PURPOSE: Secondary correction of unilateral cleft lip and nose deformity is necessary in number of patients despite advanced techniques and overall treatment philosophy. Various techniques and modifications have been reported by many centers. But the definite procedure for secondary unilateral cleft lip nasal deformity is the question under debate. METHODS: Secondary cleft lip and nosede formity has its own anatomical abnormalities, including incomplete release of nasal lining, incomplete alar cinching, and progressive septal deviation. In order to correct these anatomical abnormalities, we have performed the procedures of complete release of congenital cicatricial contracture of nasal lining, extended cinching of alar, suspension of orbicularis oris muscle, and anteriorly limited open rhinoplasty. RESULTS: Between June of 2001 and Feb of 2006, 45 patients with secondary cleft lip and nose deformity underwent correction according to our procedures. During 36 month period of follow up, there were no significant complications. Esthetic and functional improvement was identified. CONCLUSION: Consequently, total mobilization of all the displaced anatomical structures and placing them in a normal position are the basic and essential in correction of secondary cleft lip and nose deformity
Cleft Lip* ; Congenital Abnormalities* ; Contracture ; Follow-Up Studies ; Humans ; Nose* ; Philosophy ; Rhinoplasty

PURPOSE: Amelanotic melanoma represents a melanoma with an absence or a small number of melanin pigments and comprises 2% of all melanomas. These melanomas are frequently misdiagnosed, probably because of its nonspecific clinical features and difficulty in diagnosis, resulting in delayed diagnosis and treatment. We report a patient with amelanotic melanoma, who underwent surgical treatment with sentinel lymph node biopsy using gamma probe. METHODS: A 32-year-old female was presented with a slowly growing ill-defined, hypopigmented nonerythematous lesion with nail defect on right index finger tip. Preoperative punch biopsy was performed, showing an amelanotic melanoma. Sentinel lymph node biopsy was done using gamma probe(Crystal probe system, CRYSTAL PHOTONICS GmbH, Germany) and confirmed no evidence of regional lymph node metastases. The patient underwent amputation at the proximal interphalangeal joint. RESULTS: Histopathologic findings showed superficial spreading melanoma. There were no melanin pigments in Hematoxylin & Eosin stain but positive immunohistochemical stainings for S-100 protein and Hmb45, which were consistent with amelanotic melanoma. Patient's postoperative course was uneventful without any complication and had no evidence of recurrence of tumor in 6 months follow-up period. CONCLUSION: Amelanotic melanoma is extremely rare subtype of malignant melanoma with histopathologic findings of atypical melanocytes without melanin pigments. Early detection is crucial since survival is strongly related to tumor thickness and tissue invasion at the time of diagnosis. Wide excision is the treatment of choice and other conjunctive therapy has not been successful.
Adult ; Amputation ; Biopsy ; Delayed Diagnosis ; Eosine Yellowish-(YS) ; Female ; Fingers ; Follow-Up Studies ; Hematoxylin ; Humans ; Joints ; Lymph Nodes ; Melanins ; Melanocytes ; Melanoma ; Melanoma, Amelanotic ; Nails ; Neoplasm Metastasis ; Nitriles ; Optics and Photonics ; Pyrethrins ; Recurrence ; S100 Proteins ; Sentinel Lymph Node Biopsy

No abstract available.
Hypothyroidism* ; Myasthenia Gravis*

BACKGROUND: This is the studies about "If the soldiers expose in the paraquat, how much have it influenced on themselves who participated in the Vietnam War and their second generation?" and this is also researched about the factors that "How differents do the symptoms according to their health conditions and a class of diseases?". First of all, We divided them into 3 groups as exposure duration and exposure degree of the paraquat and We gave marks against each steps, too. (< point 10: low group, point 11-19: middle group, > point 20: high group). We've focused in "Does the high score really involves with their descendants who suffers from paraquat?" as direct damages men during from June 1965 to February 1971 (72 persons) and their descendants (266 persons) who are in the Pusan veterans hospital and outpatients. METHODS: It is completed by direct interview, telephone interview, army records, army history, and medical records with them. We've tried to minify sample bias as analyzing their information. We could contact only a few people among living in Pusan or Kyongnam province. Generally, someone including persons who couldn't get a damaging proofs from paraquat hardly joined us and the others strongly rejected the interview for this research. RESULTS: Among the 72 participating soldiers in the Vietnam war, average age of patient is 53 years old (the youngest: 46 years old, the oldest: 64 years old), average of exposure score is 16 point (minimum: 1.9 point, maximum: 31.9 point), average of pregnant frequency is 5.2 persons, and average degree of smoking is 14.382 single cigarette (minimum: 4 single cigarette, maximum: 60 single cigarette). The second generation is suffering from abortion, skin disorder, still birth, congenital anomalies, weakness, visual disturbance, peripheral neuropathy in frequency. CONCLUSION: There's no relation between exposure score of paraquat and diseases of the descendants.
Bias (Epidemiology) ; Busan ; Gyeongsangnam-do ; Hospitals, Veterans ; Humans ; Interviews as Topic ; Male ; Medical Records ; Middle Aged ; Military Personnel ; Outpatients ; Paraquat* ; Parturition ; Peripheral Nervous System Diseases ; Skin ; Smoke ; Smoking ; Tobacco Products ; Vietnam*

PURPOSE: To evaluate the incidence of retinal angiomatous proliferation (RAP) and retinal pigmented epithelial detachment (PED) in Korean age-related macular degeneration (ARMD) patients and results of photodynamic therapy (PDT) with verteporfin. METHODS: Between May 2001 and December 2004, two hundred fifty-eight patients diagnosed of ARMD were evaluated and nine eyes of seven patients were as having RAP with PED. All patients underwent two or more sessions of PDT. Best-corrected visual acuity (BCVA), fundus photography, fluorescein angiography and ICG angiography were performed before and after treatment. RESULTS: The incidence of RAP with PED was 2.8%. The mean age of onset was 71.7 and five of seven patients were female. After 17 months and mean 2.3 PDT treatments, mean BCVA decreased from 0.2 to 0.04. In two eyes, additional Transpupillary thermotherapy was undertaken. Occlusion of RAP and flattening of PED was observed in one eye, and four evolved toward stage 3 RAP. Three eyes with PDT developed tear of retinal pigmented epithelium. CONCLUSIONS: Korean ARMD patients showed a low incidence of RAP and poor visual outcomes even with treatment.
Age of Onset ; Angiography ; Epithelium ; Female ; Fluorescein Angiography ; Humans ; Hyperthermia, Induced ; Incidence ; Macular Degeneration* ; Photochemotherapy* ; Photography ; Retinaldehyde* ; Visual Acuity

Peritonsillar abscess is a common deep throat infection. Early diagnosis and prompt, appropriate management of a peritonsillar abscess prevents mortality. A 45-year-old woman on steroids for an ulcerative colitis (UC) exacerbation presented with sore throat and multiple skin ulcers on her left forearm and right foot. Computed tomography of the neck revealed a peritonsillar abscess. Gram staining and culture of the abscess were negative, and a skin biopsy suggested pyoderma gangrenosum (PG). The final diagnosis was peritonsillar involvement of steroid-refractory PG-associated UC. The patient showed a complete response to infliximab. Here, we report a case of successful infliximab treatment for peritonsillar involvement of steroid-refractory PG-associated UC.
Abscess ; Biopsy ; Colitis, Ulcerative* ; Diagnosis ; Early Diagnosis ; Female ; Foot ; Forearm ; Humans ; Infliximab ; Middle Aged ; Mortality ; Neck ; Peritonsillar Abscess ; Pharyngitis ; Pharynx ; Pyoderma Gangrenosum* ; Skin ; Skin Ulcer ; Steroids

A 69-year-old male was admitted to the neurosurgery department for traumatic intracra-nial hemorrhage in both frontal lobes. After 2 months, he complained of epigastric dis-comfort, nausea, vomiting, and loose stools. The gastric endoscopic examination found acute hemorrhagic gastritis and there were rhabditoid nematode larvae in the gastric fluid and biopsy sections. The filariform larvae of Strongyloides sp. were discovered from a fecal culture. The patient was treated with albendazole (200 mg, po bid, for 4 weeks). The epigastric discomfort disappeared and endoscopic findings improved after treatment.
Aged ; Albendazole ; Biopsy ; Frontal Lobe ; Gastritis* ; Hemorrhage ; Humans ; Larva ; Male ; Nausea ; Neurosurgery ; Strongyloides ; Vomiting

BACKGROUND: The previous studies suggested that the rate of the people who reported having sensitivity to cold and Raynaud's disease were 12% and 5~10% of general population respectively. There are surprisingly few data on 'cold hands and feet syndrome', the conventional circulatory disorder in far-eastern Asia in spite of the assumption that it is a common disorder among Korean population. Besides, the prevalence of Raynaud's disease has not been studied for Korean complaint of the syndrome. Therefore, we conducted the survey regarding the frequency of Baynaud's disease and phenomenon among the people appealed abnormal sensory symptoms on hands and feet, and 'cold hands and feet syndrome'. METHODS: The questionnaires were asked to 1,008 out- patients who complained abnormal sensory symptoms on hands and feet. The subjects were screened among the patients who visited the clinics, mainly department of family medicine in Uijongbu St. Mary's hospital from January to July 2003. RESULTS: The most common abnormal sensory symptoms were tingling feeling and coldness, pain in the descending order. The mean age of the patients is 47 years, the average age at the onset of the symptoms is 40 years, and the mean duration they had been suffered by the symptoms is 7 years. During interview, 289 patients voluntarily appealed 'cold hands and feet syndrome' in expression of "I have cold extremities" or "I have the syndrome". Among the screened patients, 510 patients answered, "yes" to the question "Are your fingers unusually sensitive to cold?" Two hundred and nineteen patients (43%) of them showed Raynaud's phenomenon. One hundred and sixty patients were diagnosed as Raynaud's disease among 219 patients who had Raynaud's phenomenon. The rest 59 patients were diagnosed as secondary Raynaud's phenomenon. Eighty-seven patients (30%) of 289 patients who voluntarily reported 'cold hands and feet syndrome' were diagnosed as Raynaud's disease. The average age of Raynaud's disease patients is 37 years old, average first attack age is 24 years, and average suffering period is 14 years. Only 10% of cases experienced the first attacks after 40 years old. The attack rates are different by gender. The ratio is 2.3 and higher in female. Only six patients (4%) of Raynaud's disease had been diagnosed accurately. Fifty-three patients (33%) have family history and 41 of them are the first-degree relatives. The causes of secondary Raynaud's phenomenon (59 patients) are connective tissue disorders, neurologic diseases, carpal tunnel syndrome, hypothyroidism, vascular disorders, etc. The statistically significant factors that influence on Raynaud's disease are female, below 40 years old, stress, family history, hypertension, diabetes, etc. The statistical analysis in this study does not prove the association between the disease and the factors such as physical labor, manual labor using hands heavily, smoking, drinking, thyroid diseases, joint disorders, ischemic heart disease, depression. CONCLUSION: Raynaud's disease has been underlooked even though it is not uncommon and can be easily diagnosed and treated. In conclusion, the result of our study suggests that abnormal sensory symptoms on hands and feet, especially 'cold hands and feet syndrome', the conventional circulatory disorder, are the medical condition where special concern on Raynaud's disease is required.
Adult ; Asia ; Carpal Tunnel Syndrome ; Connective Tissue ; Depression ; Diagnosis* ; Drinking ; Female ; Fingers ; Foot* ; Hand* ; Humans ; Hypertension ; Hypothyroidism ; Joints ; Myocardial Ischemia ; Nervous System Diseases ; Prevalence ; Raynaud Disease* ; Sensation* ; Smoke ; Smoking ; Thyroid Diseases ; Surveys and Questionnaires

Fibrous capsular contracture has been considered as a major side effect of breast silicone implant. The etiology of fibrous capsular contracture has not been fully determined. In the present study, we tried to determine the indirect effect of immune system in fibroblast function which plays a major role in fibrous capsular contracture. For preparation of conditional medium of lymphocytes, mouse (ICR) splenocytes were cultured for one day. Two kinds of conditioned medium, silicone conditioned medium (SCM) and silicone free normal conditioned medium (NCM), were prepared from splenocyte cell suspension cultured on silicone gel coated surface and naked surface, respectively. Mouse fibroblasts (NIH 3T3) were cultured in usual culture dish. Conditioned medium of 25% concentration was added. On day 2 after innoculation, cell number, thymidine incorporation and proline uptake of fibroblasts were measured. The results were as follow; 1) There was no difference of fibroblast number by cultivation in SCM of splenocytes compared with that in fresh medium(FM). 2)There was significant increase of DNA synthesis of fibroblasts in SCM compared with that in FM (p < 0.001). 3) There was significant increase of collagen synthesis of fibroblasts in SCM compared with that in FM (p < 0.01) and in NCM (p <0.001). 4) The functional activities of DNA and collagen synthesis mediated by same number of fibroblast were calculated to be significantly increased in SCM compared with that in NCM and in FM (p < 0.001). In conclusion, fibroblasts cultured in SCM had a higher potential to synthesize macromolecules such as collagen and DNA. We can postulate that SCM may contain certain amount of unknown growth stimulant of fibroblasts, which is produced by silicone gel sensitized murine splenocytes.
Animals ; Breast ; Cell Count ; Collagen ; Contracture ; Culture Media, Conditioned* ; DNA ; Fibroblasts* ; Immune System ; Lymphocytes* ; Mice ; Proline ; Silicone Gels ; Thymidine

PURPOSE: The purpose of this study was not only to evaluate the relative mRNA expression of interleukin-1beta(IL-1beta), cyclooxygenase2 (COX-2) and prostaglandin E2 (PGE2) by RT-PCR analysis but to observe pattern of edema by light microscopic and electron microscope after topical apply of hyaluronic acid in inflammation-guided mouse. MATERIAL AND METHODS: Mice of this study were devided into 4 groups: Control group (no inflammation guided), Positive control (inflammation guided + vaselin apply), Protopic group (inflammation guided + protopic apply), Hyaluronic group (inflammation guided + hyaluronic acid apply). RESULTS: Hyaluronic group showed less expressions of IL-1beta, COX-2, PGE2 than those of positive control & protopic group. Hyaluronic group revealed a decreased inflammation than positive control & protopic group in Light Microscope. Hyaluronic group appeared decreased edema of ear compare to positive control & protopic group in Elecron Microscope. CONCLUSION: It was considered that hyaluronic acid has an antiinflammatory effect for intercepting the gene expression of cytokines related to inflammation.
Animals ; Cytokines ; Dinoprostone ; Ear ; Edema ; Electrons ; Gene Expression ; Hyaluronic Acid ; Inflammation ; Light ; Mice ; RNA, Messenger