When the facial neurofibroma is involved with craniofacial skeleton and causes dysplastic bony anomaly, the deformity or the defect can be corrected by craniofacial surgery. However, it is impossible to radically remove all the involved facial soft tissues and facial nerve. Therefore, the partial excision may cause recurrence of the disease and thus result in the deformity of facial soft tissue because of the persisting force of gravity. We used Teflon mesh as replacement material for destroyed subcutaneous tissue or substitute for superficial fascia damaged by tumor infiltration. This method enables to prevent the deformity of facial soft tissue caused by recurrence and gravity effect after partial excision and to control the tumor growth. We performed suspension into the superio-posterior direction of Teflon mesh like the fish netting procedure after partial excision in attempt to prevent further progress of remnant tumor, thus compressing or capturing remnant neurofibroma. Surgical correction was performed for 8 patients of neurofibroma and all the patients were followed up for 5 or 6 years. According to the results, the Teflon mesh, which is inserted for replacement for subcutaneous tissue or superficial fascia after partial excision of the tumor mass, is well maintained as part of layers of facial structure along with collagen. No tumor proliferation under mesh was observed. Deformity of facial contour caused by recurrence of tumor or gravity effect was not observed. Our method using Teflon mesh for replacement of destroyed subcutaneous tissue and compression on the remnant tumor is considered a proper treatment modality for facial neurofibroma, thus hereby we report our studies with the review of the literature.
Collagen ; Congenital Abnormalities ; Facial Nerve ; Gravitation ; Humans ; Neurofibroma* ; Polytetrafluoroethylene ; Recurrence ; Skeleton ; Subcutaneous Tissue

Management of the bulbous nasal tip with inadequate projection and drooping is challenging aesthetic plastic surgery. The bulbous nasal tip is influenced by several factors; 1) thick, non-elastic oily skin, 2) soft tissue bulkiness due to supratip fibrous fatty tissue, and 3) a wide intercrural angle or increased interdormal distance. Another common factor among caucasians, hypertrophic alar cartilage, is seen less in orientals. These variable factors can be corrected with various surgical maneuvers for proper tip projection and refined alar shape. All these procedures are performed through open rhinoplasty incision. The fibromuscular fatty tissue on the nasal tip is resected with subdermal tangential excision without violating the detmal blood supply. The proximal part of the lateral crus, dome and the part of medial crus which was isolated from the skin and nasal mucosa are replaced and plicated in midline in the role of a new columellar strut and skeletal support. If more skeletal supports are desired, the new columellar is reinforced with a silicone strut and conchal cartilage onlay grafts are applied. And for lengthening of the columella, a V-Y advancement incision on the columellar base with open rhinoplasty is applied. The pressure splint on the upper third of the columella and nasal tip is applied on the 7th postoperative day and maintained for two months. All procedures are focused on the preservation of catilaginous integrity and in providing skeletal support. We performed nasal tip plasty on the bulbous nasal tip and its simple technique and predictability resulted in improved nasal tip projection and contour.
Adipose Tissue ; Cartilage ; Inlays ; Nasal Mucosa ; Rhinoplasty ; Silicones ; Skin ; Splints ; Surgery, Plastic ; Transplants

Lateral osteotomy has been chosen as a part of rhinoplasty for modification of the nasal bony vault, alteration of the base width of the lateral walls, establishment of a new profile line of the nasal dorsum and lateral profile line, and closure of the open roof. Various methods of lateral osteotomy may be employed, however Orientals have characteristically broad and flat noses Compared to caucasians and for an esthetically satisfactory result, it is important to correct both in rhinoplasty. In this study, the authors performed their devised method of lateral osteotomy in 12 patients for the correction of broad, flat nasal dorsum and deviated noses. The operations could be broadly categorized into two groups: 1) short lateral osteotomy in which the lateral osteotomy line was incomplete and short, extending to the infraorbital rim; and 2) green-stick transverse osteotomy which was induced by in-siturotation fracture by osteotomy and, if considered necessary, augmentation rhinoplasty and nasal tip plasty were also performed simultaneously. Our nasal osteotomy has limited mobilization, where as the previous method has total mobilization, and it has the advantages of repositioning the broad and deviated nose in a preferable direction and shape, as well as the capability of narrowing the preferable area selectively. Especially if there is a necessity to correct both broad and flat noses such as in Orientals, our osteotomy methods have a synergistic effect in esthetic outcome when performed with augmentation rhinoplasty with a silastic implant. There were no complications such as relapse or air-way obstruction during the 4.5-month follow-up period. However, a long-term follow-up period is needed to evaluate the complications considering the physiologic aspect of the nose.
Follow-Up Studies ; Humans ; Nose ; Osteotomy* ; Recurrence ; Rhinoplasty*

This investigation evaluated the fracture toughness (KIC) of eight currently available core materials, and relate the fracture toughness value to fractography analysis and surface characteristics using a atomic force microscope (AFM). Single-edge notched (SEN) test specimens (n=10) and compact tension (CT) test specimens (n=10) were prepared conforming to the ASTM Standard E-399 for a high copper amalgam, three composite core materials (Core-Max II, Core Paste, Bisfil Core), two reinforced composite core materials (Ti-Core, Ti-Core Natural), a resin-modified glass ionomer core material (Vitremer), and a conventional glass ionomer core material (Ketac-Molar). The specimens were tested with an Instron Universal Testing Machine. The maximum loads were measured to calculate the fracture toughness (KIC). Thereafter, fracture surfaces of SEN specimens of each material were investigated for fractography analysis using scanning electron microscope. And, disc-shaped specimens with 1mm thickness were fabricated for each material and were investigated under AFM for surface morphology analysis. The results were as follows : 1. Bisfil Core showed the highest mean fracture toughness regardless of test methods. 2. For the tooth-colored materials, Ti-Core Natural exhibited the highest fracture toughness. 3. Ketac Molar showed a significantly low fracture toughness when compared with the amalgam and the composite resin core materials (p<0.05). 4. The fracture toughness values obtained with the single-edge notched test, except Ketac Molar, were higher than those obtained in the compact tension test. 5. SEM revealed that the fracture surface of high fracture toughness material was rougher than that of low fracture toughness material. 6. AFM revealed that the surface particles of the composite resins were smaller in size, with a lower surface roughness than the glass ionomer core materials.
Composite Resins ; Copper ; Glass ; Molar

No abstract available.
Abdominal Cavity* ; Catheters* ; Diaphragm*

STATEMENT OF PROBLEM: Currently, there are some 20 different geometric variations in implant/abutment interface available. The geometry is important because it is one of the primary determinants of joint strength, joint stability, locational and rotational stability. PURPOSE: As the effects of the various implant-abutment connections and the prosthesis height variation on stress distribution are not yet examined, this study is to focus on the different types of implant-abutment connection and the prosthesis height using three dimensional finite element analysis. MATERIAL AND METHOD: The models were constructed with ITI, 3i TG, Bicon, Frialit-2 fixtures and solid abutment, TG post, Bicon post, EstheticBase abutment respectively. And the superstructures were constructed as mandibular second premolar shapes with 8.5 mm, 11 mm, 13.5 mm of crown height. In each model, 244 N of vertical load and 244 N of 30 degree oblique load were placed on the central pit of an occlusal surface. von Mises stresses were recorded and compared in the crowns, abutments, fixtures. RESULTS: 1. Under the oblique loading, von Mises stresses were larger in the crown, abutment, fixture compared to the vertical loading condition. 2. The stresses were increased proportionally to the crown height under oblique loading but showed little differences with three different crown heights under vertical loading. 3. In the crown, the highest stress areas were loading points under vertical loading, and the finish lines under oblique loading. 4. Under the oblique loading, the higher stresses were located in the fixture/abutment interface of the Bicon and Frialit-2 systems compared to the ITI and TG systems. CONCLUSIONS: The stress distribution patterns of each implant-abutment system had difference among them and adequate crown height/implant ratio was important to reduce the stresses around the implants.
Bicuspid ; Crowns ; Finite Element Analysis* ; Joints ; Prostheses and Implants

STATEMENT OF PROBLEM: Currently, there are some 20 different geometric variations in implant/abutment interface available. The geometry is important because it is one of the primary determinants of joint strength, joint stability, locational and rotational stability. PURPOSE: As the effects of the various implant-abutment connections and the prosthesis height variation on stress distribution are not yet examined, this study is to focus on the different types of implant-abutment connection and the prosthesis height using three dimensional finite element analysis. MATERIAL AND METHOD: The models were constructed with ITI, 3i TG, Bicon, Frialit-2 fixtures and solid abutment, TG post, Bicon post, EstheticBase abutment respectively. And the superstructures were constructed as mandibular second premolar shapes with 8.5 mm, 11 mm, 13.5 mm of crown height. In each model, 244 N of vertical load and 244 N of 30 degree oblique load were placed on the central pit of an occlusal surface. von Mises stresses were recorded and compared in the crowns, abutments, fixtures. RESULTS: 1. Under the oblique loading, von Mises stresses were larger in the crown, abutment, fixture compared to the vertical loading condition. 2. The stresses were increased proportionally to the crown height under oblique loading but showed little differences with three different crown heights under vertical loading. 3. In the crown, the highest stress areas were loading points under vertical loading, and the finish lines under oblique loading. 4. Under the oblique loading, the higher stresses were located in the fixture/abutment interface of the Bicon and Frialit-2 systems compared to the ITI and TG systems. CONCLUSIONS: The stress distribution patterns of each implant-abutment system had difference among them and adequate crown height/implant ratio was important to reduce the stresses around the implants.
Bicuspid ; Crowns ; Finite Element Analysis* ; Joints ; Prostheses and Implants

A 31-year-old pregnant woman with pruritus in pregnancy was described; she presented with a one-week history of generalized pruritus at gestational age 6 weeks without primary skin lesion. She had no dermatologic problem before pregnancy. Her pruritic symptom was not con-trolled with conventional emollient and topical corticosteroids. Broadband Ultraviolet B(UVB) phototherapy successfully improved her pruritus. UVB phototherapy also worked well after recurrence of pruritus at pregnancy 23rd week. We report herein a case of pruritus in pregnancy successfully treated with broadband UVB phototherapy.
Adrenal Cortex Hormones ; Adult ; Female ; Gestational Age ; Humans ; Phototherapy* ; Pregnancy* ; Pregnant Women ; Pruritus* ; Recurrence ; Skin

To delineate the coronary anatomy and the left ventricular function during early myocardial infarction, coronary arteriography and left ventriculography were performed prospectively in 28(34%) of 83 patients who were admitted to the coronary care unit at Severance Hospital from November 1983 to August 1984 within 30 days(median : 14 days;range : 4 hours to 30 days) after the onset of symptoms. The frequency of total occlusion of the infarct related artery was evaluated in the time course of infarction. To prove spontaneous recanalization, 3 patients who had total coronary occlusion underwent serial study within 11-20 days after the first study. We categorized the patients into two comparable groups according to the infarction site, coronary angiographic findings, and age. Comparison of clinical and angiographic findings between each group was made. The following results were obained. 1) There were 23 patients with transmural myocardial infarction(82.1%) and 5 with nontransmural infarction(17.9%). Among 23 patients with transmural infarction, 14 had anterior infarction(60.9%) and 9(39.1%) inferior infarction. 2) The mean age was 51.3 years(range : 31-79 years). The ratio of male to female was 3.7:1. 3) Fifteen patients(53.6%) had one-vessel disease, 10(35.7%) two-vessel disease and 2(7.1%) three-vessel disease, One patient(3.6%) had insignificant disease(less than 50% reduction in luminal diameter). Nontransmural infarction had a tendency to be associated with higher prevalence of multivessel disease than transmural infarction(80% vs 34.8%). 4) In 23 patients with transmural infarction, 12(52.2%) had complete occlusion and 11(47.8%) incomplete occlusion of the infarct related artery. Three patients(13.0%) had subtotal occlusion(90-99%) and 4(17.4%) had lesions of 70-89% luminal diameter narrowing. Three patients(13.0%) had 50-69% lesions and the remaining 1(4.4%) had insignificant obstructive lesions. 5) Of the 23 patients with transmural infarction, 12 were studied within 14 days and 11 in 15-30 days after the onset of symptoms. The frequency of total coronary occlusion was significantly higher in the patients studied within 14 days of symptom onset vs those studied in the 15-30 days period(83.3% vs 18.2%;p<0.001). Serial studies of 3 patients with total coronary occlusion at the initial study demonstrated occurrance of spontaneous recanalization in 2 patients. 6) The left ventricular-ejection fraction was higher in the patients with nontransmural infarction, inferior infarction, and incomplete coronary occlusion(65+/-14%, 58+/-16% and 57+/-17%) than that of the patients with transmural infarction, anterior infarction, and complete coronary occlusion(51+/-15%, 47+/-14% and 46+/-13, p<0.05). But there was no significant difference in left ventricular ejection fraction between the young(<45 year) and the old(> or =45 year) age groups. And also 0-1 vessel disease and 2-3 vessel disease groups did not show significant difference in ejection fraction. The degree of congestive heart failure was more severe in the patients with anterior infarction than in those with inferior infaction. multi-vessel disease group was significantly older than 0-1 vessel disease group(55+/-8 yrs vs 46+/-12 yrs, p<0.05), and the young age group had a tendency to be associated with higher prevalence of single vessel disease. 7) As for the complications of angiocardiography in this study, there was ventricular finbrillation in 2 patients(7.1%) without mortality. It is concluded that coronary arteriography can be safely performed within one month after acute myocardial infarction;high prevalence of one-vessel disease in acute myocardial infarction in the Korean adult patients admitted to a general hospital;lower incidence of total coronary occlusion in the late time course of infarction due to spontaneous recanalization;better left ventricular function in the patient groups with nontransmural infarction, inferior infarction and incomplete coronary occlusion.
Adult* ; Angiocardiography ; Angiography ; Arteries ; Coronary Care Units ; Coronary Occlusion ; Female ; Heart Failure ; Humans ; Incidence ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Phenobarbital ; Prevalence ; Prospective Studies ; Stroke Volume ; Ventricular Function, Left

This study was designed to observe more closely about clinical course, complication, predilection site of skin eruption and associated diseases with herpes zoster. Total 122 cases of herpes zoster were prospectively observed from April 1986 to July 1987. The results obtained were as follows : 1. The ineidence of herpes zoster versus the total number of outpatients was 20.6%. There was no difference in sex ratio of male(52.5%) to female(47.5%). 2. Herpes zoster was observed most frequently in the 50-59 year age group (25.4%). 3. There were no marked monthly or seasonal difference in herpes zoster without an explosive outbreak or an epidemic cycle. 4, We found that 68 cases(55.7%) were associated with underlying diseases : the most common disease was hypertension(23 cases), the next one was malignsncy(10 cases), namely, lung cancer, Hodgkin's lymphoma, other malignant lymphoma, leukemia and mediastinal mass, and the other diseases were tuberculosis of intenal organs, diabetes mellitus, hepatic diseases, cardiac diseases, chronic pulmonary diseases, cord injury, gastric ulcer, brain damage, burn, renal diseases, rheumatoid arthritis, and measles. 5. It was suggested that the distributuon of skin lesion were related to dermatome. The incidence of skin lesion was distributuon in the following region in order : T5-T8(25.4%), C6-T4(24.6%), Cl-C5(20.5%), Ll-S3(13.9%), Vl-V3 (12.3%), and T9-T12(3.3%), there was involvement of the entire thoracic dermatome(C6-T12) in 65 cases(53.3%). A great many cases of malignancy, chronic pulmonary disease, cardiac disease, tuberculosis and gastric ulcer were most frequently distributed in the thoracie dermatome, but the involvement of ophthalmic dermatome was found only in the patients with hypertension. 6. The most common complication was postherpetic neuralgia for 31 cases(25.4%) with the highest frequency in 60's(32.3%). Other complications were ophthalmic complication, Ramsay-Hunt syndrome, secondary bacterial infection, moter nerve involvement, difficulty of urination, and recurrent herpes zoster.
Arthritis, Rheumatoid ; Bacterial Infections ; Brain ; Burns ; Chronic Disease ; Diabetes Mellitus ; Heart Diseases ; Herpes Zoster* ; Hodgkin Disease ; Humans ; Hypertension ; Incidence ; Leukemia ; Lung Diseases ; Lung Neoplasms ; Lymphoma ; Measles ; Neuralgia, Postherpetic ; Outpatients ; Prospective Studies ; Seasons ; Sex Ratio ; Skin ; Stomach Ulcer ; Tuberculosis ; Urination