Facial aging is a complex process of gravity-induced soft tissue ptosis and photoaging. In the standpoint of ideal rejuvenation, face lifting combined with laser resurfacing offers significant improvement in aesthetic outcome unachievable by either procedure alone and has many advantages. Neverthless, the simultaneous combination has never been popularized due to the non-specific thermal effects of the laser and risks of skin necrosis in Korea. This report documents the safety and effectivness of combined procedures when using systematic consideration and modified techniques in orientals. This study included 26 Fitzpatrick type III, IV orientals who didn't complaint lower face aging. A dramatic rejuvenation in soft tissue reposition and skin quality was produced in combined endoscopic forehead and midface lift with laser resurfacing cases. The standard forehead lift using endoscopic subperiosteal deep plane seldom interfere flap resurfacing. An endoscopic subperiosteal and subcutaneous midface lift repositions the midface tissue effectively without preauricular incision. Newer variable pulse Er:YAG lasers allow precise ablation and coagulation separately. The minimal excessive thermal injury from variable Er:YAG lasers, modified techniques for flap and skin care program would make it possible to safely perform laser resurfacing with surgical facial rejuvenations on non smokers. There were no incidents of persistent erythema or pigmentation abnormality, scar, full thickness flap necrosis. By following the considerations suggested in this report, the combination of controlled skin resurfacing with face lifting may be safe and effective in orientals.
Aging ; Cicatrix ; Erythema ; Forehead ; Korea ; Necrosis ; Pigmentation ; Rejuvenation* ; Rhytidoplasty* ; Skin ; Skin Care

Vacuum Assisted Closure (V.A.C.) has been reported to speed up the healing of various chronic wounds including pressure sores, stasis ulcers, cutaneous gastrointestinal fistula, hardware exposure almost due to intrinsic factors. We applied V.A.C. for the treatment of the nonhealing wounds with impaired healing mechanism due to extrinsic factors. The extrinsic factors of our cases were systemic factors that have local effects on the wound healing response, including diabetes mellitus, systemic steroid administration, chemotherapy and end stage renal disease. A total of ten patients whose wound failed conservative management over 2 weeks were successfully treated by V.A.C. therapy. The healthy granulation tissue was formed and the wounds were closed by skin graft or delayed closure. In theses cases, the positive effect of V.A.C may be the local compensation of extrinsically deviated cellular environment by dressing foam structure, continuous drainage of inhibitory wound fluid and sufficient blood supply required for inflammatory response and cell proliferation. Our results demonstrate the usefulness of V.A.C. as an adjunct in management of chronic wounds with other extrinsic factors as well as diabetes mellitus.
Bandages ; Cell Proliferation ; Compensation and Redress ; Diabetes Mellitus ; Drainage ; Drug Therapy ; Fistula ; Granulation Tissue ; Humans ; Intrinsic Factor ; Kidney Failure, Chronic ; Negative-Pressure Wound Therapy ; Pressure Ulcer ; Skin ; Transplants ; Varicose Ulcer ; Wound Healing ; Wounds and Injuries*

PURPOSE: The clinical usefulness of hyaluronic acid (HA) instillation during visual internal urethrotomy (VIU) for decreasing the incidence of recurrent urethral stricture was assessed. MATERIALS AND METHODS: Twenty-eight patients were treated by VIU with HA instillation between May 2007 and June 2009. After insertion of a Foley catheter following urethrotomy, HA was instilled via an 18-gauge tube catheter between the urethral lumen and Foley catheter. Seventeen cases were analyzed retrospectively 12 months postoperatively. We evaluated the success rate of this procedure by comparing retrograde urethrography (RGU) results, maximum flow rates, and postvoid residual urine volumes preoperatively and 3 and 12 months postoperatively. Success was defined as either a maximum flow rate of at least 15 ml/s or no visible urethral stricture on RGU at 12 months postoperatively. RESULTS: Total success rates were 76.5% (13/17) and 52.9% (9/17) at 3 and 12 months postoperatively, respectively. By etiology, success rates at 3 and 12 months postoperatively, respectively, were 66.7% and 33.3% for inflammation, 66.7% and 50.0% for trauma, and 83.3% and 66.7% for unknown causes. Success rates were 63.6% for strictures less than 10 mm in length and 33.3% for strictures of 10 mm or more in length at 12 months postoperatively. Success rates were 61.5% for single strictures and 25% for multiple strictures at 12 months postoperatively. CONCLUSIONS: The success rate of VIU with HA instillation was not better than that observed in the literature for conventional VIU.
Catheters ; Constriction, Pathologic ; Humans ; Hyaluronic Acid ; Incidence ; Inflammation ; Retrospective Studies ; Urethral Stricture

Intrascrotal extratesticular malignancies are rare, and the radiologic findings of extraskeletal chondrosarcoma have not been reported. We describe the radiologic findings of a case of mesenchymal chondrosarcoma arising from intrascrotal extratesticular soft tissue and represented by a complex, cystic, solid mass containing calcifications and hematoma.
Chondrosarcoma ; Chondrosarcoma, Mesenchymal* ; Hematoma ; Sarcoma

Purpose: The aim of this study was to evaluate complementary and alternative medicines (CAM) employed for treating patients with erectile dysfunction. Materials and Methods: A total of 204 patients with erectile dysfunction who completed a questionnaire between January and June 2005 were evaluated. The questionnaire was composed of 13 questions. This survey employed a broad definition for CAM, including acupuncture, biofeedback, folk remedies, chiropractic, homeopathy, hypnosis, massage, psychotherapy, relaxation, energy healing, imagery, special diet, spiritual healing and herbal medicine. The CAMs used by the patients with erectile dysfunction were divided into processed health foods, natural health foods and other therapies, and these were all analyzed. Results: The mean age was 57.9+/-10.1 years. 78 of the total patients with erectile dysfunction had employed at least one CAM. CAM users were more likely to be high school educated, nonsmokers and exercisers. The CAMs used were processed health foods 62% (48/78), natural health foods 15% (12/78), and other therapies 66% (52/78). The processed health foods were soy 25%, ginseng 23% and mushroom 19%. Of the natural health foods, tomato was 42%, soy was 25% and ginseng was 17%. Of the other therapies, herbal medicine was 45%, acupuncture was 25%, moxibustion and cupping a boil were 17%. 35% (27/78) of the patients with erectile dysfunction had employed more than one of the processed health foods, natural health foods and other therapies. Conclusions: Patients with erectile dysfunction had mainly employed processed health foods more than the natural health foods, herbal medicine and acupuncture. We think that more research is required about the effects and benefits of CAM in association with ED.
Acupuncture ; Agaricales ; Biofeedback, Psychology ; Chiropractic ; Complementary Therapies* ; Diet ; Erectile Dysfunction* ; Health Food ; Herbal Medicine ; Homeopathy ; Humans ; Hypnosis ; Lycopersicon esculentum ; Male ; Massage ; Medicine, Traditional ; Moxibustion ; Panax ; Psychotherapy ; Surveys and Questionnaires ; Relaxation ; Spiritual Therapies ; Food, Organic