No abstract available.
Hepatitis B, Chronic* ; Hepatitis, Chronic*

No abstract available.

No abstract available.

No abstract available.

The recent development of microsurgical tissue transfer has enabled any defect in any area to be reconstructed with free flaps. However, the need for a more functional and thinner flap has been raised due to bullkiness of the flap and donorsite morbidity. For better functional and aesthetic results, various perforator flaps excluding muscles or adjacent subcutaneous tissue have been recently reported. We report 44 cases of perforating artery pedicled flaps from April 1995 to August 1998, including 21 cases of anterolateral thigh flap, 12 cases of gluteal artery perforator flap, 4 cases of posterior interosseous flap, and 7 cases of paraumbilical perforator flap for various soft tissue defects. Even though marginal necrosis of flap occurred in 9 cases, complete healing without significant problem was possible. The advantages of perforator flaps are as follows: 1. It is possible to obtain a relatively thin fasciocutaneous flap, but still with sufficient volume 2. Donor site morbidity was reduced without damage of main artery. 3. In spite of diverse vascular pattern of the perforator, the location of perforating arteries can be Detected with relative ease and mapped preoperatively with an ultrasound Doppler. The need of meticulous and tedious dissection could be a sole disadvantage of these flaps. This report describes the clinical experience with a perforator-based flap, anticpating applications of many other types of perforator flap in the future.
Arteries* ; Free Tissue Flaps ; Humans ; Muscles ; Necrosis ; Perforator Flap ; Subcutaneous Tissue ; Surgical Flaps* ; Thigh ; Tissue Donors ; Ultrasonography

No abstract available.
Electric Stimulation* ; Epilepsy* ; Evoked Potentials*

Chronic hepatitis B infection is the most common cause of chronic liver diseases in Korea and can induce chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. If patients have significant viral replication and persistent abnormal liver function and/or significant liver pathology, antiviral agents can be administered to prevent progression of the disease. Each antiviral agent shows different antiviral efficacy, resistance rate, and adverse events. Interferon alpha and pegylated interferon alpha have the advantage of relative short duration of treatment, however show high incidence of adverse events. Lamivudine has significant long-term data indicating the prevention of disease progression, but shows high resistance rate. Clevudine, entecavir, telbivudine, and tenofovir show high antiviral efficacy, however clevudine shows only short-term data, entecavir shows carcinogenesis in mouse, telbivudine shows relatively high resistance rate. In addition, clevudine and telbivudine show myopathy, and adefovir and tenofovir show renal toxicity as adverse events. AASLD and EASL guideline advise pegylated interferon alpha, entecavir, and tenofovir as first line treatment, which show high antiviral efficacy and low resistance rate. KASL and APASL guideline permits the use of all antiviral agents because of their respective advantage and problems as mentioned above. If resistance occurs during first line therapy, add-on therapy should be performed to prevent resistance of to second line antiviral agents. Ideal antiviral agents have to show high antiviral efficacy, low resistance rate, no significant adverse events and their effect on prevention of disease progression must be supported with a long-term data.
Adenine ; Animals ; Antiviral Agents ; Arabinofuranosyluracil ; Carcinoma, Hepatocellular ; Disease Progression ; Guanine ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Imidazoles ; Incidence ; Interferon-alpha ; Korea ; Lamivudine ; Liver ; Liver Cirrhosis ; Liver Diseases ; Mice ; Muscular Diseases ; Nitro Compounds ; Organophosphonates ; Tenofovir ; Thymidine

The orbitozygomatic area occupies a key anatomic position in midface, is prone to injury, and plays a prominent role in facial aesthetics. So the facial appearance including orbital shape can be altered by complications of orbitozygomatic fractures. Most possible initial complications include blindness, hyphema, retinal detatchment, and paralysis or entrapment of extraocular muscles. Long term sequelaes include infraorbital nerve dysfunction, loss of malar projection, enophthalmos, and dystopia. Accurate anatomic reduction and rigid fixation is essential for management of orbitozygomatic fractures to minimize those late sequelaes. Conventional fixation devices to fix displaced fracture of facial bone are interosseous wire and miniplate. But interosseous wirings are unstable for primary bone healing and time consuming. Miniplates have great deal in rigid fixation but their high profile and palpability are the main complaints in many patients, especially in orbital rim area. In this article, we reviewed the 30 cases of zygomamaxilla complex fractures with orbital rim fracture fixed with microplates, and discussed the stability of microplate and superiorities in final aesthetics result. The use of microplates in these area permits enough stability of fracture segment with ease of procedures and superiorities in final results without any palpability.
Blindness ; Enophthalmos ; Esthetics ; Facial Bones ; Humans ; Hyphema ; Muscles ; Orbit* ; Paralysis ; Retinaldehyde

PURPOSE: In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed. METHODS: This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group. RESULTS: The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002). CONCLUSION: The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP.
Cranial Nerve Diseases ; Critical Pathways* ; Hearing Loss ; Hospitalization ; Humans ; Methods ; Microvascular Decompression Surgery* ; Patient Satisfaction ; Quality Control

Viral hepatitis is one of major causes of liver diseases in Korea. Acute hepatitis that is characterized by symptoms of fatigue, nausea, anorexia, malaise, and jaundice is caused by various hepatitis viruses such as hepatitis A, B, and C virus. Viral hepatitis has 4 clinical phases, incubation period, preicteric phase, icteric phase, and convalescence period. Hepatitis A is spread by the fecal-oral route, and is associated with poor sanitary conditions. Sometimes acute hepatitis A shows prolonged cholestatic hepatitis or recurrent hepatitis after a convalescence period; however, acute hepatitis A is usually self-imited and does not progress to chronic hepatitis. Hepatitis B virus can cause both acute and chronic hepatitis. Acute hepatitis B shows similar clinical manifestations as in hepatitis A, however, chronic hepatitis can develop in about 5% of acute hepatitis B. Chronic hepatitis B is the major cause of chronic liver diseases such as liver cirrhosis and hepatocellular carcinoma in Korea. The route of chronic infection correlates with vertical infection and sexual contact because hepatitis B virus is spread by the parenteral route. Recently hepatitis B vaccine can protect the transmission of hepatitis B virus effectively from mother to neonate, so the incidence of carrier state in child ages is very low. Hepatitis C virus can also cause both acute and chronic hepatitis. Acute hepatitis C shows similar clinical manifestations as in hepatitis A; however, chronic hepatitis can develop in about 80~90% of acute hepatitis C. Chronic hepatitis C is also one of the major causes of chronic liver diseases in Korea.
Anorexia ; Carcinoma, Hepatocellular ; Carrier State ; Child ; Convalescence ; Fatigue ; Hepacivirus ; Hepatitis A* ; Hepatitis B ; Hepatitis B Vaccines ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis C ; Hepatitis C, Chronic ; Hepatitis Viruses ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Incidence ; Infant, Newborn ; Jaundice ; Korea ; Liver Cirrhosis ; Liver Diseases ; Mothers ; Nausea