Dermal injectables are the most popular material for facial enhancement, including volumizing and wrinkle correction. However, although hyaluronic acid is the most common component of dermal injectables, the character of hyaluronic acid products is quite variable. These materials can be described in terms of their viscoelastic properties using four parameters. In this article, the author would like to describe these properties in detail. Although many physicians consider this material to be convoluted, thoroughly understanding the characteristics of various injectables enables us to tailor procedures accordingly and to enhance the final results.

Background: Facial rejuvenation techniques using thread lifts are performed by passing sutures under the facial skin to treat sagging and facial flaccidity, and their advantages include a relatively short recovery time and relatively small incisions. In this study, we describe the short-term safety of a facial rejuvenation technique involving an absorbable polydioxanone monofilament thread (Mint Lift) in patients with mild-to-moderate facial skin sagging. Methods: The current multicenter, retrospective, case-series study was conducted in a total of 196 patients who visited the Grace Plastic Surgery Clinic or the Songdo IB Clinic between 2016 and 2018. The patients underwent insertion of the Mint Lift 43 and 17 in the deep temporal fascia and the deep subcutaneous layer, respectively. Of these patients, 179 met the eligibility criteria and their medical records were retrospectively reviewed. Results: The patients comprised six men (3.4%) and 173 women (96.6%), with a mean age of 44.4±14.4 years. In our series, postoperative complications included ecchymosis (1.7%), infection (0.4%), thread extrusion (1.1%), and skin dimpling (1.5%). No cases of iatrogenic nerve injury were observed, and all postoperative complications spontaneously resolved. Conclusions The Mint Lift 43 and 17 may be safe for thread lifting in patients with mildto-moderate facial skin sagging. However, further long-term follow-up studies are warranted.

Commonly, the lateral canthus is located higher than medial canthus and many people are often shown short lateral palpebral fissure. This seemed to be shown as wild, anxious, and pierced eye. Many surgeons have made desperate efforts to improve this by anchoring lateral canthus to lower part of orbital bone. But, authors would like to show the two-third portion of the lateral lower eyelid by anchoring to capsulopalpebral fascia via transconjunctival approach. Authors performed this operation since 2009 and first named it by "Nun-Mit-Teuim" in Korean. Key of this operation is that anchoring of the lower tarsus and capsulopalpebral fascia via transconjunctival approach without resection of skin. It is not necessary to remove a redundant conjunctiva. Commonly, the lateral canthoplasty is performed simultaneously to descend a lower eyelid easily. After the operation, it can be observed that the lower eyelid lift up a little bit for 1~2 weeks and redundant conjunctiva will be constricted in several months. The operation is defined as anchoring the lower tarsus to capsulopalpebral fascia. The limit of the operation is it cannot change the position of the lateral canthus. Over-lowering the lower eyelid to increase palpebral fissure, results in scleral show and unfavorable line. Thus, it is important that surgeons should remind the purpose and limitation of this operation.
Animals ; Ankle ; Conjunctiva ; Eye ; Eyelids ; Fascia ; Isothiocyanates ; Orbit ; Skin

No abstract available.
Leiomyoma* ; Treatment Outcome*

OBJECTIVE: To evaluate the efficacy of clinical use of a intrauterine Sengstaken-Blakemore tube (S-B tube) in postpartum hemorrhage not controlled with medication and conservative treatment. METHODS: Retrospective review was done in 18 women with insertion of S-B tube into intrauterine cavity who did not controlled with medication and conservative treatment for postpartum hemorrhage. After third stage of labor, women were treated with prophylactic intramuscular Methylergonovine 0.2 mg and intravenous infusions of oxytocin routinely. If the postpartum bleeding continued, Misoprostol 800 microgram (per rectal) and intravenous infusions of Dinoprost 2 mg mixed with 5% D/S 500 cc were employed. And then women were examined for retained placenta and laceration of birth canal. Where necessary, retained placenta was removed and lacerations were sutured. If the postpartum bleeding did not controlled despite all of procedures, we decided use of intrauterine S-B tube. RESULTS: The mean age of the patients was 30.9+/-4.4 (27-39) years, their mean body weights and parities were 67.8+/-8.2 (56.2-85.7) kg, 1.8+/-0.8 (1-4) and mean gestational age was 38.5+/-2.9 (37-42) weeks respectively. The mean time from delivery to insertion of S-B tube was 107.6+/-94.0 (24-360) minutes. The mean filled normal saline amount was 190.5+/-35.2 (120-230) cc. Of 18 who was inserted of S B tube, 15 cases needed not additional surgical therapy. So success rate was 83.3%. CONCLUSION: Insertion of intrauterine S-B tube appears as a simple and effective means of treating postpartum hemorrhage not controlled with medication and conservative treatment.
Body Weight ; Dinoprost ; Female ; Gestational Age ; Hemorrhage ; Humans ; Infusions, Intravenous ; Lacerations ; Methylergonovine ; Misoprostol ; Oxytocin ; Parturition ; Placenta, Retained ; Postpartum Hemorrhage* ; Postpartum Period* ; Retrospective Studies

OBJECTIVE: This study was performed to investigate the effects of metformin in PCOS patients undergoing IVF-ET. METHODS: From January 2002 to December 2004, 87 cycles in 32 PCOS patients undergoing IVF-ET at the Infertility clinic of Grace Women's Hospital were randomly divided into two groups and enrolled in this study. The diagnosis of PCOS was made by the criteria from 2003 Rotterdam Consensus. Metformin group (19 patients, 45 cycles) received metformin (Daewoong Pharma Co., Korea; 500 mg three times or two times a day from one or two months before and during IVF cycle) and control group (13 patients, 42 cycles) did not receive metformin. All patients received controlled ovarian hyperstimulation (COH) using gonadotropins (Fostimon, IBSA, Switzerland) with GnRH antagonist (Cetrotide, Serono, Germany). When leading follilces reached 18 mm in diameter, recombinant hCG 250 ?g (OVIDREL, Serono, Italy) was injected. Oocytes were retrieved transvaginally 35 hours later. The luteal phase was supported everyday by progesterone 50 mg IM (Progest, Samil, Korea) with micronized progesterone 200 mg vaginal insertion (Utrogestan, Besins, France). RESULTS: There was no statistical difference in the patients age (34.1+/-3.0 vs 33.5+/-2.9 years), the duration of infertility (4.3+/-1.3 vs 4.5.+/-1.3 years) and BMI (23.5+/-2.4 vs 24.01+/-2.7 kg/m2) among two groups (p> or =0.05 for each). There was also no statistical difference in the indications of IVF among two groups; ovulation factor (27 cycles vs 23 cycles), tubal factor (7 vs 8), male factor (8 vs 7) and other factor (3 vs 4) (p> or =0.05). The duration of ovulation induction in metformin group was significantly shorter when compared with control group (10.1+/-2.3 vs 13.8+/-2.2 days, p<0.05). Total doses of FSH-HP in metformin group were significantly less than that in control group (30.3+/-11.5 vs 39.9+/-11.7 ampules, p<0.05). There was no difference in the number of aspirated oocytes (10.5+/-4.7 vs 9.6+/-3.6), the fertilization rate (65.9+/-17.4% vs 63.2+/-25.9%), implantation rate (30.3+/-11.5% vs 38.1+/-17.3%) and the number of good quality embryo (5.0+/-1.8 vs 4.7+/-2.5, p< or =0.05). Clinical pregnancy rate was higher in metfomin group (33.3% vs. 23.8%), although statistically not significant. CONCLUSION: Although more randomized study is needed, metformin therapy in PCOS patients undergoing IVF has possibility of reducing the duration of COH and the gonadotropin doses.
Consensus ; Diagnosis ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Infertility ; Korea ; Luteal Phase ; Male ; Metformin* ; Oocytes ; Ovulation ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Pregnancy Rate ; Progesterone

Trisomy 18 is the second most common chromosomal anomaly which reach to live birth next to Down syndrome. Several methods were proposed to screen patients on the risk of Edward syndrome like maternal serum levels of total human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP) and unconjugated estriol or free beta hCG with AFP, but the serum screening has only 67% detection rate with a 7.2% of false positive rate. Therefore, in order to overcome the limitations which the serum markers have, detailed ultrasound examination is also necessary and sensitivity of 80% was reported. We report a case of Trisomy 18 fetus in which choroid plexus cyst was the only abnormal sonographic finding.
alpha-Fetoproteins ; Biomarkers ; Chorionic Gonadotropin ; Choroid Plexus* ; Choroid* ; Down Syndrome ; Estriol ; Fetus ; Humans ; Live Birth ; Mass Screening ; Trisomy ; Ultrasonography

Stress urinary incontinence is the predominant symptom in young and middle-aged women. Stress urinary incontinence is not a life-threatening disease but can lead to discomfort, which can also limit the social and sexual activities of women. Lately TOT operation is performed in most cases of stress urinary incontinence. But Burch colposuspension had been one of successful operations for genuine stress incontinence until TOT procedure was performed. Burch colposuspension has significant morbidity such as bleeding, infection and wound hematoma, and subsequent complications including voiding difficulty, de novo detrusor instability, recurrent urinary tract infection and uterovaginal prolapse. In this case, Delayed migration of the suture and bolster after an endoscopic Burch colposuspension across tissue planes, with subsequent erosion into the bladder, is uncommon. We report an unusual complication 5 years after Burch operation. It was an intravesical foreign body granuloma caused by suture material.
Female ; Foreign Bodies ; Granuloma, Foreign-Body ; Hematoma ; Hemorrhage ; Humans ; Prolapse ; Sexual Behavior ; Sutures ; Urinary Bladder ; Urinary Incontinence ; Urinary Tract Infections

Trichoderma fungi have been intensively studied for mycoparasitism, and the latter is closely related to their cell-wall degrading enzymes including chitinase. Here, we studied marinederived Trichoderma spp., isolated from distinct sources and locations, for chitinolytic and antifungal activity. Based on morphological and phylogenetic analyses, two strains designated GJ-Sp1 and TOP-Co8 (isolated from a marine sponge and a marine alga, respectively) were identified as Trichoderma bissettii. This species has recently been identified as a closely related species to Trichoderma longibrachiatum. The extracellular crude enzymes of GJ-Sp1 and TOP-Co8 showed activities of chitobiosidase and β-N-acetylglucosaminidase (exochitinase) and chitotriosidase (endochitinase). The optimum chitinolytic activity of the crude enzymes was observed at 50°C, pH 5.0, 0–0.5% NaCl concentrations, and the activities were stable at temperatures ranging from 10 to 40 C for 2 h. Moreover, the crude enzymes showed inhibitory activity against hyphal growth of two filamentous fungi Aspergillus flavus and Aspergillus niger. To the best of our knowledge, this is the first report of the chitinolytic and antifungal activity of T. bissettii.