The mandibular contour determines the shape of the lower part of face and thus influences the appearance of head and neck. A prominent mandibular angle produce characteristic quadriangular, coarse and muscular appearance. To correct this facial contour to oval shape, the prominent angle can be contoured. the cutaneous approach has been used, but it leaves noticeble scar and has risk of facial nerve injury. Thus the intraoral approach has been used commonly. But because of restricition of operation field, the intraoral approach disadvantages of long operation time, high risk of complications. So, we have performed mandibular contouring procedure by new approach which uses reciprocating saw through stab incision under the mandibular body to correct the 9 patients of mandibular angle protrusion who visited our clinics recently. And we found that mandibular angle contouring by this new approach is easy, and makes the operation and recovery time shorter. There were no complications and cosmetic results were quite satisfactory.
Cicatrix ; Facial Nerve Injuries ; Head ; Humans ; Neck

Childhood granulomatous periorificial dermatitis (CGPD) is a benign facial eruption of unknown etiology characterized by a monomorphic papular eruption occurring in the perinasal, perioral, and periocular areas. We report an 11-year-old boy with characteristic features of CGPD. He presented with a 4-month history of non-pruritic, papular eruptions on the face. The histopathologic exam revealed an upper dermal granuloma with surrounding lymphocytes. Treatment was initiated with tetracycline 500 mg/day, but there was no response for 3 weeks. We tried 0.03% topical tacrolimus to treat recalcitrant skin lesions. After 10 weeks of treatment, the lesions resolved without scarring.
Child ; Cicatrix ; Dermatitis ; Granuloma ; Humans ; Lymphocytes ; Skin ; Tacrolimus ; Tetracycline

PURPOSE: To assess the malignant potential of small(< or =15mm) portal defects seen on CT arterial portography,the findings of CT hepatic arteriography and lipiodol CT CT were reviewed. MATERIALS AND METHODS: In 91 patientswho underwent both CTAP and CTHA, small portal defects were re-viewed for frequency, multiplicity and location. Weprospectively evauluated changes in the size and enhance-ment pattern of malignant lesions on follow up CTaccording to density on CTHA, location, lipiodol deposits on lipiodol CT, and multiplicity. RESULTS: Among the 91patients, 102 small defects were defected in 42 patients(46%). Small portal defects were benign, malignant, and ofundetermined malignant potential in 77%, 20% and 3% of cases, respectively. Small portal defects that werehyperattenuated on CTHA, and lipiodol deposits on lipiodol CT, were malignant in 42% and 70% of cases,respectively. Location and multiplicity did not show statistically significant variation between benign andmalignant defects. CONCLUSION: Small portal defects are common and there is a high probability that portaldefects smaller than 15mm are benign, even in patients with a known hepatic mass and defect that washyperattenuated on CTHA. If a small defect showed lipiodol deposit on lipiodol CT, malignancy must be suspected.
Angiography* ; Ethiodized Oil* ; Follow-Up Studies ; Humans ; Liver* ; Portography*

BACKGROUND: Potential involvement of the angiotensinogen gene(M235T) in the pathogenesis of essential hypertension has been suggested by some investigators. However, an association between M235T gene polymorphism and essential hypertension has been reported by some, but not by others. Since genetic diversity exists among different ethnic population, we addressed the question of whether there is an association between M235T gene polymorphism and essential hypertension in the Korean. METHODS: 100 patients with essential hypertension and 100 control subjects were recruited from outpatients at the Department of Internal Medicine, Soon-chunhyang Hospital, Chunan City. The criteria for hypertension was defined as systolic blood pressure higher than 160mmHg and/or diastolic blood pressure higher than 95mmHg. For detection of the M235T polymorphism at the angiotensinogen locus, the primer sequences were: sense primer : 5'-TGAAGGAG- AAGGTGTCTGCGGGA-3' and antisense primer : 5'- AGGACGGTGCGGTGAGAGTG-3'. The PCR product mixture was exposed to restriction enzyme Tthlll I and then submitted to electrophoresis in polyacrylamide gel. Differences between the molecular variants of the gene in hypertensives and normotensives were compared by using the chi square test. p<0.05 was considered statistically significant. The odds ratio and 95% confidence interval were calculated using Woolf's method. RESULTS: Compared with the control subjects, hypertensives had higher values of three established risk factors for hypertension : age, BMI cholesterol (total and LDL). X analysis showed no difference in the distribution of genotype or allele frequency between the hypertensives and normotensives (chi square=1.14, p=0.29). The crude odds ratio was 0.73 for CC over CT (95% confidence interval 0.41-1.30). The adjusted odds ratio with age, sex, lipid profilcs and BMI was 0.68 for CC over CT (9596 confidence interval 037-1,23). CONCLUSION: The molecular varient M235T of the angiotensinogen gene is not associated with essential hypertension in Korean population.
Angiotensinogen* ; Blood Pressure ; Cholesterol ; Chungcheongnam-do ; Electrophoresis ; Gene Frequency ; Genetic Variation ; Genotype ; Humans ; Hypertension* ; Internal Medicine ; Korea* ; Odds Ratio ; Outpatients ; Polymerase Chain Reaction ; Research Personnel ; Risk Factors

The complement system is composed of more than 25 different proteins and is usually divided into classical and alternative pathways. Complement component 7(C7) is one of the five terminal complement proteins that, upon activation of either the classical or the alternative pathway, interacts sequentially to form a large protein-protein complex, called membrane attack complex(MAC). Assembly of the MAC on target cells results in the formation of transmembrane pores that can lead to the killing of the cells. C7 deficiency is an autosomal recessive disorder that is mostly reported in Caucasians. The gene for C7 has been assigned to chromosome 5p13. To date, 15 different molecular defects leading to total or subtotal C7 deficient defects have been reported. C7 deficiency is associated frequently with recurrently bacterial infections, especially meningitis caused by Neisseria meningitidis. We report a case of a hereditary C7 deficiency associated with meningococcal meningitis.
Bacterial Infections ; Complement C7 ; Complement System Proteins ; Homicide ; Membranes ; Meningitis ; Meningitis, Meningococcal* ; Neisseria meningitidis

Cutaneous bronchogenic cysts are rare, and stem from developmental abnormalities of the tracheobronchial tree. The condition is often misdiagnosed clinically, with the correct diagnosis usually established by histopathologic examination. Published reports of bronchogenic or branchial anomalies are increasing, and the traditional defining characteristics of location and histopathology are proving to be less reliable for the identification of cutaneous bronchogenic cysts. In this report, we describe a case of a cutaneous bronchogenic cyst that presented with unusual histologic features, and was associated with several lymphoid follicles.
Bronchogenic Cyst

Lichen planus is a relatively common chronic inflammatory disease of the skin, mucous membranes, and hair follicles. Oral lichen planus develops in any area of the oral mucosa, especially in the buccal mucosa, tongue, gingiva and lip. The cutaneous lesions of lichen planus are characterized with gray or white punta or streaks, referred to as Wickham striae. We report 53-year-old woman with lichen planus on the lower lip diagnosed by dermoscopy.
Dermoscopy ; Female ; Gingiva ; Hair Follicle ; Humans ; Lichen Planus ; Lichen Planus, Oral ; Lip ; Middle Aged ; Mouth Mucosa ; Mucous Membrane ; Skin ; Tongue

Necrobiotic xanthogranuloma (NXG) is a rare, progressive, histiocytic disease characterized by destructive cutaneous lesions, a close association with paraproteinemia, multiple myeloma, hypertension, and multiple extracutaneous manifestations. Multiple indurated yellow-red plaques or nodules are commonly present in this disorder. The pathogenesis of NXG is poorly understood. Histopathologically, NXG features with hyaline necrosis or necrobiosis are present. We describe a patient with typical cutaneous and histologic findings of NXG with an associated monoclonal gammopathy.
Humans ; Hyalin ; Hypertension ; Multiple Myeloma ; Necrobiotic Disorders ; Necrobiotic Xanthogranuloma ; Necrosis ; Paraproteinemias

In the current years, it has now become necessary to establish standards for micronutrient intake based on scientific evidence. This review discusses issues related to the development of the 2020 Dietary Reference Intakes for Koreans (KDRI) for magnesium (Mg), zinc (Zn), and copper (Cu), and future research directions. Following issues were encountered when establishing the KDRI for these minerals. First, characteristics of Korean subjects need to be applied to estimate nutrient requirements. When calculating the estimated average requirement (EAR), the KDRI used the results of balance studies for Mg absorption and factorial analysis for Zn, which is defined as the minimum amount to offset endogenous losses for Zn and Mg. For Cu, a combination of indicators, such as depletion/repletion studies, were applied, wherein all reference values were based on data obtained from other countries. Second, there was a limitation in that it was difficult to determine whether reference values of Mg, Zn, and Cu intakes in the 2020 KDRI were achievable. This might be due to the lack of representative previous studies on intakes of these nutrients, and an insufficient database for Mg, Zn, and Cu contents in foods. This lack of database for mineral content in food poses a problem when evaluating the appropriateness of intake. Third, data was insufficient to assess the adequacy of Mg, Zn, and Cu intakes from supplements when calculating reference values, considering the rise in both demand and intake of mineral supplements. Mg is more likely to be consumed as a multi-nutrient supplement in combination with other minerals than as a single supplement. Moreover, Zn-Cu interactions in the body need to be considered when determining the reference intake values of Zn and Cu. It is recommended to discuss these issues present in the 2020 KDRI development for Mg, Zn, and Cu intakes in a systematic way, and to find relevant solutions.

An inverted nipple may have both functional and aesthetic problems such as loss of lactability and hygiene. The inverted nipple may be congenital or caused by trauma, mastitis, mammmoplasy and breast cancer. Many procedures have been described for creating the normal anatomic configuration of the retracted nipple. For correcting the inverted nipple, the authors choose surgical procedure according to the grade of inverted nipple and the need of lactation. A total 37 nipples in 20 patients were operated on from February of 2001 to February of 2005. The patients were classified into 3 grades according to Han and Hong's grading system of inverted nipple. We applied modified Elsahy method to the group of patients in Grade I and patients in Grade II with need of lactation, and we applied Broadbent-Woolf method to the group of patients in Grade III and Grade II with need of lactation. Recurrence was found in 1 case corrected by modified Elshay method and no recurrence was found in those corrected by Broadbent-Woolf method. The patients' satisfaction score was 4.6 points in 5 points perfect score system. We prevented recurrence of inverted nipple with patients' satisfaction by applying different operative procedures according to the grade and patients' need of lactation.
Breast Neoplasms ; Female ; Humans ; Hygiene ; Lactation ; Mastitis ; Nipples* ; Recurrence ; Surgical Procedures, Operative