We present our experience with autologous fat injection and collager implantation in the treatment of facial atrophy. The surgical teclinigues are described for injecting the colagen into the nasolabial fold and collecting fat from the lower abdomen and then injecting the fat into the depressed site on the face. There were no serious complications without slowly progressive, volume reduction. We think that, these techniques could have a plae in the treatment of problems relatcd to facial depression. However, a longer follow-ups and more clinical experiences will be needed in order to reach some definite conclusions.
Abdomen ; Atrophy ; Collagen* ; Depression ; Follow-Up Studies ; Nasolabial Fold

BACKGROUND: Neopterin is released from monocytes/macrophages specifically by stimulation with interferon-γ. Therefore the increase refers to the activation of T lymphocytes. OBJECTIVE: Our objective was to examine the potential role of neopterin in the cell mediated immune response to Behçet's disease. METHODS: We studied 67 patients of Behçet's disease classified by Shimizu and a control group of 30 normal healthy people. Serum neopterin was detected by radioimmunoassay technique. RESULTS: The serum neopterin concentration of the group with Behçet's disease was significantly elevated, compared with the control group (6.36 nmol/ml vs 3.63 nmol/ml). The increase of neopterin concentration was well correlated to the clinical severity of the diseases in increasing order. CONCLUSION: Our data suggest that the T lymphocyte derived IFN-γ which stimulates the production of neopterin has some role in the pathogenesis and clinical severity of Behçet's disease.
Humans ; Interferon-gamma ; Lymphocytes ; Neopterin* ; Radioimmunoassay ; T-Lymphocytes

Given the complications involved in corticosteroid (CS) injections, subacromial platelet-rich plasma (PRP) injections may provide a valid alternative to CS in the treatment of rotator cuff (RC) tendinopathy. Methods: We retrospectively reviewed a total of 98 patients affected by RC tendinopathy who were treated with either subacromial injection of PRP or CS. The PRP group received three injections of autologous PRP at 2 weeks interval, and the CS group received one injection of CS. The Western Ontario Rotator Cuff Index (WORC) was the primary outcome measure, while the secondary outcome measures were the visual analog scale (VAS), range of motion (ROM), and need for cuff repair surgery, which were analyzed at intervals of 6, 12, and 18 months. Results: A total of 75 patients were included in the analysis (PRP, n=35; CS, n=40). The mean follow-up for PRP was 21.1±8.7 months and for CS was 33.6±16.3 months (p<0.001). Both groups showed improvement in WORC, VAS, and ROM. No significant differences were detected between the two groups in any of the primary (WORC) or secondary outcomes over 6, 12, and 18 months (all p>0.05). No adverse events were detected. Conclusions: Both treatments improved patient symptoms, but neither resulted in a significantly better outcome in this series of patients. PRP can be a safe and feasible alternative to CS, even at long-term follow-up, to reduce local and systemic effects involved with CS injections.

We reviewed 48 skin bicpsies obtained from 48 patients with epidermal nevus during a 10 year period from January 1981 to December 1990. The results are summarized as follows : 1) Of our 48 patients, 23 were male and 25 were female, and male to female ratio was 1 to 1.1. 2) The average of the patients was 19.8 years at the time of diagnois. 3) Lesions were present at birth in 45.7 percent of patients, and most of the remainder de veloped in childhood. The mean age of onset was 7.7 years. 4) The clinical varieties of the nevi in 48 patients were classified according to caicegories of nevus verrucosus, including systematized epidermal nevus, nevu, unius lateris, ichthyosis hystrix, epidermal nevus syndrome and inflammatory linear veirucous epidermal nevus. The most common type was nevus verrucosus(88.6%). 5) A large variety of histopathologic changes can be seen in epidermal nevi. The most common histopathologic .ype was nonspecific(31.3%), follows by common(12.5%), epidermolytic hyperkertosis(12.5%), and acanthosis nigricans(10.4%). 6) The most commonly affected area was head and neck(48.5%) followed by trunk(28.6%), upper limb(11.4%) and lower limb(2.9%).
Age of Onset ; Female ; Head ; Humans ; Ichthyosis ; Male ; Nevus* ; Parturition ; Porcupines ; Skin

We investigated inhibitory effects of extract containing quercetin-3-O-beta-D-glucuronopyranoside (ECQ) extracted from Rumex Aquaticus Herba on indomethacin-induced gastric damage in Rats. Gastritis was induced in male Sprague-Dawley rats (200~220 g) by oral administration of indomethacin at a dose of 40 mg/kg. One hour before administration of indomethacin, animals were orally pretreated with ECQ at doses of 0.3, 1, 3 or 10 mg/kg. Six hours after indomethacin administration, the rats were sacrificed and the stomach was excised and opened along the greater curvature, and the surface area of gastric lesion was measured using optical microscope. Superoxide dismutase (SOD), catalase (CAT), myeloperoxidase (MPO) activities and malondialdehyde (MDA) levels were measured by ELISA. Western blot analysis was performed to detect protein expression of SOD-2. Linear hemorrhagic mucosal lesions were observed in the stomach 6 hours after oral administration of indomethacin. Pretreatment with ECQ significantly reduced the severity of the lesions in a dose-dependent manner. It also inhibited the reductions in SOD and CAT activities and SOD expression by the indomethacin-induced gastric damage. In addition, the pretreatment with ECQ significantly suppressed the elevation of the MPO activity and the MDA levels induced by indomethacin. These results suggest that ECQ has the inhibitory effects via antioxidative action against indomethacin-induced gastritis in rats.
Administration, Oral ; Animals ; Blotting, Western ; Catalase ; Cats ; Enzyme-Linked Immunosorbent Assay ; Gastritis ; Humans ; Indomethacin ; Male ; Malondialdehyde ; Peroxidase ; Quercetin ; Rats ; Rats, Sprague-Dawley ; Rumex ; Stomach ; Superoxide Dismutase

BACKGROUND: The use of monitored anesthesia care (MAC) as the technique of choice for a variety of invasive or noninvasive procedures is increasing. The purpose of this study to compare the outcomes of two different methods, spinal anesthesia and ilioinguinal-hypogastric nerve block (IHNB) with target concentrated infusion of remifentanil for inguinal herniorrhaphy. METHODS: Fifty patients were assigned to spinal anesthesia (Group S) or IHNB with MAC group (Group M). In Group M, IHNB was performed and the effect site concentration of remifentanil, starting from 2 ng/ml, was titrated according to the respiratory rate or discomfort, either by increasing or decreasing the dose by 0.3 ng/ml. The groups were compared to assess hemodynamic values, oxygen saturation, bispectral index (BIS), observer assessment alertness/sedation scale (OAA/S), visual analogue scale (VAS) for pain score and patients' and surgeon's satisfaction. RESULTS: BIS and OAA/S were not significantly different between the two groups. Hemodynamic variables were stable in Group M. Thirteen patients in the same group showed decreased respiratory rate without desaturation, and recovered immediately by encouraging taking deep breaths without the use of assist ventilation. Although VAS in the ward was not significantly different between the two groups, interestingly, patients' and surgeon's satisfaction scores (P = 0.0004, P = 0.004) were higher in Group M. The number of the patients who suffered from urinary retention was higher in Group S (P = 0.0021). CONCLUSIONS: IHNB under MAC with remifentanil is a useful method for inguinal herniorrhaphy reflecting hemodynamic stability, fewer side effects and higher satisfaction. This approach can be applied for outpatient surgeries and patients who are unfit for spinal anesthesia or general anesthesia.
Ambulatory Surgical Procedures ; Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Hemodynamics ; Herniorrhaphy ; Humans ; Nerve Block ; Oxygen ; Piperidines ; Respiratory Rate ; Urinary Retention ; Ventilation

OBJECTIVE: Fall is one of major causes of morbidity and mortality in the elderly. It is known that sleep is associated with quality of life in the elderly. Snoring is one of the factors affecting sleep quality. The aim of the study was to examine whether snoring affect fall in the community elderly. METHODS: This survey was performed as a part of the Korean Social Life, Health, and Aging Project, which studied the elderly living in Ganghwa-gun. Fall was defined as any history of fall in the last year through face-to-face interview. We examined the following variables: age, sex, snoring, insomnia, hypertension, diabetes, stroke, bone disease, vision problems, depression, alcohol intake, mini-mental state examination, and body mass index. The data was analyzed by multiple logistic regression to determine the association of fall with the risk factors. RESULTS: In the multivariate analysis of 516 participants, the adjusted odd ratios (95% confidence interval) of simple snoring affecting fall was 1.70 (1.10–2.63). In addition, sex (female), age, and diabetes were significantly predicted the fall. CONCLUSION: Our result suggested that snoring could be a risk factor of fall. A more comprehensive study of the relationship between snoring and fall is needed to improve the quality of life of the community elderly.
Aged* ; Aging ; Body Mass Index ; Bone Diseases ; Depression ; Humans ; Hypertension ; Logistic Models ; Mortality ; Multivariate Analysis ; Quality of Life ; Risk Factors* ; Sleep Initiation and Maintenance Disorders ; Snoring* ; Stroke

Background: Although insomnia and constipation are highly prevalent worldwide, studies examining a possible association between them are lacking. We examined the relationship between insomnia and constipation in shift workers who have a high prevalence of insomnia and other diseases. Methods: This study had a multicenter cross-sectional design and conducted using health examination data including self-reported questionnaires. In total, 12,879 and 4,650 shift workers were enrolled in Severance Hospital and Wonju Severance Hospital, respectively, during 2015-2017. Multivariate logistic regression models and subgroup analysis were performed in each center with the same protocol, using a common data model. Results: The mean age of the total population was 44.35 (standard deviation = 8.75); the proportion of males was 56.9%. Female sex, being underweight and non-smoker were strongly associated with an increased risk of constipation symptom (p < 0.001). Pooled odds ratios (ORs) were calculated using ORs of both centers with weights; there was a significant dose–response relationship (sub-threshold 1.76 [95% confidence interval [CI] 1.62–1.91]; moderate 2.28 [95% CI 2.01–2.60]; severe 4.15 [95% CI 3.18–5.41] in the final model, p for trend < 0.001). Subgroup analysis performed by stratifying sex and pooled ORs showed a similar trend to that of the entire group. Conclusion We observed a strong correlation between insomnia and constipation in this population. Our findings may help in formulating guidelines and policies to improve quality of life in shift workers through the management of sleep quality and proper bowel function. This study is the first to report this relationship among people working in shifts.

Extracranial carotid artery aneurysm is an uncommon disease that otorhinolaryngologists may encounter only rarely. It usually presents as pulsatile neck mass or as other neurologic symptoms. We report a case of extracranial internal carotid artery aneurysm in an 81-year old female who presented with a fever and nonpulsatile oropharyngeal swelling mimicking a peritonsillar abscess. Incision and drainage of the swelling lesion could have resulted in catastrophic events such as aneurismal rupture or a stroke. We thus recommend radiologic evaluations of peritonsillar abscess before performing any procedure, even if it is clinically highly suspicious.

Background and Objectives: The aim of this study was to investigate the surgical outcomes of revision operation due to recurrence of non-cholesteatomatous chronic otitis media (COM) surgery cases.Subjects and Method From 1989 to 2018, 5197 cases of COM surgery were performed at Kangdong and Hallym University Sacred Heart Hospital. Among them, clinical data of 297 subjects who had undergone revision tympanoplasty and/or mastoidectomy for recurrent noncholesteatomatous COM were retrospectively collected from computerized database of middle ear surgery (Korean Otological Society program 2005). Each case was categorized by surgical approaches into canal wall down mastoidectomy (CWDM), canal wall up mastoidectomy (CWUM), or tympanoplasty only groups. Results: Tympanoplasty only was performed in 170 cases, CWDM in 74 cases, and CMUM in 53 cases. Postoperative perforation occurred in 9.4% of total cases, and less frequently in CMDM compared with tympanoplasty only (p=0.023), and CMUM (p=0.049), respectively, whereas no differences between tympanoplasty only and CMUM (p=0.930) were found. Postoperative infection rate was 1.0% and did not show any differences among the groups. Postoperative successful hearing was obtained in 66.7% of total cases, and the success rate of tympanoplasty only was better than that of CMDM (p=0.001), and CMUM (p=0.011). And, that of CMUM was better than that of CMDM (p=0.011). Conclusion The results showed that postoperative perforation occurred less frequently in CMDM than in tympanoplasty only and in CWUM; successful hearing was achieved more frequently in tympanoplasty alone than in the other surgical approaches in recurrent non-cholesteatomatous COM.