PURPOSE: In the correction of cleft lip, there have been various methods to minimize recurrence of the nasal deformity after primary nasal surgery. After cheiloplasty and primary nasal surgery, we tried to elongate the columella of the cleft side, to stretch the vestibular lining of cleft side, and to elevate the alar cartilage of the cleft side with a molding prong. METHODS: We had fifteen cleft lip patients; 12 unilateral cases(6.3-8.2 months), and 3 bilateral cases(3 -7.5 months). Immediately after primary repair of the cleft lip, the toboggan shaped molding prong was located to deep inside of vestibular web of the cleft side. It was persistently suspended by a silicone tube which was connected to the prong and the frontal scalp. The results were analyzed with Photoshop(R) photogrammetrically for 6-48 months with on average of 20.6 months. We measured the proportion index of columellar length-interalar distance for three times(preoperation, immediate postoperation, and postoperation) on the nasal base views. RESULTS: In unilateral, the index had a significant increase statistically between preoperation(10.73) and immediate postoperation(23.96). It is supposed that columellar length was reconstructed to 105.80% of normal side. But, it was decreased to maintain 87.7% of normal side in postoperation(20.54). The results were similar in bilateral. The linear scars by suture penetrating nose skin were not discernable. CONCLUSION: In summary, placement of the molding prong could elongate the reconstructed columella with some relapse postoperatively.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Fungi* ; Humans ; Nasal Surgical Procedures ; Nose ; Recurrence ; Scalp ; Silicones ; Skin ; Sutures

No abstract available.
Arthroplasty* ; Knee*

Drug-induced thrombocytopenia and purpura have boon developed by many various agents. Rifampin and Pyrazinamide have been known as bactericidal antituberculous drugs, but, the above side effects have been a problem. Especially, hematologic side effects art fatal to patients occasionally. Rifampin-induced thrombocytopenia and purpura have been well known, also, pyrazinamide-induced thrombocytopenia have been reported. A new quilonone agent Ciprofloxacin, has been commonly used in clinics now, but it's side effects are not known well. So, we report a case of a 23-year-old female with thrombocytopenia and purpura after taking Rifampin, Pyrazinamide, and Ciprofloxacin as antituberculous agents.
Ciprofloxacin* ; Female ; Humans ; Purpura* ; Pyrazinamide* ; Rifampin ; Thrombocytopenia* ; Young Adult

STATEMENT OF PROBLEM: There have been previous studies about considerable variations in machining accuracy and consistency in the implant-abutment-screw interfaces. PURPOSE: The purpose of this study was to evaluate the machining accuracy and consistency of implant/abutment/screw combinations on two randomly selected implants from each of four manufactures. MATERIAL AND METHODS: In this study, screws were respectively used to secure a cemented abutment to a hexlock implant fixture; teflon coated titanium alloy screw(Torq-Tite) and titanium alloy screw in Steri-Oss system, gold-plated gold-palladium alloy screw(Gold-Tite) and titanium alloy screw in 3i system, gold screw and titanium screw in AVANA Dental Implant system, and titanium screws in Paragon System. The implants were perpendicularly mounted in polymethyl methacrylate autopolymerizing acrylic resin block(Orthodontic resin, Densply International Inc. USA) by use of dental surveyer. Each abutment screw was secured to the implant with recommended torque value using a digital torque controller. Each screw was again tightened after 10minutes. All samples were cross sectioned with grinder-polisher unit(Omnilap 2000 SBT Inc) after embeded in liquid unsaturated polyester (Epovia, Cray Valley Inc). RESULTS: There were the largest gaps in the neck areas of screws in hexagonal extension implants which were examined in this study. The leading edge of the abutment screw thread (superior surface) was in contact with the implant body thread, and the majority of the contacting surfaces were localized to the middle portion of the mating threads. Considerable variation in the contacting surfaces was noted in the samples evaluated. Amounts of contact in the abutment screw thread were larger for assemblies with Gold-Tite screw, gold alloy screw, Torq-Tite screw than those with titanium screws. The findings of intimate contact between the screw and screw seat were seen in all samples, regardless of manufacturers. However, microgap between the head and lateral neck surface of the screw and the abutment could be dectected in all samples. The findings of intimate contact between the platform of the implant and the bottom of the abutment were consistent in all samples, regardless of manufacturers. However, microgaps between the lateral surface of external hex of the fixture and the abutment could be dectected in all samples. CONCLUSION: Considerable variations in machining accuracy and consistency were noted in the samples and the implant-abutment-screw interfaces were incomplete. From the results of this study, further development of the system will be required, including improvements in pattern design.

PURPOSE: Hook nail deformity is caused by inadequately supported nail bed due to loss of distal phalanx or lack of soft tissue, resulting in a claw-like nail form. A composite graft from the foot bencath the nail bed gives adequate restoration of tip pulp. METHODS: From September of 1999 to March of 2004, six patients were treated for hook nail deformity and monitored for long term follow up. Donor sites were the lateral side of the big toe or instep area of the foot. We examined cosmetic appearance and nail hooking and sensory test. The curved nail was measured by the picture of before and after surgery. RESULTS: In all cases, composite grafts were well taken, and hook nail deformities were corrected. The curved nail of the 4 patients after surgery were improved to average 28.7 degrees from average 55.2 degrees before surgery. The static two point discrimination average was 6.5mm and the moving two point discrimination average was 5.8mm in the sensory test. CONCLUSION: Composite graft taken from foot supports the nail bed with the tissue closely resembling the fingertip tissue, making it possible for anatomical and histological rebuilding of fingertip.
Congenital Abnormalities* ; Discrimination (Psychology) ; Follow-Up Studies ; Foot ; Humans ; Tissue Donors ; Toes ; Transplants*

PURPOSE: In the partial thickness burn management, despite of several advantages, the use of human amniotic membrane has been limited. The authors applied dried bovine amniotic membrane(DBAM) to overcome disadvantages of amniotic membrane for partial thickness burn and to compare the effectiveness of cultured allogenic keratinocytes(CAK) that have been recently used for the management of burn. METHODS: From August 2007 to May 2008, 16 patients with partial thickness burn were assigned to this study. The ages ranged from 12 to 59, with the average of 38. Either DBAM or CAK were applied, and the secondary dressing was removed on the following day. To compare treatment effect, time for epithelization, Vancouver scar scale and chromameteric results were evaluated. RESULTS: The time for epithelization was 10.1 days and 9.1 days in DBAM and CAK, respectively, which are shorter than the previous 2-3 weeks. At the follow up Vancouver scar scale was 2.8 in DBAM and 3.0 points in CAK, both of which showed good results. The results of chromameter showed that the L*, a*, and b* values of the area applied DBAM were 60.1, 13.6, and 13.3, respectively, and the values of the area applied CAK were 60.1, 12.4, and 12.4, respectively. It was found that the skin color of the healed area after burn was darker, the redness was higher, and the yellowness was lower. After dressing, no significant side effects were observed, and in the cases of applying CAK, it was inconvenient as the moving area had to be fixed. CONCLUSION: As CAK, DBAM has several advantages such as the shortening of the epithelization period, reduction of scar and pigmentation, and convenient application, etc., it is an effective method for the partial thickness burn management.
Amnion ; Bandages ; Burns ; Cicatrix ; Follow-Up Studies ; Humans ; Keratinocytes ; Pigmentation ; Skin

BACKGROUND: Lung cancer continues to increase worldwide. Also, the proportion of female patients incease and adenocarcinoma is the predominant histological type among lung cancer in many western countries. So, we studied these current trends of lung cancer by clinical approach of recent patients from our department. METHOD: We conducted a retrospective analysis on 212 subjects who were diagnosed with lung cancer at the department of chest medicine in National Medical Center between January 1990 and July 1996. The contents of analysis were patient's profile, clinical manifestation, smoking habits, accuracy of diagnostic methods, histological cell type, staging and treatment, etc. RESULTS: The results were as follows. 1) The ratio of male to female was 5.2:1. The peak incidence of age was 7th decade(35.4 %). 2) Chief complaints were cough, dyspnea and chest pain, etc. The most common duration of symptoms before the first admission was less than 3 months(57.7%). On the other side, duration more than 1 year represented 6.5%. The early diagnosed patients has been increased from the 1980s. 3) Smokers among the total patients were 77.2%. The proportion of smokers in sqamous cell carcinoma, small cell carcinoma and adenocarcinoma were 88.4%, 85.7% and 55.7%, respectively. Smoking history and histological cell type were correlated in squamous and small cell carcinoma. 4) Squamous cell carcinoma is still the predominant histological type(44.8%), but, adenocarcinoma increased more than the previous study(30.7%). The other histological types were small cell carcinoma(17.0%) and large cell carcinoma(3.8%) in order of their proportions. 5) The accuracy of diagnostic methods were as follows : sputum cytology 75.3%, bronchoscopic biopsy 65.7%, lymph node aspiration cytology 95.8%, percutaneous lung aspiration cytology 94.6% and open lung biopsy 100%. The general accuracies of diagnostic methods were improved than previous studies. 6) Performance status scales on admission were relatively good. After diagnosis, chemotherapy and/or radiotherapy were undertaken in 69.3% of the patients, and only 7.5% of the patients were operated. CONCLUSION: In our study, squamous cell carcinoma is still the predominant histological cell type, but, adenocarcinoma continues to increase. Because adenocarcinoma is less correlated with smoking habits, further evaluation of other carcinogens than smoking is requested. Screening and early diagnosis of lung cancer is important for good performance status scales in spite of advanced stages. But, we think that the prevention, for example, stop smokings is more important as because of no perfect treatment for lung cancer.
Adenocarcinoma ; Biopsy ; Carcinogens ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Chest Pain ; Cough ; Diagnosis ; Drug Therapy ; Dyspnea ; Early Diagnosis ; Female ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Lymph Nodes ; Male ; Mass Screening ; Radiotherapy ; Retrospective Studies ; Smoke ; Smoking ; Sputum ; Thorax ; Weights and Measures

The challenge of accurately predicting eyelid height after blepharoptosis surgery is well-known problem even in complete hands. From May 1988 to December 2004, authors reviewed 182 cases(240 eyes) of blepharoptosis corrected by frontalis muscle transfer or levator resection and had experienced 10 cases(15 eyelids) of early reoperation around the first week. The period from initial operation to reoperation are between six to eight days and mean period is seven days. Initial operative procedures were frontalis muscle transfer in 3 cases(4 eyelids) and levator resection in 7 cases(11 eyelids). Follow up period ranged from 6 months to 16 years. Early adjusting surgery was performed in accordance with the preoperative and postoperative degree of ptosis of patient and by previous operative technique. The results are evaluated according to the criteria of an ideal correction by Souther and Jordan. Seven patients have good or satisfactory results(less than 1 mm asymmetry, good in 5 cases and satisfactory in 2 cases). Three patients(5 eyelids) recorded as poor results(more than 2 mm asymmetry). Even if early or late reoperation can be effective in correcting unsatisfactory results after correction of blepharoptosis, early reoperation may lead to better results than late reoperation because early reoperation can offer a reduction in time to final result, the ease with which it is performed and potential cost savings. The experience of surgeon is also important factor for the treat ment of recurred blepharoptosis.
Blepharoptosis ; Cost Savings ; Eyebrows ; Eyelids ; Follow-Up Studies ; Forehead* ; Hand ; Humans ; Jordan ; Reoperation ; Rhytidoplasty ; Surgical Procedures, Operative

The upper and lower lateral cartilages provide the key to the lower cartilaginous portion of the nose. Lifting the cartilages is essential procedure for correction of unilateral cleft lip nose deformity. After correction of cleft lip nose deformity, authors used acoustic rhinometry (AR) to compare the lower nasal cavity of cleft side with non-cleft side. AR is a well known new, non-invasive diagnostic technique in which nasal geometry is assessed by means of acoustic reflection. From June 1996 to January 2004, we performed acoustic rhinometric analysis after correction of unilateral cleft lip nose deformity. This study involved 40 children of age ranged from 3 months to 8 years. Subjects were divided into the group of incomplete unilateral cleft lip nose deformity(20 subjects), and the group of complete unilateral cleft lip nose deformity(20 subjects). Results show that lower nasal cavity volume between non-cleft side and cleft side has no difference, and better results were obtained when nasal molding prong was applied at cleft side nostril. The results between incomplete type and complete type have no significant difference. In conclusion, AR is an effective method to calibrate cross sectional area and nasal cavity volume of unilateral cleft lip nose deformity, and furthermore effective in comparing the volume of cleft side with non-cleft side after unilateral cleft lip nose deformity correction with lifting the lower lateral cartilages to the upper lateral cartilages.
Acoustics* ; Cartilage ; Child ; Cleft Lip* ; Congenital Abnormalities* ; Fungi ; Humans ; Lifting ; Nasal Cavity ; Nose* ; Rhinometry, Acoustic

The silicone rubber implants are widely used in plastic surgery because of various advantages; however, calcification in surface of implant(as a chemical resistance) may transform or destroy the high molecular biomaterial when it stays too long within the human body. The purpose of this study is to determine the relationship between calcification and the histological disparities of the tissues surrounding the area adjoining the silicone nasal implant by examining the regional characteristics of calcium deposits in the silicone nasal implant via elemental analyses using EDX(energy-dispersive X-ray analysis) and ultrastructural analyses using SEM(scanning electron microscopy). The subjects of the study were 19 silicone nasal implants removed by revision rhinoplasty, all displaying calcification. According to the tissue characters, the implant surface was divided into 4 zones with the rhinion as the basis. For each zone, elemental and ultrastructural analyses were performed. Elemental analysis revealed that the calcium deposits consisted of Ca and P only. There were no statistically significant disparities among the ratios between Ca and P according to the zones. Ultrastructural analysis showed acellular mineral-like deposits coalesced to create amorphous deposits in all zones; however, in zones 1 and 3(more pressurized zones by periosteum or nasal bone), additional flaky cylinder-shaped calcium deposits were detected. Thus, it seems that the histological disparities in the surrounding tissues do not affect the components and their proportions in the calcification process. However, it can be inferred that the physical environment due to the histological disparities in the surrounding tissues affects the ultrastructures of calcium deposits.
Calcium ; Human Body ; Periosteum ; Rhinoplasty ; Silicone Elastomers ; Surgery, Plastic