The reduction of nasal bone fracture has been done by a simple procedure. The nasal bone fracture was not a serious problem and patients are usually treated as outpatients. However it is causing increased demand for medical services far cosmetic reasons. We studied the nasal bone fracture by retrospective analysis, it comprising 606 patients with nasal bone fractures in various accidents and treated of Chonnam University Hospital from March 1995 to February 1998. We reviewed and analyzed the medical records and facial bone CT scans of 606 patients. The following results were obtained. 1. The prevalent age group was in the third decade, the most common cause was traffic accidents, while nasal swelling, tenderness, nasal deviation and crepitation were examined 2. The classification of nasal bone fracture was done by facial bone CT. Class 1: Nasal tip depressed fracture(16%) Class 2: Displaced nasal bone fracture without depression(30%) Class 3: Displaces nasal bone fracture with depression(12%) Class 4: Comminuted nasal bone fracture (10%) Class 5: Simple fracture of nasal bone and frontal process of maxilla(14%) Class 6: Comminuted fracture of nasal bone and frontal process of maxilla(11%) Class 7: Nasal bone fracture without displacement(9%) .
Accidents, Traffic ; Classification* ; Facial Bones ; Fractures, Comminuted ; Humans ; Jeollanam-do ; Medical Records ; Nasal Bone* ; Outpatients ; Retrospective Studies ; Tomography, X-Ray Computed

Facial beauty depends on the form, proportion and position of its various units. The chin is the most prominent element of the lower third of the face, both in the frontal view and in profile. Whether it is advisable to perform rhinoplasty first, followed by genioplasty, or the reverse depends on the type and severity of the deformities of the nose and chin. The selection of material is a matter of the plastic surgeon's preference. Fat is an ideal tissue filler substance because it is living tissue and from the patient's own body. So it is nonallergenic. The procedure can be performed alone as a chin augmentation with fat grafting or in combination with rhinoplasty or other facial surgery. The technique requires minimally traumatic fat harvesting, fat preparation, and multi-level facial infiltration. Remnant fat in the initial procedure is frozen and stored at -18C and can be used successfully for minor touch-up procedures. We have performed a review of chin surgery, the multiple aesthetic analyses available and the advantages and disadvantages of the various materials. Autologous fat transfer to the chin is safe, cost effective, and can produce long term aesthetic improvement. Although there are many synthetic fillers available, autologous fat is perhaps the best option for genioplasty. This simple, fast procedure is a very good alternative for patients with some form of microgenia or when patients and surgeons are not likely to use alloplastic implants.
Adipose Tissue ; Beauty ; Chin ; Congenital Abnormalities ; Genioplasty ; Humans ; Mandible ; Nose ; Rhinoplasty ; Transplantation, Autologous ; Transplants

The accurate measurement is essential in evaluating the patients in the aesthetic plastic surgery. So many plastic surgeons would have increased the accuracy of photograph. But the results of the efforts are not satisfactory. Now, we can use the 3-D scanner possibly. We want to investigate the reliability of the 3-D scanner by comparing real measurements with the 3-D scanner measurements. Between Apr, 2003 and Nov, 2005, the Korean agency for technology and standards(ATS) investigates the size of 15,576 Korean by real measurements and 5,186 Korean by the 3-D scanner measurements. We selected the measurements of female aged from 20 to 24. These measurements divide into the sections of height, width, thickness, circumference, and compared in each sections. The statistical analysis was performed by STATA 9.0. If the datum points were fixed, unstable and the data was easily measured by the measuring devices such as height, the 3-D scanner measurements were almost coincident with the real measurements. The p-value was statistically not significant. Otherwise, If the datum points were unfixed and the data was measured by a measuring tape, the 3-D scanner measurements were not coincident with the real measurements. The p-value was statistically significant. According to these results, the height can be measured by the 3-D scanner instead of real measurements. But the circumference, thickness and width by the 3-D scanner is almost incompatible with that of the real measurements. The new paradigm of anthropometry is needed.
Anthropometry ; Female ; Humans ; Surgery, Plastic*

PURPOSE: Full-thickness skin grafts are usually used in facial reconstruction, but on occasion, split-thickness skin graft is also used from the scalp due to the limitation of donor site. However, there were complications, such as alopecia, folliculitis and blood loss. In addition, it can not be used in patients with baldness. Under the circumstances, we used medial arm skin as split-thickness skin graft donor site in lieu of scalp. We investigated the efficacy of the medial arm skin as a donor site of facial skin graft in comparison with scalp. METHODS: From 2000 to 2005, the split-thicknesss skin grafts were performed using the medial arm skin in 10 patients and the scalp in 10 patients. We inspected the skin color match, texture match by the visual analogue scale. Scar contracture was estimated by the Visitrak grade(R)(Smith & Nephew). The statistical analysis was performed by SPSS 12.0. RESULTS: There was a more satisfaction in color match, texture, and scar contracture in medial arm skin than in scalp. CONCLUSION: According to these results, medial arm skin may be used efficiently as an alternative donor site of scalp in the facial reconstruction.
Alopecia ; Arm* ; Cicatrix ; Contracture ; Folliculitis ; Humans ; Scalp ; Skin* ; Tissue Donors ; Transplants*

PURPOSE: Full-thickness skin grafts are usually used in facial reconstruction, but on occasion, split-thickness skin graft is also used from the scalp due to the limitation of donor site. However, there were complications, such as alopecia, folliculitis and blood loss. In addition, it can not be used in patients with baldness. Under the circumstances, we used medial arm skin as split-thickness skin graft donor site in lieu of scalp. We investigated the efficacy of the medial arm skin as a donor site of facial skin graft in comparison with scalp. METHODS: From 2000 to 2005, the split-thicknesss skin grafts were performed using the medial arm skin in 10 patients and the scalp in 10 patients. We inspected the skin color match, texture match by the visual analogue scale. Scar contracture was estimated by the Visitrak grade(R)(Smith & Nephew). The statistical analysis was performed by SPSS 12.0. RESULTS: There was a more satisfaction in color match, texture, and scar contracture in medial arm skin than in scalp. CONCLUSION: According to these results, medial arm skin may be used efficiently as an alternative donor site of scalp in the facial reconstruction.
Alopecia ; Arm* ; Cicatrix ; Contracture ; Folliculitis ; Humans ; Scalp ; Skin* ; Tissue Donors ; Transplants*

The latissimus dorsi has been used as an excellent donor site for free flap because of many advantages such as reliable anatomy, long pedicle with large-caliber vessels, easiness of dissection, and minimal functional deficit of the donor site. It is also one of the most versatile free flaps due to its carrying skin, muscle, and bone components. Nevertheless, bulkiness limits its use for resurfacing the defect in thin regions such as hand, foot, and anterior tibial area. To reduce its excessive volume when bulk is considered a disadvantage, surgical modifications were introduced: muscle sectioning, reduced musculocutaneous flap, muscle splitting, and thoracodorsal perforator-based cutaneous flap. Although the thoracodorsal perforator-based cutaneous flap excluding muscle component is thinner than others, it also needs secondary debulking procedures to resurface the thin regions. Thinning of the cutaneous flap was successfully performed in paraumbilical perforator-based flap and anterolateral thigh flap. These thinned flaps depend for their circulation on the subdermal plexus originating from their pedicled vessel. Based on their survival concept, we made the thoracodorsal perforator-based cutaneous flap thin and clinically applied it to 7 patients as a free flap. They were all survived and there was no need for secondary debulking procedures. This flap adds the advantage of little bulkiness to the conventional latissimus dorsi flap. However, it has some disadvantages such as technical difficulties in dissection of the perforator, anatomical variation in the location of the perforator, and nonsensory flap.
Foot ; Free Tissue Flaps* ; Hand ; Humans ; Myocutaneous Flap ; Skin ; Superficial Back Muscles ; Thigh ; Tissue Donors

Human cysticercosis is an infestation with C. cellulosae, the larval stage of the tapeworm T. solium. It prevails in regions of poverty and where personal hygiene is poor. They can lodge in almost any tissue, but cysticerci are most frequently found in brain, skeletal muscle, subcutaneous tissues. We experienced a 41-year old male with 5 x 12 cm sized movable non tender brownish hard mass at lateral abdominal wall. The laboratory study didn't show any specific symptoms except peripheral blood eosinophilia and positive parasite ELISA screen for cysticercosis. The ultrasonogram revealed multiple ill-defined mixed echoic inflamatory lesion. Excisied cyst showed multiple severe foul-odor gelatinous subcutaneous mass. Microscopic examination disclosed necrotic body with foreign body reaction, massive eosinophilia and dead parasitic organism, compatible with cysticercosis. There was no evidence of recurrence during 12 months follow-up.
Abdominal Wall* ; Adult ; Brain ; Cestoda ; Cysticercosis* ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Follow-Up Studies ; Foreign-Body Reaction ; Gelatin ; Humans ; Hygiene ; Male ; Muscle, Skeletal ; Parasites ; Poverty ; Recurrence ; Subcutaneous Tissue ; Taenia solium ; Ultrasonography

Ingrowing toenail has been treated conventionally by various surgical treatment modlities. However, none of these procedures are perfect to achieve esthetic results with low cost, recurrence, and complication rates. Although mild cases can be treated conservatively, in severe recurrent cases, surgical treatment is preferred. The purpose of this study is to evaluate the effectiveness and safety of using partial matricectomy and paronychial advancement flap for correction of recurrent ingrowing toenail. Eight patients suffering from recurrent ingrowing toenail were operated using partial matricectomy and paronychial advancement flap in our department from August 2004 to August 2005. The number of recurrent episodes ranged from 2 to 5. With digital nerve block, the excision area was marked on nailplate and inflammed lateral nail fold. The horizontally designed paronychial flap considering defect size was effective for wide exposure of the neighboring germinal matrix, which is later to be completely excised or cauterized because remnant germinal matrix made postoperative spicule formation. The nailplate on the affected side was removed about 3-5mm width longitudinally, being cautious not to damage the proximal dorsal nail fold. The same width of the sterile matrix including germinal matrix was excised longitudinally with inflammed granulation tissue and partial lateral nail fold on the affected side. The subcutaneously elevated paronychial flap was advanced to cover the defect and was anatomically sutured with 5-0 nylon sutures. We evaluated our procedure's effectiveness by examining some factors such as cosmetic results, recurrence, spicule formation, postoperative pain and duration of return to normal activities. In eight patients, no complication was observed such as recurrence, severe pain and spicule formation except for 1 case of infection. Postoperative discomfort was minimal. Average duration of return to normal activities was 12 days. Cosmetically the results were acceptable in all patients. The partial matricectomy and paronychial advancement flap for correction of recurrent ingrowing toenail were found to be technically simple, efficient procedure with a relative low recurrence rate and better cosmetic results.
Granulation Tissue ; Humans ; Nails* ; Nerve Block ; Nylons ; Pain, Postoperative ; Recurrence ; Sutures

PURPOSE: Necrotizing fasciitis is a rapid progressive, life-threatening disease. Many organisms have been identified for causative pathogens of necrotizing fasciitis. And necrotizing fasciitis caused by Vibrio vulnificus is a matter of grace concern in Southwest seashore of Korea recently. But concrete analysis between these pathogens was not executed yet. METHODS: Sixty necrotizing fasciitis patients were included in this study. We divided the patients into 2 groups: Group A was the case which Vibrio vulnificus was cultured for causative pathogen of necrotizing fasciitis, and Group B was the case of other organisms. And we analysed each group for treatment, progression and prognosis. RESULTS: There was no significant difference between two groups in total hospital stay but there was a great difference in ICU stay and progression to septic shock. Also, there was a great difference in mortality within 48 hours but there was no difference in mortality of 48 hours after hospital visit. CONCLUSION: This indicates that intial management of necrotizing fasciitis cased by Vibrio vulnificus is the key of treatment. So initial medical management with early surgical intervention is necessary for necrotizing fasciitis.
Fasciitis, Necrotizing* ; Humans ; Korea ; Length of Stay ; Mortality ; Prognosis ; Shock, Septic ; Vibrio vulnificus

PURPOSE: Necrotizing fasciitis is a rapid progressive, life-threatening disease. Many organisms have been identified for causative pathogens of necrotizing fasciitis. And necrotizing fasciitis caused by Vibrio vulnificus is a matter of grace concern in Southwest seashore of Korea recently. But concrete analysis between these pathogens was not executed yet. METHODS: Sixty necrotizing fasciitis patients were included in this study. We divided the patients into 2 groups: Group A was the case which Vibrio vulnificus was cultured for causative pathogen of necrotizing fasciitis, and Group B was the case of other organisms. And we analysed each group for treatment, progression and prognosis. RESULTS: There was no significant difference between two groups in total hospital stay but there was a great difference in ICU stay and progression to septic shock. Also, there was a great difference in mortality within 48 hours but there was no difference in mortality of 48 hours after hospital visit. CONCLUSION: This indicates that intial management of necrotizing fasciitis cased by Vibrio vulnificus is the key of treatment. So initial medical management with early surgical intervention is necessary for necrotizing fasciitis.
Fasciitis, Necrotizing* ; Humans ; Korea ; Length of Stay ; Mortality ; Prognosis ; Shock, Septic ; Vibrio vulnificus