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

PURPOSE: As the number of children who attend child care centers has increased, concerns has increased about the effect of child day care on childhood illness. This study was conducted to examine the relationship between experience in child care and common infectious diseases in children under 5 years of age. METHODS: Data were collected by surveying 1,000 respondents with children under age 5 through online interviews using a structured questionnaire. The contents of the survey were composed of demographic characteristics, child care facilities usage, experience in infectious diseases, and immunization status. RESULTS: Among the 1,000 children <5 years of age, 78.5% attended a child care facility. Rates of common communicable illnesses were higher in children in child care than for children reared exclusively at home. The predominant communicable diseases which the respondents' children experienced, in order of decreasing frequency, were gastroenteritis (47.1%), otitis media (41.8%) and pneumonia (19.1%). The immunization rate of vaccines that are not included the national immunization program (NIP) (Haemophilus influenzae type b vaccine - 76.6%, hepatitis A vaccine - 63.3%, pneumococcal vaccine - 59.4%, rotavirus vaccine - 43.1%) was lower than that of the NIP vaccines (90.4%). CONCLUSION: Children in child care experience more bouts of common infectious disease, so nationwide policies to prevent or to control the spread of infectious agents in a child-care should be available and appropriate immunization should be emphasized as the most effective method for the control of infectious disease for children.
Child ; Child Care ; Communicable Diseases ; Surveys and Questionnaires ; Day Care, Medical ; Gastroenteritis ; Hepatitis A Vaccines ; Humans ; Immunization ; Immunization Programs ; Influenza, Human ; Otitis Media ; Pneumonia ; Rotavirus ; Vaccination ; Vaccines

PURPOSE: The aim of this study was to determine the frequency, epidemiology and the clinical manifestation of human metapneumovirus (hMPV) infection in Korean children. METHODS: From February 2010 to January 2012, we collected nasopharyngeal aspiration from 1,554 children who were hospitalized for acute lower respiratory tract infections at the Department of Pediatrics, Severance Children's Hospital. hMPV was detected by performing reverse transcriptase-polymerase chain reaction (RT-PCR). The medical records of the patients with positive results were retrospectively reviewed. RESULTS: We detected hMPV in 99 of the 1,554 hospitalized children. The mean age of the hMPV infected children was 25 months, and 87% of the illnesses occurred between April and June. The most common diagnoses were pneumonia (73%) and bronchiolitis (16%). The clinical manifestations included cough, fever, respiratory distress, hoarseness, tachypnea, and wheezing. Coinfection with other respiratory viruses was found in 43 children (43%). CONCLUSION: hMPV is one of the major virus causing acute respiratory tract infection in the age between 13 months and 48 months old with peaks during April to June. Reports of hMPV in Korea has been increasing but additional studies are required to define the epidemiology and the extent of disease caused by hMPV to determine future development of this illness in Korean children.
Bronchiolitis ; Child ; Child, Hospitalized ; Coinfection ; Cough ; Fever ; Hoarseness ; Humans ; Korea ; Medical Records ; Metapneumovirus ; Pediatrics ; Pneumonia ; Respiratory Sounds ; Respiratory Tract Infections ; Retrospective Studies ; Tachypnea ; Viruses

No abstract available.
Burns* ; Granulation Tissue*

The extensive knowledge of accurate anatomical morphology and acceptable proportion of the eyelid and orbit should be needed for plastic surgeons. The normal morphological and functional values of eyelids and orbits are variable according to races, sex and ages, and there are a few articles concerning them in Korea yet. The author measured eigt items of morphological and functional values of eyelids in Koreans and statistically analyzed them in 498 individuals including 234 males and 264 females. We divided them into nine age-related groups and measured the values. Especially, we subdivided 10 to 19 year-old group into three subgroup concretely because most of the values in the 10 to 19 year-old group reach the peak level of growth. The mean values in adults were recorded as follows: The horizontal dimension of the palpebral fissure was 27.0 +/- 1.8 mm in males and 26.8 +/- 1,7 mm in females and the vertical dimension of the palpebral fissure was 8.0 +/- 1.0 mm in female. The slant of the palpebral fissure was 7.9 +/- 2.4 degrees in males and 8.8 +/- 2.3 degrees in females and the height of the opened upper eyelid was 12.4 +/- 2.4 mm in males and 12.0 +/- 1.9 mm in females. The height of double fold in closed eye was 6.6 mm in males and 6.5 mm in femals and the intercanthal distance was 38.4 +/- 3.0 mm in males and 38.2 +/- 2.8 mm in females. The interpupillary distance was 64.6 +/- 2.9 mm in males and 63.6 +/- 2.9 mm in females. A double fold was seen in 36.1% of Korean. The average height of the double fold in closed eye was about 6.5 mm. The epicanthus present in 58.6% of Korean eyes and the most commom type was epicantus tarsalis. The growth of eyelids reached the peak level at teenager in a great portion. After the peak level, the changing pattern of eyelids could be divided into 3 groups; the first one was increasing more, the second was stationary, and the third was decreasing gradually. The peak levle of growth reached at 10 to 13-year-old in the vertical dimension of the palpebral fissure, at 14 to 16-year-old in the intercanthal distance, at 17 to 19-year-old in the horizontal dimension of the palpebral fissure.
Adolescent ; Adult ; Continental Population Groups ; Eyelids* ; Female ; Humans ; Korea ; Male ; Orbit* ; Vertical Dimension ; Young Adult

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