BACKGROUND: Mandibular contouring surgery to produce a more slender and small face has become popular, especially in East Asia. Narrowing genioplasty should be simultaneously performed with mandibular angle resection to achieve satisfactory results. In Korea, T-genioplasty has been frequently performed for chin narrowing. The authors developed a new, safe, and reliable method, termed M-genioplasty, that can provide a more slender and attractive lower face. METHODS: From June 2013 to December 2017, 36 patients underwent M-genioplasty with mandibular angle resection for lower facial contouring. Horizontal and vertical osteotomies were performed obliquely. The resected bone segments were wedge-shaped. The remaining two bone segments were rotated and approximated centrally. The lateral mandible bony stepoff was trimmed off for mandibular angle resection. RESULTS: In all patients, the facial contour sufficiently improved, and most patients were satisfied with the outcome. No severe complications took place during postoperative follow-up. CONCLUSIONS: M-genioplasty can provide more mandibular angle resection and can create a more acute chin angle without bone resorption than other methods, including T-genioplasty. M-genioplasty with mandibular angle resection is a safer, more accurate, and more reliable method for lower facial contouring.
Bone Resorption ; Chin ; Far East ; Follow-Up Studies ; Genioplasty ; Humans ; Korea ; Mandible ; Methods* ; Osteotomy

No abstract available.
Teratoma* ; Turner Syndrome*

OBJECTIVE: C2 laminar screw fixation is considered as an excellent alternative to Magerl's transfacetal approach or Harms construct for the atlantoaxial stabilization. However, to our knowledge, there is no report on the feasibility of the new approach to Korean population. We investigated morphometric parameters of the dorsal arch of the C2 to provide the quantitative data for the feasibility of laminar screw fixation. METHODS: One-hundred-and-two patients' cervical computed tomography had been reconstructed and investigated on the anatomical parameters related with C2 laminar screw placement. Sixty patients were male and forty-two patients were female. Measurements included the laminar thickness and slope, spino-laminar angle, and maximal screw length. RESULTS: Ages ranged from 20 to 81 and the mean age was 48.4. Mean laminar thickness was 5.7 mm (+/-1.0) (5.8 mm in male and 5.4 mm in female). Fifty-one patients (50%) had a laminar thickness smaller than 5.5 mm at least unilaterally, therefore the patients were considered as inappropriate candidates for the laminar screw fixation in the smaller side of the laminae. Mean value of maximal length of screw was 33.3 mm (34.3 mm in male and 31.9 mm in female). Mean spino-laminar angle was 43.2degrees and mean slope angle was 32.9degrees. CONCLUSION: Half of patients had inappropriate laminar profiles to accommodate a 3.5 mm screw in at least one side of the axis. The three-dimensional computed tomography reconstruction is mandatory for the preoperative assessment for the feasibility of the C2 lamina.
Axis, Cervical Vertebra ; Female ; Humans ; Male

Reconstructions of soft tissue defect of the posterior ankle including Achilles the tendon should take into account not only coverage but functional outcome. Various methods of tendon transfer and tendon graft have been reported as a single-stage procedure. With advances and refinements in microsurgical techniques, several free composite flaps including tendon, fascia, or nerve have been used in single-stage reconstructions of large defects in this area minimizing further damage to the traumatized leg. However, when free flap is not feasible for some reasons, this cannot be accomplished successfully. Here we present a patient with Achilles tendon and circumferential large soft tissue defect. Because of circulatory compromise of the lower extremity, free flap reconstruction could not be applied. Instead, cross-leg composite flap of the dorsalis pedis flap including the extensor hallucis brevis musle and tendon, and tendon strips of the Second, third and fourth extensor digitorum logus were employed, Functional reconstruction of the tendon and resurfacing were obtained at the same time. The flap was detached 3 weeks postoperatively, and the transplanted flap has survived without any complications. By 3 months after surgery, full weight bearing, tip-toe standing and even walking without crutch assistance was possible. When functional reconstruction with the free flap is unattainable in the large defect of the posterior ankle including the Achilles tendon, cross-leg composite island flap of dorsalis pedis flap and tendon strips of the extensor digitorum longus tendon is a viable alternative.
Achilles Tendon* ; Ankle ; Fascia ; Free Tissue Flaps ; Humans ; Leg ; Lower Extremity ; Tendon Transfer ; Tendons* ; Transplants ; Walking ; Weight-Bearing ; Wounds and Injuries*

BACKGROUND AND OBJECTIVES: The purpose of this study was to investigate the criterion-related concurrent validity of two standardized auditory-perceptual assessments and the Acoustic Voice Quality Index (AVQI) for measuring dysphonia severity in patients with vocal cord paralysis (VCP). MATERIALS AND METHODS: Total 210 patients with VCP and 236 normal voice subjects were asked to sustain the vowel [a:] and to read aloud the Korean text “Walk”. A 2 second mid-vowel portion of the sustained vowel and two sentences (with 26 syllables) were recorded. And then voice samples were edited, concatenated, and analyzed according to Praat script. Two standardized auditory-perceptual assessment (GRBAS and CAPE-V) were performed by three raters. RESULTS: The VCP group showed higher AVQI, Grade (G) and Overall Severity (OS) values than normal voice group. And the correlation among AVQI, G, and OS ranged from 0.904 to 0.926. In ROC curve analysis, cutoff values of AVQI, G, and OS were < 3.79, < 0.00, and < 30.00, respectively, and the AUC of each analysis was over .89. CONCLUSION: AVQI and auditory evaluation can improve the early screening ability of VCP voice and help to establish effective diagnosis and treatment plan for VCP-related dysphonia.
Acoustics* ; Area Under Curve ; Diagnosis ; Dysphonia* ; Humans ; Mass Screening ; ROC Curve ; Vocal Cord Paralysis* ; Vocal Cords* ; Voice ; Voice Quality

PURPOSE: It is not surprising that serologically based epidemiologic studies have documented the high incidence of mycoplasma respiratory infection throughout the world. We studied the epidemiologic and clinical aspects of mycoplasma pneumonia in children if there is any differences in the peak age-related incidence, seasonal predominance and clinical manifestations in compare with other studies reported in Korea. METHODS: We reviewed 1004 cases of Mycoplasma pneumoniae pneumonia diagnosed by clinical manifestations and positive serologyc tests, retrospectively, who were admitted to the department of pediatrics in four university hospitals in Seoul and Inchon during the last 5 years from 1993 to 1997. RESULTS: 1) The age distribution of mycoplasma pneumonia showed highest incidence in children 4-6 years old. There was no difference in sex distribution at any age group. 2) Although there was little difference in annual distribution, it was highest in 1997. 3) Cough was the most prevalent prodromal symptom. 4) Vomiting, Nausea, Abdominal pain and headache were noted as the extrapulmonary manifestations. 5) Pulmonary infiltration was noted mostly in lower lobe lobes on chest X-ray. They showed interstial involvement in 34.5%, lobar involvement in 30.0%, and pleural effusion in 7.8% of the total. 6). As the complications, aggravate or trigger the asthma attack were noted in 4.0%, development of sinusitis in 3.5% and otitis media in 1.4% of the total. There were four cases of aseptic meningitis and one case of lung abscess. CONCLUSIONS: In our survey, there was little or no epidemiologic differences in the incidence of Mycoplasma pneumoniae pneumonia. We can find the increasing tendency of lobar pattern of involvement on chest X-ray in mycoplasma pneumonia in children.
Abdominal Pain ; Age Distribution ; Asthma ; Child ; Cough ; Epidemiologic Studies ; Epidemiology ; Headache ; Hospitals, University ; Humans ; Incheon ; Incidence ; Korea ; Lung Abscess ; Meningitis, Aseptic ; Mycoplasma pneumoniae* ; Mycoplasma* ; Nausea ; Otitis Media ; Pediatrics ; Pleural Effusion ; Pneumonia* ; Pneumonia, Mycoplasma* ; Prodromal Symptoms ; Retrospective Studies ; Seasons ; Seoul ; Sex Distribution ; Sinusitis ; Thorax ; Vomiting

In patients with epilepsy, depression is a common comorbidity but difficult to be treated because many antidepressants cause pro-convulsive effects. Thus, it is important to identify the risk of seizures associated with antidepressants. To determine whether paroxetine, a very potent selective serotonin reuptake inhibitor (SSRI), interacts with ion channels that modulate neuronal excitability, we examined the effects of paroxetine on Kv3.1 potassium channels, which contribute to highfrequency firing of interneurons, using the whole-cell patch-clamp technique. Kv3.1 channels were cloned from rat neurons and expressed in Chinese hamster ovary cells. Paroxetine reversibly reduced the amplitude of Kv3.1 current, with an IC₅₀ value of 9.43 µM and a Hill coefficient of 1.43, and also accelerated the decay of Kv3.1 current. The paroxetine-induced inhibition of Kv3.1 channels was voltage-dependent even when the channels were fully open. The binding (k₊₁) and unbinding (k₋₁) rate constants for the paroxetine effect were 4.5 µM⁻¹s⁻¹ and 35.8 s⁻¹, respectively, yielding a calculated K(D) value of 7.9 µM. The analyses of Kv3.1 tail current indicated that paroxetine did not affect ion selectivity and slowed its deactivation time course, resulting in a tail crossover phenomenon. Paroxetine inhibited Kv3.1 channels in a usedependent manner. Taken together, these results suggest that paroxetine blocks the open state of Kv3.1 channels. Given the role of Kv3.1 in fast spiking of interneurons, our data imply that the blockade of Kv3.1 by paroxetine might elevate epileptic activity of neural networks by interfering with repetitive firing of inhibitory neurons.
Animals ; Antidepressive Agents ; Clone Cells ; Comorbidity ; Cricetinae ; Cricetulus ; Depression ; Epilepsy ; Female ; Fires ; Humans ; Interneurons ; Ion Channels ; Neurons ; Ovary ; Paroxetine* ; Patch-Clamp Techniques ; Rats ; Seizures ; Serotonin ; Shaw Potassium Channels* ; Tail

Sertraline, a selective serotonin reuptake inhibitor (SSRI), has been reported to lead to cardiac toxicity even at therapeutic doses including sudden cardiac death and ventricular arrhythmia. And in a SSRI-independent manner, sertraline has been known to inhibit various voltage-dependent channels, which play an important role in regulation of cardiovascular system. In the present study, we investigated the action of sertraline on Kv1.5, which is one of cardiac ion channels. The eff ect of sertraline on the cloned neuronal rat Kv1.5 channels stably expressed in Chinese hamster ovary cells was investigated using the whole-cell patch-clamp technique. Sertraline reduced Kv1.5 whole-cell currents in a reversible concentration-dependent manner, with an IC50 value and a Hill coefficient of 0.71 microM and 1.29, respectively. Sertraline accelerated the decay rate of inactivation of Kv1.5 currents without modifying the kinetics of current activation. The inhibition increased steeply between -20 and 0 mV, which corresponded with the voltage range for channel opening. In the voltage range positive to +10 mV, inhibition displayed a weak voltage dependence, consistent with an electrical distance delta of 0.16. Sertraline slowed the deactivation time course, resulting in a tail crossover phenomenon when the tail currents, recorded in the presence and absence of sertraline, were superimposed. Inhibition of Kv1.5 by sertraline was use-dependent. The present results suggest that sertraline acts on Kv1.5 currents as an open-channel blocker.
Animals ; Arrhythmias, Cardiac ; Cardiovascular System ; Clone Cells ; Cricetinae ; Cricetulus ; Death, Sudden, Cardiac ; Female ; Inhibitory Concentration 50 ; Ion Channels ; Kinetics ; Neurons ; Ovary ; Patch-Clamp Techniques ; Rats ; Serotonin ; Sertraline* ; Tail

Paroxetine, a selective serotonin reuptake inhibitor (SSRI), has been reported to have an effect on several ion channels including human ether-a-go-go-related gene in a SSRI-independent manner. These results suggest that paroxetine may cause side effects on cardiac system. In this study, we investigated the effect of paroxetine on Kv1.5, which is one of cardiac ion channels. The action of paroxetine on the cloned neuronal rat Kv1.5 channels stably expressed in Chinese hamster ovary cells was investigated using the whole-cell patch-clamp technique. Paroxetine reduced Kv1.5 whole-cell currents in a reversible concentration-dependent manner, with an IC50 value and a Hill coefficient of 4.11 microM and 0.98, respectively. Paroxetine accelerated the decay rate of inactivation of Kv1.5 currents without modifying the kinetics of current activation. The inhibition increased steeply between -30 and 0 mV, which corresponded with the voltage range for channel opening. In the voltage range positive to 0 mV, inhibition displayed a weak voltage dependence, consistent with an electrical distance delta of 0.32. The binding (k(+1)) and unbinding (k(-1)) rate constants for paroxetine-induced block of Kv1.5 were 4.9 microM(-1)s(-1) and 16.1 s-1, respectively. The theoretical K(D) value derived by k(-1)/k(+1) yielded 3.3 microM. Paroxetine slowed the deactivation time course, resulting in a tail crossover phenomenon when the tail currents, recorded in the presence and absence of paroxetine, were superimposed. Inhibition of Kv1.5 by paroxetine was use-dependent. The present results suggest that paroxetine acts on Kv1.5 currents as an open-channel blocker.
Animals ; Clone Cells ; Cricetinae ; Cricetulus ; Female ; Humans ; Inhibitory Concentration 50 ; Ion Channels ; Kinetics ; Neurons ; Ovary ; Paroxetine* ; Patch-Clamp Techniques ; Rats ; Serotonin ; Tail