Mandibular prognathism was defined by Johe Hunter as follows : 'The lower jaw projecting too far forwards so that the foreteeth pass before those of upper jaw, therefore disfigurement and malocclusion are the two of facial main characteristics.' Mandibular ramus osteotomy by vertical osteotomy or sagittal splitting osteotomy recently has come into more common use. Although preoperative and postoperative orthdontic management is indispensable in surgery of this type, we occasionally encounter patients who are intolerant to a long duration of orthodontic treatment and intermaxillary fixation. We describe surgical refinement accomplishing mandibular anterior segmental osteotomy, recession genioplasty by horizontal osteotomies and decortication of the anterior portion of the bony bar for a minor degree of mandibular prognathism. In results, the amount of setback is limited to 4 to 5mm, no intermaxillary fixation is required and no orthodontic treatment, in this operation, is needed. This procedure can obtain a rapid aesthetic improvement. We used this preocedure in 8 patients (3 males and 5 females) with a mild mandibular prognathism. No major complications occurred throughout the follow-up period except transient paresthesia of the mental nerves, otherwise all patients were satisfied with the result.
Follow-Up Studies ; Genioplasty* ; Humans ; Jaw ; Male ; Malocclusion ; Osteotomy* ; Paresthesia ; Prognathism*

The characteristics of modern society's trauma is a propensity for multiple and severe trauma, specially, the fatal damage accompanied by facial bone fracture. We observed the malocclusion owing to delayed prompt treatment If the fractured fragments is crushed severely, it is difficult to make them positioned into the normal anatomical states and to fix them tightly. Post-traumatic malocclusion is usually caused by a delay in treatment and inadequate anatomic reduction. Inadequately treated facial bone fractures result in facial disfiguring and functional impairment of mastication and speech.We performed 27 cases of correction of post-traumatic malocclusion between April 1994 and June 1996. We used various operative techniques such as anterior segmental osteotomy, Le Fort osteotomy, maxillary segmental osteotomy and mandibular sagittal split osteotomy. If the malocclusion was due to disarrangement segmental osteotomy. If that malocclusion was attributed to a malpositioned skeletal bone, we take maxillary segmental osteotomy or mandibular sagittal split osteotomy. We acquired the desirable occlusion first followed by a fixation between the mandible and maxillary skeletal bones with the bite block. The aim in the correction of malocclusion was to create a harmony of centric relation and centric occlusion. After operation, intermaxillary fixation with bite block have many advantages in the treatment of malocclusion.
Centric Relation ; Facial Bones ; Malocclusion* ; Mandible ; Mastication ; Maxillary Osteotomy ; Osteotomy ; Osteotomy, Le Fort

A multitude of methods for correction of the residual cleft lip nose deformity have been developed. Inspite of the development it appears that no one procedure has achieved satisfactory results. In addition, the appropriate timing for surgical correction still remains unsettled. The philtrum plays a keyhole in the appearance of the upper lip and nostril sill. But the formation of philtrum with muscle flap or conchal cartilage have been resulted in a unsatisfactory aesthetic outcome. We performed 26 cases of the correction of unilateral cleft lip nose deformity between May 1993 and September 1996, and we always used autogenous palmaris longus tendon for reconstruction of philtral column and nostril sill augmentation. Palmaris longus tendon creates a more definite philtral unit comparing to other materials which have been used and it is easy to harvest and transfer and it does not affect normal function of the hand. And we followed up all patients and confirmed that disappearance of newly formed philtrum is rare. In conclusion, this study shows that autogenous palmaris longus tendon is a useful material for reconstruction of philtral column.
Cartilage ; Cleft Lip* ; Congenital Abnormalities* ; Hand ; Humans ; Lip ; Nose* ; Tendons*

The inverted nipple presents many problems including both cosmetic and functional aspects and impairment in breast feeding. the histopathologic characters of inverted nipple are that inverted nipple has less fibromuscular tissue than normal nipple and has short lactiferous duct and dense fibrous tissue. Many surgical and non-surgical techniques have been designed for correction of the inverted nipple. But most of these techniques have produced unsatisfactory problems. especially undesirable recurrence is most important problem. We experienced 19 inverted nipples in 12 patients between March 1995 and January 1998. We combined modified Teimourian method, purse-string suture and Z-plasty. and had good result for 3weeks to 30months follow up. This method was effective for correction of the inverted nipple with low recurrence rate and simple techniques.
Breast Feeding ; Follow-Up Studies ; Humans ; Nipples* ; Recurrence ; Sutures

Many Oriental women have prominent mandibular angle and short chin, in other words, 'squared' mandibular face or 'boxy' face. That kind of face is considered to be unattractive and causes big cosmetic problems for those who want to have an ovoid or almond shaped face. A squared mandibular face often needs to be corrected by operative procedure. A reduction mandibular angleplasty by bony angle resection is one of the operative procedures, but it is not always an adequate method. The successful correction of squared mandibular face can be accomplished by horizontal facial reduction and/or vertical facial lengthening procedure. From March 1996 to March 2000, We had operated 117 patients. The patients were divided into 3 groups. Group I had prominent mandibular angle and/or massetric hypertrophy. Patients in this group were operated by reduction angleplasty with/without resection of masseter muscle. Group II had prominent mandibular angle, cheek and mandibular body. In this case, we applied reduction angleplasty, contouring of body, resection of buccal fat pad and/or masseter muscle. Group III had prominent mandibular angle with short face. We used methods used for group II and Le Fort I lengthening and genioplasty. Ancillary procedures were forehead lengthening and reduction maloplasty. Successful correction of squared mandibular face could be performed by accurate analysis of facial profile and reduction mandibular angleplasty with proper ancillary procedures for each group. The results were as follows: 1) We obtained successful correction of squared mandibular face with multiple horizontal facial reduction procedures, which reduced anterior and posterior facial plane. 2) In case of short face, we made better mid-low facial balance with vertical facial lengthening and horizontal facial reduction.
Adipose Tissue ; Cheek ; Chin ; Female ; Forehead ; Genioplasty ; Humans ; Hypertrophy ; Masseter Muscle ; Prunus dulcis ; Surgical Procedures, Operative

Background: Mac-2 binding protein glycosylation isomer (M2BPGi) was introduced as a noninvasively measurable serologic marker for liver fibrosis. Acoustic radiation force impulse imaging (ARFI) elastography is another noninvasive method of measuring hepatic fibrosis. There are limited data about the correlations between histologic fibrosis grade and noninvasively measured markers, including M2BPGi and ARFI. Methods: This prospective study was conducted among patients admitted consecutively for liver resection, cholecystectomy, or liver biopsy. ARFI elastography, serum M2BPGi levels, and the AST to Platelet Ratio Index (APRI) score were evaluated before histologic evaluation. Histologic interpretation was performed by a single pathologist using the METAVIR scoring system. Results: In patients with high METAVIR scores, M2BPGi levels and ARFI values showed statistically significant differences between patients with fibrosis and those without fibrosis. In 41 patients with hepatocellular carcinoma, as METAVIR scores increased, M2BPGi levels also tended to increase (p=0.161). ARFI values changed significantly as METAVIR scores increased (p=0.039). In 33 patients without hepatocellular carcinoma, as METAVIR scores increased, M2BPGi levels significantly increased (p=0.040). ARFI values also changed significantly as METAVIR scores increased (p=0.033). M2BPGi levels were significantly correlated with ARFI values (r=0.604, p<0.001), and APRI values (r=0.704, p<0.001), respectively. Conclusions Serum M2BPGi levels increased with liver fibrosis severity and could be a good marker for diagnosing advanced hepatic fibrosis regardless of the cause of liver disease.

Background: In clinical fields, many types of insoles are used to not only realign movement patterns, but also treat pressurerelated foot diseases. However, the characteristics of and plantar pressure in each type of insole are still unclear. Therefore, the aim of this study was to validate the plantar pressure-relieving effect of three representative types of insoles (metatarsal padding insole [MPI], lateral heel wedge insole [LHI], and arch support insole [ASI]) in asymptomatic men. Methods: A total of 35 feet of 35 asymptomatic men with a mean age of 23.4 ± 2.0 years were included. Pedobarographic data were evaluated by dividing the foot into eight designated regions to compare the three types of insoles. Peak plantar pressure (PPP) and pressure time integral (PTI) were assessed using the Pedar-X system. A repeated measures analysis of variance was used for statistical analyses. Results: In the hallux region, there was no statistically significant difference. MPI showed highest pressure in the 2nd–5th toe and midfoot region, but lowest in the central and lateral forefoot regions. Meanwhile, ASI showed highest pressure in the medial forefoot region but lowest in the lateral heel region. Lastly, pressure in the lateral heel region was highest in LHI. Overall, results of PTI were similar to those of PPP. Conclusions This study demonstrated that the three types of insole each could reduce and redistribute pressure of specific part of the foot to help select an appropriate insole for each purpose.

BACKGROUND: In Korea, the prevalence of tuberculosis and hepatitis is high, and combined therapy with rifampicin and pyrazinamide is used in tuberculosis, so drug induced hepatitis is not only problem of tuberculosis therapy but also cause of treatment failure. However most of recent reports on drug induced hepatitis during antituberculosis medication have dealt with its pathogenesis and have stressed the biochemical, and histopathological aspects of the disorder, whereas this study was designed primarily to provide information on the clinical features. METHOD: The subjects of study were 1414 patients treated with antituberculosis drugs on the department of chest medicine at National Medical Center during the 5-year 6-month period from January 1, 1988, to June 30, 1993. Retrospective analysis of clinical features for the 29 patients who developed drug induced hepatitis was done. RESULTS: 1) The incidence of antituberculosis drug induced hepatitis was 2.1%. 2) Male to female ratio of antituberculosis drug induced hepatitis was 2:1, but case rates among males and females were not significantly different. 3) Rates of drug induced hepatitis according to age distribution shows the most common incidence between 35 to 49 year old age group, but rates among groups of age were not significantly different. 4) Drug induced hepatitis was most common in the case of moderate advanced Pulmonary tuberculosis(rate is 2.78%), but rates among types of tuberculosis were not significantly different. 5) 18 cases(62%) of antituberculosis drug induced hepatitis patients had no signs or symptoms. In remaining cases, they were nausea, vomiting, jaundice, hepatomegaly, icteric sclera, right upper quadrant -tenderness in order 6) 22 cases(76%) of antituberculosis drug induced hepatitis cases had occurred within the first month. 7) The duration of abnormal liver function was 28±5(Mean±SD), ranged from 5 days to 180 days. 8) One case of antituberculosis drug induced hepatitis died. 9) The levels of abnormal GOT ranged from 64 to 1055U/L and GPT from 68 to 931U/L. CONCLUSION: There are no decided predisposing factors of antituberculosis drug induced hepatitis, so it should be done biochemical monitoring as week as close monitoring for overt signs or symptoms of hepatitis to avoid the development of irreversible hepatic reaction, especially at the treatment of the first month.
Age Distribution ; Causality ; Female ; Hepatitis* ; Hepatomegaly ; Humans ; Incidence ; Jaundice ; Korea ; Liver ; Male ; Nausea ; Prevalence ; Pyrazinamide ; Retrospective Studies ; Rifampin ; Sclera ; Thorax ; Treatment Failure ; Tuberculosis ; Vomiting

No abstract available.
Internet* ; Korea

OBJECTIVE: Dementia is major neuropsychiatic disorder in the elderly. This study was aimed to investigate the prevalence of dementia and provide fundamental data for community mental health programs. METHOD: 500 elderly people aged 65 years and over in Kwachon were interviewed according to DSM-IV and examined MMSE-K, Korea-Dementia Rating Scale (K-DRS), Clinical Dementia Rating (CDR), Modified Hatchinski Ischemic Scale (MHIS) by trained research assistants. RESULTS: Prevalence of dementia is 10.6% (Alzheimer type 8.0%;vascular type 2.6%). Old age, lower education, cardiovascular disease, head trauma and heavy smoking seem to be risk factors for developing dementia but sex difference is non significant. CONCLUSION: The results showed similar prevalence rates compared to other epidemiological studies. Demented group showed more cognitive disturbances than non-demented one. For patients of dementia, appropriate treatment and management by family members, other caregivers and mental health professionals are needed.
Aged ; Cardiovascular Diseases ; Caregivers ; Craniocerebral Trauma ; Dementia* ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Epidemiologic Studies* ; Epidemiology ; Gyeonggi-do ; Humans ; Korea* ; Mental Health ; Prevalence ; Risk Factors ; Sex Characteristics ; Smoke ; Smoking