Bicoronal approach is adopted as an universal method for reduction and internal fixation of the fractured zygomatic arch in the treatment of complex zygomatic fracture. However bicoronal approach leaves many disadvantages, such as long incision, alopecia, prolonged edema, and paresthesia. Nowadays endoscopically assisted minimal invasive technique has been widespread not only for the aesthetic surgery, but also for the reconstructive surgical fields because of the benefits. We have been recently trying to apply endoscopic surgery to facial bone fracture surgery. Endoscopically assisted minimal invasive technique has been applied to 14 patients who admitted to Chosun university hospital from March 1996 to July 1997. We used 4 mm, 30' endoscope and two 1.5-2 cm temple incisions and a subciliary incision for approaching to the zygomatic arch. Protected drill bit and driver had access to fractured zygomatic arch though tiny(5 mm) stab incision over the zygomatic arch. We have been able to successfully reduce and make fixation of the fracture of zygomatic arch by using endoscopically assisted minimal invasive technique. Follow up for 3 months revealed good maintenance of the reduction. We think that application of the endoscopic technology to midfacial bone fracture will result in significant reduction in morbidity and improve postoperative results.
Alopecia ; Edema ; Endoscopes ; Facial Bones ; Follow-Up Studies ; Fractures, Bone ; Humans ; Paresthesia ; Zygoma* ; Zygomatic Fractures

Anal incontinence following pelvic trauma, surgery, or neurologic disorders has significant medical and social implication. Both Chetwood in 1902 and Bistom in 1944 utilized coccygeal origin portion of the gluteus maximus muscle for the anal sphincter reconstruction. The gluteus maximus muscle is a broad, fan-shaped muscle with a wide origin from the ilium sacrum and coccyx and a narrow insertion along the iliotibial band of the lateral femur. Its blood supply is from the inferior gluteal artery and its innervation is from L-5, S-1 roots by means of the inferior gluteal nerve Incisions are placed at the inferior border of the ischial tuberosity. Subcutaneous tunnels are created about the rectum and gluteal and perirectal incisions. Two overacting slings are being created Their opposing pull creates sphincter or valve effect about the distal rectum. We have experienced 2 cases of irregular, deep soft tissue defects of the perianal region requiring muscle coverage with the gluteus maximus muscle overlapping slings. We think the use of the gluteus maximus muscle is one of the most useful method for reconstruction of the anal sphincter mechanism.
Anal Canal* ; Arteries ; Coccyx ; Femur ; Ilium ; Nervous System Diseases ; Rectum ; Sacrum

Influenza causes variable epidemics annually and imposes public health problems and socioeconomic burden. They cause epidemic acute respiratory disease, characterized by fever, cough and systemic symptoms. The annual epidemics of seasonal influenza can affect any age group and result in serious illness or death, particularly in high risk populations such as adults > 65 years old, children < 2 years old and those with chronic medical condition at any age. Three types (A, B, and C) are recognized as well as many subtypes within the type A. New influenza A virus subtypes sporadically emerge in humans to cause widespread disease or pandemics. Antiviral therapy with oseltamivir or zanamivir is available and shorten the duration of illness and reduce the rate of complications. Influenza vaccines are effective in the prevention of influenza illness, although improved vaccines are needed.
Adult ; Child ; Cough ; Fever ; Humans ; Influenza A virus ; Influenza Vaccines ; Influenza, Human* ; Oseltamivir ; Pandemics ; Public Health ; Seasons ; Vaccines ; Zanamivir

We report a case of neurilemmoma of deep peroneal nerve sensory branch that triggered sensory change with compression test on lower extremity. After resection of tumor, there are evoked thermal changes on pre- and post-operative infrared (IR) thermographic images. A 52-year-old female presented with low back pain, sciatica, and sensory change on the dorsal side of the right foot and big toe that has lasted for 9 months. She also presented with right tibial mass sized 1.2 cm by 1.4 cm. Ultrasonographic imaging revealed a peripheral nerve sheath tumor arising from the peroneal nerve. IR thermographic image showed hyperthermia when the neurilemoma induced sensory change with compression test on the fibular area, dorsum of foot, and big toe. After surgery, the symptoms and thermographic changes were relieved and disappeared. The clinical, surgical, radiographic, and thermographic perspectives regarding this case are discussed.
Female ; Fever ; Foot ; Humans ; Low Back Pain ; Lower Extremity ; Middle Aged ; Neurilemmoma* ; Peripheral Nerves ; Peroneal Nerve* ; Sciatica ; Toes

Variable methods have been using for reconstruction of soft tissue defect of feet and legs. Skin graft, local flap, and free flap have been using for this purpose. But, skin graft produced secondary contracture of recipient site and increased in donor site scarring. Local flap was limited its donor site and remained severe deformities of recipient site. Free flap was required prolonged operation time and secondary operation. Acelluar human dermal allograft, AlloDerm, was removed cellular elements of the epidermis and dermis. It was relatively immunologically inert. From August 1997 to April 1998, we have grafted acellular human dermal allograft with thin split-thickness skin graft on soft tissue defect of feet and legs in 7 cases. We concluded that cryopreserved acelluar human dermal allograft has been proposed as the solution to problems of skin graft, local flap, and free flap.
Allografts ; Cicatrix ; Congenital Abnormalities ; Contracture ; Dermis ; Epidermis ; Foot* ; Free Tissue Flaps ; Humans ; Leg* ; Skin ; Tissue Donors ; Transplants

Brucellosis is a zoonosis caused by several species of Brucella. Brucellosis is usually an acute or sub-acute febrile illness that histologically develops granulomatous inflammation. Brucella prostatitis is a very rare complication and is usually accompanied by epididymo-orchitis. We now report a case of histologically proven granulomatous prostatitis due to Brucella without clinical evidence of epididymo-orchitis. A 61-year-old farmer presented with myalgia, low back pain, and fever. A needle biopsy of the prostate was performed due to symptoms of urinary frequency and high prostate specific antigen levels (17.3 ng/mL). Histologically, the prostate showed granulomatous inflammation without caseous necrosis. Polymerase chain reaction (PCR) studies of blood and prostatic tissue for Brucella were positive, while a PCR study for Mycobacterium tuberculosis was negative. The patient was treated with doxycycline and rifampin. A possibility of Brucella prostatitis should be considered in the differential diagnosis of granulomatous prostatitis or prostatitis of unknown origin associated with or without epididymo-orchitis.
Biopsy, Needle ; Brucella ; Brucellosis ; Diagnosis, Differential ; Doxycycline ; Fever ; Granuloma ; Humans ; Inflammation ; Korea ; Low Back Pain ; Middle Aged ; Mycobacterium tuberculosis ; Necrosis ; Polymerase Chain Reaction ; Prostate ; Prostate-Specific Antigen ; Prostatitis ; Rifampin

Aging changes on the upper third of the face include brow ptosis, glabellar furrowing and forehead transverse wrinkle caused by an imbalance of the forehead muscles. Surgical methods to correct these phenomena include forehead lift with a coronal incision, endoscopic access, and direct forehead skin excision. In response to a common need for cosmetic improvement in the brow-upper eyelid and a desire for minimal incisions for forehead rejuvenation, an approach through blepharoplasty incision had been developed. This approach has many advantages, such as fewer skin incision, less tissue mobilization and direct excision of the hyperactive depressor muscles. However, this approach is not suitable for those who have significant forehead wrinkle and ptosis. We used a combined subperiosteal approach for forehead lift and transection of the hyperactive corrugator and procerus muscles through blepharoplasty incision. This combined surgical technique is simple and effective to correct aging of the upper third of the face without the usual complication. We performed 10 cases of the transpalpebral approach for the correction of the upper third of the face from January 1997 to September 1998, following them up for from 3 to 6 months and obtained satisfactory results. We report our experiences with a review of the literature.
Aging* ; Blepharoplasty ; Eyelids ; Forehead ; Muscles ; Rejuvenation ; Skin

PURPOSE: To evaluate the clinical efficacy and the histopathologic tolerance of 2-octylcyanoacrylate versus 8-0 polyglactin sutures for conjunctival wound closure in rabbits. METHODS: We performed an experimental study on 16 eyes of eight New Zealand albino rabbits. Conjunctival peritomy of 8 mm was done in the superior limbus followed by extensive subconjunctival dissection in both eyes. The eyes of the rabbits were divided into two groups. The conjunctiva was then attached to the limbus again by the proposed 2-octylcyanoacrylate adhesive (left eye, Group A) or 8-0 polyglactin suture (right eye, Group B). The clinical efficacy of the closure of the conjunctival wound, either with sutures or adhesives, and the clinical and histopathologic tolerances such as hyperemia, discharge, residual adhesive or suture, inflammatory change and fibrosis were observed at 1 day and at 1, 2, 4 and 6 weeks after surgery. Two rabbits were sacrificed at each of 1, 2, 4 and 6 weeks, and specimens of their conjunctiva were examined histologically. RESULTS: Both conjunctival surgical closure methods were found to be equally efficacious in fixing the conjunctiva to the limbus. There were no significant clinical or histopathologic tolerance differences between the two groups. The conjunctiva at 6 weeks of Group A showed nearly normalized morphology with disappeared inflammatory cells and fibroblasts, whereas those of Group B showed foreign body inflammatory reaction around the absorbing suture materials. CONCLUSIONS: 2-Octylcyanoacrylate adhesive was an efficient conjunctival closure method and was very well tolerated by the ocular surface. 2-Octylcyanoacrylate may be a possible tissue adhesive for conjunctival wound closure.
Adhesives ; Conjunctiva ; Fibroblasts ; Fibrosis ; Foreign Bodies ; Hyperemia ; New Zealand ; Polyglactin 910* ; Rabbits* ; Sutures* ; Tissue Adhesives ; Wounds and Injuries*

To evaluate the relapse pattern and long-term stabilities depanding on surgical methods following orthognathic surgery of Cl III patients, the author selected 24 subjects(10 male, 14 female) operated by SSRO and 26 subjects(10 male, 16 female) operated by IVRO. Each subject took four lateral cephalograms: just before surgery(Tl), within 48hrs after surgery(T2), 4-8 wks after surgery(T3), 6 month or more after surgery(T4), and the landmarks were digitized. The differences of relapse patterns in each interval between two groups were compared and the significance of correlation among the variables of each group was tested The obtained results are as follows; 1. Horizontal early relapse was forward movement of mandible in SSRO group, as compared to the backward movement in IVRO group, and there was a statistical significance between the two groups. 2. Vertical early and late relapses were decreases in anterior facial height in both groups and there was no statistical significance between the two groups. 3. There was a statistical significance in negative correlation between mandibular hornontal late relapse and surgical change of articular angle in SSRO group. 4, There was a statistical significance in negative correlation between amount of mandibular set-back and mandibular horizontal early relapse in both groups.
Humans ; Male ; Mandible ; Orthognathic Surgery* ; Recurrence*

In the East, Probably one of the most commonly performed esthetic operation is the piercing of the earlobes for earring. the complication of this procedure includes infection, the formation of the hypertrophic scar or keloid, and tearing. Keloid formation is one of the disaterous common complications of the ear piercing. the patients regard the keloid as a cosmetic blemish and they complain that they cannot wear earrings. We have experienced 5 patients of earlobe keloid complicated from piercing of the earlobes. We used intralestional steroid njection, in conjunction with surgical excision and pressure therapy for treatment of the keloid. Among various techniques for reconstructing a piercing, we chose modified Pardue's method for artificial earlobe cleft after wide excision of the keloid. the result was good and satisfactory without any complication after 4 to 24 months of follow-up. the purpose of this paper is to present a simple method of treatment of the earlobe keloid with preservation of the perforation for an earring.
Body Piercing ; Cicatrix, Hypertrophic ; Ear* ; Follow-Up Studies ; Humans ; Keloid*