Patients with a poor or total absence of levator function require correction of their ptosis by a sling procedure. The aim of the procedure is to utilize the action of the frontalis muscle to mechanically raise a droopy eyelid Frontalis suspension procedure using a temporalis fascia or Tutoplast Dura was performed on 36 ptotic eyelids of 23 patients(age range 2-37 years) with a poor or absent levator function. The author used a surgical technique based on a modified Fox`s method. Satisfactory results were achieved in 42 lids according to the criteria of Jordan after an average follow-up of 23 months. No serious complication was seen immediately postoperative and during the follow-up period. Temporalis fascia and Tutoplast Dura appear to be effective and safe alternative sling materials for frontalis suspension surgery.
Blepharoptosis* ; Eyelids ; Fascia ; Follow-Up Studies ; Humans ; Jordan

Although wound healing is a natural biologic process by which the homeostasis is preserved, the resultant hypertrophic scar or scar contracture may produce undesirable morphologic and functional sequelae. To overcome these problems, a number of attempts to produce skin substitute have been made in recent years, but none have proved to be entirely satisfactory. We compared the wound healing of full-thickness dorsal skin defects between ADM(acelluar dermal matrix)-applied wound and ADM non-applied wound group in 20 adult female Sprague-Dawley rats. The wound area was serially evaluated at 1,2,3 weeks and the difference in the mean area ratios between the two groups was then statistically analyzed using Wilcoxon rank sums test. We also performed histological evaluation of the wounds at 1,2,3 weeks. Results were as follows: 1. Experimentally produced ADM was easy to handle. Histologic findings showed no epithelium, no appendages, no cells dermal and subcutaneous layer and pure bundles of collagen. 2. The wound area ratio of ADM applied wound group was statistically larger than that of ADM non-applied(control) wound group. That is, ADM was able to inhibit the wound contraction compared with the ADM non-applied wound group. 3. In the ADM-applied group, we observed low grade exudates, no infection, fine take-up of ADM on full-thickness skin defect, gross and histologic findings of neovascularization, and progressive epithelization on ADM. These findings of biologic attachment implies the function of the ADM as a dermal substitute. These can be basis of the study on the development of artificial skin.
Acellular Dermis* ; Adult ; Animals ; Cicatrix ; Cicatrix, Hypertrophic ; Collagen ; Contracture ; Epithelium ; Exudates and Transudates ; Female ; Homeostasis ; Humans ; Rats* ; Rats, Sprague-Dawley ; Skin* ; Skin, Artificial ; Wound Healing ; Wounds and Injuries*

No abstract available.
Humans ; Orthognathic Surgery*

Core needle biopsy (CNB) was introduced as an alternative diagnostic tool to fine-needle aspiration (FNA), and is increasingly being used in the preoperative assessment of thyroid nodules. CNB provides a definitive diagnosis in most cases, but it sometimes may be inconclusive. CNB has the advantage of enabling a histologic examination in relation to the surrounding thyroid tissue, immunohistochemistry, and molecular testing that can provide a more accurate assessment than FNA in selected cases. Nevertheless, CNB should be performed only by experienced experts in thyroid interventions to prevent complications because CNB needles are larger in caliber than FNA needles. As recent evidence has accumulated, and with improvements in the technique and devices for thyroid CNB, the Korean Society of Thyroid Radiology released its 2016 thyroid CNB guidelines and the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group published a consensus statement on the pathology reporting system for thyroid CNB in 2015. This review presents the current consensus and recommendations regarding thyroid CNB, focusing on indications, complications, and pathologic classification and reporting.
Biopsy, Fine-Needle ; Biopsy, Large-Core Needle* ; Biopsy, Needle ; Classification ; Consensus ; Diagnosis ; Immunohistochemistry ; Needles ; Pathology ; Thyroid Gland* ; Thyroid Nodule*

We report a case of a 6-month-old female who had had verrucous hemangioma since birth. The lesions were dark red, verrucous surfaced, hyperkeratotic papules on the right sole. A histopathological examination showed hyperkeratosis, papillomatosis, irregular acanthosis, lobular proliferation and dilatation of blood vessels in the deep dermis with a gap devoid of vessel proliferation in the mid dermis.
Blood Vessels ; Dermis ; Dilatation ; Female ; Hemangioma* ; Humans ; Infant ; Papilloma ; Parturition

No abstract available.
Discriminant Analysis* ; Gait* ; Lower Extremity* ; Range of Motion, Articular*

PURPOSE: The majority of nasal bone fractures have been managed by routine procedure of closed reduction, intranasal packing or intranasal Kirschner wire (K-wire) splinting. But it leaves rooms for many complaints from patients such as pain, rhinorrhea and nasal obstructioon. Another option is, of course, no packing at all. The study was initiated to assess the necessity to pack or splint the nasal bone after routine closed reduction. METHODS: We analysed the medical records of 35 patients with nasal bone fracture who were operated by closed reduction in the last 2 years. We evaluated the postoperative CT scan scores and external deviation criterias 1 month after the operation. RESULTS: The postoperative deviation criteria and postoperative CT scan score were favorable and there were no serious complications using this technique. CONCLUSION: The present study demonstrates that the use of packing or splinting need not be routine in the majority of cases. The risks and discomforts associated with these procedures can often be avoided.
Humans ; Medical Records ; Nasal Bone ; Splints

PURPOSE: The crushing injury is one of the most severe type injuries in the finger. For the reconstruction of fingers with crushed and devitalized tissue, various surgical methods have been attempted to cover the soft tissue defects. We performed free flaps for finger reconstruction and investigated the results. MATERIALS AND METHODS: Between March 2010 and July 2011, we retrospectively reviewed 14 patients who had soft tissue defects of fingers after severe crushing injuries. There were 8 pulp losses, 4 dorsal skin losses with bony exposure, 1 nail complex loss, and 1 total loss of distal phalanx. In all cases, soft tissue defects in fingers were reconstructed with a free flap. RESULTS: All flaps survived successfully. We could reserve the functional length without additional necrosis and amputation. Reconstructed fingers were returned to normal activity in a short time and the atrophy or deformity was not observed. CONCLUSION: Free flap transfer for the reconstruction of the finger defect after crushing injury is useful for the functional recovery and cosmesis.
Amputation ; Atrophy ; Congenital Abnormalities ; Fingers ; Free Tissue Flaps ; Humans ; Nails ; Necrosis ; Retrospective Studies ; Skin

Reduction malarplasty is one of the common aesthetic procedures performed in the Asia. Several surgical techniques for malar reduction have been reported. In reduction malarplasty, 'reposition of mobile malar complex to more cosmetically beneficial point' is more important than making flat malar complex. 'Fixation of bone on body and arch' is important for considering the action of attached masticating muscle to zygomatic bone. We have performed reduction malarplasty which consists of lateral orbital osteotomy and oblique osteotomy on zygomatic arch, reposition of mobile malar complex to more cosmetically beneficial point, and fixation of bone on body and arch with wires through bicoronal incisions over 700 patients from January, 1984 and through preauricular and intraoral incisions in 30 patients from December, 1997 to December, 2001. Preauricular and intraoral approaches can be indicated in most cases of mild to moderate prominence and malposition of malar complex, and bicoronal approach can be indicated in cases of severe prominence and malposition of malar complex and need of combined procedures such as face lift, frontal and orbital contouring. We have obtained satisfactory results with using reposition and fixation in reduction malarplasty.
Asia ; Humans ; Orbit ; Osteotomy ; Rhytidoplasty ; Zygoma

PURPOSE: Nipple reconstruction is an important step in breast reconstruction after mastectomy. There are considerable number of reconstructive methods developed over the past years. Each of these has not only its own special advantages, but also limitations. Therefore, no single method has become the overwhelming favorite. Sometimes it seems to be compromised when the nipple must be located directly over a linear scar. METHODS: A 48-year-old female patient received a central lumpectomy with circumareolar resection of the nipple areolar complex 4 months ago. The newly designed nipple must be positioned directly astride a scar. We drew two equal-sized rectangular flaps sharing a common limb on a transverse scar and the result was two opposing plow form. Each flap size was about 1.3 cm wide and 2.5 cm long. First we elevated the flap from the distal part at a deep dermal plane, then deepened the level of dissection to raise the dermal-fat flaps. The donor site could be closed directly without any dog-ear deformity. Then we folded down the elevated flaps and loosely sutured skin with nonabsorbable materials. Each flap inner side was approximated side by side. Finally we made new natural nipple with 6mm projection. We applied tattooing in the areola area with micropigmentation device after three months. RESULTS: After ten months of follow-up periods, the nipple projection was stable and symmetric. The nipple projection was 3.1mm, compared with 2.8mm for the opposite nipple. CONCLUSION: Our experiences shows that this double opposing plow flap is a particularly useful and simple technique when there is a traverse scar crossing the center of the proposed nipple area.
Cicatrix ; Congenital Abnormalities ; Extremities ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Mastectomy ; Mastectomy, Segmental ; Middle Aged ; Nipples* ; Skin ; Tattooing ; Tissue Donors