The basic technique for total reconstruction of the microtia was established by Tanzer, who utilized autologous rib cartilages for constructing the auricular framework. In order to decrease the number of surgical stages and to achieve maximal convolution, we employed a surgical procedure with simultaneous three layered costal cartilage grafting for the high profiled auricle, concha formation and lobule rotation. However, we performed ear elevation as an additional procedure for some patients who had decreased helical height due to absorption of cartilage framework or postoperative trauma and who had wanted to wear the spectacles or to have more natural appearance of auriculocephalic sulcus. From August 1988 to October 1997 we had performed surgeries for the ear elevation of 58 patients in 177 patients with total ear reconstruction, using various elevation methods; skin graft, local flap, and local with costal cartilage block. When the ear elevation was performed with skin graft, postoperative contraction of the grafted skin was inevitable. In cases with two skin flaps, it was difficult to stabilize and maintain the correct projection of the constructed ear. So we elevated the reconstructed ear by utilizing a costal cartilage block, two skin flaps to cover the posterior region and skin graft. We conclude that the local flap with costal cartilage block is one of the most favorable methods in ear elevation which can maintain the adequate projection and make natural looking auriculocephalic sulcus.
Absorption ; Cartilage ; Ear* ; Eyeglasses ; Humans ; Ribs ; Skin ; Transplants

PURPOSE: The purpose of this study was to determine the role of CT and MR imagings in the diagnosis aortic dissection and differentiation between the true and false lumen. MATERIALS AND METHODS: We retrospectively studied forty patients with aortic dissection(AD) diagnosed imagings or surgery. Of the forty patients, 19 were examined with only CT, 14 with CT and MR, and 7 with MI~: Our points of view were(1) the classification of AD according to configuration of intimal flap by cross-sectional imaging, (2) differentiation between the true and false lumens, (3) the course of the false lumen, and (4)! detectability of the origin of major branch vessels of the abdominal aorta. RESULTS: The classification by corss-sectional imaging were crescentic(65%), circumferential(15%), flat(12%), and irregular(8%) type, in which false negative diagnosis was made in 1 case of crescentic and circumferential type, respectively. In 2 case of flat type and 1 case of irregular type, the differentiation between the true and false lumen was impossible with CT. The course of the false lumen in descending thoracic aorta revealed countrclock wise rotation(66%), clockwise rotation(5%) or fixed(29%) apperance. MR imaging was superior to CT in the detection of the origin of major branch vessels of the abdominal aorta. The determination of the origin of major branches of abdominal aorta arising from the true and false lumen were impossible in 2 cases in which only CT was done. CONCLUSION: Diagnosis of crescentic and circumferential types of AD with narrow and thrombosed false lumen was problematic in both CT and MR with no difference of diagnostic accuracy between the two modalities. The differentiation between the true and false lumen was difficult in flat and irregular types with only CT. Therefore, when surgical treatment is considered as in type B aortic dissection, MR imaging is recommended in order to determine the origin of major branch vessels.
Aorta, Abdominal ; Aorta, Thoracic ; Classification ; Diagnosis* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

Microform cleft lip is a mild form of incomplete cleft lip, also known as a minimal occult, abortive, forme fruste cleft lip. However, it has no definition and few methods have been reported for its correction. A microform cleft lip is characterized as the incomplete union of the superficial portion of the orbicularis oris muscle. It is more prominent during facial expression than in a resting state. We confined microform cleft lip in our study to the absence of philtral skin change and a contracted position on the top of cupid's bow. During the past 5 years, 17 patients of microform cleft lip were operated on. We corrected the defect of the upper vermilion border and nostril sill with minimal incision, and repaired the underlying lip musculature in superficial discontinuity. Reduction of the widened alar base was performed. Deformed alar cartilage was dissected via rim incision, and suspended in a medial and upper direction with pull-out sutures. The most important thing is precise repair of the superficial portion of the separated orbicularis oris muscle via minimal incision, and it is best to operate after 1-year of age for accurate repair. The results were satisfactory and the parents were also satisfied. The advantages of this procedure are as follows: 1. Less visible, minimal scar on upper lip 2. Simultaneous correction of vermillion notching, deformed cupid's bow and nasal deformity. 3. Eversion of philtral ridge due to tenting effect of horizontal mattress suture 4. Philtral elongation effect by reduction of alar base and Z-plasty of cupid's bow.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Facial Expression ; Humans ; Lip ; Microfilming* ; Parents ; Skin ; Sutures

OBJECTIVES: This study was designed to assess the change of heart rate variability (HRV) at resting, upright, and psychological stress in anxiety disorder patients. METHODS: HRV was measured at resting, upright, and psychological stress states in 60 anxiety disorder patients. We used visual analogue scale (VAS) score to assess tension and stress severity. Beck depression inventory (BDI) and state trait anxiety inventories I and II (STAI-I and II) were used to assess depression and anxiety severity. Differences between HRV indices were evaluated using paired t-tests. Gender difference analysis was accomplished with ANCOVA. RESULTS: SDNN (Standard deviation of normal RR intervals) and low frequency/high frequency (LF/HF) were significantly increased, while NN50, pNN50, and normalized HF (nHF) were significantly decreased in the upright position compared to resting state (p < 0.01). SDNN, root mean square of the differences of successive normal to normal intervals, and LF/HF were significantly increased, while nHF was significantly decreased in the psychological stress state compared to resting state (p < 0.01). SDNN, NN50, pNN50 were significantly lower in upright position compared to psychological stress and nVLF, nLF, nHF, and LF/HF showed no significant differences between them. CONCLUSION: The LF/HF ratio was significantly increased after both physical and psychological stress in anxiety disorder, but did not show a significant difference between these two stresses. Significant differences of SDNN, NN50, and pNN50 without any differences of nVLF, nLF, nHF, and LF/HF between two stresses might suggest that frequency domain analysis is more specific than time domain analysis.
Anxiety ; Anxiety Disorders* ; Autonomic Nervous System ; Depression ; Equipment and Supplies ; Heart Rate* ; Humans ; Stress, Psychological*

Polymerase chain reaction (PCR) method is a proced.ure for in vitro enzymatic ampli fication of a specific segment of DNA. PCR method was used to detect any M. tuberculi DNA in the 16 cerebrospinal fluid specimens from 6 patients clinically diagnosed as tuberculous meningitis. We synthesized two oligonucleotide primers derived from the sequence of a gene that codes for the 65-kilodalton antigen of M. tuberculosis. The amplified 165bp genomic DNA of M. tuberculosis was detected in 3 specimens (18.5%) with polyacrylamide gel electrophoresis. A following southem blot analysis confirmed these mycobacterial DNAs and detected another amplified DNA (25%) that was not seen on the polyacrylamide gels. Conventional detection methods such as smear and culture for M. tuberculosis found these specimens to be negative. Now we recommend PCR and combined southem blot analysis as a useful tool for early and rapid diagnosis of tuberulous meningitis.
Cerebrospinal Fluid ; Diagnosis* ; DNA ; DNA Primers ; Electrophoresis, Polyacrylamide Gel ; Gels ; Genes, vif ; Humans ; Meningitis ; Polymerase Chain Reaction* ; Tuberculosis ; Tuberculosis, Meningeal*

PURPOSE: The purpose of this study was to determine the effects of smartphone apps applying BodyThink program on BMI, percentage of body fat, skeletal muscle rate, body image, and self-esteem of adolescent girls. METHODS: Sixty-eight high school girls with a BMI of over 25kg/m² were recruited to participate in this study. Girls from four schools were divided into two groups: the experimental group, which used the smartphone apps applying BodyThink program, and the control group, which used smartphone apps and small group counseling. The experimental group received the BodyThink program 6 times, scheduled once a week, with each session lasting 40~50 minutes. Test measures were completed before and after the 6 week intervention period for all participants. Collected data was analyzed using Shapiro-Wilk test, descriptive statistics, χ² test, independent t-test, Mann-Whitney U test with the SPSS/WIN 18.0 program. RESULTS: The girls in the experimental group significantly improved their results in BMI(Z=-1.67, p=.042), percentage of body fat (Z=-3.01, p=.001), skeletal muscle rate (t=-3.50, p<.001), and self-esteem (t=2.66, p=.005) after the program, compared to the girls in the control group. CONCLUSION: Mobile applications applying psychological and emotional intervention programs have the potential to be effective alternative methods to improve the body composition and self-esteem of obese adolescent girls.
Adipose Tissue ; Adolescent* ; Body Composition ; Body Image ; Counseling ; Female* ; Humans ; Mobile Applications ; Muscle, Skeletal ; Obesity* ; Self Concept ; Smartphone*

The effects of 1-methyl-4-phenyl-1, 2. 3, 6-tetrahydropyridine (MPTP) on behavioral and histochemical changes were investigated in C57BL/6 mice. For immunocytochemis try, one group of mice received a dose of 2X30mg/kg of MPTP given 12hours apart and the other group 30mg/kg/day of MPTP for 7days. Locomotor activit,v was measured during 120minutes after a single injection of 30mg/kg of MPTP. We compared the numbers of tyrosine hydroxylase (TH)-positive cell bodies using immunocytochemical technique in the substantia nigra, ventral tegmental area and locus ceruleus 10 days after the last injection of MPTP. There was a significant decrease in locomotor activity during 100minutes after injection of MPTP and the number of TH-positive cell bodies in the substantia nigra of the mice which received the dose of 30mg/kg/day for 7 days, but not in the ventral tegmental area or the locus ceruleus. But 30mg/kg of MPTP given 12 hours apart failed to produce a significant decrease in the number of TH-positive cell bodies in any three catecholamine nuclei examined. It is concluded that MPTP-treated C57BL/6 mice provide a useful model for studying characteristics of Parkinson's disease and the dose of 30mg/kg/day for 7 days is more effective in the animal model for Parkinson s disease in C57BL/6 mice.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals ; Locus Coeruleus ; Mice* ; Models, Animal ; Motor Activity ; Parkinson Disease* ; Substantia Nigra ; Tyrosine 3-Monooxygenase ; Ventral Tegmental Area

PURPOSE: This study aimed to investigate job satisfaction, organizational commitment and turnover intention among male nurses in South Korea. METHODS: Data were collected in May, 2013 and a total of 150 male hospital nurses participated in this study. Job satisfaction, organizational commitment and turnover intention were measured using a structured questionnaire. Collected data were analyzed using SPSS/WIN 20.0 for windows. RESULTS: There were statistically significant correlations between job satisfaction and organizational commitment (r=.74, p<.001), job satisfaction and turnover intention (r=-.56, p<.001), and organizational commitment and turnover intention (r=-.69, p< .001). There was a statistically significant difference in job satisfaction of participants according to education, work unit, and salary. Organizational commitment showed significant difference according to age, education, work unit, and salary. Turnover intention was significantly different according to duration of employment in the hospital, and salary. The most influential factor for turnover intention was organizational commitment (beta=-.69, p<.001). This factor accounted for 47.8% of the variance in turnover intention. CONCLUSION: The results of this study indicate that to reduce turnover intention for men in nursing, it is necessary to increase job satisfaction, and organizational commitment.
Education ; Employment ; Humans ; Intention* ; Job Satisfaction* ; Korea ; Male ; Nurses, Male* ; Nursing ; Surveys and Questionnaires ; Salaries and Fringe Benefits

PURPOSE: This study was conducted to identify job experiences of male hospital nurses. METHODS: Data were collected from 20 male nurses working at general hospitals, through semi-structured in-depth interviews. The interviews were recorded and subsequently transcribed verbatim. Using content analysis, data were coded and categorized. RESULTS: The analyzed domains were motivations for choosing nursing, occupational experiences (3 subdomains), and attitudes toward the future. A total of 85 significant statements were selected from the data and classified into 32 categories. The nurses' motivations for choosing nursing were advantages of employment, their aptitude, scarcity value of men, professionalism and job security, good promotion, stable income, and family influence. In occupational experiences, they were assigned to special fields and dissatisfied with vertical relationship, promotion system, their salary, and gaps in military service time; they had difficulties in adapting to female-dominated groups and encountered gender role stereotype and preconception; they were satisfied with their distinguished performance, but had damaged self-esteem, and were stressed and disappointed in their work. In their attitudes toward the future, they considered their career changes, but tried to make professional and personal advancement. CONCLUSION: These findings have implications for recruiting and retaining male nurses in clinical settings.
Aptitude ; Employment ; Gender Identity ; Hospitals, General ; Humans ; Male ; Military Personnel ; Motivation ; Nurses, Male ; Salaries and Fringe Benefits ; Statistics as Topic

A strictly right handed patient showed aphasia and left hemiplegia following a deep infarct of the right hemisphere. He had no personal or family history o{ left-handedness. His aphasia was persistent and global in nature without right limb apraxia which was tested by serial Modified Western Aphasia Battery There was a deep subcortical infarc tion of the territoy supplied by the right middle cerebral artery without any lesion or .perfusion defect in the left hemisphere on brain CT and SPECT. The frequency of persistent aphasia in the right hemispheric lesion in dextrals has been known to be very low and there was no reported case in Korea So we report a case of crossed aphasia in a dextral with review of literature.
Aphasia* ; Apraxias ; Brain ; Extremities ; Hand ; Hemiplegia ; Humans ; Korea ; Middle Cerebral Artery ; Perfusion ; Tomography, Emission-Computed, Single-Photon