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

Infantile hemangioendothelioma of the liver is a common vascular tumor in infancy. The tumor is usually multinodular or diffuse and classified into two types. We present a case of infantile hemangioendothelioma of the liver, which predominantly consists of type 2. A 4-month-old female was admitted for an evaulation of an abdominal distension. A CT scan of the liver showed a multinodular mass. The right lobectomy was done. Grossly, the mass consisted of round nodules ranging from 2cm to 5cm in diameter. Microscopically, the tumor revealed proliferation of small vascular channels lined by endothelial cells. Bizarre cells and mitotic cells were frequently noted. Vesicular nuclei and multilayering of the endothelial cells were also noted.
Endothelial Cells ; Female ; Hemangioendothelioma* ; Humans ; Infant ; Liver* ; Tomography, X-Ray Computed

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

No abstract available.
Aged* ; Humans

PURPOSE: This study was done to investigate the probability of stroke, knowledge of stroke, and health-promoting lifestyle among stroke risk groups. METHOD: A descriptive correlational design was used. Data for 110 patients were analyzed. The probability of stroke was calculated using the Stroke Risk Profile from the Framingham Heart Study (2013), knowledge of stroke was measured using a questionnaire developed by Yoon et al. (2001), and health-promoting lifestyle was measured using the HPLP-II, developed by Walker et al. (1995). RESULTS: The average probability of stroke was 11.74, knowledge of stroke, 67.88, and health-promoting lifestyle, 2.27. Probability of stroke showed significant differences according to gender. Knowledge differed according to patients' salaries. Health-promoting lifestyle showed significant differences according to gender. There were no significant correlations between probability of stroke and knowledge of stroke or probability of stroke and health-promoting lifestyle, but there was a significant correlation between knowledge of stroke and health-promoting lifestyle. CONCLUSION: Results indicate the necessity of active education to increase knowledge related to stroke which will contribute to an increase in health-promoting behaviors and make primary prevention a reality in the reduction of risk of stroke among stroke risk groups.
Education ; Health Behavior ; Heart ; Humans ; Life Style* ; Primary Prevention ; Surveys and Questionnaires ; Salaries and Fringe Benefits ; Stroke*

Objective To quantitatively assess severity of movement disability by analyzing physical activities recorded by an actigraph monitor in patients with neurology disorders.Methods Eighty-one patients with Parkinson' s disease(PD)and 61 patients with acute cerebral infarction(ACI)accompanying impaired upper limb motor function were included in the study.PD patients and ACI patients were treated using the international PD and ACI treatment guidelines,respectively.The patients were asked to wear an Actigraph monitor for 6 days before the treatment in both PD and ACI patient groups and at 24-38 days post-treatment in PD patients or at 28 days post-treatment in ACI patients.The recorded data was analyzed by power-law exponent(PLE)and detrended fluctuation analysis(DFA).Clinically,before and after the treatments,PD patients were evaluated using the conventional Unified Parkinson Disease Rating Scale (UPDRS),and ACI patients were evaluated by assessing upper limb motor function using Fugl-Meyer Assessment(FMA)and Functional Independence Measure(FIM).The correlation of the UPDRS scores with PLE was analyzed in PD patients,and the correlation of FMA or FIM with DFA in ACI patients.Results Both the UPDRS scores and the PLE values in PD patients were improved after the drug administration(UPDRS total:32.8 ± 16.2 and 28.8 ± 14.7,Z =2.080,P =0.038; UPDRS Ⅲ:18.6 ± 8.2 and 15.7±6.8,Z=2.155,P=0.031; PLE:0.98 ±0.25 and 0.82 ±0.21,Z=2.212,P=0.027,before and after the treatment,respectively).There were a linear correlation coefficient of 0.699 between the improvements of total UPDRS scores and the PLE values,and of 0.823 between the UPDRS Ⅲ and the PLE values.FMA,FIM scores and DFA were improved significantly than before treatment(FMA:12.39 ± 8.21 and 30.28 ±7.29,Z=3.016,P =0.004; FIM:8.98 ±7.29 and 13.21 ±7.6,Z =2.282,P=0.038; DFA:0.86 ±0.31 and 0.98 ±0.27,Z =2.360,P =0.036,before and after the treatment,respectively).It also showed linear correlations between the improvements of FMA scores and DFA(r =0.638),and between FIM scores and DFA(r =0.712,both P ＜0.05).There was no correlation between UPDRS scores and DFA values in PD patients,nor between FIM scores or FMA scores and PLE values in ACI patients.Conclusions Actigraph device can be used to monitor patients activity in movement disorders.Analysis of its PLE can provide a quantitative evaluation in PD while its DFA may provide useful specific assessment of impaired upper limb motor function in ACI patients.It can also be used in quantitatively assessing new drug efficacy.

No abstract available.
Liver Cirrhosis* ; Liver* ; Pregnancy*

PURPOSE: Acute poststreptococcal glomerulonephritis(APSGN) follows infection of group A beta-hemolytic streptococci. The prognosis of APSGN has been reported as favorable. However, several studies have reported that some patients progress to chronic renal failure. In an attempt to clarify this, we analyzed the clinical course of patients with APSGN. METHODS: Between January 2000 and December 2004, a total of 48 children who were diagnosed with APSGN according to the presence of hematuria, transient hypocomplementemia and evidence of group A beta-hemolytic streptococcal infection were evaluated. RESULTS: Six(12.5%) patients showed elevation of serum creatinine level but there was no patient with persistent renal dysfunction. Blood pressure was controlled with ease in all patients and there was no case of persistent hypertension. Renal biopsy was done in 5 patients who showed heavy proteinuria or renal insufficiency and the outcomes showed findings consistent with ordinary APSGN except one with findings of rapidly progressive glomerulonephritis(RPGN). Serum complement levels normalized within 8 weeks(92.9%). Hematuria disappeared within 6 months(79%) and proteinuria within 6 months(100%) from the disease onset. CONCLUSION: Prolonged renal dysfunction or heavy proteinuria found in five patients(10.4%) led to renal biopsy. All these problems resolved within 6 months. Our data support that the prognosis of childhood APSGN is favorable without any serious sequela.
Biopsy ; Blood Pressure ; Child* ; Complement System Proteins ; Creatinine ; Glomerulonephritis* ; Hematuria ; Humans ; Hypertension ; Kidney Failure, Chronic ; Prognosis* ; Proteinuria ; Renal Insufficiency ; Streptococcal Infections

Families of children with cancer face many illness-related demands. The perceived social support is a critical resource for the family adaptation process. And the patterns of family adaptation to childhood cancer varies as characteristics of disease, which is prognosis, the influence of cognition function, and treatment process. The conceptual definition of social support is not unidimensional. However, most studies focus on general aspect of mediating effects on adaptation. Diverse dimensions of perceived social support should be considered in its effectiveness for intervention. Therefore, this study was undertaken to determine whether family's perceived social support influences the family adaptation of family with pediatric cancer and what dimension influences mostly in family adaptation as the characteristics of disease in the family of children with cancer. The subject was consisted of 102 families with pediatric cancer who had been diagnosed as leukemia or brain tumor last 2 years. Those families had participated in the education program or meetings for family who have with pediatric cancer children. The measurement for this study were Personal Resource Questionnaire (PRQ) Part- ll developed by Brandt and Weinert to measure parents' perceived social support, and the McCubbin's Coping Health Inventory for Parents (CHIP) to measure family coping. The results of this study can be summarized as follows; Regression analysis showed that perceived social support has effect on family adaptation with beta=.43, p < .01. In the group of family of child with leukemia, social support as general has effect on adaptation (beta=.40, p < .01) and specially, social support perceived as intimacy was strongly effect on family adaptation. And In the group of brain tumor, Social support has effect on adaptation(beta=.46, p < .01) and among the social support domains, the self esteem dimension was most predictable to family adaptation. In conclusion, the perceived social support is a predictor on family adaptation and useful vehicle to help family who has child with pediatric cancer. An important clinical implication is that specified support program for intervention may be useful and critical for the family who has diverse pediatric conditions of childhood cancer. Further studies should stress the effects of family support for clinical intervention and is needed with diverse stage of development and pediatric conditions.
Brain Neoplasms ; Child* ; Cognition ; Education ; Humans ; Leukemia ; Negotiating ; Parents ; Prognosis ; Self Concept ; Child Health ; Surveys and Questionnaires