied with the results. Although suitable radiofrequency power and heating duration have not been defined yet, which is mandatory in order to obtain the best results, the radiofrequecy could be a safe and effective treatment modality for axillary osmidrosis with a good clinical outcome and few complications.
Apocrine Glands ; Carcinoma, Hepatocellular ; Cicatrix ; Follow-Up Studies ; Heating ; Hematoma ; Hot Temperature ; Humans ; Hypertrophy ; Masseter Muscle ; Muscle, Skeletal ; Necrosis ; Prostate ; Skin ; Snoring ; Sweat Glands

Pachydermodactyly is a rare distinct form of fibromatosis characterized by acquired, asymptomatic dense fibrosis and fibroblastic proliferation around one or more proximal interphalangeal joints. Intralesional triamcinolone injection may be helpful in improving the clinical appearance. A 20-year-old unemployed female patient gave a four years history of progressive swelling of the fingers affecting predominantly the proximal interphalangeal joints of index fingers of left hand and index, middle fingers of right hand. There was no pain and tenderness. Physical examination, complete blood count, antinuclear antibody, rheumatoid factor were unremarkable and radiograph of both hands showed soft tissue swelling only without bony abnormality. We excised the redundant soft tissue from the both sides of proximal interphalangeal joint with longitudinal elliptical fashion. After operation, the fingers of the patient showed marked improvement cosmetically. There were no motor or sensory changes. Pachydermodactyly was first reported in 1996 in Korea. Histologic features include an increased dermal accumulation of collagen and occasionally an increased number of fibroblast. We report for one patient with pachydermodactyly treated with longitudinal elliptical excision and obtained an improvement of clinical appearance.
Antibodies, Antinuclear ; Blood Cell Count ; Collagen ; Female ; Fibroblasts ; Fibroma ; Fibrosis ; Fingers ; Hand ; Humans ; Joints ; Korea ; Physical Examination ; Rheumatoid Factor ; Triamcinolone ; Young Adult

The ALM(acral lentiginous melanoma) on extremities are less common and less well studied. The purpose of the study is to investigate the surgical management for 19 cases of ALM on extremities for last 10 years. When tumor depth was less than 1.5mm on thumb, the lesion was removed with distal periosteum and full skin through degloving procedure and the defect was covered with wrap around procedure. When tumor depth was more than 1.5mm, distal amputation of thumb was performed, and new thumb was reconstructed through bone graft and wrap-around procedure. The ALM on palm was treated with wide excision, and then reconstruction was performed with reversed radial island flap. Because heel was required for weight bearing, the defect of heel after wide tumor resection was reconstructed with volume rich free flap. During 3 years follow-up period, local recurrence and general metastasis was 0% respectively in cases of tumor depth below 1.5mm. In cases of tumor depth more than 1.5mm, local recurrence and general metastasis rate were 0% and 20% respectively. In terms of function, the reconstructed thumb could have ability of pinch and grasp, and the reconstructed heel could be achieved good contour and weight bearing function.
Amputation ; Extremities* ; Follow-Up Studies ; Free Tissue Flaps ; Hand Strength ; Heel ; Melanoma* ; Neoplasm Metastasis ; Periosteum ; Recurrence ; Skin ; Thumb ; Transplants ; Weight-Bearing

PURPOSE: The zygomatic arch is a key element which composes the facial contour. In many cases of zygomatic arch fracture, it is difficult to fix rigidly the fractured segments. If reduced bone segments were not fixed rigidly, they are proven to be displaced by mastication or unintentional external forces. So, unfixed zygomatic arch fracture after reduction may require a external device of prevention of collapse. We introduce a new protector which stabilizing the fractured segments to prevent for collapse of the reduced zygomatic arch fracture. METHODS: After reduction of zygomatic arch with blind approach(Gillies', Dingman or Keen's approach), bone segments was pulled with percutaneous traction suture in medial aspect of zygomatic arch. Then, the suture was fixed with Aqua splint(R), externally. And intraoperative and postoperative X-ray was done. The splint was removed on 14 days after the operation. RESULTS: 5 patients were treated with this method. 4 patients of total patients had no collapse in zygomatic arch. There was minimal collapse in one patient. Postoperative complications such as facial nerve injury, mouth opening difficulty, contour deformity, infection, scar were not observed. CONCLUSION: In comparison with other techniques, this technique has several advantages which are simple and easy method, short operation time, no scar, less soft tissue injury, and facilitated removal of splint. Therefore, Aqua splint(R) would be a good alternative to prevent for collapse in unstable zygomatic arch fractures
Cicatrix ; Congenital Abnormalities ; Facial Nerve Injuries ; Humans ; Mastication ; Mouth ; Postoperative Complications ; Soft Tissue Injuries ; Splints ; Sutures ; Traction ; Zygoma*

The purpose of this study is to assess abdominal sensation after free TRAM flap for breast reconstruction. 74 patients underwent breast reconstruction with free TRAM flap by authors and were followed up to check the sensation on abdomen following the surgery at the out patient clinic. They are compared with 20 female volunteer controls. Abdomens were divided into 13 zones, and assessed for superficial touch, superficial pain, temperature, two-point discrimination, and vibration. For all five sensory modalities, subjects were found to have decreased sensation in the umbilical and infraumbilical regions. This was statistically significant compared with controls. Division following pedicle dissection showed more reduction of sensation than non-dissection side. Both Inguinal areas below the donor site closure also showed markedly decreased sensation. Sensation on most area of abdomen recovered in postoperative 1 year, however, there were remained hypoesthesia in umbilical and infraumbilical area after post operative 1 year. This study clearly demonstrates that there is a significant and persistent reduction in abdominal sensibility following free TRAM flap surgery.
Abdomen* ; Breast* ; Discrimination (Psychology) ; Female ; Humans ; Hypesthesia ; Mammaplasty* ; Sensation ; Tissue Donors ; Vibration ; Volunteers

Neovascularization is an important factor in the prognosis of brain tumor and many angiogenetic factors have been evaluated for prognostic significance. Among them, basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) are known as potent angiogentic factors and mitogens. We evaluated seven cases of grade II brain astrocytoma. Four, group A, was diagnosed as anaplastic progression at their second operation, and three, group B, did not. Using monoclonal antibodies to bFGF and VEGF in paraffin embedded tissue from first operation, their immunoreactivity and differences between two groups were examined. The growth fractions of these tumor were also measured by Ki-67 monoclonal antibodies (MIB1). Immunostaining for bFGF in tumor cells were observed in both nuclei and cytoplasm, and for VEGF, mainly observed in the cytoplasm. Mean cell count number +/- standard deviation per high power field in each were as follows: 1) for bFGF, 20.08 +/- 6.38 in group A and 0.87 +/- 0.90 in group B (p< 0.01), 2) for VEGF, 43.75 +/- 17.09 in group A, and 0.8 +/- 1.06 in group B (p< 0.05) and 3) for the proliferation index with Ki-67 antibodies, 3.20 +/- 0.81 in group A and 0.77 +/- 1.03 in group B (p< 0.05). This data supports the assertion that angiogenetic factor such as bFGF and VEGF may contribute to progressive change of astrocytoma by tumor angiogenesis.
Adolescent ; Adult ; Astrocytoma/*pathology ; Brain/*blood supply ; Brain Neoplasms/*pathology ; Endothelial Growth Factors/*metabolism ; Female ; Fibroblast Growth Factor 2/*metabolism ; Human ; Lymphokines/*metabolism ; Male ; Middle Age ; Neovascularization, Pathologic/*genetics ; Prognosis ; Tumor Markers, Biological