Aging process of the forehead in human reflects imbalance of the forehead muscles, forehead ptosis including eyebrow, and winkles of the forehead and glabella. Forehead lifting through bicoronal incision was adopted as an universal method to correct these problems of the aging process. In a view of the aesthetic surgery, however, there are several problems such as large scar alopecia, and numbness beyond the incision line in the scalp for the correction of the forehead aging stigma. During the part few decades, minimally invasive technology forced many surgical specialities to undergo dramatic changes. In plastic & reconstructive surgery also minimally invasive technology using endoscope gave many advantages. Therefore it has reduced morbidity rates and got greater patient acceptances for the forehead lifting. When we perform endoscopic blow-forehead lift to get a good results in oriental people, 1. it needs a extended periorbital dissection. 2. we have to concern lift in the lateral part of forehead rather than in medial forehead. 3. it needs more aggressive tissue modifications (e.g. myotomies, neurotomy) 4. it needs more strong fixation such as permanent microscrew fixation or cortical bone drill hole technique. We performed 13 cases of the eyebrow-forehead lifting by using endoscope from August 95 to September 96 followed up them from 3 to 12 months and obtained satisfactory result. We would like to report our experiences with literature review.
Aging ; Alopecia ; Cicatrix ; Endoscopes ; Eyebrows ; Forehead ; Humans ; Hypesthesia ; Lifting* ; Muscles ; Plastics ; Scalp

This study was performed in order to recognize the identifications of the glycoproteins containing oligosaccharides in human gingiva. After made paraffin sections of human gingiva at 4µm, the sections were incubated with 7 lectins (UEA-I, BS-I, SBA, DBA, WGA, PNA, PNA after neuraminidase treated, Con-A). In order to increase specificity of reactions, the sections were applicated with ABC system. And then the sections were incubated with DAB and were counterstained with hematoxylin. Using the same sections, the sections were done H-E and PAS stains. In WGA, DBA and Con-A, plasma membranes of the layers of all epithelium and connective tissue were stained. In BS-I ; In the epithelium of marginal gingiva, plasma membranes of upper layer of the spinous cell layer and granular cell layer were stained. And in epithelium of sulcular gingiva, plasma membranes of the all spinous cell layer and granular cell layer were stained. In SBA ; Plasma membranes of the granular cell layer were stained. In PNA ; In the epithelium of marginal gingiva, plasma membranes of the basal cell layer and lower layer of spinous cell layer were stained. But lectin reactions were not occurred in thc sulcular gingiva. In PNA treated neuraminidase, plasma membranes of the all epithelial layer except basal cell layer membranes especially cytoplasms of upper layer at the sulcular gingiva and connective tissue were reacted. 1. By the above results, authors could know the identification of oligosaccharides existing g1ycoproteins in the human gingiva. 1) All epithelial layer ; α-D-N-Acetyl-Galactosamine, Sialic acid, D-Glucosamine, α-D-Mannose 2) Basal cell layer ; Galactose-β-(1-3)-N-Acetyl-Galactosamine 3) Spinous cell layer ; α-D-Galactose, Galactose-β-(1-3)-N-Acetyl-Galactosamine 4) Granular cell layer ; α-D-Galactose 5) Connective tissue ; α-D-N-Acetyl-Galactosamine, Siallic acid, β-(1-4)-D-Acetyl-Glucosamine, α-D-Glucosamine, α-D-Mannose 2. The Galactose-β-(1-3)-N-Acetyl-Galactosamine was not existed in the basal cell layer and spinous cell layer in the sulcular gingiva.
Cell Membrane ; Classification* ; Coloring Agents ; Connective Tissue ; Cytoplasm ; Dronabinol ; Epithelium ; Gingiva* ; Glycoconjugates ; Glycoproteins ; Hematoxylin ; Humans* ; Lectins ; Membranes ; N-Acetylneuraminic Acid ; Neuraminidase ; Oligosaccharides ; Paraffin ; Periodic Acid-Schiff Reaction* ; Sensitivity and Specificity

Anal incontinence following pelvic trauma, surgery, or neurologic disorders has significant medical and social implication. Both Chetwood in 1902 and Bistom in 1944 utilized coccygeal origin portion of the gluteus maximus muscle for the anal sphincter reconstruction. The gluteus maximus muscle is a broad, fan-shaped muscle with a wide origin from the ilium sacrum and coccyx and a narrow insertion along the iliotibial band of the lateral femur. Its blood supply is from the inferior gluteal artery and its innervation is from L-5, S-1 roots by means of the inferior gluteal nerve Incisions are placed at the inferior border of the ischial tuberosity. Subcutaneous tunnels are created about the rectum and gluteal and perirectal incisions. Two overacting slings are being created Their opposing pull creates sphincter or valve effect about the distal rectum. We have experienced 2 cases of irregular, deep soft tissue defects of the perianal region requiring muscle coverage with the gluteus maximus muscle overlapping slings. We think the use of the gluteus maximus muscle is one of the most useful method for reconstruction of the anal sphincter mechanism.
Anal Canal* ; Arteries ; Coccyx ; Femur ; Ilium ; Nervous System Diseases ; Rectum ; Sacrum

Bicoronal approach is adopted as an universal method for reduction and internal fixation of the fractured zygomatic arch in the treatment of complex zygomatic fracture. However bicoronal approach leaves many disadvantages, such as long incision, alopecia, prolonged edema, and paresthesia. Nowadays endoscopically assisted minimal invasive technique has been widespread not only for the aesthetic surgery, but also for the reconstructive surgical fields because of the benefits. We have been recently trying to apply endoscopic surgery to facial bone fracture surgery. Endoscopically assisted minimal invasive technique has been applied to 14 patients who admitted to Chosun university hospital from March 1996 to July 1997. We used 4 mm, 30' endoscope and two 1.5-2 cm temple incisions and a subciliary incision for approaching to the zygomatic arch. Protected drill bit and driver had access to fractured zygomatic arch though tiny(5 mm) stab incision over the zygomatic arch. We have been able to successfully reduce and make fixation of the fracture of zygomatic arch by using endoscopically assisted minimal invasive technique. Follow up for 3 months revealed good maintenance of the reduction. We think that application of the endoscopic technology to midfacial bone fracture will result in significant reduction in morbidity and improve postoperative results.
Alopecia ; Edema ; Endoscopes ; Facial Bones ; Follow-Up Studies ; Fractures, Bone ; Humans ; Paresthesia ; Zygoma* ; Zygomatic Fractures

In the East, Probably one of the most commonly performed esthetic operation is the piercing of the earlobes for earring. the complication of this procedure includes infection, the formation of the hypertrophic scar or keloid, and tearing. Keloid formation is one of the disaterous common complications of the ear piercing. the patients regard the keloid as a cosmetic blemish and they complain that they cannot wear earrings. We have experienced 5 patients of earlobe keloid complicated from piercing of the earlobes. We used intralestional steroid njection, in conjunction with surgical excision and pressure therapy for treatment of the keloid. Among various techniques for reconstructing a piercing, we chose modified Pardue's method for artificial earlobe cleft after wide excision of the keloid. the result was good and satisfactory without any complication after 4 to 24 months of follow-up. the purpose of this paper is to present a simple method of treatment of the earlobe keloid with preservation of the perforation for an earring.
Body Piercing ; Cicatrix, Hypertrophic ; Ear* ; Follow-Up Studies ; Humans ; Keloid*

A case of the comminuted fracture of the femoral shaft with osteoporosis is presented. The patient lacked sufficient bony stability and cortical bone-contact which allows union by conventional reconstruction method. Therefore, the authors performed a technique utilizing an intramedullary plate in combination with the standard lateral plate in order to obtain bony stabilization, early range of motion of the knee, and partial weight bearing ambulation and the technique is introduced.
Femur ; Fractures, Comminuted* ; Humans ; Knee ; Methods ; Osteoporosis ; Range of Motion, Articular ; Walking ; Weight-Bearing

A case of the comminuted fracture of the femoral shaft with osteoporosis is presented. The patient lacked sufficient bony stability and cortical bone-contact which allows union by conventional reconstruction method. Therefore, the authors performed a technique utilizing an intramedullary plate in combination with the standard lateral plate in order to obtain bony stabilization, early range of motion of the knee, and partial weight bearing ambulation and the technique is introduced.
Femur ; Fractures, Comminuted* ; Humans ; Knee ; Methods ; Osteoporosis ; Range of Motion, Articular ; Walking ; Weight-Bearing

PURPOSE: We analyzed the correlation of the Lysholm score, anterior displacement of tibia on stress radiography and muscle strength around the knee with postural control after anterior cruciate ligament reconstruction and also compared them with the normal subjects. MATERIALS AND METHODS: Twenty-five patients after ACL reconstruction were evaluated with Lysholm knee score, anterior displacement on stress radiography with Telos, muscle strength around the knee with Biodex dynamometer and postural control with posturography. RESULTS: The postural control had significant correlation with the Lysholm knee score & anterior displacement on stress radiography(r=0.565, r=0.783, p<0.01), but not with muscle strength around the knee(p>0.05). Patients group with 5mm instability under anterior displacement on stress radiography showed no significance compared with normal control group, while the group with instability more than 6mm showed significant differences in some conditions com- pared with control group. CONCLUSION: Postural control after ACL reconstruction have significant correlation with Lysholm score and we presumed that the acquisition of mechanical stability of the knee after ACL reconstruction may be one of the important factors associated with the recovery of postural control by improvement of the proprioception.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Humans ; Knee ; Muscle Strength ; Proprioception ; Radiography ; Tibia

Undifferentiated pleomorphic sarcoma of the breast are uncommon and often present diagnostic challenges. Herein, we report a case of the undifferentiated pleomorphic sarcoma occurring in the male breast. A 76-year-old man presented with a palpable bean-sized mass in his left breast for two months. Core needle biopsy revealed the presence of atypical cells in a fibrous proliferative lesion, which was removed by wide excision. Based on examination of the excised tumor, the initial pathologic diagnosis was atypical spindle cell lesion with uncertain malignant potential. One year later, the patient returned with a recurrent mass atthe previous surgical site. The mass was again surgically removed using wide excision. Based on histological findings with immunomarkers, the final diagnosis was undifferentiated pleomorphic sarcoma. Undifferentiated pleomorphic sarcoma of the breast can cause genuine diagnostic difficulty and appropriate immunohistochemistry is mandatory for differential diagnosis.
Aged ; Biopsy, Large-Core Needle ; Breast ; Breast Neoplasms ; Diagnosis, Differential ; Histiocytoma, Malignant Fibrous ; Humans ; Immunohistochemistry ; Male ; Sarcoma

OBJECT: Many studies found that psychological stress produced significant increases in cholesterol concentration. But recent study results suggested that lowering cholesterol increased non-illness mortality. Suicide rate were higher in low cholesterol groups. Also, depression and violence were related to low cholesterol. It is the purpose of this study to determine which psychiatric symptoms are correlated with serum concentration of cholesterol, triglyceride and HDL-C. METHOD: The subjects we included were 61 neurotic outpatients. Their psychiatric symptoms were assessed with SCL-90-R and additional symptoms check list and the results of their fasting serum concentration of cholesterol, triglyceride and HDL-C were obtained. The correlation between serum concentration of lipids and psychiatric symptoms were analyzed using Pearson's correlation test. RESULTS: The result showed significant positive correlation between somatization symptom dimension and serum cholesterol concentration. Serum cholesterol concentration were also negatively correlated with suppressed emotion of anger Serum concentration of triglyceride and HDL-C were not correlated with any symptom dimensions of SCL-90-R. CONCLUSIONS: These results suggest that somatization symptoms have some relationship with serum cholesterol and the role of cholesterol in psychiatric symptoms need to be included in future study.
Anger ; Cholesterol ; Depression ; Fasting ; Humans ; Mortality ; Outpatients ; Stress, Psychological ; Suicide ; Triglycerides ; Violence