Since the nose is the most prominent part in the face, the plastic surgeons are interested in the continued effort for rhinoplasty. Nasal tip projection is essential to optimal nasal for the patient's face. But, the nasal tips of Orientals are characterized by bulbous appearance due to thick and tense skin, flaring of nostril. and restriction of nasal tip projection due to underdevelopment of medial crus of alar cartilage and short columella. Most orientals want to correct their nasal tip as well as shape of nose. We present clinical cases of various nasal tip deformities which were corrected with various operative methods through either alar rim incision of open rhinoplasty incision depending upon the severity of tip deformity in order to achieve more natural tips and good nasal tip projection. And the clinical cases were categorized into causes of nasal tip deformity and methods of nasal tip augmentation. We are reporting these reporting these cases with review of literatures.
Cartilage ; Congenital Abnormalities ; Nose ; Rhinoplasty ; Skin ; Transcutaneous Electric Nerve Stimulation

Fracture healing is the ongoing process but it is often delayed in elderly patients. Because the fractures in elderly patients with osteoporosis are severely comminuted and their quality of bone is poor, the associated delay of fracture healing is likely to lead to surgical failure. Recently, as a way to promote healing fractures, intermittent systemic parathyroid hormone treatment has been actively researched. Although the effect of parathyroid hormone, which is demonstrated by animal experiments, is well known, there are not many clinical applications. The authors report 2 cases which had the time-shortened callus formation by intermittent parathyroid hormone (teriparatide) administration after surgical treatment, maximum preservation of periosteum as possible, in elderly patients who have supracondylar fracture on distal femur.
Aged ; Animal Experimentation ; Bony Callus ; Femoral Fractures ; Femur ; Fracture Healing ; Humans ; Osteoporosis ; Parathyroid Hormone ; Periosteum

BACKGROUND: Trimetazidine 1(2, 3, 4 trimethoxybenzyl)-piperazine dihydrochloride has shown improved exercise tolerance and delayed ischemic threshold in patients with effort angina. But, unlike other classical antianginal drugs, it netiher reduces oxygen consumption nor increases the blood supply. Its effects could be attributed to protection of the myocardial cell function during ischemia, preventing the fall of ATP, reducing intracellular acidosis and subsequently preventing the accumulation of sodium and calcium in the myocyte. METHODS: We investigated the antianginal efficacy of trimetazidine(Vastinan) in 36 patients(22 males, 14 females, mean age of 56.5 year) who had positive exercise stress test among those with typical effort anginal symptoms from Feb, 1992 to Oct, 1992. These patients received 60mg trimetazidine per day(20mg tid) for 1 month and then exercise stress test, routine hematologic examination and urinalysis were performed at the beginning and at the end of therapeutic examination and urinalysis were performed at the beginning and at the end of therapeutic period. The results were as follows. RESULTS: In exercise parameters, there were 19.2% increase in total work, 30.3% increase in exercise duration and 13% shortening in the normalization time of depressed ST-segment and these were no significant change in hemodynamic parameters(heart rate, blood pressure and maximum Rpp(rate pressure product)(p>0.05). The characters of chest pain were changed in the 19 patients, complete disappearance in 4 patients, reduction of intensity or frequency in 12 patients and aggravation in 3 patients. 2 patients complained of mild epigastric discomfort. There were no significant changes in hematologic findings and urinalysis. CONCLUSIONS: Trimetazidine 60mg per day was efficient in patients with angina and more observations are necessary in assessing the long-term therapeutic efficacy and side effects of this drug.
Acidosis ; Adenosine Triphosphate ; Angina Pectoris* ; Blood Pressure ; Calcium ; Chest Pain ; Exercise Test ; Exercise Tolerance ; Female ; Hemodynamics ; Humans ; Ischemia ; Male ; Muscle Cells ; Oxygen Consumption ; Sodium ; Trimetazidine* ; Urinalysis

Myotonic dystrophy is an autosomal-dominantly inherited neuromuscular disorder characterized by slowly progressive muscular dystrophy, muscle weakness and myotonia. The clinical features may vary from just cataracts to involvement of multiple organ systems such as various muscles, heart, lung and intestine. During pregnancy and delivery, serious maternal and obstetrical complications may occur. The myotonia is often aggravated during pregnancy and it leads to obstetrical complications such as fetal loss, preterm premature delivery, hydrops, in-utero fetal death, difficulties in fetal expulsion, postpartum hemorrhage and/or anesthetic accidents. The affected neonate may display severe hypotonia, facial displegia and respiratory distress. This report presents a woman with myotonic dystrophy complicated with congestive heart failure and preterm delivery during pregnancy.
Cataract ; Edema ; Estrogens, Conjugated (USP)* ; Female ; Fetal Death ; Heart Failure* ; Humans ; Infant, Newborn ; Intestines ; Lung ; Muscle Hypotonia ; Muscle Weakness ; Muscular Dystrophies ; Myocardium ; Myotonia ; Myotonic Dystrophy* ; Obstetric Labor, Premature* ; Postpartum Hemorrhage ; Pregnancy*

For effective construction of OCS(Order Communication System), the most core part of medical information system on medium and small hospital, this thesis understands the interface types of current medical treatment examination equipments and operational problems and shows the solution through the integrated interface management system. Showing the development cases of real time interface system for integration of clinical pathology inspection equipment, LIS(Laboratory Information System) and medical treatment system, this thesis suggests the basic construction element and the functions.
Clinical Laboratory Information Systems ; Information Systems ; Pathology, Clinical

The clinical entity of Dysplasia Epiphyseal Multiplex was first descrihed by Fairbank in 1935, characterized by the disturbance of endochondral ossification in hoth epiphyseal centers and regions of physeal growth. It manifests itself radiologically as late appearance and mottling of the ossification centers and clinically as short stature, stubby digits and painful stiffness of multiple joints. It is typically transmitted as an autosomal dominant trait though recessive forms have been described. The spine is normal apart from a mild increased lumbar lordosis. Many patients are referred to an orthopaedic surgeon for bilateral Perthes disease, as was one of the authors cases. This Paper reports four cases of multiple epiphyseal dysplasia which affected one family.
Animals ; Hip ; Humans ; Joints ; Knee ; Legg-Calve-Perthes Disease ; Lordosis ; Osteochondrodysplasias* ; Spine

Ischemic myelopahty of spinal cord after cardiac arrest is rarely reported. In general brain stem and spinal cord is less vulnerable to ischemic injury than cerebrum and cerebellum. Ischemic myelopathy usually occurs in the midthoracic region (T3~T8) and rarely reported after cardiac arrest. In this case previously healthy 62 year old patient suffered from cardiac arrhythmia for a few days and then developed cardiac arrest and sustained paraplegia due to ASIA class B spinal cord injury. After paraplegia MRI showed predominant involvement of the anterior horn cell area in the midthoracic region.
Anterior Horn Cells ; Arrhythmias, Cardiac ; Asia ; Brain Stem ; Cardiopulmonary Resuscitation* ; Cerebellum ; Cerebrum ; Heart Arrest ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Paraplegia ; Spinal Cord Injuries ; Spinal Cord Ischemia* ; Spinal Cord*

Many studies have failed to prove the health effects of herbicides on exposed Vietnam veterans. The main difficulties for the studies have been the methodologic weakness, the time delay from the onset of exposure to the assessments and inability of measuring exposure amount. The purpose of this study is to evaluate human health effects among Vietman veterans who were exposed to herbicides while staying in Vietnam. The subjects were patients who visited to Taegu veterans hospital between November, 1995 and July, 1996. Any veterans stationed in Vietnam for six or more months between 1966 and 1973 were included in this study. We performed a comprehensive study including a neurologic test, physical examination, medical history, serum and urine chemistry, electrodiagnostic study and a roentgenographic study. We have found that the patients with peripheral neuropathy were 24 cases, soft tissue sarcoma 1 case and Buerger's disease 1 case. And many other diseases were also diagnosed in these patients. However we were unable to find the strong evidences of association between the clinical illness and the exposure to herbicides.
Chemistry ; Daegu ; Herbicides* ; Hospitals, Veterans ; Humans* ; Peripheral Nervous System Diseases ; Physical Examination ; Sarcoma ; Thromboangiitis Obliterans ; Veterans* ; Vietnam*

Dysesthetic pain syndrome is a common disabling painful sequelae of spinal cord injury patients. The purposes of this study were to gather the general informations of pain in spinal cord injury patients and to investigate the correlation between the various factors affecting pain severity. Twenty-seven spinal cord injury patients with dysesthetic pain were evaluated by medical histories, physical and neurological examinations. The pain intensity was measured by a visual analogue scale. Twenty-one subjects were males and six were females. The mean age of patients was 35.1 years. The patients were classified into five pain categories : diffuse pain, segmental pain, root pain, visceral pain, and non-neurogenic pain. Nineteen patients (70.4%) were categorized into diffuse pain group, six patients (22.2%) into both diffuse and segmental pain group, two patients (7.4%) into root pain group and five patients (18.5%) into perianal pain group. According to this study, the only significant factor affecting the severity of dysesthetic pain in spinal cord injury patients was the severity of spinal cord injury. Pain appeared earlier and more intensely in the complete spinal cord injury patients. There was no correlation between the severity of pain and the level of lesion, age, or the posterior tibial nerve SEP response.
Female ; Humans ; Male ; Neurologic Examination ; Spinal Cord Injuries* ; Spinal Cord* ; Tibial Nerve ; Visceral Pain

High tibial osteotomy has been widely accepted as a method of treatments for middle-aged varus osteoarthritides with uncompartmental involvements. There have been several reports regarding the managements of fibula and their complications during the valgization procedure of tibia. They are, for example, osteotomy of fibular diaphysis or neck and excision of fibular head. Each level of fibular management is often complicated by nonunison, peroneal nerve palsy and lateral instability respectively. We have reviewed 20 cases of cases of high tibial osteotomy using proximal tibiofibular arthrolysis performed between March 1987 and February 1993. This method has proved excellent exposure of upper lateral tibia for the wedge removal, internal fixation and relief of the tethering effect of fibula. There was no peroneal nerve palsy relate to this degenerative change of the proximal tibiofibular was 3.4mm(range 1-11mm) and there was neither degenerative change of the proximal tibiofibular joint nor varus instability. In conclusion the arthrolysis of proximal tibiofibular joint can be highly recommended in high tibial osteotomy.
Diaphyses ; Fibula ; Head ; Joints ; Methods ; Neck ; Osteoarthritis ; Osteotomy ; Paralysis ; Peroneal Nerve ; Tibia