The cleft lip nasal deformity includes not only distorted lower lateral cartilage but generally also an abnormal deficient maxillary bony platform as well as distorted anterior nasal spine and deviated nasal septum. The main defect in the nose is in the position and shape of lower lateral cartilage. There were many literatures for modification of alar cartilage for nasal symmetry in the past several decades, that is, relocation, suture fixation and graft augmentation with deformed alar cartilage itself. But the various corrective techniques were unsatisfactory for both surgeons and patients. The purpose of this article is to present new concepts and surgical techniques. Author's basic concept is total replacement of deformed alar cartilage with new sources of contoured alar cartilage. The grafts were taken from conchal cartilage en bloc. The medial crus, dome, and lateral crus were replaced by the lamina tragi, isthmus and cavum conchae, respectively. The unilateral secondary cleft lip and nose deformity patients were reviewed with charts and photographs from 1991 to 1998. The surgical procedures were open rhinoplasty incision technique with reversed U-incision of nostril web and wide undermining of cartilaginous vault. The total en bloc reconstruction technique has been performed for 125 patients, aged from 5 to 40 years, and they were followed up for 6 months to 8 years. There were no surgical complications and donor site morbidities. There were no relapse and growth disturbance over time. The postoperative results showed symmetry of alar unit, alar dome projection, tip-defining points and nostrils. CONCLUSION: A new technique is described for sensational improvement of the nasal esthetics in secondary cleft lip nasal deformity by using an en bloc autogenous conchal cartilage graft. But further observation is needed for evaluating its effect on the long-term growth potentials.
Cartilage* ; Cleft Lip* ; Congenital Abnormalities* ; Esthetics ; Humans ; Nasal Septum ; Nose ; Recurrence ; Rhinoplasty ; Spine ; Sutures ; Tissue Donors ; Transplants

Reconstruction of the male urethra is required for a multitude of congenital anomalies, such as hypospadias and epispadias, as well as fort acquired lesions such as stricture disease and trauma. No method is appropriate for all types of repair of the urethra. A successful surgical reconstruction of the urethra is the result of a proper operative selection that depends on the site and length of the disrupted urethra and also depends on, as well as the experience of the surgeon. Reconstruction of the urethra has been performed by the use of homografts, silicone tubes, grafts taken from the bladder mucosa. But serious postoperative problems, such as urinary fistula, urethrostenosis, stricture of the site of urethral anastomosis, and diverticulum formation, are not uncommon. Especially, reconstruction of Proximal urethra is very difficult because of limitations of operation field exposure and flap transfer. However, the hairless median scrotal skin flap with the scrotal septum attached, rich in neurovascular plexus, is ideal material for creating a new urethra without interference to its blood supply and other complications. We experienced a successful reconstruction of the proximal urethral defect in about 8cm length and perineal sore with pedicled scrotal septal flap and gracilis musculocutaneous flap, respectively.
Allografts ; Constriction, Pathologic ; Diverticulum ; Epispadias ; Female ; Humans ; Hypospadias ; Male ; Mucous Membrane ; Myocutaneous Flap ; Silicones ; Skin ; Transplants ; Urethra ; Urinary Bladder ; Urinary Fistula

A concern about drug therapy for obesity has been increased with launching of new anti-obesity drug in Korea. Subcutaneous injection of aminophylline was used for regional lipolysis, but its effectiveness and safety are controversial. The purpose of this study is to investigate the effects of aminophylline on lipolytic activity and cytotoxic effect in adipocytes. Preadipocytes obtained from human breast fat tissue were cultured in monolayer culture system. Cells were treated with media added 1, 5, 10, 15, 25 mM aminophylline concentrations, respectively. Cytotoxicity was measured by XTT colorimetric assay and cell count. The lipolytic activity was measured by enzymatic autoanalyzed system. At above 15mM of aminophylline concentration, preadipocyte and adipocyte markedly presented cytotoxic effects. In proportion to concentration, lipolytic activity was increased and maximal lipolytic activity without marked cytotoxicity was measured at 10mM of aminophylline concentration.
Adipocytes* ; Aminophylline* ; Breast ; Cell Count ; Drug Therapy ; Humans ; Injections, Subcutaneous ; Korea ; Lipolysis ; Obesity

Gastric variceal bleeding has relatively low incidence rate compared to esophageal variceal bleeding. However, gastric variceal bleeding tends to lead to a massive bleeding and rebleeding which in turn leads to high mortality rate. In cases where endoscopic approach is limited, Ballon-occluded retrograde transvenous obliteration (BRTO) could be considered as a next modality of seizing acute bleeding. Venous catheterization should be preceded to perform venous embolization, however, in cases of hypovolemic shock status, alternative approaches are required. We are reporting a case of 60-year old female with hypovolemic status due to a massive hematemesis, who went through a percutaneous transhepatic glue embolization to control gastric variceal bleeding.
Adhesives* ; Catheterization ; Catheters ; Esophageal and Gastric Varices* ; Female ; Hematemesis ; Hemorrhage ; Humans ; Hypovolemia ; Incidence ; Mortality ; Shock