PURPOSE: Correction of cleft lip nasal deformity has been performed from March, 1995 to June, 2006 at Donga-A University. The goal of this study is to evaluate children's psychosocial development and to determine the optimal timing of repair. METHODS: This is the retrospective study of patients operated at pre-school and school age. The patients could be divided into two groups, corrected at pre-school age(n=30), and school age(n=30). To evaluate the social development, we used 4 parameters, Children individualism-collectivism scale, Pictorial scale perceived competence social acceptance for young children, Matson's children social adaptability scale, Academic performance rating scale. RESULTS: Operated group at pre-school age had better social adaptation, social acceptance, self-image, self- esteem and academic performance than operated group at school age. CONCLUSION: It is better that correction of secondary lip nasal deformity at pre-school age than at school age in social development.
Child* ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Lip ; Mental Competency ; Retrospective Studies ; Social Change* ; Social Distance

It is believed that surgery on human immunodeficiency virus (HIV)-positive patients is dangerous and should be avoided due to the possibility of postoperative infection of the patients or HIV occupational transmission to the medical staff. We discuss here the preparations and measures needed to conduct surgery safely on HIV-positive patients, based on our experience. We performed sex reassignment surgery on two HIV-positive patients from January 2013 to January 2015. Both of them were receiving highly active antiretroviral therapy and were asymptomatic, with a normal CD4 count (>500 cells/microL). The HIV-RNA was undetectable within the bloodstream. All the staff wore protective clothing, glasses, and three pairs of protective gloves in the operating room because of the possibility of transmission. Prophylactic antibiotics were administered to the patients, and antiviral therapy was performed during their perioperative course. Neither of the patients had postoperative complications, and none of the medical staff experienced accidental exposure. Both patients had satisfactory surgery outcomes without complications. HIV-positive patients can undergo surgery safely without increased risk of postoperative complications or HIV transmission to the staff through the proper use of antibiotics, active antiretroviral therapy, and supplemental protective measures with post-exposure prophylaxis for the staff in case of HIV exposure.
Anti-Bacterial Agents ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Eyeglasses ; Glass ; Gloves, Protective ; HIV ; HIV Infections ; Humans* ; Medical Staff ; Operating Rooms ; Post-Exposure Prophylaxis ; Postoperative Complications ; Protective Clothing ; Sex Reassignment Surgery*

OBJECTIVE: This study is undertaken to review clinical characteristics of spontaneous intracranial aneurysms in young adult patients. METHODS: The authors reviewed medical records and radiological findings in patients, aged 16 to 35 with spontaneous intracranial aneurysm(s) who underwent transcranial or endovascular treatment in our hospital from 1989 to 2002. RESULTS: The number of cases was 157 and the ratio of male to female was 95:62. The majority(88.5%) of patients presented with subarachnoid hemorrhage and underlying medical diseases were found only in 12.1%. Acccording to Hunt-Hess grade, 145 patients(92.4%) showed good clinical grade on admission. Aneurysms were located most commomly at the anterior communicating artery(35.7%). Patients with multiple aneurysms were 11.5% and giant aneurysms were found in 4.5%. We performed transcranial surgery in 95.5% and endovascular treatment in 4.5%. 144 patients(91.7%) showed good outcome at discharge and 8 patients died of rebleeding in two cases, brain swelling in two cases, postoperative infarction after parent artery occlusion in two cases, vasospasm in one case, and acute myocardial infarction in one case. CONCLUSION: Because of good neurological status on admission, low incidence of intraventricular hemorrhage and hydrocephaus, low incidence of underlying medical disease, and low incidence of symptomatic vasospasm, the overall outcomes of the young adult patients are better than those of the old patients.
Aneurysm ; Arteries ; Brain Edema ; Female ; Hemorrhage ; Humans ; Incidence ; Infarction ; Intracranial Aneurysm* ; Male ; Medical Records ; Myocardial Infarction ; Parents ; Retrospective Studies* ; Subarachnoid Hemorrhage ; Young Adult*

PURPOSE: Facial rejuvenating surgery has become a challenge to most plastic surgeons. Patients are demanding fewer complications, a prompt recovery, and more natural results. Current trend of the face lift surgery has been developed into less invasive procedures. Every aging patient in Asia wants to look younger without obvious evidence of surgical correction. METHODS: The authors performed the limited dissection face lift with PDS quilting suture on twenty five patients. These five quilting sutures consist of sutures at 1~2 cm posterior to the prominent point of zygoma to the periosteum of the zygomatic arch, at the lateral border of Bichat's fat pad area to the zygomatic arch, at the lateral border of the orbicularis oculi muscle to the deep temporal fascia, at the upper lateral border of the platysma to the periosteum of the mastoid, and at the anterior lower margin of the earlobe to the deep temporal fascia by quilting suture technique to achieve rejuvenation. RESULTS: These procedures could produce a balanced volumetric rejuvenation. This method gave considerable benefit of stable and satisfactory results. It provides reduced operative time, well corrected nasolabial fold and neck wrinkle, and swift recovery with minimal complications. CONCLUSION: Although it could not replace the classic facelift, this technique can be recommended as an option for patients who do not present with advanced facial aging or not want a more extensive procedure.
Adipose Tissue ; Aging ; Asia ; Fascia ; Humans ; Mastoid ; Muscles ; Nasolabial Fold ; Neck ; Operative Time ; Periosteum ; Rejuvenation ; Rhytidoplasty ; Suture Techniques ; Sutures ; Zygoma

BACKGROUND: Cryptotia is a congenital ear deformity in which the upper pole appears buried beneath the mastoid skin. Cryptotia is a common auricular malformation among Asians. The aim of this paper is to examine the surgical techniques for and complications of 34 cryptotic patients. METHODS: Surgery was performed for 34 cryptotic deformities (January 2005 to January 2012). Twenty-two patients (64.7%) were classified as having type I cryptotia, and 12 patients (37.5%) type II cryptotia. Among the type I cryptotia patients, 8 patients had mild deformity and 14 severe deformity. Among the type II cryptotia patients, 10 patients had mild deformity and 2 severe deformity. RESULTS: The mild deformities were corrected via Z-plasty, V-Y plasty, full-thickness skin graft, and transposition flap, while the severe deformities were corrected via cartilage graft or Medporfor the spread of cartilage adhesion of antihelix. There were two cases of reinvagination in the autologous cartilage graft group. Implant exposure occurred with Medpor (two cases). There were two cases of hypertrophic scar on the previous surgical wound with Medpor. There were no complications in the 18 patients who had mild deformities. CONCLUSIONS: The type I cryptotia patients had more severe deformities than the type II cryptotia patients. As most of the type II cryptotia patients had only mild deformities, their deformities were corrected without using autologous conchal cartilage graft or Medpor, except for two patients. Through more case analyses, researchers should make an effort to identify methods for recurrence and prevention of complication.
Asian Continental Ancestry Group ; Cartilage ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Ear ; Humans ; Mastoid ; Polyethylenes ; Recurrence ; Skin ; Transplants

The septal extension graft is a very useful method of controlling nasal lengthening and tip projection, rotation, and shape by fixing a graft to the septum, which leads to a strong supporting structure. Enhancing graft stability is important for better long-term outcomes and minimizing complications or relapse, and even more efficient application of these methods is needed for East Asians who lack enough cartilage to be harvested in addition to possessing a weak cartilage framework. In this paper, the methods for overcoming the drawbacks of the septal extension graft, such as instability, a fixed tip, and insufficiency of cartilage, are presented, and the applications of each method for greater satisfaction with surgical outcomes are also discussed.
Asian Continental Ancestry Group ; Cartilage ; Humans ; Methods ; Nasal Septum ; Recurrence ; Rhinoplasty ; Transplantation, Autologous ; Transplants*

Inflammatory pseudotumor of the bladder is an unusual benign lesion arising from the bladder submucosa. This benign lesion must be differentiated histologically from several malignant lesions of the bladder. Complete surgical excision, either by transurethral resection or partial cystectomy, appears to be curative. We report a case and describe the clinical presentation, and radiographic and histological findings.
Cystectomy ; Granuloma, Plasma Cell* ; Urinary Bladder*

PURPOSE: Until now, many kinds of treatment modalities for facial bone fractures have been proposed. Among them, the semi-rigid fixation using miniplates has become the most popular procedure due to its simplicity and good clinical results. However, achieving anatomic reduction of bone fragments with miniplates may be difficult because of inadequate instrumentation for fracture fragment stabilization. We examined the use of inter-maxillary fixation screws or titanium screws tied with stainless steel wire to assist in positioning of fractured segment. METHODS: We used this method for reduction in 50 cases of facial bone fractures. Inter-maxillary fixation screws or titanium screws tied with stainless steel wire were used to assist in aligning bony segment. Postoperative radiologic and clinical follow-ups were performed. RESULTS: Radiologic follow-up showed correct reduction and fixation in all cases. Nonnunion and malunion were not shown. Clinical follow-up showed an satisfactory results. CONCLUSION: By using Inter-maxillary fixation screws tied with stainless steel wire, it was shown that reducing the bony segment to their preinjury position is easy to perform and it enables us to make more accurate reduction, ensure wider visual field.
Dietary Sucrose ; Facial Bones ; Follow-Up Studies ; Stainless Steel ; Titanium

For recent years, use of autologous fat injection has increased significantly in facial contouring surgery. Along with such increase in use, complications like atypical mycoplasma infection have been also on the increasing trend. The authors report two cases of Mycobacterium chelonae infection that occurred after autologous fat injection. Patients were treated as infection that resistant to common antibiotics and results were negative to routine culture and Gram staining. Acid-fast bacillus stain, polymerase chain reaction (PCR) test and mycobacterial cultures were conducted for diagnosis under suspicion of atypical mycoplasma infection. Then, combination antibiotics therapy, surgical treatment, and steroid injection were performed for treatment. Both patients were diagnosed with Mycobacterium chelonae in PCR test. They were positive to mycobacterial cultures. Combination antibiotics therapy was repeated to improvement of symptom. However, they could not be free from side effects such as deformation in facial contour, scar and pigmentation even after full recovery. When chronic wound infections after autologous fat injection, we must suspect atypical or mycobacterial infection and conduct examinations for a early diagnosis and proper antibiotic therapy that is effective to the nontuberculous mycobacteria.
Anti-Bacterial Agents ; Bacillus ; Cicatrix ; Diagnosis ; Early Diagnosis ; Humans ; Mycobacterium chelonae* ; Mycoplasma Infections ; Nontuberculous Mycobacteria ; Pigmentation ; Polymerase Chain Reaction ; Surgical Procedures, Minimally Invasive ; Wound Infection

PURPOSE: Augmentation rhinoplasty using alloplastic materials is a relatively common procedure among Asians. Silicon, expanded polytetrafluoroethylene (Gore-tex(R)), and porous high density polyethylene (Medpor(R)) are most frequently used materials. This study was conducted to analyze revisional rhinoplasty cases with alloplastic materials, and to investigate the usage of alloplastic materials and their complications. We also reviewed complications caused by various materials used in plastic surgery while operating rhinoplasty. MATERIALS AND METHODS: We report 581 cases of complications rhinoplasty with alloplastic implants and review of the literature available to offer plastic surgeons an overview on alloplastic implant-related complications. RESULTS: Among a total 581 revisional rhinoplasty cases reviewed, the alloplastic materials used were silicone implants in 376, Gore-tex(R) in 183, and Medpor(R) in 22 cases. Revision cases and complications differed according to each alloplastic implant. CONCLUSION: Optimal alloplastic implants should be used in nasal structure by taking into account the properties of the materials for the goal of minimizing their complications and revision rates. A thorough understanding of the mechanism involved in alloplastic material interaction and wound healing is the top priority in successfully overcoming alloplastic-related complications.
Asian Continental Ancestry Group ; *Biocompatible Materials/adverse effects ; Humans ; Polyethylene ; Polyethylenes ; *Polytetrafluoroethylene ; Postoperative Complications ; Prosthesis Implantation/*methods ; Rhinoplasty/*methods ; Silicones ; Treatment Outcome