The nasal tips of Orientals are different from those of caucasians with are characterized by flat nose and bulbous nasal tip appearance because of its thick and tense skin, shory columella, flaring of nostrils, and restriction of nasal tip projection due to underdevelopement of medial crus of alar cartilage. For better nasal tip definition and projection, alar carilage must be realigned and tip might be augmented with autogenous cartilage onlay graft. Furthermore in patient with short columella, strut formation might be performed because the nostril comprises two-thirds of height of nasal tip. If the nasal tip is prjected without lengthening of columella, sometimes we noted unnaturally tented appearance of nasal tip may result. Also for the soft tissue lengthening in columella in proportion to the nasal tip projection, the short columella can be lengthened with columella based V-Y advancement. Surgical approach through alar rim incision or open rhinoplasty incision may be employed depending upon the severity of tip defomity. If flattening is severe to enough require lengthening of the columella, open rhinoplasty incision is the best choice. Through the incision, the alar cartilage is dissected freely from the skin and vestibulsr mucosa. Cartilage grafts are performed using carilage onlay graft or columella strut formation after transdormal fixation suture. This study presents clinical cases of various nasal tips in the view of nasal tip deformity which were corrected with various operative methods using combined technique of approximating the alar cartilage and a multilayered autogenous onlay cartilage graft on the nasal tip harvested from the auricular cartilage, also Silicone implant was used for augmetation of nasal dorsum and columella strut formation with columella base V-Y advancement. The ten years of our experience with nasal tip plasty in over one hundred patient showed excellent result and no complications were observed during post operative follow-up so we are reporting these cases with review of literature.
Cartilage ; Congenital Abnormalities ; Ear Cartilage ; Follow-Up Studies ; Humans ; Inlays ; Mucous Membrane ; Nose ; Rhinoplasty ; Silicones ; Skin ; Sutures ; Transcutaneous Electric Nerve Stimulation ; Transplants

Angiogenesis is an essential process in tumor growth and metastasis. VEGF has been considered a leading candidate inducing tumor angiogenesis. VEGF expression was significantly correlated with clinical stage, lymph node matastasis, and prognosis of cancers of various parts of body. However, little has been known about the correlation between VEGF expression and clinicopathologic parameters in oral squamous cell carcinoma. The aim of this study was to correlate VEGF expression with the clinicopathological parameters and microvessel density. Forty six oral squamous cell carcinomas were analyzed using immunohistochemical method with primary antibodies to VEGF and CD31. VEGF expression was detected in 33 (71.7%) of the 46 cases. The microvessel density was significantly correlated with VEGF expression (P=0.002). There was no correlation between microvessel density and tumour size, clinical stage, and lymph node metastasis, respectively. VEGF expression did not correlate with the histological grade of tumour differentiation, tumour size, and clinical stages. The VEGF-positive rate seemed to be higher in patients with cervical lymph nodal metastasis than in those without it, but it was not statistically significant. In conclusion, the overexpression of VEGF in the oral squamous cell carcinoma seemed to be associated with a more aggressive course of the disease. Further study is necessary to define the role of VEGF in oral squamous cell carcinoma.
Antibodies ; Carcinoma, Squamous Cell* ; Humans ; Lymph Nodes ; Microvessels* ; Neoplasm Metastasis ; Prognosis ; Vascular Endothelial Growth Factor A*

Purpose: To assess the combined therapeutic effects of topical rebamipide 2% and hyaluronic acid 0.15% in managing dry eye symptoms following cataract surgery. Methods: Patients who underwent cataract surgery (phacoemulsification with intraocular lens insertion) were assessed for dry eye one week following the procedure. Dry eye patients were randomly assigned to two groups: a treatment group receiving rebamipide 2% and hyaluronic acid 0.15% eye drops, and a control group who did not receive these treatments. Various dry eye tests, including Schirmer’s test, tear break up time (TBUT), ocular surface staining, tear film osmolarity, tear lipid layer thickness, and the ocular surface disease index, were conducted at one and two months after surgery. Results: Significant improvements in TBUT (1 month: p < 0.001; 2 months: p < 0.001) and ocular surface staining scores (1 month: p = 0.001; 2 months: p < 0.001) were observed in the treatment group at both one and two months after surgery compared to baseline. During the follow-up period, the treatment group consistently showed significantly longer TBUT (p < 0.001 at both intervals) and lower ocular surface staining scores (1 month: p = 0.007; 2 months: p < 0.001) when compared to the control group. Conclusions The combined application of rebamipide and hyaluronic acid eye drops following cataract surgery effectively improved TBUT and ocular surface staining scores.

Purpose: To assess the combined therapeutic effects of topical rebamipide 2% and hyaluronic acid 0.15% in managing dry eye symptoms following cataract surgery. Methods: Patients who underwent cataract surgery (phacoemulsification with intraocular lens insertion) were assessed for dry eye one week following the procedure. Dry eye patients were randomly assigned to two groups: a treatment group receiving rebamipide 2% and hyaluronic acid 0.15% eye drops, and a control group who did not receive these treatments. Various dry eye tests, including Schirmer’s test, tear break up time (TBUT), ocular surface staining, tear film osmolarity, tear lipid layer thickness, and the ocular surface disease index, were conducted at one and two months after surgery. Results: Significant improvements in TBUT (1 month: p < 0.001; 2 months: p < 0.001) and ocular surface staining scores (1 month: p = 0.001; 2 months: p < 0.001) were observed in the treatment group at both one and two months after surgery compared to baseline. During the follow-up period, the treatment group consistently showed significantly longer TBUT (p < 0.001 at both intervals) and lower ocular surface staining scores (1 month: p = 0.007; 2 months: p < 0.001) when compared to the control group. Conclusions The combined application of rebamipide and hyaluronic acid eye drops following cataract surgery effectively improved TBUT and ocular surface staining scores.

Purpose: To assess the combined therapeutic effects of topical rebamipide 2% and hyaluronic acid 0.15% in managing dry eye symptoms following cataract surgery. Methods: Patients who underwent cataract surgery (phacoemulsification with intraocular lens insertion) were assessed for dry eye one week following the procedure. Dry eye patients were randomly assigned to two groups: a treatment group receiving rebamipide 2% and hyaluronic acid 0.15% eye drops, and a control group who did not receive these treatments. Various dry eye tests, including Schirmer’s test, tear break up time (TBUT), ocular surface staining, tear film osmolarity, tear lipid layer thickness, and the ocular surface disease index, were conducted at one and two months after surgery. Results: Significant improvements in TBUT (1 month: p < 0.001; 2 months: p < 0.001) and ocular surface staining scores (1 month: p = 0.001; 2 months: p < 0.001) were observed in the treatment group at both one and two months after surgery compared to baseline. During the follow-up period, the treatment group consistently showed significantly longer TBUT (p < 0.001 at both intervals) and lower ocular surface staining scores (1 month: p = 0.007; 2 months: p < 0.001) when compared to the control group. Conclusions The combined application of rebamipide and hyaluronic acid eye drops following cataract surgery effectively improved TBUT and ocular surface staining scores.

BACKGROUND: Beta-adrenergic receptor Kinase 1(betaARK1) is a serine/threonine kinase attached, which inhibits the coupling of beta-adrenergic receptor with G-protein. Myocardial betaARK1 level is usually elevated in heart failure and hypertrophy, but it is not known whether the circulating betaARK1 level is related with the degree of cardiac hypertrophy. This study was performed to evaluate the association of the betaARK1 level in circulating mononuclear leukocytes(MNL) in untreated hypertension with left ventricular mass in hypertensive patients. Method: Nineteen non-treated hypertensive patients were included for this study. High blood pressure was confirmed when systolic BP is over 150 mmHg or diastoli BP is over 95 mmHg. Echocardiography was performed to evaluate the degree of hypertrophy by measuring the left ventricular mass index(LVMI) and relative wall thickness(RWT), and test the LV function by measuring the ejection fraction(EF) according to ASE guideline. At the same time, blood was collected from each patient and MNL were isolated by gradient centrifuge with Ficoll-400. Total RNA was purified from MNL and semi-quantitative RT-PCR was performed. After reverse transcription, PCR was done with primers for human betaARK1 and GAPDH as external control. betaARK1 levels were expressed by ratio to GAPDH level and estimated the relations with clinical and Echocardiographic parameters. Result: We studied confirmed 19 hypertensive patients(10 men and 9 women, mean age of 50.6 years). Echocardiographically measured indices(mean+/-SD) were as follows; LVMI(137.3+/-30.6g/m2), PWT(0.53+/-0.09) and EF(54.6+/-8.5%). Ratio of betaARK1 levels to GAPDH was from 0.10 to 0.96 (0.62+/-0.25). betaARK1 levels were correlated with LVMI(correlation coefficient: r=.502, p=.029) and RWT(r=.627, p=.004). But Systolic BP(r=0.009, p=.93), diastolic BP(r=.07, p=.85) or EF(r=.045, p=.84) were not related to level of betaARK1. CONCLUSIONS: The betaARK1 level of circulating MNL was correlated well with the degree of the cardiac hypertrophy estimated by LVMI and RWT. This data suggests that activation of sympatho-adrenal system would exert a major role in developing cardiac hypertrophy and we can expect the decreased responsiveness to catecholamine in the heart of hypertensive patients. betaARK1 in circulating MNL might be used as a predictor or marker for LV hypertrophy in hypertensive patients.
beta-Adrenergic Receptor Kinases ; Cardiomegaly ; Echocardiography ; Female ; GTP-Binding Proteins ; Heart ; Heart Failure ; Humans ; Hypertension ; Hypertrophy ; Leukocytes, Mononuclear* ; Male ; Phosphotransferases ; Polymerase Chain Reaction ; Reverse Transcription ; RNA

PURPOSE: To evaluate the long-term effects of reduced-fluence photodynamic therapy (RF-PDT) combined with intravitreal anti-vascular endothelial growth factor (anti-VEGF) for polypoidal choroidal vasculopathy (PCV). METHODS: Twenty-two eyes of 21 patients with PCV that were followed up for more than 24 months after RF-PDT and anti-VEGF combination therapy were retrospectively reviewed. The patients received intravitreal anti-VEGF (bevacizumab 1.25 mg, ranibizumab 0.5 mg, or aflibercept 2.0 mg) within 7 days of PDT. Patients were retreated with either RF-PDT and anti-VEGF injection, or with only anti-VEGF injection, as indicated. The main outcome measures were best-corrected visual acuity (BCVA) and central foveal thickness (CFT), which were measured before and after combination therapy. RESULTS: During follow-up, the mean logMAR BCVA significantly improved from 0.75 at baseline to 0.54 at 12 months and 0.52 at 24 months (p=0.009 and p=0.032, respectively). The mean CFT significantly decreased from 409.8 µm at baseline to 234.1 µm at 12 months and 245.9 µm at 24 months (p<0.001 and p=0.001, respectively). In 20 eyes (90.9%), the BCVA remained stable or improved. CONCLUSIONS: The efficacy of this combination therapy for 24 months resulted in stabilized vision and anatomical improvement. RF-PDT combined with intravitreal anti-VEGF injection could be an effective treatment modality for patients with PCV.
Choroid* ; Endothelial Growth Factors* ; Follow-Up Studies ; Humans ; Outcome Assessment (Health Care) ; Photochemotherapy* ; Ranibizumab ; Retrospective Studies ; Vascular Endothelial Growth Factor A ; Visual Acuity

The aim of this study was to evaluate the clinical efficacy of mouthrinses prepared by sterilized water-generating device(Purister(R)) on the control of gingivitis and incipient periodontitis when it was used as a adjunctives to the mechanical plaque control. 40 healthy patients with gingivitis or incipient periodontitis were divided into two groups. Patients in the experimental group use mouthrinses prepared by sterilized water-generating device(Purister(R)) after tooth brushing while patients in the control group do only tooth brushing for plaque control. All patients received scaling and tooth brushing instruction. 1 week after scaling was set as baseline. Probing pocket depth, clinical attachment level, and bleeding on probing were scored at baseline, 4 weeks. Gingival index and plaque index were scored at baseline, 2 weeks, and 4 weeks. The results were as follows: 1. In the experimental group, gingival index, plaque index, probing pocket depth, and clinical attachment level showed statistically significant decrease, but in the control group, significant increase(p<0.05). 2. There was no significant difference between the experimental and the control group in bleeding on probing, but significant decrease in the experimental group and significant increase in the control group in a time-dependent manner(p<0.05). From these results, it can be concluded that regular use of mouthrinses prepared by sterilized water-generating device(Purister(R)) as adjunctives of mechanical plaque control, may be effective to prevent and treat gingivitis and incipient periodontitis.
Gingivitis ; Hemorrhage ; Humans ; Periodontal Diseases* ; Periodontal Index ; Periodontitis ; Tooth

Osteoporosis associated with pregnancy and lactation is a rare disease that can cause osteoporotic vertebral compression fracture (OVCF).Patients usually complain of severe back pain, which is easily mistaken for pain due to pregnancy, childbirth, and lactation, making a rapid diagnosis and treatment difficult. The authors diagnosed OVCF related to pregnancy and lactation through a physical examination, simple radiography, whole-body bone scan, magnetic resonance image, bone marrow density, and blood tests in a 29-year-old female patient and a 31-year-old female patient who presented with low back pain. This paper reports two cases of symptom improvement through a teriparatide injection, wearing thoracic lumbar sacral orthosis and taking calcium and vitamin D with a review of the literature.

Osteonecrosis of the femoral head usually affects young or middle-aged adults and frequently leading to femoral head collapse and hip arthritis. This review reports the updated treatments of the disease.