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

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

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

PURPOSE: Direct anthropometry is an ideal method for preoperative planning and postoperative evaluation in plastic surgery, but it requires highly skilled specialty. Indirect anthropometry, especially photogrammetry, is an alternative method. In photogrammetry, standardized clinical photography is essential. Photogrammetry-based standardized clinical photography has several advantages over direct anthropometry. It is easier to measure and has less chance to make errors during measurement. Furthermore, it is possible to repeat measurements, and available for follow up study based on permanent custody. But, it is still different from actual measurement, and inherently less accurate than anthropometry. METHODS: The authors revised the standardized clinical photography and then, carried out photogrammetry using Photoshop(Adobe, U.S.A.), and compared each data with those of anthropometry. The subjects were 50 males and 50 females, undergraduate medical students in twenties. Standard head position was obtained from the wire, fixed to cephalostat which indicates the Frankfort horizontal plane. All photographs were taken at the same situation such as fixed position of light, subject and camera, etc. RESULTS: Total 96 measurements, based on 40 landmarks, consist of linear measurements, angular measurements and inclinations include 3 measurements in head, 22 in face, 15 in orbit, 28 in nose, 16 in lip and mouth, and 12 in ear. CONCLUSION: Normal photogrammetric data of face of Korean in twenties was obtained. Reliable photogrammetric measurements, not significantly different from anthropometric measurement statistically, accounted for 44 in 96 measurements(45.8%). Anthropometric values different from those of photogrammetric values were obtained by multiplying coefficient by photogrammetric value.
Anthropometry ; Ear ; Female ; Follow-Up Studies ; Head ; Humans ; Lip ; Male ; Mouth ; Nose ; Orbit ; Photogrammetry* ; Photography* ; Students, Medical ; Surgery, Plastic

PURPOSE: Direct anthropometry is an ideal method for preoperative planning and postoperative evaluation in plastic surgery, but it requires highly skilled specialty. Indirect anthropometry, especially photogrammetry, is an alternative method. In photogrammetry, standardized clinical photography is essential. Photogrammetry-based standardized clinical photography has several advantages over direct anthropometry. It is easier to measure and has less chance to make errors during measurement. Furthermore, it is possible to repeat measurements, and available for follow up study based on permanent custody. But, it is still different from actual measurement, and inherently less accurate than anthropometry. METHODS: The authors revised the standardized clinical photography and then, carried out photogrammetry using Photoshop(Adobe, U.S.A.), and compared each data with those of anthropometry. The subjects were 50 males and 50 females, undergraduate medical students in twenties. Standard head position was obtained from the wire, fixed to cephalostat which indicates the Frankfort horizontal plane. All photographs were taken at the same situation such as fixed position of light, subject and camera, etc. RESULTS: Total 96 measurements, based on 40 landmarks, consist of linear measurements, angular measurements and inclinations include 3 measurements in head, 22 in face, 15 in orbit, 28 in nose, 16 in lip and mouth, and 12 in ear. CONCLUSION: Normal photogrammetric data of face of Korean in twenties was obtained. Reliable photogrammetric measurements, not significantly different from anthropometric measurement statistically, accounted for 44 in 96 measurements(45.8%). Anthropometric values different from those of photogrammetric values were obtained by multiplying coefficient by photogrammetric value.
Anthropometry ; Ear ; Female ; Follow-Up Studies ; Head ; Humans ; Lip ; Male ; Mouth ; Nose ; Orbit ; Photogrammetry* ; Photography* ; Students, Medical ; Surgery, Plastic

PURPOSE: Anthropometry can be divided into two methods, direct anthropometry and indirect anthropometry. The most ideal and accurate method is a direct anthropometry. However, it is difficult to measure in the case of children because of poor cooperation, and it lacks re-productivity. Cast model has advantages of three dimensional featuring, inexpensive and easy fabrication. This study is conducted to find out an accuracy of indirect anthropometry on cast model by comparing it with direct anthropometry. METHODS: Total 48 cleft lip nasal deformity patients (unilateral, 40; bilateral, 8) were included in this study. Cast models were made before surgery under general anesthesia with alginate impression material and model plaster. Eleven linear measurements among 7 landmarks were taken as direct anthropometry before surgery with Castroviejo spreading caliper. At the same time, indirect anthropometry on cast model was done at the same linear distances as well. RESULTS: Of the total 11 linear measurements, both ala lengths, both columella lengths, nose width, projective distance between facial insertion points of the ala, projective distance between the alar base points, right nostril floor width, and columella width were statistically correlated between indirect anthropometry on cast model and direct anthropometry. However, the nasal tip protrusion and the left nostril floor width were not statistically correlated. CONCLUSION: Accuracy of indirect anthropometry on cast model can be influenced by cast model fabrication techniques and correct identification of landmarks. Nasal tip protrusion could be reduced by compression of the nasal tip in the process of cast model fabrication and nostril floor width can be varied by muscle relaxation of anesthetics and incorrect identification of subalare in cleft lip nasal deformity. If sufficient care is taken to make cast model and to define landmarks exactly, indirect anthropometry on cast model can be a reliable method as direct anthropometry.
Anesthesia, General ; Anesthetics ; Anthropometry* ; Child ; Cleft Lip* ; Congenital Abnormalities ; Humans ; Muscle Relaxation ; Nose*