There have been so many methods described for the correction of the deviated noses but it is difficult to get satisfactory results and recurrence rate is high. There is no exact explanation why the recurrences are so high and no estabished guides for techniques according to the surgical pathology. We found the classical swinging door technique effective in cases where the caudal septum deviated from the midline. However, where the caudal septum and the tip stay in the midline, scoring or submucosal resection do not work well enough to cortet them. We used the reverse swinging door technique of our own. After elevation of mucoperichonodrium, we did sagittal section in the posterior septum and moved the septum to the midline on the pivot point of the caudal septum and. The gap created in the posterior portion of the septum were filed with bone grafts, cartilage grafts or Medopor, which were sutured to the septum, We did this technique with or without osteotmies in 56 deviated noses for last 5 years. The results were very satisfactory and there was no complication.
Cartilage ; Nose* ; Pathology, Surgical ; Recurrence ; Transplants

Scars on anterior chest after operative correction of funnel chest have been the challenging problem despite introduction of refined techiniques by numerous authors. From December 1996 to September 1998, the authors have performed prefabricated silicone implant insertion in eight female patients presenting funnel chest, using transaxillary approaches instead of substernal or inframammary incisions. In two of eight patients, augmentation mammaplasty was performed simultaneously. Except one case of seroma occurred in early stages, all eight cases of pectus excavatum were satisfactorily reconstructed by this technique. All eight patients expressed their satisfaction with the results during the follow-up visits made between 3 months and 3 years. In conclusion, endoscopic transaxillary approach for the scarless anterior chest can be useful technique in aesthetic correction of the funnel chest.
Cicatrix ; Female ; Follow-Up Studies ; Funnel Chest* ; Humans ; Mammaplasty ; Seroma ; Silicones* ; Thorax

OBJECTIVES: The aim of this study was to estimate the burden of disease through an analysis of Years of Life Lost due to premature deaths, one component of the Disability-Adjusted Life Years (DALY). In addition, the cause of death statistics were adjusted to improve validity, and the results were compared with those of the Global Burden of Disease (GBD). METHODS: In closely following the approach taken in the original GBD study, most of the explicit assumptions and the value judgments were not changed. However, the statistics for some problematic concerns such as deaths of infants or those due to senility, were adjusted. Deaths, standard expected years of life lost (SEYLL), and potential years of life lost (PYLL) were computed using vital registration data compiled by the National Statistical Office. RESULTS: The burden for males is 1.8 and 2.3 times higher than that for females, according to SEYLL and PYLL, respectively. The proportions of deaths due to Group I, II, and III causes are 5.4%, 80.4%, and 14.3%, respectively, for PYLL, but in a major shift from Group II to III they are 6.3%, 66.2%, and 27.5%, respectively, for SEYLL. The proportion of Group III causes in Korea, 27.5%, is extremely high when compared to 10.1% for the world, 7.6% for developed countries, and 10.7% for developing countries. CONCLUSIONS: Estimation results showed that the total burden due to premature deaths is smaller than that for the entire world but larger than that for developed countries. The disease structure of Korea has changed to resemble that of developed countries. Also, an overly large portion of the total burden in Korea stems from injuries arising from car accidents.
Cause of Death ; Cost of Illness ; Developed Countries ; Developing Countries ; Female ; Health Transition ; Humans ; Infant ; Judgment ; Korea* ; Life Expectancy ; Male ; Mortality, Premature*

The use of a tissue expander and implant is the simplest option for breast reconstruction after mastectomy. Use of a round dome-shaped prosthesis and the commonly used one-stage technique with a Becker type prosthesis, however, often produces an undesirable upper pole fullness. To overcome this and to achieve improved aesthetic results, we started using an anatomically-shaped expander and implant, as described by Maxwell, as a two-stage breast reconstruction. We reviewed the results of our 21 reconstructed breasts in 22 patients who were deemed suitable for reconstruction using this technique since January 1995. The most commonly used expander was 350cc (range 350-550cc) and an average of 4.2 inflations were required before replacing the expander with a permanent implant. All the expanders were placed in submuscular pockets and implant volume. The longest follow-up was 36 months. Few complications developed and most patients were satisfied with the results. We found that the anatomically-shaped expander and implant produced better aesthetic results compared to a done-shaped prosthesis.
Breast* ; Female ; Follow-Up Studies ; Humans ; Mammaplasty* ; Mastectomy ; Prostheses and Implants ; Tissue Expansion Devices

No abstract available.
Pulmonary Embolism*

Intussusception in Schoenlein-Henoch Vasculitis is of interest because of its rarity & the importance of making what may be a difficult diagnosis. We recently experienced one case of Intussusception in Schoenlein-Henoch Vasculitis, who was a 3 year-old girl treated with mannual reduction following surgical operation & we reviewed some literature.
Child, Preschool ; Diagnosis ; Female ; Humans ; Intussusception ; Vasculitis*

Plasmodium vivax malaria re-emerged in South Korea in 1993, and epidemics continue since then. We examined genetic variation in the region encompassing the apical membrane antigen-1 (PvAMA-1) of the parasites by DNA sequencing of the 22 re-emerging P. vivax isolates. The genotype of the PvAMA-1, which was based on sequence data previously reported for the polymorphic regions, showed that two haplotypes were present at one polymorphic site. Compared with reported data, the two types, SKOR type I and type II, were similar to Chinese CH-10A and CH-05A isolates, respectively. Thus, the present study showed that two genotypes of AMA-1 genes coexist in the re-emerging Korean P. vivax.
Adult ; Aged ; Amino Acid Sequence ; Animals ; *Antigens, Protozoan ; Base Sequence ; Child ; Female ; Genotype ; Human ; Korea ; Malaria, Vivax/*genetics ; Male ; Membrane Proteins/chemistry/*genetics ; Middle Aged ; Molecular Sequence Data ; Polymorphism (Genetics) ; Protozoan Proteins/chemistry/*genetics ; Support, Non-U.S. Gov't

No abstract available.
Rhytidoplasty*

We introduce a new silicone implanting method to correct facial depression caused by trauma or congenital anomaly. It resulted in good facial aesthetics in patients with facial depression. From August 1997 to January 1999, 5 patient (3 males and 2 females), in ages from 19 to 34 years, underwent silicone implantation for facial depression using our method. Three males were injured by traffic accident and had facial depression with or without bone defect. Two females had congenital forhead depression and requested aesthetic contouring. An impression of the face was taken with alginate backed with quick setting plaster. When set, a further stone plaster model was taken from the alginate-plaster, which was removed after fixation. Wax was then carved into the patient's stone model to fill the depression. Another stone cover was taken to cover this was-stone model. Then wax was melted away and medical implant grade room temperature vulcanized silicone adhesive was squeezed into the empty space. After cured, this precisely-shaped silicone imlant was inserted into the patient. We did not experience major complicaion such as infection, implant extrusion during 4 to 18 months' follow-up periods. All patients were satisfied with the results. The clinical result of this technique would be useful for accurate and excellent aesthetic implantation.
Accidents, Traffic ; Adhesives ; Depression* ; Esthetics ; Female ; Follow-Up Studies ; Humans ; Male ; Silicones*

Neonatal hyperbilirubinemia is a significant risk factor for the developemtn of otoneurologic disorder. Hyperbilirubinemia resulting in kernicterus produces widespread neuronal damage with the most common sites of staining and destruction involving the hippocampus, basal ganglia and the brainstem nuclei in the floor of the fourth ventricle, including the dorsal cochlear nucleus. ABR may be a useful tool for the monitoring early bilirubin toxicity and postcteric sequelae in infants. This study attempts to evaluate the clinical neurodevelopmental outcome in hyperbilirubnemic infants requiring exchange transfusion through the assessment of ABR. Eight hyperbilirubinemic neonates with severely abnormal ABR findings and twelve hyperbilirubinemic neonates with normal ABR findings were studied to assess their neurodevelopemental outcome. The results were as follows; 1) There were 8 severely abnormal ABR cases, including 5 cases of bilateral flat wave and 3 cases of unilateraly elevated hearing throeshold. 2) The major cause of hyperbilirubinemia was ABO incompatibility(65%) 3) Significant clinical finding associated with severely abnormal ABR was kernicterus(p<0.05) 4) Significant laboratory findings associated with severely abnormal ABR were lower levels of hemoglobin and hematocrit(p<0.05) 5) 2 cases of bilateraly flat ABR and 3 cases of unilaterally elevated hearing threshold could be classified into sensorineural type hearing defect by latency-intensity function curve. 6) At the follow up tests of 3 cases of bilaterally flat ABR, 2 cases showed no change and 1 case showed mild improvement. 7) Among 5 follow up cases of severely abnormal BR, only 1 case showed normal neurodevelopmental outcome, 3 cases showed major neurodevelopmental defect and 1 case showed minor neurodeveoplemental defect. Among them, 1 case has had definite hearing disability.
Basal Ganglia ; Bilirubin ; Brain Stem ; Cochlear Nucleus ; Evoked Potentials, Auditory, Brain Stem* ; Follow-Up Studies ; Fourth Ventricle ; Hearing ; Hippocampus ; Humans ; Hyperbilirubinemia* ; Hyperbilirubinemia, Neonatal ; Infant ; Infant, Newborn* ; Kernicterus ; Neurons ; Risk Factors