STUDY DESIGN: This is a retrospective study. OBJECTIVES: To evaluated the clinical and radiological effectiveness of sacral alar screws for augmentation of S1 pedicle screws in long-level fusion including L5-S1 segment. SUMMARY OF LITERATURE REVIEW: The fusion rates of lumbosacral junction in long-level fusion are various when S1 pedicle screws are used without augmentation. But, reports of sacral alar screw augmentation are rare. MATERIAL AND METHODS: From 1996 to 2005, 63 patients performed more than two-level fusion including lumbosacral junction were reviewed. 47 patients underwent lumbosacral fusion with S1 pedicle screws only (S1 group), and 16 patients with sacral alar screws augmentation in addition to S1 pedicle screws (S1-2 group). Radiologically, bony union, halo sign, and breakage of implants were evaluated. Clinically, complications associated with screw placement and general complications were evaluated. RESULTS: Bony union was obtained in 56 cases(89%) at postoperative 4.3 months. Nonunion was observed in 7 cases(11%, S1 group:5, S1-2 group:2). Loosening of S1 pedicle screw was observed in 32 cases(89%) of S1 group and in 4 cases(25%) of S1-2 group. It showed statistical significance between two groups. Sacral alar screw loosening occurred in 8 cases(50%) of S1-2 group. Metal breakage was developed in 2 cases of S1 group without nonunion or loosening. Postoperative infection occurred in 7 cases(11%, S1 group:5, S1-2 group:2). CONCLUSIONS: Sacral alar screw augmentation was effective on protecting the loosening of S1 pedicle screw. Additional sacral alar screw can improve the rate of fusion for lumbosacral junction despite no statistical significance.
Humans ; Retrospective Studies ; Succinates

Lumbosacral fixation or spinopelvic fixation is frequently required for the surgical treatment of neuromuscular scoliosis and degenerative lesions, trauma and tumor in the lumbosacral vertebrae. However, the establishment of stable fixation with these procedures is difficult due to the anatomic characteristics of the sacrum and this is even more problematic for the cases with long segmental fixation, severe instability and bone defects. Although the emergence of pedicle screws makes spinal fixation easier and more rigid, S1 pedicle screws alone do not provide enough stability for lumbosacral fixation. For the purposes of reinforcing lumbosacral fixation, procedures using rods or screws can be used: the procedures using rods include the Galveston method, the McCarthy S-rod and the Jackson intrasacral rod, and the procedures using screws include sacral alar screws, transdiscal screws and iliac screws. The purpose of this study was to ascertain the proper fixation methods, according to each indication, for spinopelvic fixation and we analyzed the advantages and drawbacks of each fixation method. In addition, the fixation method of iliac screws, which has recently become more popular, is presented in detail to enhance the availability and reduce the complication of this technique.
Sacrum ; Scoliosis ; Spine ; Succinates

PURPOSE: To evaluate whether upper eyelid blepharoplasty causes eyebrow position change in patients with or without brow ptosis. METHODS: We analyzed the photographic records of 28 patients 53 eyes with dermatochalasis who had undergone upper eyelid blepharoplasty. Brow-pupil, brow-lid margin, lid margin-pupil, brow-lateral canthus, and brow-medial canthus distances were measured, and then the proportions of medial canthus-nasal alar were taken. Preoperative and postoperative measurements were compared. RESULTS: After blepharoplasty, no one in the group without brow ptosis developed new brow ptosis. In the group with brow ptosis, only one patient felt a significant change in brow position after blepharoplasty. In both groups, the distance between the eyebrow and the lid margin decreased by similar amounts. There was no change in the upper eyelid margin position after blepharoplasty. CONCLUSIONS: In patients with dermatochalasis, upper eyelid blepharoplasty caused a lowering of the eyebrow without a change in the eyelid margin. It is important to evaluate the brow ptosis preoperatively and excise the correct amount of excess skin to avoid aggravation of brow ptosis.
Blepharoplasty ; Eye ; Eyebrows ; Eyelids ; Humans ; Skin ; Succinates

PURPOSE: To evaluate whether upper eyelid blepharoplasty causes eyebrow position change in patients with or without brow ptosis. METHODS: We analyzed the photographic records of 28 patients 53 eyes with dermatochalasis who had undergone upper eyelid blepharoplasty. Brow-pupil, brow-lid margin, lid margin-pupil, brow-lateral canthus, and brow-medial canthus distances were measured, and then the proportions of medial canthus-nasal alar were taken. Preoperative and postoperative measurements were compared. RESULTS: After blepharoplasty, no one in the group without brow ptosis developed new brow ptosis. In the group with brow ptosis, only one patient felt a significant change in brow position after blepharoplasty. In both groups, the distance between the eyebrow and the lid margin decreased by similar amounts. There was no change in the upper eyelid margin position after blepharoplasty. CONCLUSIONS: In patients with dermatochalasis, upper eyelid blepharoplasty caused a lowering of the eyebrow without a change in the eyelid margin. It is important to evaluate the brow ptosis preoperatively and excise the correct amount of excess skin to avoid aggravation of brow ptosis.
Blepharoplasty ; Eye ; Eyebrows ; Eyelids ; Humans ; Skin ; Succinates

BACKGROUND AND OBJECTIVES: No definite concepts or nomenclature have yet been established in Korean for a number of different grafts used frequently in Korean rhinoplasty. The aims of this study were to define indications and usages of grafts frequently used in Korean rhinoplasty and to suggest appropriate Korean nomenclatures for these grafts. MATERIALS AND METHOD: We prepared diagrams and explanations for the grafts frequently used in rhinoplasty in Korea and suggested Korean nomenclature that were considered the most appropriate. We carried out a survey on the rhinoplasty experts in order to reach a consensus on the nomenclature. We also reviewed recent Korean articles on rhinoplasty to investigate how names of each graft had been translated into Korean nomenclature. RESULTS: We classified grafts according to anatomical locations; the nasal dorsum, the nasal tip, the alar region, and the alar base. Grafts of the nasal dorsum included radix graft, dorsal onlay graft, dorsal sidewall onlay graft, and spreader graft. Grafts of the nasal tip were the columellar strut, shield graft, buttress graft, cap graft, and septal extension graft. The alar batten graft, alar rim graft, composite alar rim graft, lateral crural onlay graft, and lateral crural strut graft belonged to grafts of the alar region. Grafts of the alar base included the columellar plumping graft, premaxillary graft, and alar base graft. The names of all these grafts were translated into Korean. CONCLUSION: We set definitions, indications, and usages of each graft, and suggested the most appropriate Korean nomenclature. We hope that this nomenclature can be widely accepted and used in future papers and books on Korean rhinoplasty.
Consensus ; Inlays ; Korea ; Rhinoplasty ; Succinates ; Transplants

OBJECTIVETo investigate the apoptosis induction effect of vitamin E succinate (VES) on Tca8113 cells and its possible mechanisms.

METHODSThe proliferative activity of Tca8113 was assessed by methyl thiazolyl tetrazolium (MTT) assay. After Tca8113 cells were treated with different concentrations of VES, apoptotic rates were analyzed by flow cytometry (FCM). Fas monoclonal antibody was used for the blocking test. Fas expression was detected by immuocytochemistry(SABC assay) and FCM.

RESULTSVES demonstrated a significant growth inhibitory effect and apoptosis induced effect on the Tca8113 cells in a dose- and time-dependent manner. Fas neutralizing antibody can block the apoptosis induced by VES. After the administration of VES, the expression of Fas protein increased and the kytoplasm staining enhanced. Proteinum quantitative analysis showed that the mean fluorescence intensity increased.

CONCLUSIONVES can induce apoptosis in human tongue cancer cells, and the up-regulation of the cell surface Fas protein may play an important role in the process.

PURPOSE: Straight closure line of classic Weir excision leaves visible scars and makes it difficult to precisely approximate resection margins. Hence this study introduces Park-Weir excision that effectively reduces alar width with minimal alar rim scar by 3-dimensional zigzag incision and properly controls the approximation of edges. METHODS: From 2008 to 2010, 14 patients underwent Park-Weir excision, crossed wedge excision on alar rim not exceeding 5mm in width. Each patient was photographed in the same position. Alar width and columellar height against intercanthal distance was compared preoperatively and postoperatively, using image analysis software. RESULTS: Five patients were female and nine were male. Average follow up period was 8 month. Alar width was reduced by 50.50% to 45.96%, original alar width reduced by 8.98% without significant changes in columellar height which was reduced by 0.39%. No visible scar was reported during outpatient follow-up. CONCLUSION: Park-Weir excision effectively reduces alar width and corrects the flaring of alar without affecting the columellar height. Zigzag incision of Park-Weir excision leaves aesthetically more pleasant scar than straight single incision of classical Weir excision.
Cicatrix ; Female ; Follow-Up Studies ; Humans ; Male ; Outpatients ; Succinates

STUDY DESIGN: This is a retrospective study. OBJECTIVES: We wanted to assess the stability of distal instrumentation using the bilateral S1 and sacral alar screws for the treatment of degenerative lumbar deformity. SUMMARY OF LITERATURE REVIEW: Various instrumentation methods have been introduced for increasing the strength of lumbosacral fusion. However, there are not many clinical studies that have evaluated the effectiveness of a sub-S1 alar screw for treating degenerative lumbar deformity surgery. MATERIALS AND METHODS: A total of 39 patients with degenerative lumbar deformity were treated by long fusion and we retrospectively analyzed these patients after a minimum follow-up of 1 year. All the patients underwent an operation with distal instrumentation using either bilateral S1 screws alone (the S1 group) or additional bilateral sub-S1 sacral alar screws (the SA group). There were 19 patients in the S1 group and 20 patients in the SA group. The stability of the distal instrumentation was assessed by breakage or backout of a rod and/or screws based on simple radiography. RESULTS: Instability of the distal instrumentation was detected in 6 cases (32%) in the S1 group and in 1 case (5%) in the SA group. The SA group had a more stability of the distal instrumentation than that of the S1 group with a significant difference (P<0.05). Distal instrumentation was unstable in 6 (19%) of the 32 cases with an anterior metal cage through posterior interbody fusion at L5-S1 and in 1(14%) of 7 cases without it at L5-S1. There was no significant difference in the stability of distal instrumentation in each group according to whether or not their L5-S1 was treated with an interbody cage (P>0.05). CONCLUSIONS: Bilateral sacral alar screws coupled with bilateral S1 screws can provide good distal fixation for stability of the distal instrumentation when performing long fusion for treating degenerative lumbar deformity.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Retrospective Studies ; Succinates

The nasal ala is a challenging area for surgical reconstruction, with thick sebaceous skin, the lack of an ample tissue reservoir, and an adjacent free margin. Numerous flaps have been reported for the repair of alae defects. A 71-year-old woman with simultaneous basal cell carcinomas involving both nasal alae was treated by Mohs micrographic surgery. The surgical defects measured 1.5x1.5 cm on the center of the right nasal ala and 1.0x1.0 cm on the left nasal ala, including the alar crease and rim. The right nasal ala was used as a nasolabial transposition flap and the left nasal ala was reconstructed by an island pedicle flap. The final shape and texture were satisfactory. The flaps survived and nasal symmetry was preserved. Combined nasolabial transposition and island pedicle flaps thus offer a superior esthetic and functional result owing to minimized tension. This may be a valuable reconstructive option in the repair of bilateral nasal alae defects.
Aged ; Carcinoma, Basal Cell ; Female ; Humans ; Mohs Surgery ; Skin ; Succinates

To establish an HPLC method for determination of dactylorhin A and militarine in Cremastrae Pseudobulbus/Pleiones Pseudobulbus. The analysis was achieved on an Alltech Prevail C18 column (4. 6 mm x 250 mm, 5 microm) using a mobile phase of acetonitrile (A), water (B) gradient elution in a total run time of 35 min (0 min, 20:80; 30 min, 55:45; 35 min, 55:45) and a diode array detector was set at 224 nm. The flow rate was 0.8 mL x min(-1). The assay displayed good linearity over the concentration range of 0.257-9.95 microg (r = 0.999 8), and 0.128-10.27 microg (r = 0.999 9), respectively. The average recoveries (n = 9) were 94.70% and 102.8% for dactylorhin A and militarine, respectively. The method is accurate, quick, simple and reproducibility. It can be used for the quality control of Pleione bulbocodioides and Pleione yunnanensis.
Chromatography, High Pressure Liquid ; Glucosides ; analysis ; Orchidaceae ; chemistry ; Succinates ; analysis