Patients with a poor or total absence of levator function require correction of their ptosis by a sling procedure. The aim of the procedure is to utilize the action of the frontalis muscle to mechanically raise a droopy eyelid Frontalis suspension procedure using a temporalis fascia or Tutoplast Dura was performed on 36 ptotic eyelids of 23 patients(age range 2-37 years) with a poor or absent levator function. The author used a surgical technique based on a modified Fox`s method. Satisfactory results were achieved in 42 lids according to the criteria of Jordan after an average follow-up of 23 months. No serious complication was seen immediately postoperative and during the follow-up period. Temporalis fascia and Tutoplast Dura appear to be effective and safe alternative sling materials for frontalis suspension surgery.
Blepharoptosis* ; Eyelids ; Fascia ; Follow-Up Studies ; Humans ; Jordan

Macrostomia, also called a transverse or lateral facial cleft, is a relatively rare malformation. Although many surgical procedures have been introduced, and no gold standard has yet been established. Moreover, most papers published in Korea were based on the results of the research conducted on the very limited number of patients, and for this reason its findings do not offer sufficient clinical reliability. We devised a modified commissuroplasty as follows: First, new commissure was placed 1 or 2mm inside when compared with the opposite side so that the commissure may not look longer than usual because of the scar on the side. Second, z-plasty of about 5mm was performed on the nasolabial fold to prevent the displacement of the new commissure on its lower part and avoid a continuation of a scar with the medial flap placed upward. We treated 32 cases of macrostomia from August 1, 1998 to July 1, 2002. We obtained relatively satisfactory clinical results by using this modified commissuroplasty. Based on our experience, we intend to present a clinical analysis and an operation technique of our own derived from the classic commissuroplasty, so that we may contribute to the diagnosis and treatment of the patients in the future.
Cicatrix ; Diagnosis ; Humans ; Korea ; Macrostomia* ; Nasolabial Fold

The purpose of this study was to examine the impact of the self-perceived stress of high school students on their oral health care and the relationship between stress and oral health care. The subjects in this study were the students in four different high schools located in Chungcheongnam-do, on whom a self-administered survey was conducted. The answer sheets from 939 respondents were analyzed by PASW Statistics ver.18.0 for Windows. The girls were more stressed than the boys about their studies, appearance and material resource, and the sophomores felt more stress about their home and studies. The group whose academic achievement was good in the past semester had the lowest stress about home and material resource, and the group whose economic standard was higher were less stressed about appearance and material resource. As a result of comparing their oral health care by general characteristics, the groups who were sophomores and whose academic achievement was good in the past semester were most excellent in that regard, and the students whose economic standard was higher and whose average weekly allowances were larger took better care of their oral health. Concerning the influential factors for oral health care, stress about peer relationship was positively related, and stress about material resource was negatively related. Given the findings of the study, the development of oral health care programs that include how to relieve stress is required, and more intensive education is necessary as well. Besides, education for school personnel in charge of student health management and the development of related manuals are both required.
Chungcheongnam-do ; Education ; Female ; Humans ; Oral Health* ; Surveys and Questionnaires

Vitamin C acts as a antioxidants and as free radical scavengers in biological systems. The objective of this study was to examine whether the administration of vitamin C could improve the skin flap survival. Sprague-Dawley rats (n = 40) were divided into 4 groups (n = 10); normal saline, vitamin C 200 mg/day, vitamin C 500 mg/day, vitamin C 1000 mg/day were injected subcutaneously to each group (n = 10). A classic caudally based random flap (2 X 7 cm) was elevated on the dorsum of rats and then sutured to its normal position. On the 3rd, 7th, 14th days postoperatively each animal was evaluated for percentage area of flap survival by paper template technique, thereafter rats were sacrificed and we obtained tissue from the distal ends of the flap. Following is our results. 1) The experimental group treated with vitamin C revealed an increased rate of random pattern skin flap survival compared with the control group (p < 0.005). 2) There was correlation of vitamin C dosage with flap survival rate (Spearman's correlation coefficient = 0.971). 3) The biopsy of the control group showed extensive atrophy and necrosis. However, New capillary proliferation and collagen deposition were noted in the vitamin C 200 mg and 500mg treated group. In the vitamin 1000 mg group, microscopic findings were very alike compared with normal rat skin texture. Finally, we concluded that the Vitamin C supplement increases survival rate of random pattern flap in rat skin flap model, and flap survival is correlated with vitamin C dosage.
Animals ; Antioxidants ; Ascorbic Acid* ; Atrophy ; Biopsy ; Capillaries ; Collagen ; Free Radical Scavengers ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; Skin ; Survival Rate ; Vitamins*

PURPOSE: The majority of nasal bone fractures have been managed by routine procedure of closed reduction, intranasal packing or intranasal Kirschner wire (K-wire) splinting. But it leaves rooms for many complaints from patients such as pain, rhinorrhea and nasal obstructioon. Another option is, of course, no packing at all. The study was initiated to assess the necessity to pack or splint the nasal bone after routine closed reduction. METHODS: We analysed the medical records of 35 patients with nasal bone fracture who were operated by closed reduction in the last 2 years. We evaluated the postoperative CT scan scores and external deviation criterias 1 month after the operation. RESULTS: The postoperative deviation criteria and postoperative CT scan score were favorable and there were no serious complications using this technique. CONCLUSION: The present study demonstrates that the use of packing or splinting need not be routine in the majority of cases. The risks and discomforts associated with these procedures can often be avoided.
Humans ; Medical Records ; Nasal Bone ; Splints

PURPOSE: Pressure sore wound develops inevitably in long-term, immobilized and hospitalized patients. Sore wound infection is common problem and makes healing process difficult. We aimed to identify the pathogens of the purulent discharge in sore wound and to obtain information for appropriate antibiotics through a sensitivity test METHODS: The bacteriologic study was made on 120 cases of patients who admitted or visited our hospital from 2004 January to 2005 December for sore wound treatment. Culture material was collected in BBL transport media with cotton swab and cultured by MacConkey agar plate. The method of MIC by VITEK and Microscan was used for sensitivity test. RESULTS: Among 120 specimens, organisms were isolated from 77(64.2%) cases. Gram positive organisms were cultured in 73 specimens, Gram negative organisms in 46 specemens, and fungi in 2 specimens. Mixed infection by Gram (+) and Gram (-) bacteria were observed in 34 specimens. Among them, S. aureus was the most common isolate in 24(31.2%) patients and 10 (13.0%) S. Aureus isolates were MRSA. The most prevalent Gram-negative organism was Escherichia coli in 20 patients(25.9%). Vancomycin and teicoplanin showed highest sensitivity to Gram-positive organisms and imipenem and amikacin to Gram-negative organisms. CONCLUSION: Pressure sore wound demands consideration of multimodal therapeutic aspects and these findings would be useful informations to physicians, nurses and clinical assistants in understanding the nature of sore wound and selecting appropriate antibiotics.
Agar ; Amikacin ; Anti-Bacterial Agents* ; Bacteria ; Bacteriology* ; Coinfection ; Escherichia coli ; Fungi ; Humans ; Imipenem ; Methicillin-Resistant Staphylococcus aureus ; Pressure Ulcer* ; Teicoplanin ; Vancomycin ; Wound Infection ; Wounds and Injuries

PURPOSE: Pressure sore wound develops inevitably in long-term, immobilized and hospitalized patients. Sore wound infection is common problem and makes healing process difficult. We aimed to identify the pathogens of the purulent discharge in sore wound and to obtain information for appropriate antibiotics through a sensitivity test METHODS: The bacteriologic study was made on 120 cases of patients who admitted or visited our hospital from 2004 January to 2005 December for sore wound treatment. Culture material was collected in BBL transport media with cotton swab and cultured by MacConkey agar plate. The method of MIC by VITEK and Microscan was used for sensitivity test. RESULTS: Among 120 specimens, organisms were isolated from 77(64.2%) cases. Gram positive organisms were cultured in 73 specimens, Gram negative organisms in 46 specemens, and fungi in 2 specimens. Mixed infection by Gram (+) and Gram (-) bacteria were observed in 34 specimens. Among them, S. aureus was the most common isolate in 24(31.2%) patients and 10 (13.0%) S. Aureus isolates were MRSA. The most prevalent Gram-negative organism was Escherichia coli in 20 patients(25.9%). Vancomycin and teicoplanin showed highest sensitivity to Gram-positive organisms and imipenem and amikacin to Gram-negative organisms. CONCLUSION: Pressure sore wound demands consideration of multimodal therapeutic aspects and these findings would be useful informations to physicians, nurses and clinical assistants in understanding the nature of sore wound and selecting appropriate antibiotics.
Agar ; Amikacin ; Anti-Bacterial Agents* ; Bacteria ; Bacteriology* ; Coinfection ; Escherichia coli ; Fungi ; Humans ; Imipenem ; Methicillin-Resistant Staphylococcus aureus ; Pressure Ulcer* ; Teicoplanin ; Vancomycin ; Wound Infection ; Wounds and Injuries

PURPOSE: The clinical syndrome of unilateral finger ischemia, caused by digital artery occlusions from embolization from the palmar ulnar artery associated with repetitive striking of the palm, has been called the hypothenar hammer syndrome(HHS). We report the case of a man with this unique disease probably caused by manual work. METHODS: A 52-year-old male left-hand dominant manual worker complained of pain and coldness in the left 4,5th finger. On physical examination, there was a tip necrosis and the result of Allen's test was mildly positive(sluggish filling of hand from the ulnar artery). Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch and distal digital artery. Surgical bypass with reverse autologous vein grafting was performed between ulnar artery and superficial palmar arch, common digital artery. RESULTS: He had an uneventful postoperative course and has remained asymptomatic for 18 months since discharge. Patency has been confirmed by color doppler with resolution of cold intolerance and successful digital preservation. CONCLUSION: We introduce a very unique pattern of vascular ischemic disease and recommend the arterial bypass with vein interpositional grafting.
Arteries ; Cold Temperature ; Fingers ; Hand ; Humans ; Ischemia ; Male ; Middle Aged ; Necrosis ; Perfusion ; Physical Examination ; Strikes, Employee ; Transplants ; Ulnar Artery ; Veins

PURPOSE: The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. In particular, a free flap is often required when the defect is large, in which case suitable recipient vessels must be found to insure revascularization. The authors report a case of persistent bronchopleural-cutaneous fistula developed after undergoing lobectomy for lung cancer. METHODS: The defect area was repaired using a free vertical rectus abdominis muscle flap revascularized by microvascular anastomosis to the 6th intercostal pedicle. The flap obliterated the right chest cavity, closed the site of empyema drainage, and aided healing of a bronchopleuralcutaneous fistula. RESULTS: The patient has remained healed for 14 months without any postoperative complications or recurrent infection or fistula. CONCLUSION: We suggest that a rectus abdominis musculocutaneus free flap and intercostal pedicle as a recipient could be a useful method for repair of chest defects.
Cutaneous Fistula ; Drainage ; Empyema ; Fistula ; Free Tissue Flaps ; Humans ; Lung ; Muscles ; Postoperative Complications ; Rectus Abdominis ; Thoracic Wall ; Thorax

PURPOSE: Traditionally, titanium miniplate has been used for rigid fixation of mandible fractures. However, the limitations of metal plate have been reported such as hypersensitivity, interference with the cranio-facial growth of growing child, secondary bone resorption around the plate, foreign body reaction, declination of primary callus formation, and bone atrophy, and so forth. Recently, biodegradable miniplate has been introduced and used as an alternative to the metal plate despite of its lower strength. This study evaluated the usefulness and stability of biodegradable plate and screw for treatment of mandible fractures. METHODS: In this study, 61 patients(92 areas) diagnosed as mandible fracture in the last 2 years have been reviewed. We used titanium plate and screw in 32 patients, and biodegradable plate and screw(INION?) in 29 patients. Stability of plates and screws, bony healing process and its side effects were observed by clinical and radiographic assessment. RESULTS: In the titanium material group, one of malocclusion, two of mouth opening limitation, three of pain, three of palpation were shown. The plate of six patients involved in these complications were removed. In the biodegradable group, two of mouth opening limitation, two of pain, one of localized wound infection were shown and one plate was removed secondarily. CONCLUSION: There was no statistical difference between two groups in bony healing and complication rates. Biodegradable implants show efficient stability during initial bone healing and low side effects in long-term follow up periods.
Absorbable Implants ; Atrophy ; Bone Resorption ; Bony Callus ; Child ; Follow-Up Studies ; Foreign-Body Reaction ; Fracture Fixation ; Humans ; Hypersensitivity ; Malocclusion ; Mandible ; Mouth ; Palpation ; Titanium ; Wound Infection