Aging process of the forehead in human reflects imbalance of the forehead muscles, forehead ptosis including eyebrow, and winkles of the forehead and glabella. Forehead lifting through bicoronal incision was adopted as an universal method to correct these problems of the aging process. In a view of the aesthetic surgery, however, there are several problems such as large scar alopecia, and numbness beyond the incision line in the scalp for the correction of the forehead aging stigma. During the part few decades, minimally invasive technology forced many surgical specialities to undergo dramatic changes. In plastic & reconstructive surgery also minimally invasive technology using endoscope gave many advantages. Therefore it has reduced morbidity rates and got greater patient acceptances for the forehead lifting. When we perform endoscopic blow-forehead lift to get a good results in oriental people, 1. it needs a extended periorbital dissection. 2. we have to concern lift in the lateral part of forehead rather than in medial forehead. 3. it needs more aggressive tissue modifications (e.g. myotomies, neurotomy) 4. it needs more strong fixation such as permanent microscrew fixation or cortical bone drill hole technique. We performed 13 cases of the eyebrow-forehead lifting by using endoscope from August 95 to September 96 followed up them from 3 to 12 months and obtained satisfactory result. We would like to report our experiences with literature review.
Aging ; Alopecia ; Cicatrix ; Endoscopes ; Eyebrows ; Forehead ; Humans ; Hypesthesia ; Lifting* ; Muscles ; Plastics ; Scalp

A case of herpes simplex autoinoculated on the 1st interdigital web of right hand was reported, Herpes labialis characterized by confluent rice sized vesicular eruptions had developed on the midportion of upper lip. After 3 days, typical herpetic lesion occurred on the 1st interdigital web of right hand. We reviewed briefly the recent literatures.
Hand ; Herpes Labialis ; Herpes Simplex* ; Lip

The spine fracture of osteoporotic patients is considered as meaningful since it occurs prior to other life-threatening fractures (for example; fracture of proximal of femur). The purpose of this study were to analyze the relationship between BMD and spine fracture in patients who complained of back pain without any obvious trauma history. We studied the cases of one hundred thirty patients above an age of sixty years, whose visited the Department of Orthopaedic Surgery at Kosin University Medical Center, from March 1995 to April 1996. Both simple X-ray and Dual Energy X-ray Absorptiometry (DEXA) were checked in old patients. The following results were obtained. 1. The BMD of spine fracture group with the osteoporosis (mean; -3.66 standard deviation (SD)) was significantly lower than the nonfracture group (mean; -2.38 standard deviation (SD)) (P = 0.0000). 2. According that the BMD Z-score is decreased, the proportion of spine fracture is increased significantly (above-1.0SD; 16.67%, -1.0SD~ -2.0SD; 16.67%, -2.0SD~ -3.0SD; 37.83%, - 3.0SD~ 4.0SD; 51.61%, below -4.0SD; 61.54% (P = 0.000)). 3. The probability of developing the spine fracture based on above -2.0 standard deviation (SD) was 2.8 times in -2.0SD~ -3.0SD (P = 0.044), 5.3 times in -3.0SD~ -4.0SD (P = 0.004), and 7.9 times below -4.0SD (P = 0.001). We recommended more intensive treatment to the osteoporotic patients below -2.0 SD in BMD Z- score.
Absorptiometry, Photon ; Academic Medical Centers ; Back Pain ; Humans ; Middle Aged* ; Osteoporosis ; Spine*

PURPOSE: The role of spinal alpha1 adrenoceptors in normal micturition reflex of rat has not been known clearly yet. The purpose of this study is to elucidate the role of alpha1 adrenoceptor both at the spinal and peripheral level in mediating the micturition reflex which is induced by bladder distension in normal anesthetized rat and to compare the effects of different alpha1 adrenoceptor antagonists against the micturition reflex. MATERIALS AND METHODS: Wtih eighty female Sprague-Dawley rats(200-250gm) anesthetized with urethane, continuous cystometry was done by infusion of saline at a rate of 0.5ml/min. The following drugs were injected into femoral artery(intraarterial, i.a.) and subarachnoid space(intrathecal, i.t.) at the level of L6-S1 spinal cord segment; phentolamine, prazosin, doxazosin and tamsulosin. Cystometric parameters were analyzed before and after the drug injections; basal pressure(BP), micturition pressure(MP), bladder capacity(BC), micturition volume(MV), frequency and residual volume(RV). RESULTS: After i.a. injections of prazosin, doxazosin and tamsulosin, MP was significantly decreased. Doxazosin(i.a.), markedly increased MV, BC and RV. MP was more inhibited by doxazosin than prazosin or tamsulosin injection intraarterially. After i.a. injection of phentolamine, decrease in MP and frequency but increase in MV and BC were noted. Phentolamine(i.t.) raised BP and abolished MR followed by overflow incontinence. Prazosin(i.t.) induced marked increases in MV. Tamsulosin(i.t.) caused significant decreases in frequency but increases in BC. CONCLUSIONS: At spinal level, antagonism of micturition reflex evoked by bladder distension was more prominent by phentolamine. Inhibition of micturition reflex with alpha1 adrenoceptor blockers were greater peripherally. With these results, it could be suggested that micturition reflex evoked by volume-induced bladder distension could be modulated through alpha1 adrenoceptors at both the spinal and peripheral level. In some selected cases, alpha1 adrenoceptor agonist or antagonist can be useful for the management of lower urinary tract dysfunction
Animals ; Doxazosin ; Female ; Humans ; Negotiating ; Phentolamine ; Prazosin ; Rats* ; Rats, Sprague-Dawley ; Receptors, Adrenergic* ; Reflex* ; Spinal Cord ; Urethane ; Urinary Bladder ; Urinary Tract ; Urination*

PURPOSE: Prostate volume has been known to be poorly correlated with various parameters used to assess the severity of benign prostatic hyperplasia (BPH). However, recently there were reports that the ratio between transition zone(TZ) volume and prostate volume, which termed the TZ index might served as a useful proxy for evaluating worsening obstruction. The purpose of this study was to determine if transrectal ultrasound(TRUS) measurement of RI(resistive index), PCAR (presumed circle area ratio) correlate with the parameters of prostate volume(total prostate volume, TZ volume, TZ index), Qmax, international prostate symptom score(IPSS) or age. This study was conducted to reveal the relative effects of ultrasonic appearance of BPH on urinary symptoms. MATERIALS AND METHODS: A total of 81 men aged 50 to 89 years with moderate symptom of BPH(IPSS> or =8) underwent measurement of RI, PCAR, total prostate and TZ volume at transrectal ultrasonography. All men were requested to undergo uroflowmetry and complete the IPSS. The IPSS was compared to age, Qmax, prostatic volume, RI and PCAR using simple and multiple regression analysis. RESULTS: Simple regression analysis demonstrated that IPSS correlated with age(r=0.050, p<0.05), Qmax(r=0.253, p<0.05), TV(r=0.096, p<0.05) and PCAR(r=0.266, p<0.05). However, multiple regression analysis showed that age, Qmax and PCAR were significant independent determinants of the IPSS. CONCLUSIONS: As a parameter representing the degree of BPH in terms of the severity of lower urinary symptoms, simple and multiple regression analysis confirmed that the IPSS was influenced considerably by age, peak flow rate and PCAR.
Humans ; Lower Urinary Tract Symptoms* ; Male ; Prostate* ; Prostatic Hyperplasia* ; Proxy ; Ultrasonics ; Ultrasonography

PURPOSE: For the purpose of using Re-188 as a therapeutic radionuclide, we performed the quality control of the W-188/Re-188 generation system. MATERIALS AND METHODS: Several quality control tests of the Re-188 eluate from generator were carried out of about 300 days. After elution of Re-188 with normal saline (20 ml), chromatogram and gamma-ray spectrum of Re-188 eluate were obtained. The presence of aluminum which was derived from the elumina bed of the generator was detected by using aluminum ion indicator kit. Re-188 eluate was allowed to decay for several days, and then W-188 breakthrough in the Re-188 eluate was measured by detecting gamma-ray at 227 keV and 290 keV. The pH and the pyrogenicity of the eluate were checked. The Re-188 eluate from the generator was 67.4+/-7.0% of W-188 during 270 days, and it was hightest at third day after previous elution. Radiochemical purity of Re-188 eluate obtained from chromatogram was higher than 99%. Gamma-ray spectrum of Re-188 eluate showed a peak at 155 keV. Aluminum ion and W-188 contamination were not detected. The pH of Re-188 eluate was 3 and the concentration yield was 85%. CONCLUSION: Our experiments and results on quality control tests of Re-188 eluate from W-188/Re-188 generator may be useful for setting W-188/Re-188 generator in hospitals.
Aluminum ; Hydrogen-Ion Concentration ; Quality Control*

PURPOSE: For the purpose of using Re-188 as a therapeutic radionuclide, we performed the quality control of the W-188/Re-188 generation system. MATERIALS AND METHODS: Several quality control tests of the Re-188 eluate from generator were carried out of about 300 days. After elution of Re-188 with normal saline (20 ml), chromatogram and gamma-ray spectrum of Re-188 eluate were obtained. The presence of aluminum which was derived from the elumina bed of the generator was detected by using aluminum ion indicator kit. Re-188 eluate was allowed to decay for several days, and then W-188 breakthrough in the Re-188 eluate was measured by detecting gamma-ray at 227 keV and 290 keV. The pH and the pyrogenicity of the eluate were checked. The Re-188 eluate from the generator was 67.4+/-7.0% of W-188 during 270 days, and it was hightest at third day after previous elution. Radiochemical purity of Re-188 eluate obtained from chromatogram was higher than 99%. Gamma-ray spectrum of Re-188 eluate showed a peak at 155 keV. Aluminum ion and W-188 contamination were not detected. The pH of Re-188 eluate was 3 and the concentration yield was 85%. CONCLUSION: Our experiments and results on quality control tests of Re-188 eluate from W-188/Re-188 generator may be useful for setting W-188/Re-188 generator in hospitals.
Aluminum ; Hydrogen-Ion Concentration ; Quality Control*

PURPOSE: Authors analyzed the MR findings of swollen extremities to evaluate the MR features of lymphedema and phlebedema. MATERIALS AND METHODS: We reviewed MR imagings of 17 cases of swollen extremities, including 12 lymphedemas and 5 phlebedemas. We obtained axial TI-, T2-, and Gd-DTPA enhanced T1WIs using 1.0T superconducting magnet and measured cross-sectional areas of subcutaneous and subfascial tissues of a slice with grossly largest cross-sectional area using perimeter. We also analyzed changes in the signal intensities of the subcutaneous and subfascial tissues on T2WI, presence of enhancement on Gd-DTPA enhanced T1WI, and presence of skin thickening. RESULTS: Both subcutaneous and subfascial tissues of swollen extremities were increased in the cross-sectional areas than those of contralateral normal side. The subcutaneous compartment in lymphedema was statistically significantly increased in cross-sectional area than subfascial compartment in lymphedema(p<0.005) and subcutaneous tissue in phlebedema(p<0.05). Increased signal intensities and characteristic "honeycomb appearance" of subcutaneous tissue in the lymphedema were specific findings on T2WI. CONCLUSION: MR imaging was useful and noninvasive method in the diagnosis of swollen extremities. There were increased cross-sectional area of subcutaneous compartment with "honeycomb appearance" in lymphedema and increased signal intensities of both subcutaneous and subfascial compartment in phlebedema on the T2WI.
Diagnosis ; Extremities* ; Gadolinium DTPA ; Lymphedema* ; Magnetic Resonance Imaging ; Skin ; Subcutaneous Tissue

The surgical intervention for secondary developmental cervical spinal stenosis that results in myelopathy and radiculopathy has been modified by technical improvement to obtain more reliable enlargement of the cervical spinal canal. The authours have experienced good results with the modified open door expansive laminoplasty, so we report this article. The patients were treated by surgical intervention during the period from October 1989 to February 1991. The results obtained were as follows : 1) The average age was 54.7 years, and the sex distribution ratio of female to male was 2 : 8. 2) In clinical symptoms and symptoms of both myelopathy and radiculopathy. 3) In morphological analysis of lesions, all patients except one case had lesions over 3 levels, The lesions were spondylosis, spondylosis combined with soft disc herniation, spondylosis combined with OPLL, spondylosis combined with OPLL and soft disc herniation, OPLL and OYL in the order of frequency. 4) The operation method was as follows : after the patient was positioned in modified Concorde position, open door lamina was anchored to faced joint capsule and surrounding tissue with nylon sutures. And then the raw epidural space was covered with Lyodura by the modified Hirabayashi method. By this method, reclosure of widened spinal canal was prevented. 5) The outcomes were evaluated by JOA score difference between preoperation and post operation times. The outcome of recovery rate was 100% in five cases. Therewere no aggravated or unimproved cases. The results were excellent 8 cases, good 1 case, unchanged 0 case, poor 0 case and expired 1 case.
Epidural Space ; Female ; Humans ; Joint Capsule ; Male ; Nylons ; Radiculopathy ; Sex Distribution ; Spinal Canal ; Spinal Cord Diseases ; Spinal Stenosis* ; Spondylosis ; Sutures

Bicoronal approach is adopted as an universal method for reduction and internal fixation of the fractured zygomatic arch in the treatment of complex zygomatic fracture. However bicoronal approach leaves many disadvantages, such as long incision, alopecia, prolonged edema, and paresthesia. Nowadays endoscopically assisted minimal invasive technique has been widespread not only for the aesthetic surgery, but also for the reconstructive surgical fields because of the benefits. We have been recently trying to apply endoscopic surgery to facial bone fracture surgery. Endoscopically assisted minimal invasive technique has been applied to 14 patients who admitted to Chosun university hospital from March 1996 to July 1997. We used 4 mm, 30' endoscope and two 1.5-2 cm temple incisions and a subciliary incision for approaching to the zygomatic arch. Protected drill bit and driver had access to fractured zygomatic arch though tiny(5 mm) stab incision over the zygomatic arch. We have been able to successfully reduce and make fixation of the fracture of zygomatic arch by using endoscopically assisted minimal invasive technique. Follow up for 3 months revealed good maintenance of the reduction. We think that application of the endoscopic technology to midfacial bone fracture will result in significant reduction in morbidity and improve postoperative results.
Alopecia ; Edema ; Endoscopes ; Facial Bones ; Follow-Up Studies ; Fractures, Bone ; Humans ; Paresthesia ; Zygoma* ; Zygomatic Fractures