CLINICAL OBSERVATION OF CRANIOPLASTY USING AUTOGENOUS BONE GRAFT

Calvarium protects the brain, the most important organ. The defect of calvarium results in not only deformity but also fatal injury from the trauma. The cranial bone defects result from 1) removal of bone flap for intracranial decompression or infection 2) fracture 3) excision of tumor 4) craniectomy for craniosynostosis. The goals of cranioplasty are to protect the brain from trauma and make the aesthetically acceptable contour. From 1990 to 1995, we experienced twelve cases of cranioplasty using autogenous bone graft; 5 cases with rib bone, 3 cases with iliac bone, 2 cases with calvarial bone, and 2 cases with rib and calvarial bones. The result was very excellent without any significant complications.

THE CLINICAL USES OF GLUTEUS MAXIMUS MYOCUTANEOUS FLAPS

Ulcer in buttock is mainly a pressure sore, which is frequently occurred at the sacral region in Korea and its surgical treatment is chiefly the operation using gluteus maximus myocutaneons flaps. For the treatment of ulcerated lesion in gluteal area, various methods using gluteus maximus muscle have been developed. We reviewed and analyzed the 100 cases using gluteus maximus myocutaneous flaps in our department since 1980. The results were summarized as follows ; 1) The ratio between male and female was 3:1. 2) The prevalent age groups were between third and fifth decades. 3) The main cause was the trauma. 4) The wound culture showed the pattern of mixed infections in most cases, consisting of Staphylociccus, Pseudomonas, Enterococcus, Streptococcus, and others. 5) The postoperative complications were noted in about thirty percent of the cases. The complications were flap tip necrosis, wound infection, wound disruption, and others. 6) For the treatment of small ulcers, a pure skin flap or myoplasty may be used, but for the treatment of large one, a kind of myocutaneous flap should be selected. 7) Gluteus maximus myocutaneous flaps can be used as variable methods, but of which the island flap is ideal in deep and large ulcerated lesion.

CLINICAL STUDY OF FACIAL SKIN CANCERS

No abstract available.

HISTOPATHOLOGICAL STUDY OF THE VASCULAR LESIONS IN NEUROFIBROMATOSIS

Clinical manifestations caused by vascular complications including stenosis, occlusion, aneurysm and arteriovenous malformation were rarely developed in patients with neurofibromatosis. We reviewed 23 cases of neurofibromatosis type I to identify the histopathologic features of vessels in neurofibromatosis associated with clinical features. The results were as follows: 1. The age of patients ranged from 4 to 61 years(mean: 23 years) at diagnosis and sex ratio of male to female was 1.3 : 1. The family history was present in 52%(12/23) of the patients. Angiographically, 3 cases of atherosclerosis, 1 case of arteriovenous malformation, and 1 case of aneurysm were seen. 2. peculiar vascular alternations were found in 7 of 23 cases of neurofibromatosis, which were classified as 4 types: 6 cases of pure intimal; 3 cases of advanced intimal; 1 case of intimal-aneurysmal; 3 cases of nodular type. The most frequent type of vascular lesions was observed in the patients with neurofibromatosis was Pure intimal, and the most uncommon one was intimal-aneurysmal. 3. Immunohistochemically, the positivity to S-100 protein was noted in the tumor cells arranged in the periphery of vessels, but no reaction was seen in the spindle or epithelioid cells within the vascular wall. In conclusion, the vascular lesions associated with neurofibromatosis may result from abnormal proliferation of cells in the vascular wall, possibly smooth muscle cells, not Schwann cells in origin. The various types of lesions described previously appear to be of stage of development.