The goal of cleft lip surgery is to reconstruct normal shape of the lip. To acomplish this goal, various operative method were contrived and concept of the method decided the shape of reconstructed lips. According to the operative result, some operative methods were disappeared or have been developed with a little modifiation. Traditional Millard's rotation-advancement method for unilateral cleft lip patients is largely accepted and developed as proper method for acquiring these functional and anatomic purposes. As a trial for this development, Mulliken add some modifications. He uses exaggerated high rotation incision and it lengthens into midcolumella without backcut. Also he dosen't steal from alar base or lateral lip for vertical height. C-flap is used to lengthen the affected columella and upper lip. The isolated orbicularis oris muscle is coaptated each other for more functional result. With supraperichondral dissection of alar cartilage and transpositioning of caudal septum, he performs synchronous repair of cleft lips, nose and sometimes alveolus. It is still debated when is most suitable age for surgical correction of nasal deformity of cleft lip patients. Done at the time of primary lip repair, there are both some apprehension and inducement. The former are based on technical difficulties due to shortage and fragility of neonatal tissue and possibility of progressive deformities with growing because of iatrogenic injuries to the alar cartilages. But te latter is rationalized because early reposition of deformed nasal cartilage in proper position would induce more natural growth of nasal structures. Some long-term follow up reports reveal the early operation innocent of any growth deterioration. Mulliken treats his cleft lip patient for separated lip and nasal deformities with single operation, and does gingiovoperiosteal alveoloplasty at the same time if necessary. He uses Latham appliance from 4 to 6 week after birth in case of severly collapsed lateral alveolar segment or wide alvolar gap, and perform the definitive opertation at the age of 4 to 6 months. I use lip adhension method to correct more than 10 mm alveolar gap without severe collapse of lateral alveolar segment, but if lateral segment was severely collapsed and away from alvolar arch, I apply the Latham appliance somewhat modificate from original type, which has a metal ring fastened at the front limb of appliance for rubber banding to coaptate easily. I have experienced repair of cleft lip by Mulliken's concept with some modification of my own to 44 cases of unilateral cleft lip patients and conclude that it was very flexible method. Doing with synchonous repair of cleft lip nose, we could get harmonious lip and nose with symmetric nostril sill, cupid's bow and red line. Columella was lengthened primarily. Normal growth of nose was anticipated by anatomic repositioning of alar septal cartilage.
Alveoloplasty ; Cartilage ; Cleft Lip* ; Congenital Abnormalities ; Extremities ; Follow-Up Studies ; Humans ; Lip ; Nasal Cartilages ; Nose ; Parturition ; Rubber

No abstract available.
Lichens* ; Mucinosis, Follicular*

No abstract available.
Electromyography* ; Hand* ; Humans ; Muscle Spasticity* ; Stroke*

In the past years skin grafts, local flaps and free flaps have been used in reconstructing skin of soft tissue defects and deformities of the face where primary closure is not feasible. A number of local flaps have been used for reconstruction of facial defects and deformities, but the size of a defect that could be treated in such a way was restricted and the donor site deformity was another problem of local flaps. Introduction of the tissue expansion technique has made it possible to cover even wider defects with neighboring skin and advantageous in facial reconstruction in that such defects can be resurfaced with skin of similar color, texture and thickness, a match superior to that of skin obtained elsewhere. We used tissue expanders in reconstructing defects and deformities of the face(post-burn scar ; 17cases, post-traumatic scar ; 7cases, congenital nevus ; 3cases, total 27cases) from Mar. 1990 to Sep. 1996. We used expanders of various size and shape according to the site and size of the defects. We prefered to use round or croissant type tissue expander for the reconstruction of small-sized scar on medial cheek and to use rectangular type expander for large-sized scar on lateral cheek. Ports are placed under the scar or scalp. Expansion period ranged from 28days to 97days (mean 7weeks) and overinflation (mean 170%) was done. And various methods are used for prevention of complication. We have made anchoring sutures of the remained capsule to the underlying periosteum for prevention of ectropion. We have got satisfactory results from that aesthetically and functionally, so report the results with a review of the current literature.
Cheek ; Cicatrix ; Congenital Abnormalities ; Ectropion ; Free Tissue Flaps ; Humans ; Nevus ; Periosteum ; Scalp ; Skin* ; Sutures ; Tissue Donors ; Tissue Expansion Devices ; Tissue Expansion* ; Transplants

OBJECTIVE: The purpose of this retrospective study was to evaluate the effect of neoadjuvant chemotherapy followed by radical surgery compared with conventional radical surgery in stage Ib1 cervical cancer as to operative complications, the rate of lymph node metastasis, recurrence and overall five-year survival rates. METHODS: The study materal (98 cases of stage Ib1 cervical cancer) was divided into two groups; The one group was neoadjuvant chemotherapy (Cisplatin + 5-FU) followed by radical surgery (n = 41) and the other was the conventional radical surgery (n = 57) group. Reviewing records of operative and pathological reports and clinical findings, the outcome was statistically analyzed and compared. RESULTS: As to the complication, bladder dysfuntion was more frequent in neoadjuvant chemotherapy group, statistically significant.(43.9% vs 22.8%, P=0.034). No significant difference was found in the incidence of lymphnode metastasis (17% vs 17.5%, P=0.779) and overall five year survial rates(85.3% vs 87.7%, P=0.735). CONCLUSION: No benefical effect of neoadjuvant chemotherapy could be found on stage Ib1 cervical cancer in this retrospective study. However, well controlled longterm prospective study will be need to get firm conclusion.
Drug Therapy* ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Uterine Cervical Neoplasms*

Congenital auricular deformities such as lop ear, cup ear, prominent ear, and Stahl's ear can be corrected nonsurgically in the early neonatal period(first week after birth) obtaining satisfactory results. Auricular cartilage consists of chondrocytes and intercellular materials that are mainly assembled from collagen, elastin, and a proteoglycan aggergate. Cartilageelasticity is dependent upon the concentration of the proteoglycan aggregate. Hyaluronic acid, which is a constituent of proteoglycan aggregate and is increased by estrogens, has an important play on disconnecting the proteoglycan aggregate. So the increased estrogen results in the lack of elasticity. The circulating levels of free estradiol are higher during the first 72 hours after birth and decreases thereafter, so the ear is soft and easily malleable in this early neonatal period. In this study, we have applied aluminium splint (90 degree-angulated, 180 degree-angulated, and rolled) on rabbit ear. All of the rabbit was divided into 3 groups containing 3 types of deformities. In group 1, estrogen was applied to the deformed ear with regional injection to the perichondrium of auricular cartilage. In group 2. estrogen was applied topically with ointment. In group 3, as control group, saline was injected to the perichondrium. Four weeks later, in group 2, the shape of the deformed rabbit ear was maintained, and did not return to its original shape even after splint removal. From these results, we concluded that estrogen ointment could be tried as adjunctive therapeutic modalities to the nonsurgical treatment of the congenital auricular deformities.
Chondrocytes ; Collagen ; Congenital Abnormalities ; Ear Cartilage ; Ear* ; Elasticity ; Elastin ; Estradiol ; Estrogens* ; Hyaluronic Acid ; Parturition ; Proteoglycans ; Splints

Choristomas are defined as benign congenital overgrowth of normal tissues in an abnormal location, which can contain lacrimal gland, muscle, cartilarge, adipose tissue, nerve, epidermal appendage. There are many reports about choristoma but cartilarge containing choristoma is very rare. We experienced a 20-year-old healthy male patient complaining of mass on limbus. The diagnosis was limbal dermoid. After tumor removal, histopathologically it was proved as complex choristoma. It contains not only muscular tissue, adipose tissue, neural tissue but also cartilarge. We report this case because of the rarity of cartilarge containing choristoma.
Adipose Tissue ; Choristoma* ; Dermoid Cyst ; Diagnosis ; Humans ; Lacrimal Apparatus ; Male ; Young Adult

X-linked ichthyosis is a hereditary dermatosis characterized by large dark and thick scaly skin of trunk, extremities, scalp and neck. Rare manifested ocular signs include scales on lid and lashes, corneal opacity, lens opacity, and peripheral retinal granular hyperpigmentation. The authors experienced a case of diffuse punctate corneal opacities observed in the deep stroma or pre- Descemet's layer which developed in a 12-year old male patient who visited our clinic complaining symtoms of itching and dark thick scales on trunk, extremities, and scalp since at birth a.nd diagnosed as X-linked ichthyosis by clinical and histologic features.
Cataract ; Child ; Corneal Opacity* ; Extremities ; Humans ; Hyperpigmentation ; Ichthyosis* ; Male ; Neck ; Parturition ; Pruritus ; Retinaldehyde ; Scalp ; Skin ; Skin Diseases ; Weights and Measures

BACKGROUND: The purpose of this study was to find the factors associated with becoming obese children during the past 2 years in 6th grade children of elementary school and then to evaluate the high risk groups for childhood obesity. METHODS: The 738 children from May to June, 2001 in 6th grade of 5 elementary schools in Busan were the subjects of this study. The children's height and weight in 4th grade and 6th grade were obtained from school health records. We calculated the body mass index in 4th and 6th grades and classified into 3 weight groups (normal, at risk for obesity, and obese) according to the age and sex-specific BMI established by the Korean Academy of Pediatrics. If children's weight group in 4th grade was changed to heavier weight group in 6th grade, we defined it as increased group. Otherwise, we defined it as non-increased group. The association between the increase in weight group and parental and children's characteristics were analyzed by x2-test, x2-test for the trend, t-test, ANOVA and multiple logistic regression. RESULTS: Among the total, 3.3% of children with normal weight and 16.9% of children at the risk for obesity in 4th grade were transformed to increased group in 6th grade, respectively (P<0.001). Children who had excessive appetite (P<0.001), watched TV greater than or equal to 2 hours per day (P=0.004) or had an obese father (P=0.044) were more likely to become increased group. After adjusting for father's obesity, appetite and TV watching time in children, the odds ratio of transforming to increased group after 2 years in children at risk for obesity or in obese child in 4th grade was 2.5 (95% CI: 1.09~5.55) compared to children with normal weight. Children having excessive appetite were 3.2 times (95% CI: 1.42~7.01) more likely to become the increased group after adjusting for father's obesity, TV watching time and weight in 4th grade. Children watching TV greater than or equal to 2 hours/day was 2.8 times (95% CI: 1.27~6.18) more likely to become increased group after adjusting for father's obesity, appetite and weight in 4th grade. CONCLUSION: The risk of becoming obese was higher in children at risk for obesity or obese children in those with excessive appetite or those who have watched TV> or =2 hours/day for the past two years. These findings suggest promotion of educational plan to prevent childhood obesity.
Appetite ; Body Mass Index ; Busan* ; Child* ; Fathers ; Humans ; Logistic Models ; Obesity ; Odds Ratio ; Parents ; Pediatric Obesity ; Pediatrics ; Risk Factors ; School Health Services

Lumbar spinal stenosis (LSS) is a common spinal disease in the elderly. The cardinal symptom of LSS is neurogenic claudication, but not all patients present with such typical symptom. The clinical symptoms are often confused with symptoms of peripheral neuropathy, musculo-skeletal disease and other medical conditions in elderly patients. In particular, LSS presenting with rapid progression of leg weakness must be distinguished from other combined diseases. We report a case of rapid progressive leg weakness in a patient with LSS and iatrogenic adrenal insufficiency that was induced by obscure health supplement.
Adrenal Insufficiency ; Aged ; Constriction, Pathologic ; Humans ; Leg ; Peripheral Nervous System Diseases ; Spinal Diseases ; Spinal Stenosis