Mechanochemical ablation (MOCA) is a non-thermal, non-tumescent technique for the treatment of incompetent saphenous vein. It is sometimes difficult to maintain consistency when simultaneously implementing wire rotation, sclerosant injection, and wire pullback. Here, we report a simple technique for achieving constant injection during MOCA with the help of a syringe pump; thus, the operator can focus on wire pullback only with convenience and consistency.

In the face, the nose plays an important role in both function and appearance. Among the subunits on the nose, the alar is a critical nasal structure of high aesthetic value. Previously, many surgeons have insisted that structural support should be added to the reconstruction of alar and particularly so in the case of a full-thickness defect. In a 58-year-old male patient who had a third-degree burn injury and full-thickness defect in most of the left nasal alar, forehead flap surgery alone was successfully performed without structural support.

Intramuscular hemangiomas of the masseter muscle are uncommon tumors and therefore can be difficult to accurately diagnose preoperatively, due to the unfamiliar presentation and deep location in the lateral face. A case of intramuscular hemangioma of the masseter muscle in a 66-yearold woman is presented. Doppler ultrasonography showed a 34× 15 mm hypoechoic and hypervascular soft tissue mass in the left masseter muscle, suggesting hemangioma. The mass was excised via a lateral cervical incision near the posterior border of the mandibular ramus. The surgical wound healed well without complications.

Intramuscular hemangiomas of the masseter muscle are uncommon tumors and therefore can be difficult to accurately diagnose preoperatively, due to the unfamiliar presentation and deep location in the lateral face. A case of intramuscular hemangioma of the masseter muscle in a 66-yearold woman is presented. Doppler ultrasonography showed a 34× 15 mm hypoechoic and hypervascular soft tissue mass in the left masseter muscle, suggesting hemangioma. The mass was excised via a lateral cervical incision near the posterior border of the mandibular ramus. The surgical wound healed well without complications.

BACKGROUND: Tracheal complications caused by excessive mucosal pressure from an inflated endotracheal tube are major concerns during anesthesia; hence, an intracuff pressure of 20–30 cmH₂O is recommended as a clinically acceptable intracuff pressure. Diffusion of nitrous oxide (N₂O) into the endotracheal tube cuff increases the intracuff pressure, which may also be influenced by the cuff shape. Therefore, we investigated whether the intracuff pressure of a tapered cuff was different from that of a cylindrical cuff in patients undergoing general anesthesia using 60% N₂O. METHODS: Twenty-six patients who underwent general anesthesia using 60% N₂O in supine position were randomly allocated to the cylindrical cuff group (Group C) or tapered cuff group (Group T). The baseline intracuff pressure was set at 20 cmH₂O, and measured every 10 minutes for 60 minutes. RESULTS: The primary outcome was the intracuff pressure at 60 minutes after N₂O exposure, which was 40 cmH₂O in Group C (95% CI 36–44) and 40 cmH₂O (95% CI 35–45) in Group T (P = 0.895). The lower confidence limit of the intracuff pressures in both groups exceeded 30 cmH₂O at 60 minutes of N₂O exposure, which is the upper limit for clinically acceptable intracuff pressure (20–30 cmH₂O). CONCLUSIONS: There was no significant difference in the intracuff pressures between cylindrical and tapered cuffs. Continuous or frequent monitoring is recommended regardless of the duration of the 60% N₂O exposure because the intracuff pressure can exceed 30 cmH₂O within an hour.
Airway Management ; Anesthesia ; Anesthesia, General ; Clinical Study* ; Diffusion ; Humans ; Intubation, Intratracheal ; Nitrous Oxide* ; Supine Position

We tried to check the vertical palpebral height when the patient sit up as well as when one lie down respectively. Measurements of the vertical palpebral height and corneal diameter were taken in pictures of both eyes of 96 Koreans. They consisted of 59 males and 37 females of average age 25.3. The picture was taken in the position of primary eyeball, and the measured values were adjusted by the known photometrical average value of corneal diameter. During adjustment, the ruler tool in the software Adobe(R) Photoshop(R) was used. They were divided into 4 groups: females with same or larger(group 1, n=20) and with smaller(group 2, n=17) than 11.3mm, and males with same or larger (group 3, n=28) and with smaller(group 4, n=31) than 11.6mm during sitting position. There was no statistical difference in the rate of respective postural effect on vertical height according to sex and the covering amount of cornea. However, the changing amount was meaningful statistically(p=0.000) through two samples t-test. The average ratio of vertical palpebral height was 1:0.929(sitting:lying). We introduce the objective way to compare postural change of vertical dimension of palpebral fissure through the photometrical method.
Cornea ; Deception ; Eye ; Eyelids ; Female ; Humans ; Male ; Vertical Dimension

The tear trough deformity and the palpebromalar groove are characteristic appearances in midface aging. The aim of this study is to suggest the direction of aging process in midface by sampling survey in the Koreans. Sampling survey was conducted to 480 subjects who had preoperative pictures of the midface in Koreans. The excluding criteria of the subjects were with prior oculoplastic surgery, facial bone fracture, facial palsy, previous rejuvenation procedure, Grave's oculopathy and some medical history affecting eyelid position. Prevalence of tear trough deformity and palpebromalar groove in each subject, and age-related change in prevalence were analyzed. Prevalence of the tear trough deformity and the palpebromalar groove was 57.92% and 44.58%, respectively. Prevalence of tear trough deformity was higher than that of palpebromalar groove in both males and females(Chi-Square test, p<0.05). The tear trough deformity and the palpebromalar groove showed a strong positive correlation with age. All the subjects with the palpebromalar grooves had the tear trough deformities. From the results of survey, it suggested that the aging process of midface of the Korean, from medial to lateral direction, differed from that in westerns.
Aging ; Congenital Abnormalities ; Eyelids ; Facial Bones ; Facial Paralysis ; Humans ; Male ; Prevalence ; Rejuvenation

PURPOSE: Pseudoaneurysms after percutaneous vascular access are common and potentially fatal if left untreated. The aim of this study was to determine the incidence and risk factors associated with access site pseudoaneurysms after endovascular intervention for peripheral arterial disease (PAD) under a routine postintervention ultrasound (US) surveillance protocol. METHODS: A total of 254 PAD interventions were performed in a single center between January 2015 and November 2016, and puncture site duplex US surveillance was routinely performed within 48 hours of the procedure. Clinical, procedural and follow-up US data were analyzed. RESULTS: The overall incidence of pseudoaneurysm was 2.75% (6 cases in the femoral artery and 1 in the brachial artery). There was no difference between retrograde and antegrade approach, but there was a higher rate of pseudoaneurysm formation after manual compression compared to arterial closure device (ACD) use (4.3% vs. 0.87%). Manual compression was more commonly used for antegrade punctures (79.0%) and ACD for retrograde punctures (67.7%). Calcification was more frequently found in antegrade approach cases (46.8% vs. 16.9% for retrograde cases) and manual compression was preferred in its presence. All pseudoaneurysms were treated successfully at the time of diagnosis by US-guided compression repair and there were no cases of rupture. CONCLUSION: Pseudoaneurysm rates after therapeutic endovascular intervention for PAD were comparable to other cardiologic or interventional radiologic procedures despite the higher possibility of having a diseased access vessel. Routine US surveillance of access sites allowed for early diagnosis and noninvasive treatment of pseudoaneurysms, preventing potentially fatal complications.
Aneurysm, False ; Diagnosis ; Early Diagnosis ; Endovascular Procedures ; Femoral Artery ; Follow-Up Studies ; Incidence ; Peripheral Arterial Disease ; Punctures ; Risk Factors ; Rupture ; Ultrasonography ; Vascular Closure Devices

Traumatic lip injury is one of the most common clinical conditions in facial injuries. Nonetheless, the degree of the convex and concave slopes on the vermilion border appears to be unique and dynamic; therefore, the reconstruction of the lip defect is always challenging for plastic surgeons [1]. We present a patient who fell off a motorcycle at speed and had a severe friction burn injury with a significant loss of the skin and soft tissue on the left lower lip.