We compared the incidence of graft rejection and the rejection time after penetrating keratoplasty on the 72 keratoconus patients retrospectively between the range of 5.5 mm to 7.0 mm diameter in graft size(Group 1) and the range of 7.25 mm to 8.0 mm diameter(Group 2). The graft rejection was developed in 25 eyes(28.09%) among 89 penetrating keratoplasty patients with keratoconus. In group 1, there was graft rejection in 6 eyes(23.08%) among 26 eyes and in group 2, 19 eyes(30.16%) among 63 eyes. The rejection time of 21 eyes(84.00%) was within the first postoperative year. In group 1, graft rejections in 5 eyes(83.33%) were noted within the first postoperative year among 6 rejected eyes, and in group 2, rejections in 16 eyes(84.21%) among 19 rejected eyes. The statistical analysis showed no significant differences between the two groups in the incidence of graft rejection and rejection time(p>0.05).
Corneal Transplantation* ; Graft Rejection* ; Humans ; Incidence ; Keratoconus* ; Keratoplasty, Penetrating ; Retrospective Studies ; Transplants*

PURPOSE: The anterolateral thigh flap has many advantages over other conventional free flaps. But the anterolateral thigh flap has yet to enter widespread use because perforating arteries exhibit a wide range of anatomic variations and are difficult to dissect when small. The aim of this study is to identify the vascular variability of perforating arteries and pedicle in the anterolateral thigh free flap. METHODS: We studied 12 cadavers and dissected 23 thighs. An anterolateral thigh flap (12x12cm) was designed and centered at the midpoint of the line drawn from anterior superior iliac spine to the superolateral border of the patella. After we identifed the perforating arteries we dissected up to their origin from lateral circumflex femoral artery along descending branch of lateral circumflex femoral artery. We then investigated the number and the position of perforating arteries, length and diameter of vascular pedicle and pattern of lateral circumflex femoral arterial system. RESULTS: On average 2.3+/-1.1 perforating arteries per thigh were identified. The musculocutaneous perforators were 63.1%. In those perforators five perforators were arose from transverse branch of lateral circumflex femoral artery and two were arose from rectus femoral artery. Most of the perforators were near the intermuscular septum between rectus femoris muscle and vastus lateralis muscle. The length and diameter of pedicle were 11.9+/-3.5cm and 3.1+/-0.8mm on average. CONCLUSION: This study will be helpful for the success in anterolateral thigh free flap.
Anatomy, Regional ; Arteries ; Cadaver ; Femoral Artery ; Free Tissue Flaps ; Muscles ; Patella ; Quadriceps Muscle ; Spine ; Thigh

PURPOSE: The oral teratoma is found approximately in live birth at the rate from 1:35,000 to 1:200,000. In a review of literature 16 cases of midline teratoma with cleft palate were reported. We report a case of congenital palatal teratoma with cleft palate in a 1-year-old girl. METHODS: A 1-year-old girl was admitted our institution for the closure of cleft palate. On the intraoperative findings there was 4x1x0.5cm sized hairy soft mass at the midline and complete cleft palate. We did incisional biopsy intraoperatively and its pathology revealed heterotopic brain tissue. The excision of remaining mass and palatoplasty with Sommerlad's method were performed. The final pathology of the mass was mature cystic teratoma. RESULTS: After the operation there were neither recurrence nor oronasal regurgitation. CONCLUSION: We report for one patient with congenital palatal teratoma associated with cleft palate and obtained an excellent result.
Biopsy ; Brain ; Cleft Palate* ; Female ; Humans ; Live Birth ; Pathology ; Recurrence ; Teratoma*

PURPOSE: As a recipient vessel, internal mammary vessels have many advantages for microvascular reconstruction of the breast. But the approach is time consuming and results in large morbidities. However, the perforating branches of the internal mammary vessels can be used to minimize such demerits. The purpose of this cadaver study is to clarify the location and diameter of the perforating branches of internal mammary vessels and to prove that they are safe and reliable recipient vessels. METHODS: We studied 11 formalin-fixed cadavers and dissected their anterior chests bilaterally. The chests were exposed using midline presternal incisions. We dissected and found all perforators at subfascial planes under loupe magnification. The number, external diameter, and the distance from the midline were measured. Result: The mean external diameter of the arterial perforators was 1.32mm and the mean external diameter of the venous perforators was 1.48mm. The largest arterial and venous perforators were most frequently found in the second intercostal space. The mean distance from the midline to the perforator was evaluated; the artery averaged 1.95cm and the vein averaged 2.08cm. CONCLUSION: This study will be helpful when using the internal mammary perforating vessels as a recipient vessel during breast reconstruction.
Arteries ; Breast ; Cadaver ; Glycosaminoglycans ; Mammary Arteries ; Thorax ; Veins

No abstract available.
Adrenocortical Carcinoma ; Child ; Humans ; Neoplasm Metastasis

PURPOSE: In recent decades, amputation is still recommended for patients with extensive lower extremity wounds requiring coverage. Although the feet contribute relatively little to total body surface area, they are essential organ for ambulation, and a high mortality rate after amputation has been reported. We report on 10 challenging cases of a mangled foot which was reconstructed using an anterolateral thigh (ALT) free flap, and analyze the advantages and disadvantages of this technique. MATERIALS AND METHODS: This retrospective study was conducted on 10 patients who underwent reconstructive surgery on a foot. Patients' charts were reviewed for age, sex, causes, defect size and site, flap size and type, flap type, and complications. Cases with a defect size of >100 cm2 were included. RESULTS: Seven of the 10 patients were male, and overall mean age was 38.5 years (range, 22 to 61 years). Mean defect size was 179.6 cm2 (range, 104 to 330 cm2), and mean flap size was 193 cm2 (range, 120 to 408 cm2). Three cases were reconstructed with a musculocutaneous free flap and seven cases were reconstructed with a fasciocutaneous free flap. There were two occurrences of local wound complication. All ten flaps survived well, however five patients underwent a debulking procedure to reduce flap volume. CONCLUSION: Reconstruction of a near completely degloved soft tissue defect or a wide defect containing two or more surfaces of extremity with an ALT free flap was performed. The purpose of this case study is to report on free tissue transfer using the ALT flap for salvage of the lower extremity.
Amputation ; Body Surface Area ; Extremities ; Foot Injuries ; Foot* ; Free Tissue Flaps* ; Humans ; Lower Extremity ; Male ; Mortality ; Retrospective Studies ; Soft Tissue Injuries ; Thigh* ; Walking ; Wounds and Injuries

OBJECTIVE: The primary purpose of this study was a replication of the effectiveness and tolerability of risperidone in the treatment of patients with acute mania in very larger cohort in naturalistic treatment setting to extend the data on the effect and tolerability of risperidone in the treatment of patients with acute mania to Asian population. METHODS: A total of 909 patients with DSM-IV criteria of bipolar disorder current manic and hypomanic episode, entered this large, open, multicentre study. The Young Mania Rating Scale (YMRS), Clinical Global Impression (CGI) and Simpson-Angus Rating Scale (SARS) were measured at baseline and weeks 1, 3 and 6, for the assessment of effectiveness and extrapyramidal symptom (EPS). RESULTS: This study showed statistically significant reduction of scores on the YMRS and CGI-s (mean change=-23.5+/-11.8, p<0.0001;mean change=-2.7+/-1.5, p<0.0001, respectively) from the baseline to the endpoint (week 6). Number of patients with 50% reduction or more in the YMRS and CGI-s scores was 693 (77.8%) and 630 (70.7%) at endpoint, respectively. There were no statistically significant increments of scores on SARS. Risperidone was generally well tolerated. CONCLUSION: The present larger open study demonstrates that risperidone add-on therapy is effective and tolerable in treatment of bipolar disorder, replicating results in various controlled and uncontrolled studies from Western countries.
Asian Continental Ancestry Group ; Bipolar Disorder* ; Cohort Studies ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Risperidone*

OBJECTIVE: Mirtax is a generic mirtazapine widely used since 2003. We conducted an open-label, uncontrolled 6-week study to evaluate the efficacy and safety of Mirtax for major depressive disorder (MDD). METHODS: Ninety three MDD patients with the diagnosis of MDD and 17-item Hamilton Depression Rating Scale (HDRS) score > or =14 were recruited. The HDRS, Montgomery-Asberg Depression Rating Scale (MADRS), and the Clinical Global Impressions-Severity Scale (CGI-S) were administered at baseline, 1, 2, 4 and 6 weeks. Response (> or =50% decrease in the HDRS or MADRS score), remission (absolute HDRS score < or =7 or MADRS score < or =10) and CGI-I score < or =2 were also calculated. Adverse event (AE) frequency and severity, weight, blood pressure, and pulse rate were checked to assess safety. RESULTS: The starting dosage was 11.5+/-6.4 mg/day, and the maintenance dosage was 23.1+/-9.4 mg/day. During 6 weeks, HDRS, MADRS and CGI-S scores decreased from 25.1+/-5.6 to 11.9+/-8.6 (mean change -13.1+/-8.3, p<0.001), from 30.2+/-6.3 to 13.73+/-10.40 (mean change -16.5+/-9.8, p<0.001), and from 5.0+/-0.8 to 2.5+/-1.3 (mean change -2.5+/-1.3, p<0.001), respectively. The percentages of responders, remitters by HDRS and patients with a CGI-I score < or =2 were 64.6%, 35.4% and 52.7%, respectively. Significant decreases in HDRS, MADRS and CGI-S scores were confirmed at week 1. The total rate of AEs was 32.3%; the most frequently reported AEs were sedation (4.3%) and constipation (4.3%). Weight was increased from 58.8+/-10.6 to 60.3+/-9.3 kg (mean change 0.7+/-1.7 kg, p=0.004). CONCLUSION: This study, as the first clinical trial of generic mirtazapine, demonstrated the efficacy and tolerability of Mirtax for MDD using a single treatment design.
Blood Pressure ; Constipation ; Depression ; Depressive Disorder, Major* ; Diagnosis ; Drugs, Generic ; Heart Rate ; Humans ; Prospective Studies*

No abstract available.
Fallopian Tube Neoplasms/*genetics ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; *Genetic Testing ; Humans ; Mutation ; Ovarian Neoplasms/*genetics ; Peritoneal Neoplasms/*genetics ; Republic of Korea ; Societies, Medical

No abstract available.
Fallopian Tube Neoplasms/*genetics ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; *Genetic Testing ; Humans ; Mutation ; Ovarian Neoplasms/*genetics ; Peritoneal Neoplasms/*genetics ; Republic of Korea ; Societies, Medical