Correction of alveolar cleft with bone grafting has become a well-established step in the integral management of cleft lip and palate patients. Secondary bone graft at mixed dentition is a widely accepted protocol and iliac bone graft is recommended as the gold standard by a multitude of cleft centers. However, grave morbidities of the iliac donor site have discouraged cleft surgeons from adopting this reliable method. In this study, percutaneous bone biopsy set was used to avoid the morbidities of conventional iliac bone graft. Iliac bone graft was performed on 20 patients with alveolar cleft during the period from January 1995 to February 1999. The tube saw of the bone biopsy set was introduced through a small incision of less than 1 cm, and cancellous bone cores were harvested from the iliac crest. After the pericoronal incision, a wide gingival mucoperiosteal flap was elevated at both sides of the cleft. A soft tissue pocket that was created by closure of the nasal and palatal lining was filled with harvested bone cores. Medial transposition and water-tight closure of both gingival mucoperiosteal flaps provided coverage of the bone graft. During the follow-up period from 5 to 50 months (mean, 29 months), completion of the goals of the alveolar bone graft was observed. There was no serious complication except for one case the exposure of the bone graft, and this was resolved spontaneously. Bone harvest with a percutaneous bone biopsy set enables early ambulation by reducing postoperative pain, and it may be faster and simpler than any other method introduced so far. Furthermore, blood loss was minimal, while the scar was small and acceptable. Iliac bone graft with percutaneous bone biopsy is a reliable method for correction of the alveolar cleft and it has many advantages over conventional iliac bone graft and other sources of bone.
Biopsy* ; Bone Transplantation ; Cicatrix ; Cleft Lip ; Dentition, Mixed ; Early Ambulation ; Follow-Up Studies ; Humans ; Pain, Postoperative ; Palate ; Tissue Donors ; Transplants

During flap elevation, most perforators are cut except one or more perforators that are essential to flap survival. However these cutout perforators can cause deterioration of the blood circulation of the flap. To salvage the jeopardized flaps, rebuilding the perforator system is essential for flap survival. In the first case, after flap elevation, the upper abdominal flap margin was severely ischemic. To supply blood to the upper abdominal flaps, we found and used a major perforator underneath the upper abdominal flap which was cut earlier during the elevation, and we performed reanastomosis with ipsilateral deep inferior epigastric artery. Upper abdominal flap ischemic area was limited to a narrow suture area. In the second case, we performed free superficial inferior epigastric artery (SIEA) flap reconstruction. After successful anastomosis of the SIEA and superficial inferior epigastric vein (SIEV) with internal mammary artery and vein, serious venous congestion occurred immediately because of SIEV malfunction. We found the largest perforator vein under the flap, as an alternate way to drain, then connected it with the thoracoacromial vein with a vein graft harvested in the contralateral SIEV. Circulation has improved. In conclusion, perforator system reconstruction is essential in a jeopardized flap salvage.
Blood Circulation ; Epigastric Arteries ; Female ; Free Tissue Flaps ; Hyperemia ; Mammaplasty ; Mammary Arteries ; Perforator Flap ; Sutures ; Transplants ; Veins

OBJECTIVES: North Korean people's thought and opinions on their contry, society, and economy were studied through North Korean defectors. METHODS: At Hanawon, 163 defectors were surveyed with 2 questionnaires in May 2002. RESULTS: North Koreans believe that socialism it was a right choice for North Korea. Because of the gap between the ideal and economic reality, however admitted sense of frustration. They think that the communist value system and the communal consciousness have been shrinking gradually, and their attitude to South Korea was one of ambivalence. Peoples views are different according to age and institutional education they received. CONCLUSION: For the day of unification, we suggest the followings. First, South and North Korea should put in more effort for building a common nationalistic consciousness. Second, reasonable criticism against communism and the advantages of alternative systems which are expected to be accepted by North Koreans through education after unification, need to be prepared. Third, the development of psychological conflicts and the frustration of North Korean people after unification are anticipated and their solutions must be saught after. Fourth, continuos studies for the understanding of North Korean people's psychological characteristics and it's change is needed.
Communism ; Consciousness ; Democratic People's Republic of Korea ; Education ; Frustration ; Korea* ; Surveys and Questionnaires ; Socialism

OBJECTIVES: This study evaluated the quality of life (QoL) of North Korean defectors in South Korean society in the year 2007 for purposes of comparing it to their QoL in 2004 and identifying demographic variables that influence QoL. METHODS: We used the Korean version of WHOQoL-BREF to evaluate the QoL of 106 North Korean defectors. Other instruments included a questionnaire for discerning demographic data, life experiences, and physical health. RESULTS: For last 3 years, more defectors had higher education, married, and higher income. However, their unemployment numbers did not decrease, while their number of believers in a religion did decrease. QoL scores remained low in the areas of negative feelings, financial resources, dependence on treatment and drugs, recreation and leisure activities, and opportunities for new information and skills, but were high in areas of cognitive mental functions, personal beliefs, work capacity, self-esteem, and transportation. Path analysis suggested that the psychological domain influenced overall QoL while other domains influenced overall QoL indirectly, through the psychological domain. Since 2004, defectors' QoL in the physical domain and in opportunities for education and transportation had improved, while QoL with regard to pain and discomfort, mobility, and negative feelings had worsened. Variables that were negatively correlated with QoL included male sex, higher age, being married, experiencing army service in North Korea, and shorter stays in third countries. In South Korea, QoL was negatively correlated with current physical illness but positively correlated to having a family, a stable job, higher income, and someone to talk with. CONCLUSION: These results suggest that defectors' QoL would be improved by tailored services according to their sex and age, focusing on educational programs to provide new information and skills, support for building families, health services, and community support.
Democratic People's Republic of Korea ; Follow-Up Studies ; Health Services ; Humans ; Leisure Activities ; Life Change Events ; Male ; Mental Health ; Quality of Life ; Surveys and Questionnaires ; Recreation ; Republic of Korea ; Transportation ; Unemployment

The demand for the breast reconstruction continues to grow following the acute increase in the incidence of breast cancer in Korea. The pedicled transverse rectus abdominis musculocutaneous (TRAM) flap is one of the most commonly used methods among the autologous breast reconstruction options. A pedicled TRAM flap consists of the lower abdominal skin, subcutaneous fat tissue, and one of the rectus abdominis muscles. The blood flow to the flap is supplied through the muscle perforators, which should be strictly selected and preserved. This flap can provide sufficient healthy tissue, which can create the most ideal breast shape. Although the free flap has largely replaced the pedicled TRAM flap, the latter has also evolved with increased understanding of anatomy and physiology. Furthermore, if refined techniques are applied, complications can be minimized and comparable outcomes can be achieved. Besides all the advantages of autologous tissue breast reconstruction, the most distinct feature of the pedicled TRAM flap over the free flap is simplicity of flap elevation and elimination of the microsurgical crisis. The pedicled TRAM flap is still a competitive procedure, yielding consistent results with acceptable complication rates for most patients and should be considered as a primary option for breast reconstruction.
Breast ; Breast Neoplasms ; Female ; Free Tissue Flaps ; Humans ; Incidence ; Korea ; Mammaplasty ; Muscles ; Rectus Abdominis ; Skin ; Subcutaneous Fat

Background: As rhinoplasty techniques have become more complex, surgeons often need more than what septal or conchal cartilage can provide. While costal cartilage became more popular for that reason, some surgeons are still uncomfortable with its invasiveness and donor site morbidity. Here, we used lyophilized allogeneic costal cartilage for septorhinoplasty and investigated its safety and usefulness. Methods: The costal cartilage was harvested from a cadaveric donor and treated via multiple steps, including defatting and lyophilization, to remove all viable cells and antigenicity. The cartilage was then stored at room temperature and rehydrated 24 hours before use. Lyophilized cartilage allografts were used in 20 patients. Three types of septal graft were performed — spreader, batten, and extension — to correct septal or columellar deviation and enhance the nasal tip. Results: The mean follow-up period was 4.3 years. In all cases, the graft successfully met the rhinoplasty purpose. No significant deformation was detected in any of the patients. Although warping was observed in one patient (5%), there was no case of clinical infection, extrusion, or graft removal and no revisional surgery for an unfavorable aesthetic result. Conclusions Lyophilized allogeneic cartilage was used for septorhinoplasty very safely and effectively. It can be carved into any shape and has all other properties required for perfectly replacing autologous costal cartilage. The main advantage of cartilage allografts is a limitless supply of high-quality cartilage without donor site morbidity. The disadvantages include the need for special facilities and manpower and extra covering cost.

PURPOSE: This study attempted to investigate the effects of supply of highly concentrated (30%) oxygen on human ability of visuospatial cognition using time course data analysis of functional Magnetic Resonance Imaging (fMRI). MATERIALS AND METHODS: To select an item set in the visuospatial performance test, two questionnaires with similar difficulty were developed through group testing. A group test was administered to 263 college students. Two types of questionnaire containing 20 questions were developed to measure the ability of visuospatial cognition. Eight college students (right-handed male, average age of 23.5 yrs) were examined for fMRI study. The experiment consisted of two runs of the visuospatial cognition testing, one with 21% level of oxygen and the other with 30% oxygen level. Each run consisted of 4 blocks, each containing control and visuospatial items. Functional brain images were taken from 3T MRI using the single-shot EPI method. Using the subtraction procedure, activated areas in the brain during visuospatial tasks were col-orcoded by t-score. To investigate the time course data in each activated area from brain images, 4 typical regions (cerebellum, occipital lobe, parietal lobe, and frontal lobe) were selected. RESULTS: The average accuracy was 50.63 +/-8.63 and 62.50 +/-9.64 for 21% and 30% oxygen respectively, and a statistically significant difference was found in the accuracy between the two types of oxygen (p<0.05). There were more activation areas observed at the cerebellum, occipital lobe, parietal lobe and frontal lobe with 30% oxygen administration. The rate of increase in the cerebellum, occipital lobe and parietal lobe was 17% and that of the frontal lobe, 50%. Especially, there were increase of intensity of BOLD signal at the parietal lobe with 30% oxygen administration. The increase rate of the left parietal lobe was 1.4% and that of the right parietal lobe, 1.7%. CONCLUSION: It is concluded that while performing visuospatial tasks, high concentrations of oxygen administration make oxygen administration sufficient, thus making neural network activate more, and the ability to perform visuospatial tasks increase.
Brain ; Cerebellum ; Cognition ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Male ; Occipital Lobe ; Oxygen* ; Parietal Lobe ; Surveys and Questionnaires ; Statistics as Topic*

PURPOSE: This study attempted to investigate the effects of supply of highly concentrated (30%) oxygen on human ability of visuospatial cognition using time course data analysis of functional Magnetic Resonance Imaging (fMRI). MATERIALS AND METHODS: To select an item set in the visuospatial performance test, two questionnaires with similar difficulty were developed through group testing. A group test was administered to 263 college students. Two types of questionnaire containing 20 questions were developed to measure the ability of visuospatial cognition. Eight college students (right-handed male, average age of 23.5 yrs) were examined for fMRI study. The experiment consisted of two runs of the visuospatial cognition testing, one with 21% level of oxygen and the other with 30% oxygen level. Each run consisted of 4 blocks, each containing control and visuospatial items. Functional brain images were taken from 3T MRI using the single-shot EPI method. Using the subtraction procedure, activated areas in the brain during visuospatial tasks were col-orcoded by t-score. To investigate the time course data in each activated area from brain images, 4 typical regions (cerebellum, occipital lobe, parietal lobe, and frontal lobe) were selected. RESULTS: The average accuracy was 50.63 +/-8.63 and 62.50 +/-9.64 for 21% and 30% oxygen respectively, and a statistically significant difference was found in the accuracy between the two types of oxygen (p<0.05). There were more activation areas observed at the cerebellum, occipital lobe, parietal lobe and frontal lobe with 30% oxygen administration. The rate of increase in the cerebellum, occipital lobe and parietal lobe was 17% and that of the frontal lobe, 50%. Especially, there were increase of intensity of BOLD signal at the parietal lobe with 30% oxygen administration. The increase rate of the left parietal lobe was 1.4% and that of the right parietal lobe, 1.7%. CONCLUSION: It is concluded that while performing visuospatial tasks, high concentrations of oxygen administration make oxygen administration sufficient, thus making neural network activate more, and the ability to perform visuospatial tasks increase.
Brain ; Cerebellum ; Cognition ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Male ; Occipital Lobe ; Oxygen* ; Parietal Lobe ; Surveys and Questionnaires ; Statistics as Topic*

PURPOSE: This study purposed to measure the standard volume of the cerebellum of normal Koreans who were in their 20s and 40s, and we also wished to find out the difference in the volume of the cerebellum according to gender and age. MATERIALS AND METHODS: This study collected MR brain images from 118 people in their 20s (males: 58, females: 60) and 100 people in their 40s (males: 41, females: 59), for a total of 218 people. For each of sagittal, coronal and axial sections, the cerebellar part of the images was segmented using automatic and manual methods, and the volume was then measured. In order to observe differences according to gender and age and also to observe the interactive effect between gender and age, a two-way ANOVA test was performed using gender (2 levels) and age (2 levels) as independent variables. RESULTS:The average volume of the cerebellum of Koreans in their 20s was 133.74 (cm3) and that of Koreans in their 40s was 121.83 (cm3). The average volume of the cerebellum of male Koreans in their 20s and 40s was 134.55 (cm3) and that of female Koreans was 123.06 (cm3). The volume of the cerebellum was significantly larger in Koreans in their 20s than those volumes of the cerebellum of Koreans in their 40s, and the cerebellum volumes in male Koreans were larger than those of the Korean females. Moreover, the reduction of the volume of the cerebellum with age was significantly larger in male Koreans than in the Korean females. CONCLUSION: According to the results of measuring the volume of the cerebellum for normal Koreans in their 20s and 40s, the volume was significantly different according to gender and age, and the reduction of the volume of the cerebellum with age was significantly larger in men than in women.
Brain ; Cerebellum ; Female ; Humans ; Magnetic Resonance Imaging* ; Male

Researches on brain functions using MRI or PET generally involve the process that normalizes spatially the results of functional images into a standard brain template in order to find out a common activation area of multiple subjects. So far MNI305, which is Western people's standard brain template, has been commonly used. However, the brain may be different morphologically and structurally among human races, so the use of MNI305 may produce inaccurate results. Furthermore, because the size and shape of the brain vary according to gender and age, if brain temperatures are developed considering these factors, brain activation areas may be identified more precisely. This study collected MR brain images from 121 men and women in their 20s (23.0 +/-2.6 years on the average) and 99 men and women in their 40s (47.5 +/-3.7 years on the average). After eight reference points were defined using the method proposed by Nowinski, the image that had the least error from the mean distances among the reference points was selected as the representative brain image. All images were affine-transformed into the representative brain image, and average brain templates were created by age and gender through averaging the brightness of images. The results of this study may be utilized in Korean brain probability maps to be developed in the future for more precise research on the functions of Koreans' brain.
Brain* ; Continental Population Groups ; Female ; Humans ; Magnetic Resonance Imaging ; Male