Previous anatomic concepts in cleft lip nose deformity have following characteristics: 1. Obtuse angle between medial and lateral crus in affected alar cartilage; and 2, Cleft side alar cartilage is hypoplastic. The purpose of this study was to review the anatomy of alar cartilage in cleft lip nose deformity and to find out the effects of removal of intercartilagenous soft tissue on the effects of removal of intercartilagenous soft tissue on relocation of alar cartilage. There were 97 cleft lip nose corrections from Oct. 1996 to March When the affected alar cartilage was dissected, redundant intercartilagenous fibro-fatty tissue was found. After removing this redundant soft tissue, we found that the cleft side alar cartilage was better adjusted to the normal position. In addition, the plicavestibularis was more improved. Alar cartilage suture fixation was subsequently performed. Alar cartilage suture fixation was subsequently performed. After this procedure, we found that subsequently performed. After this procedure, we found that the affected side of alar cartilage was more normally positioned than before. The summary of the author's view on affected alar cartilage is as follows: 1. An acute angle between the medial and lateral crus was noted in affected alar cartilage; 2. Redundant intercartilagenous fibro-fatty tissue was present in cleft lip nose deformity;3.The terminal portion of the lateral crus of alar cartilage makes a plica vestibularis in the cleft side; 4. The position of the medial crus of alar cartilage was lower in the cleft side with the lateral crus was lower and cephalic in the cleft side; 5. The cleft side of alar cartilage is not hypoplastic.
Cartilage* ; Cleft Lip* ; Congenital Abnormalities* ; Nose* ; Sutures

No abstract available.
Brain* ; Hydrocephalus*

PURPOSE: Percutaneous nephroureterolithotripsy is one of alternative methods for the treatment of upper ureteral stones which are impacted in ureter or unresponsive to repeated extracorporeal shock wave lithotripsy(SWL). We evaluated the factors influencing the success rate of percutaneous nephroureterolithotripsy based on clinical data. MATERIALS AND METHODS: 107 patients(2 with bilateral) were included in this study. We reviewed the medical records and analyzed the factors ; stone size, laterality, location, site of percutaneous puncture, presence of pyuria, body weight, previous procedure(open surgery or SWL), and the experience of operator. RESULTS: The overall success rate of percutaneous nephroureterolithotripsy was 85.3%(93 of 109 cases). The location of stone and the experience of operator influenced the success rate of operation. The stones located above the lower pole level were obviously more successful than those located below it(57/62, 91.9% versus 36/47, 76.6%, p<0.05). In the late period of the operator`s experience, the success rate was significantly increased than that in the early period(51/58, 87.9% versus 40/51, 78.4%, p<0.05). But the stone size, laterality, site of percutaneous puncture, presence of pyuria, body weight and previous procedure didn`t influence the success rate. The average operation time was 93 minutes, average radiation exposure time was 2.2 minutes, and average hospital stay was 5.4 days. Most of the complications such as bleeding, urinary tract infection and pneumothorax were managed successfully with conservative treatments. CONCLUSIONS: Upper ureteral stones, which are impacted in ureter or unresponsive to repeated SWL can be successfully managed with percutaneous procedures. The stone location and the experience of operator are considered to be the major factors influencing the success rate.
Body Weight ; Hemorrhage ; Length of Stay ; Medical Records ; Pneumothorax ; Punctures ; Pyuria ; Shock ; Ureter ; Urinary Tract Infections

Bilateral vocal cord paralysis generally arises from trauma, tumor compression of the recurrent laryngeal nerves, surgery on neck and neurological diseases. Progressive supranuclear palsy is a rare degenerative disease showing supranuclear ophthalnoplegia, rigidity, bradykinesia, dysarthria and dementia. Bilateral vocal cord paralysis in patients with progressive supranuclear palsy can be found only in a few cases reported in literature. The finding of bilateral vocal cord paralysis is important because it can be life threatening. We managed a patient with the laterofixation of vocal cord for preventing respiratory failure due to glottic airway compromise. We report this case with a review of literature.
Dementia ; Dysarthria ; Humans ; Hypokinesia ; Neck ; Recurrent Laryngeal Nerve ; Respiratory Insufficiency ; Supranuclear Palsy, Progressive ; Vocal Cord Paralysis ; Vocal Cords

PURPOSE: To compare clinical outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) between different graft insertion methods. METHODS: The clinical records of 32 eyes of 30 DSAEK patients were retrospectively analyzed. Patients were divided into 2 groups according to graft insertion method. Group A: Taco-folding, group B: Tan-endoglide. The best corrected visual acuities (BCVA), intraocular pressures, astigmatism, endothelial cell count, central corneal thickness and complications were evaluated pre and post-operatively. RESULTS: The average follow-up period was 19 months (range 1-67). Postoperative log MAR visual acuity had significantly improved both from 1.63 (log MAR) to 0.69 and 0.53 at 12 months in each group (p = 0.035, p = 0.000). Mean endothelial cell survival of each group at 1 month postoperative were 75.8% (range 62.7-88.6) and 87.7% (range 70.2-97.9), respectively (p = 0.012). The differences of BCVA improvement and endothelial cell survival between the groups at 12 months were not significant (p = 0.393, p = 0.544). CONCLUSIONS: Both methods showed fast visual recovery. Using Tan-endoglide insertion resulted less endothelial cell loss at early post-operative period and showed less post-operative complication and graft failure.
Astigmatism ; Corneal Transplantation* ; Descemet Membrane* ; Endothelial Cells ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Methods* ; Retrospective Studies ; Transplants* ; Visual Acuity

BACKGROUND/AIMS: Functional dyspepsia(FD) is primarily a symptom complex. There is no consensus on the pathogenesis of functional dyspepsia. Disorders of motor function of the upper gastrointestinal tract have been implicated in the pathogenesis of FD. About 25-60% of patients with FD have delayed gastric emptying and postprandial antral hypomotility. Intestinal dysmotility is common in patients with severe and incapacitating FD. But there were few reports about association with esophageal dysmotility in FD. We performed this study to investigate the esophageal motility in patients with dysmotility-like FD. METHODS: The study included twenty-three patients (M:F=6;17, mean age: 42.5 years) referred to Ajou University Hospital for evaluation of their dyspepsia from July 1994 to July 1997. All patients underwent routine blood tests, upper gastrointestinal series or esophagogastroduodenoscopy and abdominal ultrasound to rule out organic cause of dyspepsia. The patients with reflux-like symptoms such as heartbum and/or regurgitation and noncardiac chest pain were also excluded. Standard esophageal manometry was done with pneumohydraulic capillary infusion system. RESULTS: 1) Out of 23 patients, 12 patients showed normal esophageal manometric finding, 11 patients(47.8%) abnormal finding. Esophageal manometry revealed hypertensive upper esophageal sphinter (UES) in 3 patients, hypertensive lower esophageal sphinter (LES) in 2 patients, hypotensive LES in 1 patients. Four patients showed nonspecific esophageal motility disorder low-amplitude contractions in 3 patients, nontransmitted contractions in 1 patient). One patient exhibited nutcracker esophagus. 2) Out of 23 patients, 5 patients also complained of symptoms consistent with lower gut dysfuctian, chiefly irritable bowel syndrome. Three of these patitnets revealed abnormal esophageal manometric finding (hypertensive UES in 2 patient, low-amplitude contractions in one patient). CONCLUSIONS: This findings indicate that some patients with FD have esophageal manometric abnormalities. The esophageal motor dysfunction was mainly observed in esophageal body and lower esophageal sphinter, which are made up of smooth muscle.
Capillaries ; Chest Pain ; Consensus ; Dyspepsia* ; Endoscopy, Digestive System ; Esophageal Motility Disorders ; Gastric Emptying ; Hematologic Tests ; Humans ; Irritable Bowel Syndrome ; Manometry ; Muscle, Smooth ; Ultrasonography ; Upper Gastrointestinal Tract

Xanthogranulomatous pyelonephritis is a chronic inflammatory condition that can only be diagnosed by histological examination, and is often associated with renal calculi, obstruction and urinary tract infection. We report a case of bilateral xanthogranulomatous pyelonephritis in a child with end stage renal disease, which was misdiagnosed as renal cell carcinoma preoperatively.
Carcinoma, Renal Cell ; Child* ; Humans ; Kidney Calculi ; Kidney Failure, Chronic ; Pyelonephritis, Xanthogranulomatous* ; Urinary Tract Infections

PURPOSE: To evaluate whether CT scanning is useful in differentiating the between endometriomas and other benign complex cystic adnexal masses, and in determining the method of treatment for each mass lesion. MATERIALS AND METHODS: In 54 cases (47 patients), we retrospectively analysed the CT findings of 20 pathologically-proven twenty endometriomas (bilateral in four cases), eight hemorrhagic functional cysts, two tubal ectopic pregnancies, eight tubo-ovarian abscesses (bilateral in two cases), ten serous cystadenomas (bilateral in one case), and six mucinous cystadenomas. Internal attenuation, the hyperdense portion, adhesion, and cul-de-sac obliteration were evaluated by CT scanning. RESULTS: Fourteen endometriomas (70%) showed a hyperdense portion, and in only two of these (10%), was a focal nodular hyperdense portion seen on pre-contrast CT scan (10% sensitivity, 100% specificity). Partial or complete cul-de-sac obliteration was identified in 11 patients (75%), while hemorrhagic functional cysts showed a hyperdense portion in four cases (50%) and were accompanied by partial cul-de-sac obliteration in two (25%). Two unruptured tubal ectopic pregnancies showed CT findings of unilateral hyperdense cystic masses of more than 60 HU. In all cases, tubo-ovarian abscesses were accompanied by thickening of the uterosacral ligament and deviation of thickened mesosalpinx (anterior deviation in 87.5% of patients). Serous and mucinous cystadenomas showed CT findings of hypodense masses (less than 20 HU) without adhesion or cul-de-sac obliteration, and this was helpful in differentiating cystadenomas from other benign cystic adnexal masses, including endometriomas. CONCLUSION: The evaluation by CT scanning of benign complex cystic adnexal masses with respect to the hyperdense portion and the presence or absence of cul-de-sac obliteration was usful in differentiating endometriomas from other lesions, and might be helpful in determining the method of treatment for each mass lesion.
Abscess ; Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Endometriosis* ; Female ; Humans ; Ligaments ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies ; Tomography, X-Ray Computed

Acute pancreatitis is associated with a wide variety of infectious agents including mumps, hepatitis B virus, Coxsackie virus, Mycoplasma, Legionella, Aspergillus and Toxoplasma. There are a few reports of acute pancreatitis caused by Mycoplasma pneumoniae infection abroad, but rare in Korea. We treated a case of acute pancreatitis in a 13-year-old girl who presented with nausea, vomiting, diarrhea and severe abdominal pain. The clinical and laboratory findings led to the diagnosis of acute pancreatitis; the cause was confirmed by serological evidence of mycoplasma pneumoniae infection. We report acute pancreatitis caused by mycoplasma pneumoniae infection and review the literature.
Abdominal Pain ; Adolescent ; Aspergillus ; Diagnosis ; Diarrhea ; Female ; Hepatitis B virus ; Humans ; Korea ; Legionella ; Mumps ; Mycoplasma pneumoniae* ; Mycoplasma* ; Nausea ; Pancreatitis* ; Pneumonia, Mycoplasma* ; Toxoplasma ; Vomiting

PURPOSE: To evaluate the reproducibility of ImageJ software in analyzing the color of the optic disc. METHODS: One hundred twelve normal participants (56 males and 56 females) were enrolled in this study. The image of the optic disc was taken using Kowa digital disc photo-graphy, and the gray scales of the nasal rim (NR), brightest cupping center (BCC) and largest inferior retinal vein (IRV) were calculated using histogram in ImageJ. Three different observers calculated the gray scales three separate times. Reproducibility was assessed using the interclass correlation coefficient (ICC). RESULTS: The mean age of the participants was 50.6 years old (range, 11 to 82 years). The mean gray scales of the nasal rim were 91.81, 94.91, and 93.24; those of the brightest cupping center were 174.84, 179.94, and 177.76; and those of the largest inferior retinal vein were 61.85, 53.48, and 56.73 for observers 1, 2, and 3, respectively. Inter-observer reproducibility for NR, BCC and IRV was considered good based upon ICC values of 0.944, 0.860, and 0.789 for observers 1, 2, and 3, respectively. Significant age-related differences between the values of the brightest cupping center were noted, and the gray scale score was decreased in the older participants (p < 0.001). CONCLUSIONS: The gray scale of the brightest cupping center diminished with age. ImageJ can be a useful objective tool with high reproducibility in the analysis of optic disc color.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Color ; Female ; Humans ; Image Processing, Computer-Assisted/*methods ; Male ; Middle Aged ; Optic Disk/*physiology ; Organ Size ; Photography ; Reference Values ; Reproducibility of Results ; Retinal Vein/anatomy & histology ; *Software ; Young Adult