Microform cleft lip is a mild form of incomplete cleft lip, also known as a minimal occult, abortive, forme fruste cleft lip. However, it has no definition and few methods have been reported for its correction. A microform cleft lip is characterized as the incomplete union of the superficial portion of the orbicularis oris muscle. It is more prominent during facial expression than in a resting state. We confined microform cleft lip in our study to the absence of philtral skin change and a contracted position on the top of cupid's bow. During the past 5 years, 17 patients of microform cleft lip were operated on. We corrected the defect of the upper vermilion border and nostril sill with minimal incision, and repaired the underlying lip musculature in superficial discontinuity. Reduction of the widened alar base was performed. Deformed alar cartilage was dissected via rim incision, and suspended in a medial and upper direction with pull-out sutures. The most important thing is precise repair of the superficial portion of the separated orbicularis oris muscle via minimal incision, and it is best to operate after 1-year of age for accurate repair. The results were satisfactory and the parents were also satisfied. The advantages of this procedure are as follows: 1. Less visible, minimal scar on upper lip 2. Simultaneous correction of vermillion notching, deformed cupid's bow and nasal deformity. 3. Eversion of philtral ridge due to tenting effect of horizontal mattress suture 4. Philtral elongation effect by reduction of alar base and Z-plasty of cupid's bow.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Facial Expression ; Humans ; Lip ; Microfilming* ; Parents ; Skin ; Sutures

Various surgical methods have been used to reconstruct severe soft tissue defects of the finger with exposed critical structures such as tendon, bone, and nerve. Some of these methods include rotation flap, cross finger flap, or regional flap similar to neurovascular island flap. However, there were often difficult situations where a flap could not be applied depending on the remaining surrounding tissue, injured area, and size of defect. As a result, free flap or distant flap may become necessary. However, distant flaps often cause stiffness of the finger joints since the hands need to be immobilized for a long time, while standard free flaps may be too thick to cover the finger and cause problems such as morbidities of the donor site. Since May, 1997, at Anam Hospital, we have performed reconstruction on 6 patients with soft tissue defect using a thin, flexible medial plantar septo-cutaneous free flap similar to the volar aspect of the finger in anatomical characteristics of the skin and subcutaneous tissue covering. The vessels used for this flap were superficial branches of medial division of the medial plantar artery and vena comitantes, or the subcutaneous veins. The mean size of the flaps was 2.75cm x 4.25cm. Primary repair or split-thickness skin graft was performed on the donor site depending on the size. All the flaps survived without significant complications, except one case of venous insufficiency. The composition of the transferred flaps was good with the recovery of pain, touch and temperature sensation. A free medial plantar septo-cutaneous flap has several advantages, e.g., it is small in comparison with other standard free flaps, having two draining venous pathways, good color and texture, and a good recovery of protective sensation. This flap can be used for the reconstruction of soft tissue defect on the heel and foot, as well as the volar aspect of fingers.
Arteries ; Finger Joint ; Fingers ; Foot ; Free Tissue Flaps* ; Hand ; Heel ; Humans ; Sensation ; Skin ; Subcutaneous Tissue ; Tendons ; Tissue Donors ; Transplants ; Veins ; Venous Insufficiency

No abstract available.

Scalp extension involves the continuous nonvolumetric expansion of the hair-bearing scalp, via biologic creep, using implanted surgical device consists of cutting a 5 cm wide strip of plain silastic (0.02 inch thick) from a larger 16x8 inch sheet, then gluing dacron-reinforced silastic strip (5x1 cm, 0.015 inch thich) to the distal ends. A stainless steel plate from hooks is then secured to each end of the extender. During the period from March 1996 to September 1997, 21 patients including 16 patients of male pattern baldness were treated for alopecia of the scalp using internal scalp extender in the department of plastic surgery Korea university hospital. All cases were successfully reconstructed without major complications. It not only reduces the number of scalp reductions and time necessary to totally excise bald vertex scalp, but also appears to decrease the amounts of stretch back and atrophic scarring that may accompany some reductions. Scalp extension appears to be a useful adjunctive technique in hair replacement and reconstructive surgery, and has distinct advantages over standard scalp reduction and tissue expansion techniques.
Alopecia* ; Cicatrix ; Hair* ; Humans ; Korea ; Male* ; Scalp* ; Stainless Steel ; Surgery, Plastic ; Tissue Expansion

Fractures of the hip in children are rare. The reported incidence is low. It is known that the force required to fracture the bone in childhood is of great magnitude. Rang(1983) reported several important differences between childhood and adult fractures. And Morrissy (1980) also reported differences in treatment. The complications of the femoral neck fractures in children are avascular necorsis, premature epiphyseal closure, nonunion, coxa vara, and infection. The reported incidence of avascular necrosis varies from 20 to 60 percent. Many methods of trestment for this complications are introduced up to now. However, a definite method could not be found. Therefore, we reported two cases of femoral neck fracture which complicated the avascular necrosis for whom non-weight bearing trestment after osteosynthesis were given for 16 and 25 months, respectively. In these two cases, we could obtain the following results. Fracture union was not hindered by avasculsr necrosis of the femoral head. Non-weight bearing could prevent the collapse of necrotic head, and seemed to help revascularization of the necrotic head.
Adult ; Child ; Coxa Vara ; Femoral Neck Fractures ; Femur Neck ; Head ; Hip ; Humans ; Incidence ; Methods ; Necrosis ; Prognosis

In Korea, all domestic made test systems for detecting antibodies in HIV-1 contain the antigens from human immunodeficiency type 1 (HIV-1) subtype B. However, because HIV-1 subtype O is significantly different in amino acid sequences from all other subtypes of HIV-1, there has been a need for developing a test for detecting antibodies in subtype O. For this purpose, the entire nucleotide sequence corresponding to the extracellular domain of the transmembrane glycoprotein of HIV-1 subtype O was synthesized with consideration of Escherichia coli cordon usage. Various regions of the extracellular domain were cloned into E. coli expression vectors and tested for levels of protein production. The nucleotide sequence, named ECTM, that can encode a 129 amino acid-long peptide, was found to be expressed at a high level in E. coli. The protein of approximately 17 kDa specifically reacted with sera from individuals infected with HIV-1 subtype O. The ECTM protein was purified to near homogeneity by the CM-T gel chromatography, using concentrated, denatured inclusion bodies. In Western blot analysis, the purified viral antigen reacted with sera from individuals infected with subtype O more efficiently than subtype B. The enzyme linked immunoabsorbent assay (ELISA) system was developed using the subtype O viral protein and compared with the commercially available kit lacking the antigens from subtype O. The ELISA kit containing the subtype O antigen ECTM alone efficiently reacted with sera from individuals infected with subtype O. The subtype O antigen-containing kit produced a positive absorbence even when sera were diluted 512-fold, suggesting a high sensitivity. The commercially available kit also reacted with subtype O sera, but produced a negative result at a dilution of 8-fold. Our results suggest that the currently available kit may not be able to efficiently detect subtype O sera and that the viral protein developed in this study may be added to the current system to maximize the detection of sera from individuals infected with subtype O.
Amino Acid Sequence ; Antibodies ; Base Sequence ; Blotting, Western ; Chromatography, Gel ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; Glycoproteins ; HIV* ; HIV-1* ; Humans* ; Inclusion Bodies ; Korea ; O Antigens

Satisfactory surgical reconstruction of the external ear and nose is still a major challenge for the plastic surgeon. Therefore, the use of prosthesis in selected cases should be considered as viable alternative. During the period from December, 1995 to January, 1998, 10 patients, including 9 patients of ear defect and 1 patient of nose defect resulting from the resection of recurrent tumor ablation, were reconstructed by using osseointegration and prosthesis. The surgery was performed in two stages. All procedures were performed under local anesthesia and on an outpatient. At the first stage, the fixtures of titanium implant were placed in the mastoid process and maxilla. These implants were then left for 3 months before the second stage takes place, in which the skin penetrating abutments were attached. After 3-4 weeks, the impression of the defect area were taken and the silicone prosthesis was made by Anaplastologist. Two patients had focal infection but healed without problem. One patient had soft tissue infection, then flap was excised and skin graft performed. There was one loss from 20 fixtures, that was 3 years after implantation. We have concluded that osseointegration for reconstruction of the ear and nose defect is simple, soft, reliable method, which is more than autologous reconstruction and provides excellent aesthetic results.
Anesthesia, Local ; Ear ; Ear, External ; Focal Infection ; Humans ; Mastoid ; Maxilla ; Nose* ; Osseointegration* ; Outpatients ; Prostheses and Implants ; Silicones ; Skin ; Soft Tissue Infections ; Titanium ; Transplants

BACKGROUND: Aging is a significant issue worldwide, and Korea is one of the most rapidly aging countries. Along with the demographic transition, the age structure of intensive care unit (ICU) patients changes as well. METHODS: The aim of this study was to analyze the change in age distribution of the ICU patients over the last 10 years and its effect on clinical outcomes. Single-center, retrospective analysis of all patients aged ≥18 years admitted to either the medical or surgical ICU at St. Paul's Hospital, The Catholic University of Korea, between January 2005 and December 2014 was conducted. For clinical outcome, in-hospital mortality, duration of ICU stay, and hospital stay were analyzed. Cost analysis was performed to show the economic burden of each age strata. RESULTS: A total of 10,366 ICU patients were admitted to the chosen ICUs during the study period. The proportion of elderly patients aged ≥65 years increased from 47.9% in 2005 to 63.7% in 2014, and the proportion of the very elderly patients aged ≥80 years increased from 12.8% to 20.7%. However, this increased proportion of elderly patients did not lead to increased in-hospital mortality. The percent of ICU treatment days attributable to elderly patients increased from 51.1% in year 2005 to 64.0% in 2014. The elderly ICU patients were associated with higher in-hospital mortality compared to younger age groups. CONCLUSIONS: The proportion of elderly patients admitted to ICUs increased over the last decade. However, overall in-hospital mortality has not increased during the same period.
Age Distribution ; Aged* ; Aging ; Costs and Cost Analysis ; Critical Care* ; Hospital Mortality ; Humans ; Intensive Care Units* ; Korea* ; Length of Stay ; Mortality ; Population Dynamics ; Retrospective Studies*

A variety of treatments has been used to correct long forehead and frontal alopecia. These include forehead reduction (scalp reduction), hair graft and flap transfer. Among these procedures, forehead reduction (scalp reduction) is the most simple and effective method. In this procedure, various fixation techniques of scalp flap to cranial bone are used to prevent retraction of the scalp. We used Sherlock (or Piranha) screw to anchor the scalp flap to cranial bone. Between August 1998 and May 2000, this technique had been performed for 37 patients. Average follow-up period was 15 months. For forehead reduction (scalp reduction), the scalp was elevated back to the occipital region through a pretrichial incision, and relaxation incisions of galea was made at a right angle to the vector of advancement. The Sherlock (or Piranha) screw was fixed to the cranial bone. The entire scalp was then repositioned anteriorly, advancing the hairline caudally and shortening the forehead. Retraction of the scalp was prevented by anchoring the galeal fascia to the cranial bone using Sherlock (or Piranha) screws. This technique allows sufficient advancement of the scalp and a tension-free closure. Postoperatively scar widening was less than that of other methods. There were not any infection, hematoma, hair loss nor permanent paresthesia on scalp. In 2 cases, screws were palpable and we removed a screw for 1 case. Advantages of using Sherlock (or Piranha) screw are that the procedure is easy and simple, and sufficient advancement of the scalp, tension-free closure, and less scar widening can be achieved. Disadvantages of this procedure include cost of screw and palpability of screw. In conclusion, by using Sherlock (or Piranha) screw, the procedure was simple and we could get aesthetically good results.
Alopecia ; Cicatrix ; Fascia ; Follow-Up Studies ; Forehead* ; Hair ; Hematoma ; Humans ; Paresthesia ; Relaxation ; Scalp* ; Sutures* ; Transplants

No abstract available.
Intensive Care Units ; Sepsis ; Critical Illness ; Chronic Disease ; Hospital Mortality