Evaluation of Isometric Shoulder Muscle Contraction during Awakening after Arthroscopic Rotator Cuff Repair / 대한스포츠의학회지

Purpose@#Most rotator cuff repairs are performed under general anesthesia, and the shoulder muscles undergo exertion during the patient’s awakening. These may lead to subsequent retear. The purpose of this study is to evaluate the characteristics of shoulder muscle contraction during awakening from general anesthesia after rotator cuff repair. @*Methods@#Twenty patients underwent arthroscopic rotator cuff repair. Surface electromyography was used to investigate the amplitude of shoulder (upper trapezius [UT] and biceps brachii [BB]) and body (rectus femoris, RF) muscles during awakening in the operating room and resting in the postanesthesia care unit (PACU). @*Results@#The mean maximum voluntary isometric contraction (MVIC) of the UT, BB, and RF during awakening were 28.00%, 27.84%, and 35.65%, and the mean durations of activation were 3.98, 2.50, and 2.71 seconds. In the PACU, the mean MVIC of the UT, BB, and RF were 27.18%, 25.03%, and 27.20%, and the mean durations were 2.72, 0.26, and 0.67 seconds. No correlation between muscle contraction and postoperative pain was identified. @*Conclusion@#Less than 10% of the involuntary muscle contractions of the UT and BB measured in this study exceeded 20% of the MVIC and the contractions lasted less than 4 seconds. As the percentage of the MVIC of the rotator cuff is typically lower than that of the UT and BB, strong contractions of the rotator cuff muscle with detrimental effects occur at a low frequency and short duration. Therefore, retear due to muscle contraction during awakening is unlikely.

Early Transformed Diabetic Foot Ulcer into a Malignancy: A Case Report / 대한족부족관절학회지

This paper presents a case of an early malignant transformation of untreated ulcers in a patient with diabetes. This case shows that Marjolin's ulcer can occur not only after chronic injury, but can also develop in the early stages after the onset. Hence, an early biopsy for diabetic foot ulcers that fail to heal with acute treatment can enable an earlier diagnosis and treatment without amputation, resulting in a better quality of life for the patient.

Do Cerclage Cables Delay the Time to Bone Union in Patients with an Unstable Humeral Shaft Fracture Treated with Intramedullary Nails?

PURPOSE: To evaluate the time to bone union after open reduction and internal fixation with cerclage cables followed by intramedullary nailing (IMN) for unstable humeral shaft fractures. MATERIALS AND METHODS: Patients with a humeral shaft fracture treated by IMN were enrolled. One group of patients was treated via open reduction and internal fixation with cables followed by IMN (cable group; n=32), while the other group was treated with a conventional closed IMN (non-cable group; n=64). The length of time to bone union and functional scores [Disabilities of the Arm, Shoulder and Hand (DASH) and University of California, Los Angeles (UCLA) scores] were measured for all patients. RESULTS: No significant differences were found in terms of age, gender, injury type, or smoking history between the two groups, except for the type of fracture. The cable group had significantly more complex types of fracture than the non-cable group (p0.05). No differences were identified in terms of DASH and UCLA scores (28.8 and 32.1 in the cable group and 26.4 and 32.6 in the non-cable group, respectively; p=0.335 and 0.264). CONCLUSION: In unstable humeral shaft fractures treated by IMN, open reduction and internal fixation with additional cerclage cables do not delay the length of time to bone union or increase the rate of other complications.

Semicircular Horizontal Approach in Breast Reduction: Clinical Experience in 38 Cases

BACKGROUND: Various techniques are used for performing breast reduction. Wise-pattern and vertical scar techniques are the most commonly employed approaches. However, a vertical scar in the mid-lower breast is prominent and aesthetically less pleasant. In contrast, a semicircular horizontal approach does not leave a vertical scar in the mid breast and transverse scars can be hidden in the inframammary fold. In this paper, we describe the experiences and results of semicircular horizontal breast reductions performed by a single surgeon. METHODS: Between September 1996 and October 2013, our senior author used this technique in 38 cases in the US and at our institution. We used a superiorly based semicircular incision, where the upper skin paddle was pulled down to the inframammary fold with the nipple-areola complex pulled through the keyhole. RESULTS: The average total reduction per breast was 584 g, ranging from 286 to 794 g. The inferior longitudinal pedicle was used in all the cases. The average reduction of the distance from the sternal notch to the nipple was 13 cm (range, 11-15 cm). The mean decrease in the bra cup size was 1.7 cup sizes (range, a decrease of 1 to 3). We obtained very satisfactory results with a less noticeable scar, no complication such as necrosis of the nipple or the skin flap, wound infection, aseptic necrosis of the breast tissue, or wound dehiscence. One patient had a small hematoma that resolved spontaneously. CONCLUSIONS: This technique is straightforward and easy to learn, and offers a safe, effective, and predictable way for treating mammary hypertrophy.

Efficacy of Intra-articular Hyaluronic Acid Injection in Early Stage Ankle Osteoarthritis / 대한족부족관절학회지

PURPOSE: This study evaluated the efficacy of an intra-articular injection of sodium hyaluronate in the treatment of early stage osteoarthritis of the ankle. MATERIALS AND METHODS: Early stage ankle osteoarthritis (Takakura stage I and II) patients who received hyaluronic acid injection therapy were retrospectively reviewed. Patients underwent intra-articular injections of 2 mL of sodium hyaluronate for 3 consecutive weeks. Clinical evaluation and Visual Analogue Scale (VAS) scoring were performed at every three months after treatment. RESULTS: Total 27 patients were involved and mean age was 55 year old (range 33 to 77 years). There were 13 male and 14 female patients. Mean follow up duration was 13 month and. Pre-intra-articular VAS score was 8.9+/-0.7 and three month follow up score was 3.8+/-2.8. VAS score of last follow up was 3.2+/-3.4. The effect of hyaluronic acid continued about one year when analyzed the VAS score change of the patients followed for more than one year. Patients' satisfaction was "very satisfied" in nine, "satisfied" in 12, "fair" in one, and "not satisfied" in five patients. Overall satisfaction rate was 82%. There were no ankle osteoarthritis stage changes in serial follow up radiograph. CONCLUSION: Symptomatic relief of signs and symptoms of osteoarthritis of the ankle was achieved by injection of an intra-articular hyaluronate injection. Efficacy of Hyaluronate acid injection persisted more than 1 year in our study. Intra-articular hyaluronate injection to ankle osteoarthritis is safe and effective as knee joint and should be considered as a valid conservative treatment for ankle osteoarthritis.

Pseudomallet Finger Caused by an Osteochondroma from the Distal Part of the Middle Phalanx in a Child: A Case Report

Osteochondroma is the most common benign bone tumor around the metaphysis. Usually, it is originated from the peripheral area of metaphysis-physis junction due to mutation of physeal chondrocyte. This 1-year and 3-month-old boy presented with a mallet deformity. Radiographs showed an abnormal mass on the distal part of the middle phalanx. It was connected to the articular cartilage which was not associated with the physis. Operative and pathologic findings showed typical osteochondroma. After excision of the osteochondroma with sparing of the extensor tendon and immobilization for 6 weeks with a full extension splint, the pseudomallet deformity disappeared.

Analysis of Initial Choice Antibiotics Efficacy in Diabetic Foot Infection / 대한족부족관절학회지

PURPOSE: Foot infections are common complications in patients with diabetes. The patients are usually immune-compromised; therefore the pathogens could be resistant to narrow spectrum antibiotics. Those drugs, however, are categorized as specially managed antibiotics, and access are difficult without confirming of the pathogens. Our aim was to analyze the common pathogens in diabetic foot infection and figure out the proper antibiotics. MATERIALS AND METHODS: We studied 68 patients treated with diabetic foot infection. The pathogens which caused the infection and their sensitivity to initial antibiotics were analyzed. We also investigated the change of the antibiotics after the confirming of the culture result and average time to get the result. RESULTS: Among the 68 patients, 56 (82%) received cephalosporin and beta-lactam antibiotics. Only 12 (18%) who were confirmed the drug resistant pathogens from previous culture, were treated with broad spectrum antibiotics such as vancomycin and tazoperan. Average culture study time was 6 days. Methicillin-resistant staphylococcus aureus (MRSA) was cultured in 19 patients (28%), Methicillin-resistant coagulase negative staphylococcus (MRCNS) in 11 patietns (17%), pseudomonas in 11 patients (17%). Total 44 (65%) including 3 of other antibiotics resistant pathogen needed broad spectrum antibiotics. Thirty two patients (47%) were resistant to initial antibiotics.irt follow up culture, 2 MRSA and 2 MRCNS were found. The antibiotics resistant pathogens were confirmed in 48 (71%) patients at last. CONCLUSION: Diabetic patients with foot infection need proper antibiotics from initial treatment. The proper broad spectrum antibiotics should assigned to the patients from the first time without the confirming of the culture results.

Comparison of the Radiologic Results of Total Knee Arthroplasty using Electromagnetic Navigation with the Conventional Technique / 대한정형외과학회잡지

PURPOSE: We wanted to examine the accuracy of the lower limb alignment and implant positioning that was obtained with using the electromagnetic (EM) navigation technique. MATERIALS AND METHODS: We examined 64 patients who underwent 100 TKAs with using EM navigation technique from July 2006 to February 2007. Sixty-two patients who underwent 100 TKAs with using the conventional technique between August 2005 and July 2006 were used as controls. We assessed the mechanical axis and the alpha, beta, gamma and delta angles in the postoperative radiograph of each patient and we compared them among the two groups. RESULTS: The patients in the EM navigation group achieved better accuracy than did the conventional group in terms of the postoperative mean mechanical axis (1.2degrees vs. 2.3degrees). Less variations in the coronal femoral component and the tibial component angle were observed in the navigation group (femur: 89.3degrees vs. 88.7degrees; tibia: 89.6degrees vs. 89.3degrees, respectively), although the difference in the coronal tibial component angle was not significant. CONCLUSION: The use of EM navigation technique in TKA does not always guarantee the precise alignment of the mechanical axis in all planes, as compared to using the conventional technique. Yet it is useful for obtaining better coronal alignment of the femoral component.

Corrective Dome Osteotomy for Cubitus Varus and Valgus Deformity / 대한정형외과학회잡지

Purpose: To examine the clinical results of a corrective dome osteotomy for a cubitus varus and valgus deformity. Materials and Methods: Between January 1998 and April 2005, nineteen patients with a cubitus varus or valgus deformity were treated with a corrective dome osteotomy. The mean age of the patients was 29.5 years and the mean follow-up period was 39 months (range, 15 to 95 months). A dome osteotomy was performed along the circle centered approximately 1 cm distally from the olecrenon tip. Internal fixation was performed with multiple K-wires or plates. Results: Bony union was achieved in 18 cases. In the cubitus varus group, the carrying angle was corrected from a mean varus of 17.9o to a mean valgus of 5.9o. The lateral prominence angle (LPI) was corrected from a mean of 15.6% to a mean of -7.6%. In the cubitus valgus group, the carrying angle was corrected from a mean valgus of 36o to 6.7o. The LPI was corrected from a mean -31% to -1.3%. On the functional assessment, 12, 5 and 2 cases showed excellent, good and fair outcomes, respectively. Conclusion: Corrective dome osteotomy for a cubitus varus or valgus deformity is an excellent cosmetic procedure through which a correctional angle can be achieved easily without shortening the humeral length.

Intra-synovial Ropivacaine and Morphine for Pain Relief after Total Knee Arthroplasty -A Prospective, Randomized, Double Blind Study-

PURPOSE: Several analgesic techniques are available for pain management after a major operation. MATERIALS AND METHODS: From December 2005 to February 2006, a prospective, double-blind study was performed involving 90 patients who had undergone a total knee arthroplasty. Patients were randomly divided into three equal groups (n=30). Demographic data, including age, height, weight, knee score, visual analogue scale (VAS), and range of flexion were evaluated preoperatively. Before wound closure, patients were given intra-synovial injections of the following solutions: patients in group I received 40mL of 300mg ropivacaine with 1:200,000 epinephrine and 5mg morphine; patients in Group II received 40mL of 300mg ropivacaine with epinephrine; and patients in Group III received 50mL normal saline as a control. All patients received an epidural patient-controlled analgesia (PCA) for 24 postoperative hours. Analgesic efficacy was evaluated using the VAS at intervals of 2, 4, 6, 12, 24, 32, 40, and 48 hours postoperatively. During this period, the side effects, the dosage of rescue analgesia required, and the range of knee flexion were recorded for each group. RESULTS: There were no significant differences among the three groups with regards to the VAS and the required dose of rescue analgesia (p > 0.05). None of the groups demonstrated significant differences in the range of knee flexion and the incidence of postoperative nausea and emesis (p > 0.05). CONCLUSION: Therefore, we found that ropivacaine, alone or with morphine, injected into the synovial tissue, along with an epidural PCA has no additional benefits in pain control after a total knee arthroplasty.

Minimally Invasive Lumbar Microdiscectomy using Tubular Retractor: A Preliminary Report / 대한정형외과학회잡지

PURPOSE: To evaluate the early clinical results of lumbar microdiscectomy using minimally invasive tubular retractor (METRx-MD system, Medtronic Sofamor Danek, Memphis, TN), and to validate the merits of minimally invasive spinal surgery. MATERIALS AND METHODS: From April, 2003 to April 2004 we retrospectively studied a consecutive series of 45 patients who underwent lumbar microdiscectomy using minimally invasive tubular retractor. In all cases, minimally invasive approach using the tubular retractor were performed with a 2 cm sized paramedian incision. The following data were collected: clinical outcomes, operative time, intraoperative blood loss, need for blood replacement, time needed before ambulation, length of hospital stay, and complications. The clinical outcomes were assessed by the modified MacNab criteria. RESULTS: Minimally invasive tubular microdiscectomy was performed in 45 patients over a 12-month period with an average follow-up of approximately 8 months. The clinical outcomes assessed by MacNab criteria were excellent in 33 patients (73%), good in 10 patients (22%). The average operative time was 63 minutes (range, 35 to 95 minutes). The average blood loss was 62 mL (range, 50 to 110 mL). None of the patients needed blood replacement. With the exception of 2 patients, all patients could walk at the day of surgery. The average hospital stay was 2.3 days. None of the patients had dural tear, wound problem, or other complications. CONCLUSION: Lumbar microdiscectomy using tubular retractor can offer a useful modality for the treatment of lumbar herniated disc with the merits of minimally invasive spinal surgery. Further long-term, randomized, prospective investigations are needed to fully evaluate the impact of this technique.

Cannulated Screw Fixation for 4 Part Fractures of the Neck of Humerus

PURPOSE: To analyze radiological and functional results after open reduction and internal fixation for fractures of the neck of humerus (4-part) using cannulated screws. MATERIAL AND METHODS: Between January 1997 and April 2004, 11 patients with neck of humerus fracture (4-part) were treated operatively by open reduction and internal fixation with cannulated screws. Two surgical approaches (deltopectoral for 9 cases and deltoid splitting for 2 cases) were used. The mean age was 36 years old and the mean duration of follow-up was 56 months. ASES (American Shoulder and Elbow Surgeons) score was checked to evaluate the function in shoulder joint. We used 2 cannulated screws in 2 cases, 3~4 screws in 6 cases and over 5 screws in 3 cases for fixation. In 2 cases, K-wires were used additionally and autoiliac bone graft was done in 1 cases which had poor bone mass. RESULTS: All cases got bony union at 5.6 months on average. In functional assessment of shoulder, eight patients got excellent, one got good points. There were complications including shoulder stiffness in 2 cases, avascular necrosis of humeral head in 1 case and subacromial impingement syndrome in 1 case. CONCLUSION: Internal fixation using cannulated screws for fractures of humerus neck (4 part) showed good bony union and functional results in patients under 50 years old who had average bone quality.

The Prostaglandin E Receptor Agonists Increase Granulocyte Macrophage Colony-Stimulating Factor in Prostate Cancer Cells / 대한비뇨기과학회지

PURPOSE: The predilection for prostate carcinoma cells to metastasize to bone suggests the hypothesis that bone and/or bone marrow-derived factors may promote prostate carcinoma cell growth and/or their survival. To date, little work has been performed to characterize the nature of granulocyte macrophage colony-stimulating factor (GM-CSF) and the expression of prostaglandin E2 receptors (EPs) in prostate cancer (PC) cells. The aim of this study is to evaluate the effects of GM-CSF on cell proliferation and the effects of EP agonists on the production of GM-CSF in the PC-3 cells. MATERIALS AND METHODS: The bone-derived PC-3 cell line was used in this study. Reverse transcription polymerase chain reaction (RT-PCR) was performed to detect the mRNA expression of EP1, 2, 3 and 4 and hGM- CSF. 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide (MTT) assay was done to estimate the viability of PC-3 cells after hGM-CSF treatment. hGM-CSF was measured by enzyme-linked immunosorbent assay (ELISA) after treatments with the EPs agonist at 10(-10), 10(-8), 10(-6)M, respectively. RESULTS: EP2, 3 and 4 and hGM-CSF were expressed in the PC-3 cell line. Viability of the PC-3 cells was significantly increased by hGM-CSF administration in a dose- and time-dependent manner. Also, our data indicated that EP2, 3 and especially 4 agonists induced a significant dose- dependent increase in hGM-CSF production in comparison to the control group in the conditioned ELISA medium. CONCLUSIONS: These results suggest that GM-CSF may be part of a network of an autocrine-regulatory loop system that modulates the biologic activity of prostate carcinoma cells. Our data suggest that GM-CSF and EPs may represent a possible novel therapeutic target that manipulates the proliferative rate of prostate tumors.

The Prostaglandin E Receptor Agonists Increase Granulocyte Macrophage Colony-Stimulating Factor in Prostate Cancer Cells / 대한비뇨기과학회지

PURPOSE: The predilection for prostate carcinoma cells to metastasize to bone suggests the hypothesis that bone and/or bone marrow-derived factors may promote prostate carcinoma cell growth and/or their survival. To date, little work has been performed to characterize the nature of granulocyte macrophage colony-stimulating factor (GM-CSF) and the expression of prostaglandin E2 receptors (EPs) in prostate cancer (PC) cells. The aim of this study is to evaluate the effects of GM-CSF on cell proliferation and the effects of EP agonists on the production of GM-CSF in the PC-3 cells. MATERIALS AND METHODS: The bone-derived PC-3 cell line was used in this study. Reverse transcription polymerase chain reaction (RT-PCR) was performed to detect the mRNA expression of EP1, 2, 3 and 4 and hGM- CSF. 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide (MTT) assay was done to estimate the viability of PC-3 cells after hGM-CSF treatment. hGM-CSF was measured by enzyme-linked immunosorbent assay (ELISA) after treatments with the EPs agonist at 10(-10), 10(-8), 10(-6)M, respectively. RESULTS: EP2, 3 and 4 and hGM-CSF were expressed in the PC-3 cell line. Viability of the PC-3 cells was significantly increased by hGM-CSF administration in a dose- and time-dependent manner. Also, our data indicated that EP2, 3 and especially 4 agonists induced a significant dose- dependent increase in hGM-CSF production in comparison to the control group in the conditioned ELISA medium. CONCLUSIONS: These results suggest that GM-CSF may be part of a network of an autocrine-regulatory loop system that modulates the biologic activity of prostate carcinoma cells. Our data suggest that GM-CSF and EPs may represent a possible novel therapeutic target that manipulates the proliferative rate of prostate tumors.

A Case of Kasabach-Merritt syndrome with generalized hemorrhagic diathesis

Kasabach-Merritt syndrome is the association of thrombocytopenia, disorder of coagulation, spontaneous bleeding and enlargement of a hemangima or extensive hemangiomatosis, which can be often life threatening. We experienced a three years-old girl with suddenly enlarging hemangioma of right cheek, complicated by severe thrombocytopenia, consumptive coagulopathy and hemorrhagic cystitis. Generalized petechia and ecchymosis were noted on the overlying skin of hemangioma, trunk and extremities. But the study of MRI and angiography, hypevascular was located within the right masseter muscle extending to temporalis muscle and anterior to parotid gland. So selective embolization with PVA (polyvinyl alcohol) was performed through the distal branch of internal maxillary artery and facial artery. She was medicated with oral corticosterioid for 3 weeks. After embolizationn, blood flow to hemangioma and facial swelling were markedly decreased. Patient was followed up for 7 years and she showed normal contour of face and no bleeding diathesis.

In Vitro Tissue Engineering of Cartilage using Autologous Fibrin Glue and Chondrocytes

Neomorphogenesis of cartilage using chondrocyte-polymer constructs is a potential source for development of cartilage reconstruction. Current tissue engineering techniques of neocartilage rely on in vivo implantation of polymer-chondrocyte constructs. The purpose of this study was to find a way to bioengineer cartilage in vitro by entrapping chondrocytes in a molded autologous fibrin glue. Chondrocytes isolated from the cartilage of rabbit joints were combined with fibrinogen extracted by a single cryoprecipitation of autologous plasma, and they were then polymerized with thrombin to create a fibrin glue with a final cell density of 2.5x10(6) cells/ml. The collagen for a control study was used as a polymer. The polymer-chondrocyte constructs were cultured for 4 weeks and the fibrin-chondrocyte constructs molded in the shape of a human ear were cultured for 6 weeks in vitro. Morphometric, histochemical, and histomorphometric analysis including glycosaminoglycan quantitation confirmed the following results: 1) Highly-concentrated autologous fibrinogen was easily extracted by a single cryoprecipition of autologous olasma. 2) The fibrin-chondrocyte constructs demonstrated the presence of actively proliferating chondrocytes with the production of cartilaginous matrix(collagen and glycosaminoglycan) at 1 week after culture, as well as gross and histologic evidence similar to those of normal cartilage at 3-4 weeks after culture. 3) The collagen-chondrocyte constructs demonstrated lower degrees of hardness and transparency, as well as a lower density of cells and glycosaminoglycan during the culture period. 4) Neocartilage generated from fibrin-chondrocyte constructs in the shape of a human ear nearly retained their original configuration and size without degeneration for 6 weeks of culture in vitro. This study demonstrated a novel method for bioengineering the molded cartilage in vitro using autologous fibrin glue as a matrix scaffold. The generated cartilage showed gross and histologic evidence similar to those of normal cartilage, retaining the original gross dimension. With further refinement, this may be a new application of tissue engineering for the reconstruction of cartilage.

A study on the clinical improvement according to the fracture sites pure blow-out fracture

As the traffic accidents and occupational accidents increase, the pure blow out fracture has been increased. If we could know the prognostic information of the pure blowout fracture according to the fracture sites, it would be of benefit in consulting the patients preoperatively and in planning the treatment. In this study we defined the posterior wall fracture as that extending 2 cm from orbital rim and the anterior wall fracture as that presenting within 2 cm from orbital rim. These fractures were individually classified into inferior wall fractures, medial wall fractures, and combined inferior and medial wall fractures, based on the operative finding and the preoperative CT scanning. We experienced 76 cases of pure blowout fracture patients underwent surgical correction and followed up the subsidence of diplopia and extraocular muscle limitation with ophthalmic Hess test. The results obtained are as following: 1. Posterior wall fractures were improved more slowly than anterior wall fractures. 2. Combined inferior and medial wall fractures were improved more slowly than isolate inferior wall or medial wall fractures. These results may be related to the difference of the traumatic forces and the anatomical structure of the fracture sites. These results inform the importance of accurate anatomical reconstruction of fracture sites and can be used as a prognostic information of the pure blow out fractures.

A study on the preparation of an acellular allogenic dermis and usefulness in a full thickness wound model

The use of artificial skins for full thickness wounds is an accepted technique, but unfortunately the take rate is low and the aesthetical result is not acceptable. The freeze-drying treatment of allogenic tissues can destroy cells with preserving the structural organization of extracellular matrices, permitting allogenic transplantation. In this study we investigated a new method to process the allogenic skin for transplantable allogenic dermis and this dermis was evaluated in a full thickness wound model. The results are as followings; 1. After treatment with NaCl and SDS solution and then with freeze-drying method, the allogenic dermis shows acellular dermal matrix with preserved normal extracellular matrix. 2. This allogenic dermis became completely incorporated into the wound without evidence of rejection or replacement by scar tissue. 3. The take rate of thin autografts overlying the allogenic dermis that were applied simultaneously was comparable to take rate of autograft alone. 4. The reduction in secondary contraction by allogenic dermis treated wounds was significant. 5. After grafting with cultured keratinocytes, the degree of epithelial coverage was 70% at 2 weeks. In conclusion, the allogenic dermis processed with our method displayed lack of antigenicity, and rapid revascularization. This allogenic dermis can permit simultaneous engraftment of an overlying STSG or cultured kerationocytes, reduce secondary contraction and improve cosmesis of full thickness wounds.

Craniofacial growth following unilateral lambdoid synostosis in rabbits

Immobilization of unilateral (right) lambdoid suture was produced in 9-day-old rabbits to determine its effect on subsequent craniofacial growth. The suture was immobilized by the topical application of methyl-2-cyanoacrylate adhesive, subsequent growth effects on the cranial vault, cranial base and facial skeleton were assessed by serial radiographic cephalometry. The statistically significant result(p < 0.05) were: 1. The growth of immobilized lambdoid suture was decreased accompanying compensatory growth at coronal suture bilaterally. 2. The length of anterior and posterior cranial base was increased. 3. Anterior midfacial height was increased. 4. Lower midfacial angle (angular relationship of cranial base to lower midface) was decreased. With the view of above findings, it is clear that restricted growth was seen at unilateral lambdoid suture accompanying compensatory growth at coronal suture and resulted in altered cranial base and facial growth.

A case of tongue volume measurement with the plaster tongue model for partial glossectomy in macroglossia

The tongue is located inside the oral cavity at rest, and the structural interrelations between the tongue and the oral cavity is essentially important for normal tongue function. Macroglossia is clinically diagnosed whenever the tongue does not fit the oral cavity, thus patients complain of noisy breathing, drooling, speech and swallowing dysfunction, malocclusion, and social ridicule. Partial glossectomy for macroglossia volume has been assumed to be difficult. In this study, we attempted to measure the tongue volume with the plaster tongue model in a 7-year-old macroglossia patient. This method is reliable and simple for measuring the tongue volume in macroglossia.