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

A total of 21 patients were operated. Via a columellar labial incision, the upper lateral cartilages were separated from the septum. A submucous resection of the septal cartilage was carried out. After rasping the convex lateral nasal wall of the unaffected side, a low-to-low lateral nasal osteotomy was conducted. Along the deviated dorsal line at the bony vault passing the submucous tunnel, a paramedian nasal osteotomy was performed. The convex side of the nasal bone flap was contoured by rasping. The convex side of the "T"-shaped dorsal septum was trimmed. A total direct septal extension graft of the septal cartilage was done and the alar cartilages were suspended to it. The postoperative results were evaluated by photogrammetric analysis processed by a "neon glow" filter in Adobe Photoshop. The distance from the nasal midline to the most deflective point at 5 levels was measured, and the proportion indices were obtained in regard to intercanthal distance. The results revealed improvement in all levels (p < 0.05), although not perfect. In summary, this technique can result in a clinically good-looking in spite of a slight deflection that still exists.
Cartilage ; Humans ; Nasal Bone* ; Nose* ; Osteotomy ; Transplants

The purpose of this research is to find out the degree of cartilage regeneration by inserting the atelo- collagen scaffold obtained from dermis of a calf on cartilage defect site. Dissection underneath the perichondrium by the periosteal elevator on both side of ears of six New Zealand white rabbits were made to expose the cartilage, leaving pairs of circular holes 3, 6, 9 mm width with punches. One hole was left for a control, and on the other hole atelo-collagen scaffold of the same size was transplanted. In postoperative 1, 2, 4 weeks, the tissues were dyed. The length of long axis of neocartilage was measured through an optical microscope with a 0.1mm graduation at original magnification, x40. In the first and second week, both group showed no sign of cartilage regeneration. In the fourth week, regeneration on marginal portions was observed on all groups and the average values of length of long axis of neocartilage according to defect size were as follows: In the cases with 3mm defect, it was 0.85+/-0.30mm in the control group, and 1.85+/-0.38mm in the graft group; in the cases with 6 mm defect, 1.33+/-0.58mm in the control group, and 2.25+/-0.46mm in the graft group; and in the cases with 9mm defect, 2.33+/-0.77mm in the control group, and 4.47+/-1.39mm in the graft group. This means that the collagen scaffold has an influence on the regeneration of neocartilage. But the relative ratio of the length of neocartilage to cartilage defect size was not significant in the statistics.
Axis, Cervical Vertebra ; Cartilage* ; Collagen ; Collagen Type I* ; Dermis ; Ear ; Elevators and Escalators ; Rabbits ; Regeneration ; Transplants

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by the presence of IgG autoantibody against platelet, low platelet count, and bleeding disorders. Anecdotal experience of renal transplantation adopting the use of 2 weeks of steroids treatment, perioperative intravenous immunoglobulin, and simultaneous splenectomy in a patient with ITP was reported recently. However, advantage of these procedures is not yet confirmed. Recently, we performed a case of uneventful renal transplantation in a patient with ITP without immunoglobulin treatment and no splenectomy. Although platelet counts have been under normal limit after transplantation, the anti-platelet antibody converted to negative postoperatively and the graft function has been stable until now. Our case report raised the question about the use of perioperative immunoglobulin and splenectomy in these particular patient groups waiting for renal transplantation.
Blood Platelets ; Hemorrhage ; Humans ; Immunoglobulin G ; Immunoglobulins ; Kidney Transplantation* ; Kidney* ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy ; Steroids ; Transplants

PURPOSE: Nasal bone fractures are often classified as minor injury. However, the incidence of posttraumatic nasal deformity remains alarmingly high. It is because of unnoticed septal fracture. This study was conducted to determine the necessity of septoplasty for patients with nasal bone fracture accompanying grade I septal fractures. METHODS: Among 105 patients with nasal bone fractures, 52 who had grade I septal fracture were diagnosed based on physical examination and computed tomography. Patients' age ranged from 14 to 65 years (mean 29.25 years), and 35 were male and 17 female. Patients were divided into 2 groups according to surgical treatment METHODS: patients who underwent closed reduction only (group 1, n=28) and those who underwent simultaneous closed reduction and septoplasty (group 2, n=24). The treatment outcomes were evaluated by comparing changes in nasal airway volume measured by acoustic rhinometry before the surgery, 3 months and 6 months after the surgery according to the timing of surgical repair and surgical treatment methods. RESULTS: Nasal airway volume increased after the surgery by 17.8% in 3 months after the surgery, 25.2% in 6 months in group 1 and by 22.7% in 3 months, 35.8% in 6 months in group 2. The increase in airway volume after the surgery by 26.3% in 3 months after the surgery, 34.2% in 6 months after the surgery in operation within 1 week after trauma and by 12.1% in 3 months, 22.2% in 6 months after the operation later 1 week after trauma. The difference was statistically significant. Three patients in group 1 complained of intermittent nasal obstruction, two of whom showed a decrease in nasal airway volume by acoustic rhinometry. CONCLUSION: Most patients with nasal bone fractures accompanying grade I septal fractures have been treated with closed reduction in clinical settings. However, the results of this study suggest that septoplasty be performed after a correct diagnosis of septal fracture is made through comprehensive physical examination and computed tomography. Septoplasty is important to obtain more favorable outcomes and reduce complication.
Acoustics ; Congenital Abnormalities ; Female ; Humans ; Incidence ; Male ; Nasal Bone ; Nasal Obstruction ; Physical Examination ; Rhinometry, Acoustic

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

PURPOSE: Complete septal extension grafts have been widely used in rhinoplasty for effective projection of the short retruded columella in Asian patients. Autologous septal cartilages and porous high-density polyethylene sheets are frequently used as septal extension grafts. This study was conducted to compare the postoperative results of porous polyethylene sheets and septal cartilages used for correction of unilateral cleft lip nasal deformities by using photogrammetric analysis. METHODS: This study investigated a total of 49 patients with cleft lip nasal deformities who underwent corrective surgery, and were followed up for at least 6 months. Septal cartilages were used in 39 patients, and porous polyethylene sheets were used in 10 patients. In all patients, through the open rhinoplasty, complete septal extension grafts were sutured to the caudal margin of the septal cartilage, and the alar cartilage was sutured with suspension. The cleft side alar cartilage was overcorrected by approximately 3 - 5 mm. Postoperative outcomes were evaluated by using photogrammetric analysis. Five indices and 4 angles were measured on their photographs taken before and after the surgery. In patients with unilateral cleft lip nasal deformities, symmetry was also evaluated by means of columellar length index. RESULTS: The postoperative values obtained in photogrammetric analysis showed improvements in comparison with the preoperative ones. The polyethylene group produced more improved outcomes than the septal cartilage group but also resulted in more complications at the same time. CONCLUSION: The results of this study indicates that complete septal extension grafts are efficient for the correction of unilateral cleft lip nasal deformities. However, since postoperative complications occur more frequently in the polyethylene group than in the septal cartilage group, caution is advised in using porous high-density polyethylene sheets in patients with cleft lip nasal deformities.
Asian Continental Ancestry Group ; Cartilage ; Cleft Lip ; Congenital Abnormalities ; Humans ; Nasal Cartilages ; Polyethylene ; Postoperative Complications ; Rhinoplasty ; Succinates ; Transplants

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