Although orthognathic surgery has been performed at the maxilla and the mandibular ramus to obtain a normal functional occulsion and aesthetic improvement of the face, deformities of the chin and disproportion of the soft tissue have been left. Mandibular set-back or advancement usually leaves soft tissue redundancy or deficiency along with its displacement. We have combined genioplasty with orthognathic surgery after intermaxillary fixation through a separate incision to get aesthetic improvement in the chin area in 28 patients. The authors obtained the aesthetic profile of the chin and lower lip according to various soft tissue analysis as follows: 1) The depth of the mentolabial fold 2) The distance from the E-line to labrale inferius (LI) 3) N-ANS/ANS-Me The soft tissue disproportion and residual deformities which were not usually corrected by the orthognathic surgery alone could be improved by combining it with genioplasty.
Chin ; Congenital Abnormalities ; Genioplasty* ; Humans ; Lip ; Maxilla ; Orthognathic Surgery

No abstract available.
Cartilage* ; Ribs* ; Transplants*

Purpose: To evaluate the risk factors for the development of osteonecrosis in civilian professional divers by an epidemiologic study and to determine the correlation between osteonecrosis in divers and coagulopathy by analysis of serologic markers that are related to thrombophilia and hypofibrinolysis. Materials and Methods: Forty-two divers, who collected pen shells (Atrina pinnata), and among whom 10 had osteonecrosis (group 1), were compared with 32 divers without osteonecrosis (group 2). Both groups were evaluated based on the number of years of diving experience, number of dives per year, mean number of dives per day, mean diving time and depth, and diving methods. We determined any statistically significant differences among these variables. We measured the levels of serologic markers that were related to hyperlipidemia, thrombophilia, and hypofibrinolysis from the divers and a control group of 20 physicians (group 3). The levels of the serologic markers were compared between groups 1 and 2 and between the divers and the control group, in order to determine the relationship between the serologic markers and the development of dysbaric osteonecrosis. Results: None of the variables demonstrated any statistically significant differences, except for the mean diving time, in which group 1 had a mean diving time of 124 minutes and group 2 had a mean diving time of 62.1 minutes (P<0.05). In the analysis of the serologic markers, there were no statistically significant differences between groups 1 and 2; however, in comparison with the group 3, the divers demonstrated significantly decreased activity levels of proteins C and S (Protein C: P<0.05; Protein S: P<0.05), and an increase in the levels of plasminogen activator inhibitor-1 (PAI-1) (P<0.05). Conclusion: The divers with osteonecrosis had a longer mean diving time than did those divers without osteonecrosis. In the serologic marker analysis, the divers with osteonecrosis demonstrated significantly decreased activity levels of Proteins C, S and a significant increase in the levels of PAI-1, compared with the control group.
Biomarkers* ; Diving ; Epidemiologic Studies* ; Epidemiology ; Hyperlipidemias ; Osteonecrosis* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein S ; Risk Factors ; Thrombophilia

INTRODUCTION: The objective of the present study was to investigate the defense style of insomnia patients and to grasp the differences in defense style between primary insomnia patients and insomnia patients with history of major depressive disorder. METHODS: Forty three subjects with insomnia (11 subjects with primary insomnia and 32 subjects with major depressive disorder) and 138 control subjects participated in this study. To diagnose insomnia and major depressive disorder, interviews including structured clinical interview for DSM-IV (SCID-IV) were done. To assess the defense style, self-reported Korean version of Defense Style Questionnaire (K-DSQ) were completed by the participants. RESULTS: Compared to normal controls, subjects with insomnia used more acting out (t=3.25, p<0.01), consumption (t=2.66, p<0.01), fantasy (t=3.51, p<0.001), resignation (t=5.42, p<0.001), suppression (t=3.28, p<0.01), projection (t=3.92, p< 0.01), splitting (t=4.31, p<0.01), undoing (t=2.66, p<0.01), withdrawal (t=6.72, p<0.001) and isolation (t=3.80, p<0.001), and less omnipotence (t=4.08, p<0.001) and humor (t=3.20, p<0.01). Compared to normal controls, subjects with primary insomnia used more undoing and withdrawal. Compared to subjects with primary insomnia, subjects with insomnia with history of major depressive disorder used more resignation and withdrawal, and less humor. CONCLUSION: In the current study, there were differences in defenses between primary insomnia patients and insomnia patients with major depressive disorder history. To evaluate the pattern of defenses through the K-DSQ might provide important clues to differentiate these two conditions.
Acting Out ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Fantasy ; Hand Strength ; Humans ; Surveys and Questionnaires ; Sleep Initiation and Maintenance Disorders

No abstract available.
Hypnotics and Sedatives*

No abstract available.
Choledochal Cyst*

Nowadays administration of bone marrow transplantation is increasing state by developing society and high leukemia incidence. Decrease of relapse and infection rate result from chemo therapy drug development of treatment and strength. So we look for continuos development of treatment. But through before and after BMT, it takes several months by planing and HLA typing matching possibility of BMT. Also, it takes one or two month by duration of BMT and discharge. During BMT, patients experience emotional change-suggering, anxiety, depression and so on-due to changed body image and strictly isolation in special facility. After BMT, the patients also experience stress such as conditions self-care, support from family, concern of relapse risk and so far enlarge mental, economic and physical change surrounding them due to high cost. Accordingly nurses are required high quality of nursing attentive assesment, understanding of patient's environment and consideration, and teaching in administrative work. The study is attempted to establish nursing theory patients' experience in BMT treatment. Research method followed grounded theory methodology by strauss & Corbin. Subjects were 1 adolescent including highschool patient and 6 adults. This study continued from February 1996 through August 1996. All of these subjects were interviewed by this author. Interview were done by long interview technique and observation. Each interview took 1 hour to 2 hours Content of interview was recorded and transcribed later. The data thus collected were analyzed immediately after interviews and fed into the next round of interviews until the data collection reaches the saturation point. In the process of data analysis, "Terribleness" or "Miserableness" was found to be the core phenomenon. Results were composed to 103 concepts. These concepts were grouped into twenty four categories, and then to eleven categories. Categories include "physical burden", "economic burden", "mental distressing", "heartbreaking", "being gloomy", "horror", "being crushed", "feel oppressed", "being exhausted", "family dependent", "support", "previous data for procedure", "inclination", "exploding", "sharing", "mitigation", "bracing oneself", "becoming attached", "dependence", "thanks", "anxiety", and "abandonment". Patients with bone marrow transplantation were revealed to face "terribleness". Terribleness is found to be progressed through the cycle production-coping-solution. Fourteen hypotheses were derived from the integration of categories as follows ; (1) The stronger the term of suffering as perceived by the subjects, the stronger the "terribleness" will be. (2) The more excessive the degree of suffering as perceived by the subjects, the more excessive the "terribleness" will be. (3) If subjects have family dependent "terribleness" is expressed with abusement. (4) If subjects have no family dependent, "terribleness" will be expressed with exposure and suppressing. (5) The more abundant the sufficient support, "terribleness" will be expressed with exposure and suppressing. (6) The less abundant the sufficient support, "terribleness" will be expressed with abusement. (7) The more abundant the previous data, "terribleness" will be expressed with exposure and suppressing. (8) The less abundant the pervious data, "terribleness" will be expressed with abusement. (9) The more introvert the subject's inclination, "terribleness" will be expressed with exposure and suppressing. (10) The more extrovert the subject's inclination, "terribleness" will be expressed with abusement. (11) The more excessive the degree of "terribleness" will be expressed with abusement. (12) The less excessive the degree of "terribleness" it will be expressed with exposure and suppressing. (13) The more expressive the abusment, "terribleness" will be solved despair. (14) The more expressive the exposure and suppressing, "terribleness" will be solved with expectation. On the basis of the patterns that have the four these below were confirmed. 1. If patients felt large amount of terribleness because of severe suffering, they had family dependent. insufficient support, no previous data and their inclination was extrovert, "terribleness" is solved despair with abusement. 2. If patients felt large amount of terrible because of severe suffering family dependent, sufficient support, pervious data, and their inclination was introvert, "terribleness" is solved expectation with suppressing and exposure. 3. If patients felt small amount of terribleness because of little suffering, no family dependent, insufficient support, no previous data, and their inclination was extrovert, "terribleness" is solved despair with abusement. 4. If patients felt small amount of terribleness because of little suffering, no family dependent, sufficient support, previous data, and their inclination was introvert, "terribleness" is solved expectation with exposure and suppressing. On the basis of the above result, in orer to help nurses take good care of their patient, and understands patient's inclination and background, nursing assessment and intervention on life readjustment, and getting support should be required. It is expected that theoretical framework provided by this study, which shows how "terribleness" products, changes, increases and decrease. Therefore public relations, education, counseling emotional support, understanding inclination and exchange of information will have to be accomplished.
Adolescent ; Adult ; Anxiety ; Body Image ; Bone Marrow Transplantation* ; Bone Marrow* ; Counseling ; Depression ; Education ; Equidae ; Histocompatibility Testing ; Humans ; Incidence ; Leukemia ; Nursing ; Nursing Assessment ; Nursing Theory ; Public Relations ; Recurrence ; Self Care ; Statistics as Topic ; Surveys and Questionnaires

The autogenous fascia graft has been used for various surgical purposes because it has good durability, a gliding capacity, elasticity and a high survival rate. However, few studies have reported histological changes of the graft in various situations. This study attempted to determine histomorphologic changes after autogenous fascia graft in various surgical conditions. The results revealed were as follows: 1. The tension applied to grafts plays the key role in the survival rate of autogenous fascia grafts. 2. Rolling the fascia reduced the volume and weight after autogenous graft due to fibrosis and central fatty degeneration. 3. Autogenous fascia graft covering silicone blocks showed its fascial structure and reduction of the formation of fibrous capsule around the silicone.
Elasticity ; Fascia ; Fibrosis ; Silicones ; Survival Rate ; Transplants*

No abstract available.
Torticollis*

Soft tissue expansion technique has been a very useful method for the reconstruction of scalp defects and alopecia since the scalp is an unyielding tissue allowing minimal distension in traditional local flap surgery. As a result, there has been wide use of the tissue expansion method in the reconstruction of scalp defect and treatment of alopecia in the plastic surgery. There have been many concerns about histomorphologic changes of the overlying skin and the underlying structure resulting from tissue expansion. We also know that progressive tissue expansion induces increased mitotic activity of the epidermis and thining of the dermis in the overlying skin, as well as significant gross, histologic bony erosion in the underlying structure. However, little informations have been reported about the changes of the hair and pilocebaceus units in scalp expansion. We compared the horizontal sections of the expanded scalp and its longterm histologic changes with a normal unexpanded scalp specimen as a control. The terminal hair proportions to the vellus hair both increased. There was a 32% decrease in follicular units, a 24% decrease in terminal hair, and a 23% decrease in total hairs 8 week after scalp expansion compared to the normal unexpanded scalp. The perifollicular inflammatory changes and fibrosis observed in the full expanded scalp specimen disappeared within 12 weeks after removal of the expander and the flap transposition. In our observation, tissue expansion at the hair-bearing scalp did not precipitate any adverse changes on the hair follicles. On the contrary, we observed that secondary scalp expasion could be safetly performed 3 months after the first scalp expansion.
Alopecia ; Dermis ; Epidermis ; Fibrosis ; Hair Follicle* ; Hair* ; Humans* ; Scalp* ; Skin ; Surgery, Plastic ; Tissue Expansion*