ABSTRACT
Plagiocephaly is a premature unilateral coronal craniosynostosis consisting of flattening of the involved frontal region and low-set orbit in affected side and compensatory occipital bulging in contralateral side with resultant facial asymmetry. The authors experienced a 20-year-old male having frontal and posterior palgiocephaly with asymmetric mid-facial appearance in left side who had undergone the strip craniectomy of the coronal suture when he was 100 days old. We performed total intracranial total calvarial remodeling including occipital region followed by two-jaw operation seven months later. Cranial vault was cut into three transverse bone flaps; anterior bi-frontal bone flap, posterior bi-fronto-parietal bone flap, and bi-parieto-occipital bone flap. Unilateral supra-orbital bar advancement with tongue-in-groove arrangement was performed. To restore contour of occipital region, the transposition cranioplasty was done after mid-sagittal osteotomy of posterior bone flap. Seven months later, Le Fort I osteotomy and BSSRO was performed to correct jaw asymmetry and cross-bite. We believe that total correction of orbito-fronto-occipital vault including jaw surgery in plagiocephaly is mandatory for more excellent aesthetic result and effectiveness.
Subject(s)
Humans , Male , Young Adult , Craniosynostoses , Facial Asymmetry , Jaw , Orbit , Orthognathic Surgery , Osteotomy , Plagiocephaly , SuturesABSTRACT
The application of microsurgical techniques to replant amputated ears has reliable outcome in ear salvage. However as the vessels available for anastomosis are relatively small, the technical success of the vascular repair is still challenging. In addition, avulsion amputations are a common occurrence and this makes ear vessels not available for use. Indeed, even when veins are identified and repaired or reconstructed, their relatively low flow state combined with postoperative swelling leads to a high rate of problems such as venous drainage. In these situations, either sticking the ear and allowing bleed freely or, more often, the leech therapy can be used as external decompression of the venous congestion in the replanted ear, which made the replantations successful. We present a successful result of microsurgical replantation in almost totally amputated ear which is anastomosed in the lower division of postauricular artery. No attempt was made to reestablish venous outflow microsurgically. Instead of venous repair, the leech therapy was applied immediately for the purpose of external decompression of postoperative venous congestion and the outcome was successful. This case provides the evidence that venous repair is not the requisite for successful replantation.
Subject(s)
Amputation, Surgical , Arteries , Decompression , Drainage , Ear , Hyperemia , Leeching , Replantation , VeinsABSTRACT
The application of microsurgical techniques to replant amputated ears has reliable outcome in ear salvage. However as the vessels available for anastomosis are relatively small, the technical success of the vascular repair is still challenging. In addition, avulsion amputations are a common occurrence and this makes ear vessels not available for use. Indeed, even when veins are identified and repaired or reconstructed, their relatively low flow state combined with postoperative swelling leads to a high rate of problems such as venous drainage. In these situations, either sticking the ear and allowing bleed freely or, more often, the leech therapy can be used as external decompression of the venous congestion in the replanted ear, which made the replantations successful. We present a successful result of microsurgical replantation in almost totally amputated ear which is anastomosed in the lower division of postauricular artery. No attempt was made to reestablish venous outflow microsurgically. Instead of venous repair, the leech therapy was applied immediately for the purpose of external decompression of postoperative venous congestion and the outcome was successful. This case provides the evidence that venous repair is not the requisite for successful replantation.
Subject(s)
Amputation, Surgical , Arteries , Decompression , Drainage , Ear , Hyperemia , Leeching , Replantation , VeinsABSTRACT
BACKGROUND/AIMS: Polyethylene glycol (PEG) electrolyte lavage solution is now commonly used for peroral colonic preparation. However, the need to ingest a large volume reduces patient acceptance and may limit compliance, thereby resulting in improper preparation. This study was designed to assess whether adding of magnesium oxide or cisapride to PEG solution decreased the volume of PEG solution required without compromising the quality of the preparation. METHODS: One hundred thirty seven patients undergoing outpatient colonoscopy were randomly chosen to receive one of three preparations (Group A: 4 L PEG; Group B: 2 L PEG plus cisapride 20 mg; Group C: 2 L PEG plus magnesium oxide 2 g). Endoscopist was blinded as to the method of preparation and scored the degree of colonic preparation (1 to 4). RESULTS: Mean scores of preparation in group A, B, and C were 2.85, 2.69, and 2.20, respectively (p=0.001). There were significant differences of the degree of preparation between group A and group C, between group B and group C, but not between group A and group B. CONCLUSIONS: Two liters of PEG plus cisapride induced equally effective colonic preparation compared to four liter PEG solution. This results show that the addition of cisapride to PEG solution can reduce volume of PEG solution during colonoscopy preparation.
Subject(s)
Humans , Cisapride , Colon , Colonoscopy , Compliance , Magnesium Oxide , Outpatients , Polyethylene Glycols , Therapeutic IrrigationABSTRACT
Loeffler's endocarditis is a recognized complication of diseases associated with eosinophilia. This disease is considered to be a part of the idiopathic hypereosinophilic syndrome, which is characterized by persistently elevated blood eosinohil counts with symptoms and signs of organ involvement especially in the heart, nervous system, and bone marrow. We have experienced a case of Loeffler's endocarditis in a 51 years old man who complained of leg pain due to acute closure of left iliac artery by emboli. We found left ventricular mural thrombus by echocardiography and confirmed Loeffler's endocarditis by endomyocardial biopsy. We present a case with the review of literatures.
Subject(s)
Humans , Middle Aged , Biopsy , Bone Marrow , Echocardiography , Eosinophilia , Heart , Hypereosinophilic Syndrome , Iliac Artery , Leg , Nervous System , Thromboembolism , ThrombosisABSTRACT
No abstract available.
ABSTRACT
No abstract available.