The midcarpal joint has inherent instability in the sagittal plane. Several instability patterns of midcarpal joint due to ligament insufficiency have been presented. We ohserved the normal midcarpal and radiocarpal behaviors of ligament laxity in the sagittal plane to investigate the significance of dorsal and palmar stress test which has been used for evaluation of the non-dissociative carpal instahilities. We performed the dorsal and palmar displacement stress test on fifty pairs of normal wrist joints under the flouroscopic views. The midcarpal joints were subluxed, more on dorsal stress, with variable degrees. Dorsal subluxations in females and third decades were more prominent than males and fourth decades. Three types of radiocarpal instability on dorsal stress test could be observed. We think that displacement stress test in the sagittal plane should be interpreted in consideration of normal instability patterns in the evaluation of ahnormal midcarpal and radiocarpal instabilities since there are variable patterns and degrees of ligament laxity in normal wrist joints.
Exercise Test ; Female ; Humans ; Joints* ; Ligaments ; Male ; Wrist Joint

No abstract available.
Jaw* ; Mass Media* ; Mortality* ; Orthognathic Surgery* ; Publications*

Despite the fact that benign skin lesions can undergo malignant transformation, the necessity and timing of the surgical resection have yet to be established. In this study, we analyse three cases of benign-appearing skin lesions, which were found to be carcinomatous on histologic examination and review the literature regarding the importance of prophylactic removal of benign-appearing skin lesion. The first and second cases were female patients wishing for cosmetic surgery. The first patient had a benign-appearing lesion on dorsum nasi, and the second patient had an inconspicuous lesion right along the right nasolabial fold. The third patient was a middle-aged male with a pigmented lesion on the left cheek, who presented to the clinic only after having met the operating surgeon through an acquaintance outside the hospital setting. All of the lesions were suspected to be of benign nature and were excised for cosmesis only. However, histologic examination of these lesions showed that the first two tumors were basal cell carcinoma with the last tumor being squamouse cell carcinoma. Thus, it is considered that removal of benign like skin lesion will result in good prognosis of patients scheduled to undergo other surgery.
Carcinoma, Basal Cell ; Cheek ; Female ; Humans ; Male ; Nasolabial Fold ; Nevus ; Prognosis ; Skin Neoplasms ; Skin* ; Surgery, Plastic

We report two cases of cleidocranial dysplasia, which was managed without significant craniofacial osteotomy. A mother and daughter, both of normal intelligence, presented with central forehead depression, mid-face hypoplasia, and blepharoptosis. The fact that they have an identically deformed face implied a genetic basis. In both patients, radiologic evaluation revealed the underdeveloped maxilla, persistent fontanelle opening, and cleidal aplasia. Clinical findings and radiologic studies were consistent with the diagnosis of cleidocranial dysplasia. Both patients underwent forehead plasty via bicoronal approach, augmentation rhinoplasty using tip plasty, and epicanthoplasty. In addition, the mother underwent malar augmentation using Medpor implantation and reduction genioplasty. The patients did not experience any postoperative complication and remained satisfied with the operation at 6-year follow-up.
Blepharoptosis ; Clavicle ; Cleidocranial Dysplasia* ; Depression ; Diagnosis ; Follow-Up Studies ; Forehead ; Genetic Diseases, Inborn ; Genioplasty ; Humans ; Intelligence ; Maxilla ; Mothers ; Nuclear Family ; Osteotomy ; Postoperative Complications ; Rhinoplasty

Behçet's disease is a systemic chronic disease that occurs in tissues such as eyes, joints, organs and nerves, and it has been noted that symptoms may be observed in a variety of tissues. In previous studies, reports of blepharoptosis observed in patients with Behçet's disease have been rare. We would like to report a case where a patient among those who visited our hospital with blepharoptosis had a history of Behçet's disease. This patient had been diagnosed with Behçet's disease, and complained of bilateral blepharoptosis even at the time of diagnosis. He complained of dysfunctions in vision and hearing, and upon eye examination, an eye movement disorder was found in his left eye. From the symptoms, neuro-Behçet's disease was diagnosed. The oculomotor and levator palpebrae superioris muscles are both controlled by cranial nerve III, which may suggest that Behçet's disease in this patient occurred in cranial nerve III. The patient received an oral steroid, and the symptoms have improved without surgery. Since we could identify the correlation between Behçet's disease and blepharoptosis, we considered that sharing this case and its outcome would be helpful for plastic surgeons who treat eyelids.
Behcet Syndrome ; Blepharoptosis* ; Chronic Disease ; Diagnosis ; Eyelids ; Hearing ; Humans ; Joints ; Muscles ; Ocular Motility Disorders ; Oculomotor Nerve ; Plastics ; Surgeons

PURPOSE: Autologous platelet rich plasma (PRP) has been known to enhance tendon healing and improve tensile strength after tendon injury. This study investigated the dosage of PRP to increase the tensile strength. METHODS: PRP was harvested from peripheral bloods of the rabbits. Direct injury model was adopted using 60 achilles tendons in 30 rabbits. The autologous PRP was infiltrated into the Achilles tendon repair site of four groups (control, 0.1, 0.2, 0.4 mL) with different dosages. Tendons were harvested at 2, 4 and 8 weeks and subjected to measuring mechanical tensile strength and dosage of collagen content. RESULTS: At 2, 4, and 8 weeks, PRP administration following experimental achilles tendon repair resulted in an overall higher average tensile strength and collagen content compared to these of the control. Also, the lengthen the time, tensile strength and collagen content was increased. CONCLUSION: Autologous PRP enhanced tendon healing in rabbits. Within the PRP dosage setted by the author, more dosage of the infiltrated PRP increases the strength of the tendon and the dosage of collagen content. Further studies will be essential to determine the optimal dosage of PRP in clinical practice.
Achilles Tendon ; Blood Platelets* ; Collagen ; Platelet-Rich Plasma* ; Rabbits* ; Tendon Injuries ; Tendons* ; Tensile Strength

BACKGROUND: The nasal septal cartilage is often used as a donor graft in rhinoplasty operations but can vary widely in size across the patient population. As such, preoperative estimation of the cartilaginous area is important for patient counseling as well as operating planning. We aim to estimate septal cartilage area by using facial computed tomography (CT) studies. METHODS: The study was performed using facial CT images taken from 200 patients between January 2012 to July 2015. Using the mid-sagittal image, the boundary of cartilaginous septum was delineated from soft tissue using the mean difference in signal intensity (or brightness). The area within this boundary was calculated. The calculated area for septal cartilage was then compared across age groups and sexes. RESULTS: Overall, the mean area of nasal septal cartilage was 8.18 cm² with the maximum of 12.42 cm² and the minimum of 4.89 cm². The cartilage areas were measured to be larger in men than in women (p<0.05). The area decreased with advancing age (p<0.05). CONCLUSION: Measuring the size of septal cartilage using brightness difference is more precise and reliable than previously reported methods. This method can be utilized as the standard for prevention of postoperative complication.
Cartilage* ; Counseling ; Female ; Humans ; Male ; Methods ; Nasal Cartilages ; Postoperative Complications ; Rhinoplasty ; Tissue Donors ; Transplants

Mucormycosis is an opportunistic fungal infection caused by the mucorales, which consist of the Rhizophus, Absidia, Mortierella, and Mucor. The diverse clinical forms of mucormycosis can be categorized as rhinocerebral, pulmonary, disseminated, gastrointestinal, cutaneous and miscellaneous. Although it can cause disease in healthy people, it most commonly affects patients who are diabetic or immunosup-pressed. Rarely, mucormycosis develops confined to the subcutaneous tissue. We experienced a case of cutaneous mucormycosis developed in a well-controlled diabetic patient who had previously injected foreign material on her face for an aesthetic purpose at the behest of an unlicensed physician. The patient had tissue necrosis and purulent discharge on her left cheek. Following histologic examination, we diagnosed the condition as cutaneous mucormycosis and treated it by wide excision combined with amphotericin B therapy. The disease was cured without any significant sequelae within 6 months of follow up. Cutaneous mucormycosis is rarely reported but it can cause facial deformity due to tissue necrosis, so that early diagnosis and appropriate treatment are important. Currently, foreign material injection for aesthetic purposes is still performed by unlicensed physicians. We present a case report concluding that one should consider the possibility of fungal infection in skin lesion in diabetic or other immunosup-pressed patients. We also emphasize the seriousness of illegal injection of foreign material.
Absidia ; Amphotericin B ; Cheek ; Congenital Abnormalities ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortierella ; Mucor ; Mucorales ; Mucormycosis* ; Necrosis ; Paraffin* ; Skin ; Subcutaneous Tissue

Miescher syndrome comprises congenital acanthosis nigricans, hypertrichosis, failure to thrive and short stature, dysmorphism especially of the jaws and oral cavity, insulin-resistant diabetes mellitus, and a characteristic general appearance. This report concerns a rare case of 12-year-old girl having insulin resistant diabetic mellitus with Miescher syndrome. The relevant literature was reviewed.
Acanthosis Nigricans ; Child ; Diabetes Mellitus* ; Failure to Thrive ; Female ; Humans ; Hypertrichosis ; Insulin ; Jaw ; Mouth

To validate the diagnostic significance of red cell indices in non-anemic iron deficiency and iron deficiency anemia, complete blood count, serum iron, total iron binding capacity, and serum ferritin were measured in 208 middle school girls between 13 and 15 years of age. We used Reciever Operatin Characteristic (ROC) curve to compare the diagnostic significances of various red cell indices (MCV, MCH, MCHC, RDW). We also established the ideal cutoff values of red cell indices for the diagnosis of iron deficiency anemia. The results were as follows: 1) The prevalence of iron deficiency anemia and non-anemic iron deficiency were 4.8% and 11.1% respectively. 2) For the diagnosis of iron deficiency anemia, MCV had the highest diagnostic capacity, and MCH was the secondly useful one. 3) For the diagnosis of non-anemic iron deficiency. MCV had the highest diagnostic capacity, but the sensitivity and specificity of the 4 red cell indices(MCV, MCH, MCHC, RDW) were so low that they could not be used as screening or confirmative tests. 4) The sensitivity and specificity of MCV were 1 for the diagnosis of iron deficiency anemia(cutoff value: MCV=79 fl). In case of MCH, the sensitivity was. 1 and the specificity was 0.995 for the diagnosis of iron deficiency anemia(cutoff value: MCH=25pg). In case of MCHC, the sensitivity was 1 and the specificity was 0.69 for the diagnosis of iron deficiency anemia (cutoff value: MCH-33g/dl). In case of RDW, the sencitivity was 0.9 and the specificity was 0.96 for the diagnosis of iron deficiency anemia(cutoff value: RDW=13.5%). With above results, we could conclude that MCV and MCH were very useful screening tests for iron deficiency anemia and MCV could be used as a confirmative test of iron deficiency anemin.
Anemia, Iron-Deficiency* ; Blood Cell Count ; Diagnosis ; Erythrocyte Indices* ; Female ; Ferritins ; Humans ; Iron* ; Mass Screening ; Prevalence ; ROC Curve* ; Sensitivity and Specificity