The choice of operative procedures was determined by many factors, but the levator function is considered as the most important factor. Fox recommended that when the levator function was 2 to 9 mm, the patient should be treated by the levator resection and when the levator function was below 2 mm, the patient should be crated by frontalis suspension. But Collin recommended that when the levator function was below 4 mm, the brow suspension procedure got the better result. Beside that, many other authors recommended various opinions. Therefore, when levator function of the patients was between 2 and 4 mm, the choice of operative procedure was much confusing us. The aim of this study is to clarify which is better Procedures between levator resection and the frontalis transfer or orbicularis oculi muscle transfer among the patients with 2 to 4 mm of levator action. From Jan. of 1991 to Dec. of 1994, among 26 patients with 2 to 4 mm levator function, 13 cases of 10 patients were operated by levator resection, 21 cases of 16 patients were teated by frontalis transfer or orbicularis oculi muscle flap. The results were evaluated with the average 27 months of follow-up and we compared the result of the levator resection procedure with that of frontalis muscle transfer or orbicularis oculi muscle transfer. The preoperative average amount of ptosis is about 2.7 mm in cases with levator resection, about 4.0 mm in cases with frontalis muscle transfer or orbicularis oculi muscle flap transfer. The postoperative average amount of ptosis is about 1.7 mm in cases with levator resection about 2.14 mm in cases with frontail muscle transfer or orbicularis oculi muscle flap transfer and so the postoperative improvement of amount of ptosis is about 1.0 mm in cases with levator resection, about 1.86 mm in cases with frontails muscle transfer or orbicularis oculi muscle flap transfer. The major complication of levator resection method is undercorrection. However, the eyelid deformity due to excessive upward traction was more frequent in frontalis muscle flap technique.
Blepharoptosis* ; Congenital Abnormalities ; Eyelids ; Follow-Up Studies ; Humans ; Surgical Procedures, Operative ; Traction

No abstract available.
Subcutaneous Tissue*

No abstract available.

Damages to the sensory, autonomic and motor nerves in leprosy patients are followed by anesthesia, dryness of the skin and muscular paralysis. Most plantar ulcers in leprosy patients are caused by repetitive moderate stress. Minor injuries such as bruising sustained as a result of the misuse of anesthetic limbs may lead to ulceration, scar formation and secondary infection. Cellulitis develops and destroys subcutaneous tissue, resulting in an infection which can reach the bone. As a result of osteomyelitis, bone is absorbed, sequestra are extruded and the architecture of the foot is destructed. The most common sites of the plantar ulceration are over the metatarsal heads, the base of the fifth metatarsal, the base of the proximal phalanx, and the calcaneus. During the past 9 years, we treated 85 patients with ulcers located on the sole and the dorsum of the foot, and lower third of the leg. To prevent osteomyelitis and amputation of the lower leg, we performed various treatment modalities such as free and pedicle flaps, skin grafts, and mechanical stretching devices of the skin (e.g., Sure Closure, Proxiderm, etc), as well as consistent vacuum-assisted closure. We obtained satisfactory results in most cases. We report detailed results and related references.
Amputation ; Anesthesia ; Calcaneus ; Cellulitis ; Cicatrix ; Coinfection ; Extremities ; Foot Ulcer* ; Foot* ; Head ; Humans ; Leg ; Leprosy* ; Metatarsal Bones ; Negative-Pressure Wound Therapy ; Osteomyelitis ; Paralysis ; Skin ; Subcutaneous Tissue ; Transplants ; Ulcer

It is difficult to treat the complete cleft lip because of wide cleft and malaligned alveolar process, outward rotation of greater(medial) alveolar segment, and severe nasal deformity. Lip adhesion without presurgical orthopedic appliance was performed on 8 consecutive infants with unilateral complete cleft of the primary palate before denfinitive lip repair with Millard I procedure. Among 8 patients, 6 patients had complete unilateral cleft lip with alveolar cleft only and 2 patients were accompanied with complete cleft palate. All patients had more than a 10-mm-wide lip cleft with alveolar arch discrepancy. Lip adhesions were performed at 1-2 months of age and definitive repair was done at 5-6 months of age. Lip adhesions were performed by Randall's method and cheiloplasty was done by Millard I technique. Satisfactory results of lip and nose were obtained aesthetically in 8 cases after an average follow-up of 32 months. The vertical height of the medial and lateral lip segment were a symmetric appearance, while the vermilion tubercle, philtrum, and Cupid's bow were natural. Disadvantages included increased operating time and the sacrifice of same-lip tissue. In conclusion, preliminary lip adhesion can have better functional, esthetic and emotional results since the disadvantages are minor compared to the advantages.
Alveolar Process ; Cleft Lip* ; Cleft Palate ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Infant ; Lip* ; Nose ; Orthopedics ; Palate

Malignant angioendothelioma is an uncommon malignant vascular tumor featuring endothelial cell, and it occurs most frequently in sixth and seventh decade. Most lesions occur over the face and scalp, and may be solitary or multiple, The lesion usally appears as a localized dark red to purplish nodules or plapue with small satellite nodules. Histopatholgic finding shows a nodule eomposed of irregular vascular spaces lined by plump endothelial cells stroma. We present a case of malignant angioendo thelioma on a 42 year-old woman. The patient had purplish nodule with satellite lesions on the right cheek. This case was confirmed by clinical picture, histologic findings and electron microscopic examination.
Adult ; Cheek ; Endothelial Cells ; Female ; Humans ; Scalp

PURPOSE: Human bocavirus (hBoV), a recently discovered virus, has been detected in children with respiratory tract infections worldwide. The aim of this study was to analyze the frequency and molecular phylogeny of hBoV in the respiratory samples of children with acute respiratory tract infections in 2010. METHODS: Nasopharyngeal samples were collected from 953 children with lower respiratory tract infections at Severance children's hospital in Korea from January 2010 to December 2010. We applied the multiplex PCR technique for the identification of 12 respiratory viruses from the samples. Among the total specimens, hBoV positive samples were subjected to phylogenetic analysis by sequencing a fragment of the VP1/VP2 gene junction. RESULTS: hBoV was detected in 141 (14.8%) among 953 patients. The 61.7% of hBoV-positive samples were found to co-exist with other respiratory viruses. The results of phylogenetic analysis showed that all 141 hBoV-positive isolates were identified as hBoV 1, revealing a high similarity among the isolates (>98%). CONCLUSION: hBoV 1 with minimal sequence variations circulated in children with acute respiratory infections during 2010. More research is needed to determine the clinical severity and outcomes of the minimal sequence variations.
Child ; Child, Hospitalized ; Human bocavirus ; Humans ; Korea ; Multiplex Polymerase Chain Reaction ; Phylogeny ; Respiratory System ; Respiratory Tract Infections ; Viruses

In correction of ptosis, symmetry of lid contour, lash position and lid height must be matched. Most of blepharoptosis patients want to perform both the double eyelid operation and ptosis repair at the same time to achieve the best cosmetic and functional result. Using a surgical technique directed at the levator aponeurosis or the frontalis muscle with double eyelid operation, we corrected 13 cases of unilateral and 10 cases of bilateral congenital blepharoptosis. In unilateral ptosis with good or fair levator function, levator resection was performed and the position of the lid margin was adjusted at 1~2 mm below the superior limbus. The height of the lid crease of the ptotic eye is determined 1~3 mm lower than that of normal side. The position of the lid margin is adjusted at the level of the superior limbus and the height of the lid crease of the ptotic eye is determined 2~4 mm lower than that of nonptotic side. The advantages of this approach are normal anatomic planes of the eyelid are maintained, to obtain symmetry of both eyelids relatively easily, entropion may be prevented, and to achieve aesthetically pleasing results.
Blepharoptosis* ; Entropion ; Eyelids* ; Humans

From May 1988 to January 1997 authors had experienced 13 cases of recurred blepharoptosis. Previous operative procedures were frontalis muscle suspension in 10 cases and levator resection in 3 cases. Follow up period ranged from 11 months to 9 years. We have treated recurred blepharoptosis using frontalis myofascial flap, orbicularis oculi muscle flap and levator resection in accordance with the postoperative levator function and degree of ptosis of patient and considering previous operative technique. The results were that 12 patients have gained the levator excursion over 7 mm and reduced the height difference between both palpebral fissures less than 2 mm after reoperation (good in 6 cases and satisfactory in 6 cases). From these results we might conclude that the frontalis myofascial flap technique is a good secondary blepharoptosis operation for patient with less than 2 mm of levator function, orbicularis oculimuscle flap technique with 2-4 mm of levator function, levator resection with over than 4 mm of levator function. The expert technique and experience are also important factor for the treatment of recurred blepharoptosis.
Blepharoptosis* ; Follow-Up Studies ; Humans ; Reoperation ; Surgical Procedures, Operative

The key points of treatment of cryptotia are the elevation of invaginated ear helix and the correction of deformed cartilage. Prevention of stabilized cartilage contouring from returning to the previous state is also important. The authors carried cartilage plasty by modified Fukuda's method that several incisions are made along the crus, and then the crus is flattened using mattress suture in cases of mild cartilage deformity. In cases of severe cartilage deformity, the cartilage plasty by Onizuka method was carried. The cartilage graft from cavum on concha served as a splint for prevention of recurrence of cartilage deformities. We have repaired 13 cryptotic deformities in 9 patients with aesthetically satisfactory results using vertical incision at the superior crus of antihelix with mattress suture or cartilage graft from cavum of concha for cartilage correction.The correction of deformed cartilage by modified Fukida or Onizuka method is a good option for the treatment of cryptotia.
Cartilage ; Congenital Abnormalities ; Ear ; Humans ; Recurrence ; Splints ; Sutures ; Transplants