No abstract available.

Histopathological diagnosis of brain stem glioma should be performed for the purpose of the determination of its management and clinical course, but its surgical biopsy has been followed by high mortality and morbidity. We performed the tissue sampling for histological examination with BRW stereotaxic system under local anesthesia successfully.
Anesthesia, Local ; Biopsy* ; Brain Stem* ; Brain* ; Diagnosis ; Glioma* ; Mortality

No abstract available.
Erythroblastosis, Fetal* ; Humans ; Immunoglobulin G* ; Infant, Newborn ; Infant, Newborn* ; Mothers*

PURPOSE: Correction of cleft lip nose deformity(CLND) in adulthood is different from one in childhood. Usually correction of CLND is final surgery for adult patient who has cleft lip, so many things have to be considered for correction. Of course, it is different from common rhinoplasty, either. The adult patients can be corrected by complete rhinoplasty with various techniques. To recognize how rhinoplasty techniques was used for correction of CLND, authors analyzed detailed techniques which were selected in the adult patients for 10 years and reviewed comprehensive operation. METHODS: A retrospective review was conducted involving 64 patients with CLND who underwent surgery and aged after 14 years at operation between 2001 and 2010. Detailed techniques were investigated by medical record review and classified according to incision, septoplasty, osteotomies, correction of vault, tip plasty and etc. RESULTS: Except one, all patients were performed open rhinoplasty. 49 patients were performed septoplasty. 33 patients were performed complete rhinoplasty with osteotomies. Hump nose correction was performed for 10 patients. Dorsal augmentation was performed for 8 patients. And all patients were performed tip plasty. Tip plasty using suture technique was performed for 58 patients and graft was performed for 48 patients. CONCLUSION: Correction of CLND in adult is one of the most challenging and varied operation of plastic surgery. In this study, the majority of patients were performed complicated and delicated procedures. It seems to be because patient's demand level has been elevated and rhinoplasty procedures have been advanced. This study may help to planning of CLND correction.
Adult ; Aged ; Cleft Lip ; Congenital Abnormalities ; Humans ; Medical Records ; Nose ; Osteotomy ; Retrospective Studies ; Rhinoplasty ; Surgery, Plastic ; Suture Techniques ; Transplants

Craniopharyngioma is one of the most challenging, Frustrating, and humbling benign intracranial tumors of childhood. Its behavior is a clinical malignancy even though it is benign tumor in microscopically. There is no single treatment of craniopharyngioma and there must be a plan customized for eacg patient. This decision may, be made from diagnostic studies alone, but in most cases exploration of the tumor and the testing of its adherence to its surroundings will be the only thorough and fair way to determine whether it can be totally excised or not. So the choice of treatment is "individualize". We experienced one case of giant cystic craniopharyngioma and performed combined operaion whih were percutaneous intermittent drainage of cystic fluid through Ommaya reservoir and following microsurgical radial excision. There was no complication and marked intellectual and psychological improvement until todays for 20 months.
Craniopharyngioma ; Drainage* ; Humans

Astrocytoma in the thalamus in not so frequent in incidence (1%). Moreover, bilateral thalamic tumor is rare. Certain tumors of the thalamus are considered resectable but most of thalamic tumors are thought to be untouchable. Bilateral thalamic astrocytoma with hydrocephalus was diagnosed by stereotactic biopsy and ventriculoperitoneal shunt operation was done with result of improvement. We report a case of astrocytoma in the bilateral thalamus with literature review.
Astrocytoma* ; Biopsy ; Hydrocephalus ; Incidence ; Thalamus* ; Ventriculoperitoneal Shunt

Reconstruction of the lower lip requires consideration of several factors. There should be retained sensation, maintenance of oral sphincter function, and a large enough opening for the mouth. In addition, it is important to achieve an aesthetically acceptable appearance. Webster's modification of Bernard operation is one of good methods which satisfy above mentioned goals. The purpose of this article is to present the results and review the perioperative problems after reconstruction of the lower lip by this operation. We reviewed seven patients after surgical reconstruction by the same method between January of 1996 and December of 2003. Five patients were male and two were female. The mean follow-up period was 15 months. We obtained functionally and cosmetically acceptable appearance after reconstruction. Most of the reconstructed lower lips were large enough for full mouth opening, but one patient required additional commissuroplasty, and one other patient was treated with wound revision for dehiscence resulting from protrusion of mandibular lateral incisor tooth. All other patients accepted their facial appearance. In conclusion, careful planning and consideration for dental problems and proper closure tension may ensure satisfactory outcome & lower lip competence, when using this modified operative method for lower lip reconstruction.
Carcinoma, Squamous Cell* ; Female ; Follow-Up Studies ; Humans ; Incisor ; Lip* ; Male ; Mental Competency ; Mouth ; Sensation ; Tooth ; Wounds and Injuries

Usually cases of brain stem hemorrhage reveal high mortality and poor prognosis in spite of meticulous medical or surgical treatment. Recently we experienced stereotaxic evacuation of brain stem hemorrhage with Brown-Robert-Wells(B.R.W.) system in four cases. If there were residual hemorrhage after initial aspiration, those were evacuated with Urokinase irrigation via stereotaxically placed catheter in the hematoma. The entry point of our operation get on the crossing point of midpupillary line and 1cm behind coronal structure. Preliminary results : 1) Volume of removed hematoma : 5ml(average). 2) Dates of urokinase irrigation : 2 to 4 days after operation. 3) No hydrocephalus, no surgical mortality. 4) Average Glasgow coma scale was improved from 6 in preoperative state to 12 in postoperative state. 5) Operation was performed within 24 hours. 6) Advantages of our procedure. (1) Accurate, simple and safe. (2) Under local anesthesia. (3) Less traumatic procedure. (4) Could remove hematoma completely with Urokinase.
Anesthesia, Local ; Brain Stem* ; Brain* ; Catheters ; Glasgow Coma Scale ; Hematoma ; Hemorrhage* ; Hydrocephalus ; Mortality ; Prognosis ; Urokinase-Type Plasminogen Activator

PURPOSE: Autologous fat grafting is a popular procedure for the correction of the soft tissue depression and deformity. But there are several issues required to be carefully considered in relation to this procedure, mainly about the unpredictability and the low survival rate of the grafted fat due to absorption and partial necrosis. Sphingosine-1-phosphate (S1P) is a lysophospholipid mediator that has been proposed to promote angiogenesis and to regulate the differentiation of adipose derived stromal cells (ASCs). In this study, we analyzed the viability of the grafted fat tissue mixed with S1P into each 12 nude mice (cann.cg-fox1nu/crlori) compared to the group of mice grafted fat tissue only. METHODS: Human aspirated fat was grafted subcutaneously into the backs of 8-week-old nude mice with or without S1P. Eight weeks later, the grafted fat was harvested and the weight and volume were checked. The fat was stained with hematoxylin-eosin and 4',6-diamidino-2-phenylindole. RESULTS: S1P group weighed significantly more than the control group (p=0.009), and the volume from the S1P group was considerably larger than that of the control group (p=0.004) either. In histological features, the surviving layer of the S1P group was thicker than the control group and microvasculature appeared to be prominent in the S1P group, especially in the outer layers. CONCLUSION: These findings suggest that S1P plays a vital role in the soft tissue augmentation, potentially providing a novel point of the control in adipose tissue for microfat graft.
Absorption ; Adipose Tissue ; Animals ; Congenital Abnormalities ; Depression ; Humans ; Indoles ; Lysophospholipids ; Mice ; Mice, Nude ; Microvessels ; Necrosis ; Sphingosine ; Stromal Cells ; Survival Rate ; Transplants

During last 48 months, in our department 5 patients with single or multiple herniated lumbar discs have received chemonucleolysis. Forty-one of r51 cases have single level herniation and remaining cases have multiple level. Age distribution were from 19 to 59 years old. Over 4 months (longest case: 18 months) follow up revealed as follows: 40 cases (78%) revealed excellent results: 4 cases (7.8%) received discectomy 3-6 months after chemonucleolysis because of recurred symptoms: no anaphylaxis and no major complications were noted.
Age Distribution ; Anaphylaxis ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc Chemolysis*