No abstract available.
Cleft Lip*

Conservative or surgical methods have been used for the treatment of fracture of mandibular subcondyle, but consensus has not been reached in regard to the proper management of this injury. Several problems related to the surgical procedure have led many surgeons to avoid surgical management of condylar fractures in favor of closed reduction and intermaxillary fixations. However, luxation of the condyle may lead to various long-term complications such as open bite on the contralateral side, dysfunction, deviation in opening and closing movements, as well as bone apposition leading to ankylosis. As a consequence, open reduction is preferable when the condyle is displaced. Various methods-for example, direct wiring technique, simple bone plating, dynamic compression plating-have been advocated for the treatment of fracture of mandibular subcondyle. Of such methods, a functionally-stable osteosynthesis can be achieved by compression osteosynthesis methods. Lag screw osteosynthesis is essentially a form of compression osteosynthesis in which the bone fragments are bound to one another as a result of traction from the screw. An advantage of compression osteosynthesis is that the end of a fractured bone can be maintained in an opposed position under pressure, and then primary bone healing occurs by direct osteoblastic activity within the fracture. As well, it obviates or reduces the need for maxillomandibular fixation, as well as the morbidity associated with conventional treatment methods such as facial nerve injury and bone resorption due to wide dissection. We have treated 9 cases of displaced subcondylar fractures of the mandible with the lag screw fixation system which is marketed by the Martin corporation. Mobilization and guidance of the jaw was begun from 7 or 10 days postoperatively. The radiologic and clinical evaluations showed good repositioning of the fragments and good occlusion postoperatively The disadvantage is that surgical procedures are relatively compound, and an additional procedure - removal of lag screw - is necessary after complete bone union. Lag screw osteosynthesis can be added as a another valid armament for plastic surgeons in the management of mandibular subcondyle fractures.
Ankylosis ; Bone Resorption ; Consensus ; Facial Nerve Injuries ; Jaw ; Jaw Fixation Techniques ; Mandible ; Open Bite ; Osteoblasts ; Traction

No abstract available.
Cartilage* ; Enophthalmos* ; Ribs* ; Transplants*

No abstract available.
Complementary Therapies

No abstract available.
Complementary Therapies

No abstract available.
Cleft Lip* ; Humans ; Lip*

In the majority of East Asian eyelids, the presence of a medial epicanthal fold is one of the unique anatomic characteristics. Roundness of medial canthal area and a narrow, short palpebral fissure are aesthetic consequences of this anatomic features. But, the idea of beauty has changed with time by influence of western culture. Many people are favorable to the wide open eye without epicanthal fold, which make improved facial balance. Double-eyelid operation is the most commonly performed procedure of aesthetic surgery field in Korea. However, many cases of successfully done double-eyelid operation results in only partial improvement by leaving medial epicanthal folds. We can get the improved results by utilizing epicanthopasty that lengthens the palpebral fissure, and thus producing the image of a larger, open eye. Consequently the requirements for epicanthoplasty has increased in modern time. The Uchida's split V-W plasty is one of the most frequently used methods. But, it has disadvantages of completely exposed scar, potential for dog-ear formation, and two stage procedure with some cases of double-eyelid operation. We modified the Uchida's method by moving the position of 2 triangular flaps more laterally and conjoining the incision line of double-eyelid operation with that of epicanthoplasty. The purposes of our modification are not complete elimination but relieving the epicanthal fold, hiding the minimal scar behind the new relieved the new relieved fold and preventing the dog-ear on the transitional zone. From January, 1995 to June, 1999, this method was applied to 93 patients who have medial epicanthal folds and performed with double-eyelid operation concomitantly. Age ranged From 12 to 47 years and the mean age was 23 years. Through the mean 15 months of follow up, the mean widening of the palpebral fissure width was 2.5mm and the mean reduction of the intercanthal distance was 5mm. The modified Uchida's method has advantages of simplicity in procedure, effectiveness in results, minimal scarring with hiding behind the new small fold, and one stage procedure with double-eyelid operation. We think it can be applied generally to almost of all double-eyelid operation except epicanthal fold is marked severe.
Asian Continental Ancestry Group ; Beauty ; Cicatrix ; Eyelids ; Follow-Up Studies ; Humans ; Korea

No abstract available.
Child* ; Down Syndrome* ; Humans

PURPOSE: This study was done to explore factors related to amount of service use for elders with long-term care needs. METHODS: A descriptive-correlation design was used. The sample included 259 elders and their primary caregivers who had cared for the elders for at least 6 months. Data on long-term care need assessment, service use and interviews with primary caregivers were analyzed. RESULTS: There was no significant relationship between the sociodemographic characteristics and the amount of services use. Amount of service use differed significantly by Long-term care classification. The mean scores for class 1, 2 and 3 were 22.68, 21.47 and 17.87 days respectively. Primary caregiver relationship with the elders and the number of family-friend helpers were also significant. Multivariate regression analysis showed that gender, marital status, activities of daily living, cognitive impairment, and secondary caregiver support explained 17% of the total variance of service use among these elders (F=3.50, p<.001). CONCLUSION: The results of this study indicate that critical factors including secondary caregiver support and individual background, and other functional dependencies except for physical function should be considered in accurately predicting the amount of service use for community dwelling elders with long-term care needs.
Activities of Daily Living ; Aged ; Caregivers ; Home Care Services ; Humans ; Long-Term Care ; Marital Status

PURPOSE: Gamma-globulin is effective in preventing coronary aneurysm, the primary complication of Kawasaki disease(KD). However, in order to predict high-risk cases which absolutely require gamma-globulin, because of its high expenses, Harada score(HS) was introduced in Japan in 1990. We attempted to compare HS scoring with the health insurance criteria currently used in Korea. METHODS: Retrospective studies were performed on 123 cases who did not receive gamma-globulin among 283 KD patients who had been treated in this hospital from 1990 to 1997. Chi-square analyses were used. RESULTS: Of the 123 subjects, 91(74%) had HS scores higher than 4, and 32(26%) had HS less than 4, whereas 56(45.5%) belonged to the high-risk group and 67(54.5%) to the low-risk group according to the insurance criteria, with both methods differing significantly(P<0.001). Of 18 cases with the coronary complications only 2 cases had an HS<4, whereas 4 patients belonged to the low-risk group. Even though both methods did not differ significantly in discriminating risky cases, twice as many patients may have been denied adequate treatment if the insurance criteria had been applied. Of various factors, the age and albumin level were found relevant to the coronary complication. CONCLUSION: No statistically significant difference was found between HS and the insurance criteria in predicting the incidence of coronary complications in 123 KD patients. But a less lenient criteria used in the current health insurance policy may result in more cases with coronary complications.
Coronary Aneurysm* ; gamma-Globulins ; Humans ; Incidence ; Insurance ; Insurance, Health ; Japan ; Korea ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies