The palatal fracture results in deformity of the midface, as well as change in occlusion. However, no report was found on the incidence, treatment and results of palatal fracture in Korea. A retrospective review was done over 6 years and 11 patients(6.5%) with palatal fracture were determind out of 168 patients who had midfacial bone fractures without nasal bone fracture. According to the Hendrickson's classification, the number of patients with specific types of palatal fracture was described as follows; sagittal (2 cases), parasagittal (2 cases), para-alveolar (3 cases), transverse(3 cases) and complex(1 case). Le Fort I (6 cases), Le Fort II (7 cases) and mandible (6 cases) fractures were also associated. Open reduction and internal fixation was applied to all patients. Internal fixation consisted of pyriform or alveolar ridge stabilization and maxillary buttress stabilization. The rigid palatal vault stabilization was applied in one patient with midline split of the palate. The duration of intermaxillary fixation was shortened to less than 3 weeks from 4 to 6 weeks with rigid fixation. The palatal splint was used temporarily before internal fixation. All the patients showed good bony union and satisfactoryocclusion postoperatively. Open reduction and internal fixation showed satisfactory results from the aspects of stability, occlusion, patient convenience and final aesthetics. The following treatment model for palatal fracture according to the fracture type is proposed; 1) Alveolar type - close reduction or open reduction and selective alveolar ridge fixation and selective application of palatal splint, 2) Sagittal type - open reduction and internal fixation of the alveolar ridge, maxillary buttress and palatal vault. 3) Parasagittal type - open reduction and internal fixation of the pyriform aperture and maxillary buttress, as well as selective fixation of the palatal vault. 4) Para-alveolar type - open reduction and internal fixation of the alveolar ridge and maxillary buttress. 5) Complex type - open reduction and internal fixation of the alveolar ridge, maxillary buttress, pyriform aperture and continuous use of a palatal splint to bony union. 6) Transverse type - open reduction and internal fixation of the alveolar ridge and maxillary buttress.
Alveolar Process ; Classification ; Congenital Abnormalities ; Esthetics ; Fractures, Bone ; Humans ; Incidence ; Korea ; Mandible ; Nasal Bone ; Palate ; Retrospective Studies ; Splints

Fibrous dysplasia in the orbit and cranial base may involve the optic canal. Although fibrous dysplasia is benign, it may produce a mass effect along the course of the optic nerve which can then induce visual disturbance as well as contour deformities of the skull and facial bone. The treatment of fibrous dysplasia in the orbit and cranial base is to resect the lesion as much as possible and then reconstruct immediately. As well, if there is any evidence of optic canal involvement and disease progression, the treatment of fibrous dysplasia may include optic nerve decompression. It is generally understood that some patients experience improvement of visual function after optic nerve decompression. We performed radical excision and reconstruction by means of autogenous calvarial bone graft and methylmethacrylate in 7 cases. The autogenous calvarial bone was used to reconstruct the orbit. The methylmethacrylate was used to reconstruct bony defect in the temporal area. The orbit was reconstruced into one block which was made of autogenous calvarial bone with a microplate and screw. This method is superior compared to the previous multifragment wiring method with regard to stability, operation time, and appearance. The patients in our series showed satisfactory appearance. In 6 cases, we performed optic nerve decompression. Therapeutic optic nerve decompression was done in 3 cases and prophylatic optic nerve decompression was done in the others. Following therapeutic optic nerve decompression, visual acuity was improved in 2 cases while the others showed a decrease in visual acuity. There was no change of visual acuity and visual field in 1 case after prophylactic optic nerve decompression. However, the others showed decrements in visual acuity or visual field. Therefore, we believe that more attention should be paid during optic nerve decompression procedure and strict indications to that procedure should be applied.
Congenital Abnormalities ; Decompression* ; Disease Progression ; Facial Bones ; Humans ; Methylmethacrylate ; Optic Nerve ; Orbit* ; Skull ; Skull Base* ; Transplants ; Visual Acuity ; Visual Fields

PURPOSE: The purpose of this study was to evaluate the long term outcome and the factors contributing to treatment outcome for chronic functional constipation in children. METHODS: Sixty three children were enrolled who had chronic functional constipation and could be followed by telephone contact. They were treated at the Bucheon Soonchunhyang Hospital for more than 1 month and observed from March 2001 to June 2005. We analyzed the clinical features, symptoms and signs, as well as the course and results of treatment. RESULTS: The male to female ratio was 35 (55.6%) : 28 (44.4%). The mean age at the onset of symptoms and diagnosis was 21.1+/-23.5 (1.9~84.0) months and 47.1+/-34.2 (6.9~138.0) months, respectively. The mean defecation frequency before treatment was 3.2+/-2.3 (0.5~10.0) times per week. The symptoms associated with constipation were as follows: soiling 34 (54.0%) which was more common in males than females, large stools in 30 (47.6%), decreased bowel movements less than three times a week in 20 (31.7%), straining during defecation in 19 (30.2%) and retentive posturing 19 (30.2%). The mean duration of follow-up was 34.2+/-14.6 (3.6~60.0) months and 44 (69.8%) patients had their symptoms resolve ("success") and 19 (30.2%) were not resloved ("fail") from the constipation. The time for recovery from soiling, straining during defecation and retentive posturing after treatment was 4.3+/-2.4 (1.0~36.0), 5.0+/-1.4 (0.8~36.0) and 5.0+/-3.1 (1.0~36.0) months, respectively. A relapse of the constipation occurred in 15 (23.8%) patients, 9 (60%) boys and 6 (40%) girls. The time to relapse after cessation of treatment was 2.9+/-1.9 (1.0~6.0) months and the only risk factor associated with relapse was the initial duration of treatment. CONCLUSION: Most of the patients had resolution of symptoms within five months after treatment; relapse occurred within three months after the interruption of treatment. The duration of treatment was important for recovery and for the prevention of relapse in the constipated children. Thus a long term maintenance of therapy and follow-up is necessary for chronic functional constipation in children.
Child* ; Constipation* ; Defecation ; Diagnosis ; Female ; Follow-Up Studies* ; Gyeonggi-do ; Humans ; Male ; Recurrence ; Risk Factors ; Soil ; Telephone ; Treatment Outcome ; Withholding Treatment

During a period of 5 years and 3 months, from January, 1980 to march, 1985, 42 cases of ventricular septal defects were observed to be closed spontaneously during their follow up period and were evaluated at pediatric department, hanyang University hospital. 1) Sex incidence shows female preponderance with male to female ration of 1:2. 2) The mean age when they were diagnosed as ventricular septal defect was 5.0+/-6.4 months, and that of VSD murmur last noted was 13.3+/-11.5 months. The mean age when typical VSD murmur disappeared due to spontaneous closure of the defects was 21.1+/-18.7 months. Spontaneous closure of ventricular septal defects disclosed under one year in 22 cases (52.4%). Of those 22 cases, ventricular septal defects were spontaneously closed under 6 months of age in 16 cases(38.8% of whole study population). From the whole study population 90.5%(38 cases) were spontaneously closed under the age of 5 years. 3) Major clinical and physical characteristics before spontaneous closure of ventricular septal defects were typical pansystolic murmur with maximum intensity at left lower sternal border in all cases, palpable thrill in 5 cases(12.8%), ventricular heaves in 4 cases(10.2%) and frequent respiratory infection histories in 27 cases(64.3%). 4) Electrocardiographic findings when they were initially presented as ventricular septal defects revealed normal axis in 28 cases(84.8%), left axis deviation in 3 cases(9.1%), right axis deviation in 2 cases(6.1%) as frontal QRS axis and left ventricular hypertrophy in 8 cases(24.2%), right ventricular hypertrophy in 5 cases(15.6%) and biventricular hypertrophy in 3 cases(8.7%). Other electrocardiographic abnormalities when they had ventricular septal defects were left atrial enlargement in 12 cases(36.4%) and intraventricular conduction delay in 12 cases(36.4%). After spontaneous closure of ventricular septal defects, the electrocardiographic findings revealed normal axis in 36 cases(92.3%), left axis deviation in 3 cases(7.7%) and left ventricular hypertrophy in one case(2.6%). The remaining abnormalities after spontaneous closure of ventricular septal defect were intraventricular conduction delay in 14 cases(35.9%), deep SV6 in 4 cases(10.3%), tall RV6 in 5 cases(12.8%) and long QTc in 1 case(2.6%). Thirty-eight cases(97.4%) do not show ventricular hypertrophy pattern in EKG after spontaneous closure of their defects. 5) When we analyse their frontal plain chest X-ray films after spontaneous closure of ventricular septal defects, cardiomegaly(cardiothoracic ratio)55%) noted in 7 cases(17.9%) and pulmonary plethora in 5 cases(12.8%);while those before the defect were closed spontaneously were 67.6% and 64.7%, respectively. 6) Among 26 cases who underwent follow up 2 dimensional echocardiographic study so-called septal aneurysm were noted with the process of spontaneous closure of ventricular septal defects in 15 cases(57.7%) and the remaining 11 cases do not have any evidence of 'septal aneurysm' even after the completion of spontaneous closure of their defects. In the patient group with so-called 'septal aneurysm' the proportion of female sex was 60% and early systolic clicky sound were heard in 9 patients from 15 cases(60.0%), while those without 'septal aneurysm'were 55% and 18.2%, respectively.
Aneurysm ; Axis, Cervical Vertebra ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Thorax ; X-Ray Film

The 635-nm low-level laser therapy was reported to "liquefy" or release stored fat in adipocytes by causing a transitory pore in the cell membrane to open, which permitted the fat content to go from inside to outside the cell. But some data do not support the belief that low-level laser therapy treatment before lipoplasty procedures disrupts tissue adipocyte structure. The purpose of this study was to determine the effectiveness of low-level laser- assisted liposuction. The use of low-level laser-assisted lipoplasty was evaluated in a series of 90 cases. There were 2 treatment groups in the clinical study. Subjects in the test group(39 patients; 31 thighs and 17 abdomen) received only liposuction on one side and laser-assisted liposuction on the other side during early 1liter aspiration time. 51 patients in the operated group received laser-assisted liposuction on both side. After adequate infiltration was obtained in all targeted body areas, a 635-nm electric diode laser was applied to the targeted areas for 12 to 15 minutes to liquefy the fat which was extracted immediately after laser treatment. On the side which received laser-assisted liposuction of the 39 test-group patients, we could gain much fat component(71+/-7.2 vs 63+/-8.6%) and it took short time(26+/-5.7 vs 31+/-7.7 minutes). Postoperative recovery was rapid, and complications were minimal. Low-level laser-assisted lipoplasty can be a valuable adjunctive tool for the performance of lipoplasty.
Adipocytes ; Cell Membrane ; Humans ; Low-Level Light Therapy ; Lasers, Semiconductor ; Lipectomy* ; Thigh

The alar cartilage malposition is defined as any displacement of lateral crura from the usual parallel alignment with nostril rims. It has several characteristics including parentheses deformity, notches in alar rims, flat nasal tip, square basal perimeter. It tends to be misdiagnosed as cartilaginous hump or bulbous tip because of its longitudinally prominent lobule. But, exact diagnosis can be easily attained with careful examination and recognition in the clinical diagnosis of bulbous or ambiguous tips. It is confirmed by the resistless collapse of lateral alar rim when light compression is applied by cotton stick. Its incorrect diagnosis can bring about inappropriate tip graft, soft tissue resection, rasping, humpectomy and secondary nasal deformity may develope as a result. Authors performed open approach followed by meticulous dissection of displaced alar cartilages. Each medial portion, corresponding to the cephalic portion of normal lateral crus, was resected. Then, each lateral crus was symmetrically rotated in the infero-lateral direction along the axis of the medial crura. If needed, autocartilage on-lay graft and dorsal augmentation were done for optimal aesthetic result. We believe accurate evaluation of the anatomical variation should be checked out preoperatively and recommend out method for the effective correction of unusual bulbous or broad tips.
Axis, Cervical Vertebra ; Cartilage* ; Congenital Abnormalities ; Diagnosis ; Transplants

BACKGROUND: Increased left ventricular mass in patients with essential hypertension, coronary artery disease, chronic renal failure or in general population has been suggested as a useful predictor of increased cardiovascular morbidity and mortality. Many studies have reported that left ventricular mass is correlated postively with body size. Thereafter normalization of left ventricular studies, but it is uncertain which is appropriate. This study was designed to determine the appropriate method for normalization of left ventricular mass to exclude influence of body size in normal adults. METHODS: We measured left ventricular mass 100 normal adults by M-mode echocardiogram using ASE cube method without(Devereux and Reichek's method) and with correction(Devereux and Alonso's method). Left ventricular mass were normalized for body weight, height, body surface area, body surface area1.5, height2.0 and height2.7 RESULTS: 1) Left ventricular mass by Devereux and Reichek's method correlated well with that by Devereux and Alonso's method(r=1.0,p<0.001). 2) Corrected left ventricular mass correlated well with weight(r=0.64, p<0.001), height(r=0.49, p<0.05), body surface area(r=0.53, p<0.01) and body mass index(r=0.58, p<0.001). 3) Correlation coefficients of left ventricular mass/weight with weight, of ventricular mass/height with height, of ventricular mass/height2.0 with height, of ventricular mass/height2.7 with height, of ventricular mass/body surface area with body surface area and of ventricular mass/body surface area1.5 with body surface area were 0.12, -0.05, -0.29, -0.42, 0.13 and -0.11 respectively. 4) Peak systolic wall stress correlated with age and left ventricular mass, but end systolic wall stress did not correlated with left ventricular mass. CONCLUSIONS: The current indexation method of left ventricular mass for height may reduce the variability associated with body size. Furthermore, it could be used reliably in normal Korean adults.
Adult* ; Body Height ; Body Size* ; Body Surface Area ; Body Weight ; Coronary Artery Disease ; Echocardiography ; Humans ; Hypertension ; Kidney Failure, Chronic ; Mortality

Gastroparesis is rare in children and is defined as delayed emptying of gastric contents into the duodenum without mechanical obstruction. We experienced a case of gastroparesis in a 7-year-old boy after a viral illness. He was admitted because of excessive abdominal bloating and diffuse abdominal pain, and was diagnosed by clinical manifestations and measurement of the gastric emtpyting time. He recovered after dietary management and with commbined medication of erythromycin and domperidone in 50 days of illness.
Abdominal Pain ; Child* ; Domperidone ; Duodenum ; Erythromycin ; Gastroparesis* ; Humans ; Male*

Duodenal web is an uncommon lesion that infrequently cause partial or complete intestinal obstruction. If the duonenal web is incomplete and only partially obstructs the duodenal lumen, the onset of symptoms may be delayed for years, and obstructive symptoms will be only minimal and intermittent. Congenital duodenal obstruction is occasionally associated with intestinal malrotation. We experienced a case of duodenal web associated with intestinal malrotation in a 9-year-old girl who had been suffered from intermittent projectile vomiting since birth without failure to thrive. The diagnosis was made by UGI series & abdominal CT. Patient remained asymptomatic after operation.
Child ; Diagnosis ; Duodenal Obstruction ; Failure to Thrive ; Female ; Humans ; Intestinal Obstruction ; Parturition ; Tomography, X-Ray Computed ; Vomiting

No abstract available.