Tanzer reported microtia reconstruction using autogenous costal cartilage, thereafter so many plastic surgeons have tried various modification to get further refinement of reconstructed auricle. But the multiple stages of ear reconstruction required prolonged hospitalization and cost. In order to decrease the number of surgical stages and for the maximal convolution, we have employed a surgical procedure with three layered costal cartilage graft for the high profile auricle, concha formation and lobule transposition at the same time. However, it has still been difficult to reconstruct the tragus in cases of microtia that lack such component. We reconstructed the tragus using part of the microtic ear in addition to our above procedure simultaneously. This procedure is started with transposition of the lower two-thirds of the microtic ear to make lobule and then the upper third of the microtic ear is elevated as a chondrocutanenous flap which is then transposed 120-180degree C downwards to reposition at the area anterior to the conchal cavity. Using this technique, we have reconstructed 28 microtic ears. Adequate positioning of the auricle and tragus have been achieved and a more natural auricle obtained.
Cartilage ; Ear ; Hospitalization ; Transplants

The prominent mandibular angle is one of the disfiguring features in the Oriental, commonly seen and considered to be unattractive. Because it gives a square and muscular facial appearance, its surgical correction is dine frequently as a modality of facial contouring surgery in the Oriental. The reduction mandibular angleplasty is not a simple surgical technique for the unexperienced surgeon. We adopted C-arm fluoroscopy as a method of identifying the osteotomy line for the beginners. The reduction mandibular angleplasties assisted by C-arm fluoroscopy were performed in 9 patients, providing symmetric and satisfactory results. Now we are sure that the reduction mandibular angleplasty assisted by C-arm fluoroscopy can be an accurate and safe method for the unexperienced surgeon, especially the patient with deep-seated prominent mandibular angle.
Fluoroscopy* ; Humans ; Osteotomy

In a population-based study with 4 years of follow up, we evaluated the prevalence of Coxiella burnetii in cattle on Ulleung Island, Korea. In this study, the rates of C. burnetii infection in cattle on Ulleung Island were determined by PCR and were found to be 0.3–1.0% in the period 2011–2014. All 17 C. burnetii partial 16S rRNA gene sequences from PCR-positive cattle were identical and 2 geographic representatives were included in our analysis. The nucleotide sequences of the 2 samples showed high (98.4–100%) identity with C. burnetii sequences obtained from the GenBank. In this long-term tracking study, the number of cattle positive for C. burnetii on Ulleung Island was low. To prevent the transmission of C. burnetii on Ulleung Island, control strategy should include biosecurity improvement in surveillance, livestock management, administering suitable tests before purchasing animals to detect C. burnetii shedders, and restricting movements between herds.
Animals ; Base Sequence ; Cattle ; Coxiella burnetii ; Coxiella ; Databases, Nucleic Acid ; Follow-Up Studies ; Genes, rRNA ; Korea ; Livestock ; Phylogeny ; Polymerase Chain Reaction ; Prevalence

There are numerous noninvasive buried suture methods available to make a double eyelid, such as, fixation with skin and pretarsal tissue, fixation with skin and conjunctiva through the tarsal plate and the sling technique, which goes between the levator and Muller muscle and subdermal tissue. But these methods have some shortcomings and many operators are concerned for preventing the double fold to lower and to fade away in puffy eyelid. Because, in puffy eyelid, the excessive orbital fat may migrate to the area of fixation and it jeopardizes the effect of suturing. So, We tried to change the thick and puffy eyelid to the slim eyelid by selectively removing soft tissue(pretarsal fat, muscle, orbital fat) through the three tiny incisions. Ninety-five patients underwent operation for creation of a double fold between January of 1996 and February of 1999. All were female. The patients' age ranged from 16 to 31 years, with the mean of 22 years. Most of our patients were satisfied except 5 cases with minor complication(mild asymmetry: 4 cases, foreign body granulation: 1 case). Our method is very similar to various nonincisional methods, however, we removed a portion of pretarsal tissue, muscle, and/or orbital fat around three small incision sites to facilitate tissue adhesion. A continued modification in nonincisional method and improvement in results for double eyelid operation can be expected.
Conjunctiva ; Eyelids* ; Female ; Foreign Bodies ; Humans ; Orbit ; Skin ; Sutures ; Tissue Adhesions

The constricted ear was suggested by Tanzer for the purpose of obviating the confusion involving lop ear, cup ear and prominent ear as defect whose helix turns down, and scapha and fossa triangularis are narrowed. The constricted ear has a spectrum of severity and therefore, requires a graded surgical approach. Tanzer has described the degree of deformities of the constricted ear as falling into three groups. For the correction of constricted ear, there are numerous techniques but we have had difficulties in adopting these techniques in various type. We also describe the various constricted ear as the Tanzer's classification and adopted three methods to each type, banner flap(group I), concha cartilage graft (group II) and rib cartilage graft(group III) for reducing postoperative deformity and confusion in correcting the ear deformities. Constricted ear repairs must be individualized to accomodate each specific deformity. We corrected 22 cases of constricted ear in 20 patients using each optimal method described above according to the degree of deformities. Mild deformities need only reshaping and adjusting of existing tissues, moderate deformities need additional skin and severe deformities require a cartilage graft. For correction of constricted ear, accurate identification of the severity of deformity is essential. The results were satisfactory and we report our experience with relative literatures.
Cartilage ; Classification ; Congenital Abnormalities ; Ear* ; Humans ; Ribs ; Skin ; Transplants

We assessed the seroprevalence of Coxiella burnetii (C. burnetii) in cattle on Ulleung Island, Korea in a population-based follow up study for 4 years and determined the spatial distribution and risk factors associated with C. burnetii. The seroprevalence of C. burnetii was determined to be 1.4–2.0% during 2011–2014. Overall, nine cattle from three farms that tested seropositive showed C. burnetii antibody seroconversions between 2011 and 2014. The number of seropositive cattle was low, suggesting that movement of and contact between animals was possible risk factors for the transmission of C. burnetii.

We assessed the seroprevalence of Coxiella burnetii (C. burnetii) in cattle on Ulleung Island, Korea in a population-based follow up study for 4 years and determined the spatial distribution and risk factors associated with C. burnetii. The seroprevalence of C. burnetii was determined to be 1.4–2.0% during 2011–2014. Overall, nine cattle from three farms that tested seropositive showed C. burnetii antibody seroconversions between 2011 and 2014. The number of seropositive cattle was low, suggesting that movement of and contact between animals was possible risk factors for the transmission of C. burnetii.
Agriculture ; Animals ; Cattle ; Coxiella burnetii ; Coxiella ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Korea ; Q Fever ; Risk Factors ; Seroconversion ; Seroepidemiologic Studies

The identification and characterization of pathogenic and zoonotic tick-borne diseases like granulocytic anaplasmosis are essential for developing effective control programs. The differential diagnosis of pathogenic Anaplasma phagocytophilum and non-pathogenic A. phagocytophilum-like Anaplasma spp. is important for implementing effective treatment from control programs. The objective of the present study was to investigate the prevalence of Anaplasma spp. in horses in Korea by nucleotide sequencing and restriction enzyme fragment length polymorphism assay. Of the 627 horses included in the study, only 1 (0.2%) was infected with A. phagocytophilum. Co-infection with A. phagocytophilumlike Anaplasma spp. was not detected in the study. The 16S rRNA sequence of A. phagocytophilum was similar (99.5–100%) to A. phagocytophilum 16S rRNA isolated from horses in other countries. PCR adapted to amplify A. phagocytophilum groEL and msp2 genes failed to generate amplicons, suggesting genetic diversity in these genes. This study is the first molecular detection of A. phagocytophilum in horses in Korea. Human granulocytic anaplasmosis and animal infection of A. phagocytophilum have been reported in Korea recently. Because of vector tick distribution, global warming, and the increase of the horse industry, horses should be considered as a potential reservoir for A. phagocytophilum, and cross infectivity should be evaluated even though a low prevalence of infection was detected in this study. Furthermore, continuous surveillance and effective control measures for A. phagocytophilum should be established to prevent disease distribution and possible transmission to humans.
Anaplasma phagocytophilum ; Anaplasma ; Anaplasmosis ; Animals ; Coinfection ; Diagnosis, Differential ; Genetic Variation ; Global Warming ; Granulocytes ; Horses ; Humans ; Korea ; Phylogeny ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Prevalence ; Tick-Borne Diseases ; Ticks

BACKGROUND: Compared with other chronic diseases, hearing loss is generally overlooked from the perspective of disease burden. However, hearing loss is emerging as an important issue in the current society. The objective of this study was to investigate disease burdens and marginal utilities associated with hearing loss and other chronic diseases. METHODS: This study analyzed the cross-sectional data of 32,986 participants aged 19 years and older who completed the Korea National Health and Nutrition Examination Surveys between 2009 and 2013. Additionally, this study used the pure tone audiometric test, European Quality of Life-Five Dimensions Questionnaire, and chronic disease status. The data were analyzed using a multiple linear regression method. RESULTS: The data of 23,297 people who underwent a pure tone audiogram and completed the European Quality of Life-Five Dimensions Questionnaire were used in this analysis. The marginal utility of hearing loss ranked fifth among nine chronic diseases. The estimated loss of quality-adjusted life years associated with hearing loss was −93.69 years per 100,000 people, which is similar to other chronic diseases. CONCLUSION: This study assessed the marginal utilities and public burdens of hearing loss and eight chronic diseases in a South Korean population. Although the values may vary depending on country and race, this study may provide an indispensable foundation for more detailed studies on hearing loss.
Chronic Disease* ; Continental Population Groups ; Hearing Loss* ; Hearing* ; Humans ; Korea ; Linear Models ; Methods ; Quality-Adjusted Life Years

BACKGROUND: Cut-off values for visceral fat area (VFA) measured by computed tomography (CT) for identifying individuals at risk of metabolic syndrome (MetS) have not been clearly established in Korean adults, particularly for large populations. We aimed to identify optimal VFA and waist circumference (WC) cut-off values and compare the ability of VFA and WC to predict the presence of ≥2 metabolic risk factors. METHODS: We included 36,783 subjects aged 19–79 years undergoing abdominal fat CT during regular health checkups between January 2007 and February 2015 in Seoul. The risk factors for MetS except WC were based on the International Diabetes Federation criteria. Receiver operating characteristic curve analyses were used to determine the appropriate VFA and WC cut-off values for MetS. RESULTS: VFA was a more significant predictor of metabolic risk factors than WC and body mass index (BMI). The optimal cut-off values for VFA and WC were 134.6 cm2 and 88 cm for men and 91.1 cm2 and 81 cm for women, respectively. We estimated age-specific cut-off values for VFA, WC, and BMI. VFA cut-off values increased with age, particularly among women. CONCLUSION: This large population study proposed the cut-off values for VFA and WC for identifying subjects at risk of MetS among Korean adults. For more accurate diagnosis, different age-specific cut-off values for VFA and WC may be considered.
Abdominal Fat ; Adult* ; Body Mass Index ; Diagnosis ; Female ; Humans ; Intra-Abdominal Fat* ; Male ; Obesity, Abdominal ; Risk Factors ; ROC Curve ; Seoul ; Waist Circumference