BACKGROUND AND OBJECTIVES: Reconstruction of the nasal defect caused by resection of nose neoplasm or trauma represents a particular challenge to reconstructive surgeons. Each tissue defect has to be evaluated individually in terms of the best possible substitution or alteration from both aesthetic and functional points of view. The method of reconstruction varies according to the location, size, and depth of the defect. Of various methods, local Rap is frequently used because the nasal contours are variable with convex and concave surfaces in close proximity, and there is little lax skin from which to borrow tissue for closure, and the skin of the nose has a texture and color not easily matched by skin elsewhere. Of various local flaps, transposition flap and forehead flap are most frequently used for reconstruction of the nasal defect. The authors carried out retrospectively a clinical study on seven cases of nasal reconstruction that used local flaps after resection of malignant tumors of the nose with a brief review of the literature. MATERIALS AND METHODS: A single surgeon's results in seven consecutive patients were clinically analyzed retrospectively. RESULTS: There were no significant complications. Good aesthetic and functional outcomes were observed with nasal defects reconstructed with the local flaps. CONCLUSION: Local flaps were the most useful choice for reconstructive rhinoplasty. Transposition flaps and forehead flaps, in particular, were particularly useful for each cosmetic unit of the nose.
Forehead ; Humans ; Nose ; Nose Neoplasms ; Retrospective Studies ; Rhinoplasty ; Skin

BACKGROUND: To evaluate the short-term effect of dynamic cardiomyoplasty on circulatory function and detect the related factors that can affect it, experimental cardiomyoplasties were performed under the state of normal cardiac function and heart failure. MATERIAL AND METHOD: A total of 10 mongrel dogs weighing 20 to 30kg were divided arbitrarily into two groups. Five dogs of group A underwent cardiomyoplasty with latissimus dorsi(LD) muscle mobilization followed by a 2-week vascular delay and 6-week muscle training. Then, hemodynamic studies were conducted. In group B, doxorubicin was given to 5 dogs in an IV dose of 1 mg/kg once a week for 8 weeks to induce chronic heart failure, and simultaneous muscle training was given for preconditioning during this period. Then, cardiomyoplasties were performed and hemodynamic studies were conducted immediately after these cardiomyoplasties in group B. RESULT: In group A, under the state of normal cardiac function, only mean right atrial pressure significantly increased with the pacer-on(p<0.05) and the left ventricular hemodynamic parameters did not change significantly. However, with pacer-on in group B, cardiac output(CO), rate of left ventricular pressure development(dp/dt), stroke volume(SV), and left ventricular stroke work(SW) increased by 16.7+/-7.2%, 9.3+/-3.2%, 16.8+/-8.6%, and 23.1+/-9.7%, respectively, whereas left ventricular end-diastole pressure(LVEDP) and mean pulmonary capillary wedge pressure(mPCWP) decreased by 32.1+/-4.6% and 17.7+/-9.1%, respectively(p<0.05). In group A, imipramine was infused at the rate of 7.5mg/kg/hour for 34+/-2.6 minutes to induce acute heart failure, which resulted in the reduction of cardiac output by 17.5+/-2.7%, systolic left ventricular pressure by 15.8+/-2.5% and the elevation of left ventricular end-diastole pressure by 54.3+/-15.2%(p<0.05). With pacer-on under this state of acute heart failu e, CO, dp/dt, SV, and SW increased by 4.5+/-1.8% and 3.1+/-1.1%, 5.7+/-3.6%, and 6.9+/-4.4%, respectively, whereas LVEDP decreased by 11.7+/-4.7%(p<0.05). Comparing CO, dp/dt, SV, SW and LVEDP that changed significantly with pacer-on, both under the state of acute and chronic heart failure, augmentation widths of these left ventricular hemodynamic parameters were significantly larger under the state of chronic heart failure(group B) than acute heart failure(group A)(p<0.05). On gross inspection, variable degrees of adhesion and inflammation were present in all 5 dogs of group A, including 2 dogs that showed no muscle contraction. No adhesion and inflammation were, however, present in all 5 dogs of group B, which showed vivid muscle contractions. Considering these differences in gross findings along with the following premise that the acute heart failure state was not statistically different from the chronic one in terms of left ventricular parameters(p>0.05), the larger augmentation effect seen in group B is presumed to be mainly attributed to the viability and contractility of the LD muscle. CONCLUSION: These results indicate that the positive circulatory augmentation effect of cardiomyoplasty is apparent only under the state of heart failure and the preservation of muscle contractility is important to maximize this effect.
Animals ; Atrial Pressure ; Capillaries ; Cardiac Output ; Cardiomyoplasty* ; Dogs ; Doxorubicin ; Heart Failure* ; Heart* ; Hemodynamics* ; Imipramine ; Inflammation ; Muscle Contraction ; Stroke ; Ventricular Pressure

Neuroblastoma is a soft tissue malignant tumor in the early childhood originating from the sympathetic nervous system, and usually occurs in the abdomen, thorax, and pelvis. It is rare in the head and neck region and primary cervical neuroblastoma (PCN) is very rare. We present 13-month old boy with slowly growing right neck mass confirmed neuroblastoma. The mass was excised with surrounding enlarged lymph nodes. Postoperative adjuvant chemotherapy was done. During chemotherapy enlarged lymph nodes were found and removed surgically. These nodes showed metastatic well differenciated neuroblastoma. Radiation therapy was added. The patient had total 15 times chemotherapy and 1500 cGy radiation, and there was no evidence after the second operation.
Abdomen ; Chemotherapy, Adjuvant ; Drug Therapy ; Head ; Humans ; Infant ; Lymph Nodes ; Male ; Neck ; Neuroblastoma* ; Pelvis ; Sympathetic Nervous System ; Thorax

The Korean hemorrhagic fever (KHF) is an acute febrile disease with characteristic of fever, bleeding tendency, and renal failure. There are many complications of Korean hemorrhagic fever such as infection, anemia, internal bleeding, hypopituitarism, respiratory, and neurologic complication. A few cases were reported on acute pancreatitis with hemorrhagic fever abroad, but there was no case about Korean hemorrhagic fever with acute pancreatitis in this country. We experienced a case of Korean hemorrhagic fever associated with suspected acute pancreatits. With review of articles, we report a case of 51 year-old woman with KHF, where acute pancreatitis developed during management.
Anemia ; Female ; Fever ; Hantavirus ; Hemorrhage ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hypopituitarism ; Middle Aged ; Pancreatitis* ; Renal Insufficiency

Soft-tissue lateral neck radiography is important for diagnosing acute supraglottitis. This study aimed to determine the objective criteria for a diagnosis of acute supraglottitis from soft-tissue lateral neck radiographs in Korean adults. The parameters in 30 adult patients with acute supraglottitis were compared with those of age- and sex-matched normal 30 Korean adults. The mean of epiglottis width (EW) and aryepiglottic fold width (AEW) in the control group were 4.37 +/- 0.93 mm, 2.45 +/- 0.71 mm, respectively and in the patient group they were 15.87 +/- 3.60 mm, 6.4 +/- 2.55 mm, respectively. The sensitivity and specificity of an EW greater than 7mm were 100%, and 100% respectively. The sensitivity and specificity of an AEW greater than 4.5 mm were 83%, and 100% respectively.
Acute Disease ; Adult ; Epiglottitis/*radiography ; Female ; Human ; Larynx/*radiography ; Male ; Middle Age

Chronic pancreatitis causes a variety of complications such as glucose intolerance, pancreatic pseudocyst and duodenal obstruction. However pericardial effusion is very rarely complicated with chronic pancreatitis and life-threatening. The hypothesis of the development of pleuropericardial effusion in chronic pancreatitis has been variously proposed; fistula formation through esophageal or aortic hiatus, local transfer of pancreatic enzyme. Recently, we experienced a case of pleuropericardial effusion complicated by chronic recurrent pancreatitis causing cardiac tamponade. There was a contrast leakage appearing from the pancreatic duct to the mediastinum in endoscopic retrograde pancreaticography. The transpapillary pancreatic stent insertion led to the disappearance of pleuropericardial effusion on the radiography. We report this unusual manifestation of chronic recurrent pancreatitis with the review of literature.
Cardiac Tamponade* ; Duodenal Obstruction ; Fistula ; Glucose Intolerance ; Mediastinum ; Pancreatic Ducts ; Pancreatic Pseudocyst ; Pancreatitis* ; Pancreatitis, Chronic ; Pericardial Effusion ; Radiography ; Stents