BACKGROUND: Numerous modalities have been used to treat scars and wrinkles. Most of them are not satisfactory and always have some degrees of complications. OBJECTIVE: This study was performed to evaluate the effect of the combination therapy of superpulse CO2 laserbrasion and dermabrasion(laser-dermabrasion) in surgical treatment of scars and wrinkles and propose that it can be a effective method to improve cosmetic results. METHODS: Twenty-eight patients with scars and wrinkles were treated using superpulse CO2 laserbrasion followed by dermabrasion. Questionnaires were completed for clinical assessments by the patients and clinicians. RESULTS: The results are summarized as follows. 1. Excellent and good results were achieved in 83.3% of scars in clinician's assessments and in 79.2% of scars in patients' assessments. 2. Excellent and good results were achieved in 100% of wrinkles in both of clinician's and patients' assessments. 3. The degrees of satisfaction were highest during 6 to 12 months after laser-dermabrasion and maintained high over 12 months. 4. Minimal and tolerable complications developed in 9 patients such as focal hyperpigmentation, changes of skin texture, erythema, milium and acne flare-up. CONCLUSION: We propose that the laser-dermabrasion would augment the effects of both laserbrasion and dermabrasion to improve cosmetic results in treatment of scars and wrinkles with minimal risks and low costs.
Acne Vulgaris ; Cicatrix* ; Dermabrasion ; Erythema ; Humans ; Hyperpigmentation ; Skin ; Surveys and Questionnaires

A 28-year old woman in DM (Ed note: Define DM) and chronic renal failure underwent an uneventful open reduction and internal fixation for an ankle fracture under spinal anesthesia. PCA with fentanyl and tramadol was started in the operating room with a background infusion of 2 ml/hr (10 microgram/h of fentanyl and 6 mg/h of tramadol), a bolus dose of 2 ml and a lockout interval of fifteen minutes. Approximately eight hours after initiating PCA the patient was found unresponsive in the ward with respiratory failure. Resuscitation was started with endotracheal intubation and cardiac massage with an injection of epinephrine and atropine. The patient made a full and immediate recovery two hours later.
Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Animals ; Ankle ; Atropine ; Epinephrine ; Female ; Fentanyl ; Heart Massage ; Humans ; Intubation, Intratracheal ; Kidney Failure, Chronic ; Operating Rooms ; Passive Cutaneous Anaphylaxis ; Respiratory Insufficiency ; Resuscitation ; Tramadol

PURPOSE: This goal of this study is to evaluate the clinical and radiological outcomes of proximal tibial comminuted fractures treated with medial minimally invasive percutaneous plate osteosynthesis (MIPPO). MATERIALS AND METHODS: We evaluated 43 patients who underwent medial MIPPO from February 2008 to February 2012 and were followed up for more than one year. According to the AO/OTA classification, there were 30 patients of 41-A3 and 13 patients of 41-C2. Thirty-six patients had closed fractures and seven patients had open fractures. We assessed clinical outcomes, radiologic results and postoperative complications. RESULTS: All fractures were united at an average of 18.3+/-8.1 weeks except three patients with nonunion. According to Schatzker and Lambert assessment, excellent results were achieved for 22 patients and good results were achieved for 21 patients. The average tibial plateau angle was 89.1degrees+/-2.7degrees and the average posterior tibial slope angle was 10.5degrees+/-4.6degrees. In assessment of lower limb alignment, the average femorotibial angle was 175.1degrees+/-2.9degrees and the mean deviation of mechanical axis was 46.5%+/-12.7%. In terms of complications, three patients had nonunion, but complete bony union was achieved by autogenous cancellous bone grafting. Seven patients complained of skin irritation around the plate. However, there was no skin necrosis, infection, or limited range of motion in seven patients with skin irritation. CONCLUSION: Medial MIPPO for proximal tibial comminuted fractures provides favorable clinical outcomes and good radiological alignments.
Axis, Cervical Vertebra ; Bone Transplantation ; Classification ; Fractures, Closed ; Fractures, Comminuted* ; Fractures, Open ; Humans ; Lower Extremity ; Necrosis ; Postoperative Complications ; Range of Motion, Articular ; Skin ; Tibia

Minimally invasive plate osteosynthesis (MIPO) is beneficial for proximal tibial fractures since these injuries are mostly caused by high energy traumas. The advantages of MIPO are minimization of soft tissue dissection and preservation of periosteal vascularization. Lateral plating has mostly developed as MIPO for proximal tibial fractures. We introduce minimal invasive percutaneous plate stabilization using a medial locking plate as alternative treatment for proximal tibial fractures.
Tibial Fractures

The antisynthetase syndrome is characterized by anti-Jo-1 antibody production, interstitial lung disease, inflammatory muscle disease, and, in many cases, fever, polyarthritis, Raynaud's phenomenon, and mechanic's hands. Joint signs and symptoms occur in up to 90% of patients with antisynthetase syndrome, occasionally as the initial manifestations. Although visual inspection of the hands shows changes that are highly suggestive of rheumatoid arthritis, notable differences exist. Antisynthetase syndrome is a predominantly nonerosive arthropathy with subluxations of the distal interphalangeal joints. It manifests as overlap syndrome with other connective tissue diseases. However, overlap syndrome of antisynthetase syndrome and rheumatoid arthritis is rare. We treated a 51-year-old male patient with overlap syndrome of antisynthetase syndrome and rheumatoid arthritis, and report the case with a review of the literature.
Antibodies, Antinuclear ; Antibody Formation ; Arthritis ; Arthritis, Rheumatoid ; Connective Tissue Diseases ; Fever ; Hand ; Humans ; Joints ; Lung Diseases, Interstitial ; Male ; Middle Aged ; Myositis ; Polymyositis

PURPOSE: The fracture of humeral lateral condyle in children was classified and the complications and results were analyzed according to the treatment modality and the types of fracture. MATERIALS AND METHODS: 92 patients who could be followed up one year or more, and were treated for a humeral lateral condyle fracture from May 1995 to May 2001 were studied. 66 cases were male, 26 cases were female, and 79 cases were under 9 years of age. The Milch stage I encountered in 12 cases, and II in 80 cases. Jacob stage I were encountered in 15 cases, stage II in 59 and stage III in 18 cases. Conservative treatment was performed in 9 cases and surgery was performed in 83 cases. A closed reduction and internal fixation with K-wire was performed in 18 cases, and an open reduction and internal fixation was performed in 65 cases. RESULTS: The change in the carrying angle was not clinically significant except for 7 cases, with a cubitus varus and cubitus valgus deformity. The change in the carrying angle showed an average -1.3 (from +7 to -18). The results according to the Hardacre criteria were `excellent' in 46 cases, `good' in 41 and `poor' in 5. Regarding the complications, bony spur formation was encountered in 8 cases, overgrowth of the lateral condyle and cubitus varus in 4, cubitus valgus in 3, avascular osteonecrosis in 3, premature epiphyseal fusion in 2, nonunion in 2, delayed union in 1, fish-tail deformity in 1, local infection in 5, range of motion limitation in 2 and transient radial nerve palsy in 1 case. CONCLUSION: Humeral lateral condylar fractures have a high rate of complications and clincally significant complication appeared mainly in stage II and III. This suggests that more a careful dissection of the soft tissue and anatomical reduction in Jakob stage III is required in cases of an open reduction.
Child* ; Congenital Abnormalities ; Female ; Humans ; Male ; Osteonecrosis ; Paralysis ; Radial Nerve ; Range of Motion, Articular

Inspissated bile syndrome (IBS) is a relatively rare condition. Many treatment options are available, including medication, surgery, and surgical interventions, such as insertion of cholecystostomy drain, endoscopic retrograde cholangiopancreatography, internal biliary drainage, and percutaneous transhepatic biliary drainage (PTBD). We herein report the first case of IBS that was successfully treated with PTBD in a two-month-old infant in Korea. PTBD was initiated on postnatal day 72. On postnatal day 105, we confirmed complete improvement and successfully removed the catheters. This report suggests that PTBD is a viable and safe treatment option for obstructive jaundice in very young infants.
Bile* ; Catheters ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystostomy ; Drainage* ; Humans ; Infant* ; Jaundice, Obstructive ; Korea

With the increased use of implantable cardiac devices, the incidence of hardware problems has also increased. Some of the hardware problems might be induced by patient factors. We experienced recurrent pacemaker lead fracture and dislocation after permanent pacemaker implantation. The patient was a bus driver who used his left arm vigorously when he turned the steering wheel. After a new lead was inserted via an axillary vein approach and the patient changed his occupation, no more lead problems have occurred. When a recurrent hardware problem with an implantable pacemaker or defibrillator occurs, patient factors related to anatomy or behavior must be considered.
Arm ; Atrioventricular Block ; Axillary Vein ; Defibrillators ; Dislocations ; Humans ; Incidence ; Occupations

PURPOSE: To find out the consequences of the surgical treatment of acromioclavicular joint dislocation, using modified Phemister technique with Mersilene tape augmentation. MATERIALS AND METHODS: We chose 26 patients who were able to follow up 1 year or more among the patients who were diagnosed as acromioclavicular joint dislocation in our hospital through February 2001 to March 2003 and took modified Phemister surgery with Mersilene tape augmentation. Patients with clavicle fracture were excluded. Evaluation of the surgical results was done with the condition or pain, function, range of motion by using Imatani evaluation system, and preoperative, postoperative and last follow up radiographs. RESULTS: Most of the cases showed satisfactory result. Clinical evaluations were 16 excellent (62%), 10 good (38%), radiological evaluations were 14 excellent (54%), 10 good (38%), 2 fair (8%), and no poor group. On the final follow up six cases showed vertical translation, but none had clinical symptoms. Seven cases showed a little inflammation at where pin were inserted, but after the removal of the pin, the inflammation was gone. CONCLUSION: The modified Phemister surgery for acromioclavicle dislocation is simple, but we can obtain strong fixation, and there is no burden of the removal of the metal plate, or complication of re- dislocation after the removal of the pin, so it is thought as a very effective surgery.
Acromioclavicular Joint* ; Clavicle ; Dislocations* ; Follow-Up Studies ; Humans ; Inflammation ; Range of Motion, Articular

We reviewed 28 patients with renal pelvic tumor during the period from 1974 to 1989 and 17 patients were followed up. The over all survival rate at l, 2, and 3 years was 88%, 63%, and 50%, respectively, by the Kaplan-Meier method. The stage and the grade of the tumor were the most influencing factors on prognosis. Simultaneous tumors of ureter or bladder, non-visualizing kidney on excretory urography, duration of the gross hematuria more than 6 months showed relatively poor prognosis. But development of subsequent bladder tumor did not seem to influence on prognosis.
Hematuria ; Humans ; Kidney ; Prognosis ; Survival Rate ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urography