The basic technique for total reconstruction of the microtia was established by Tanzer, who utilized autologous rib cartilages for constructing the auricular framework. In order to decrease the number of surgical stages and to achieve maximal convolution, we employed a surgical procedure with simultaneous three layered costal cartilage grafting for the high profiled auricle, concha formation and lobule rotation. However, we performed ear elevation as an additional procedure for some patients who had decreased helical height due to absorption of cartilage framework or postoperative trauma and who had wanted to wear the spectacles or to have more natural appearance of auriculocephalic sulcus. From August 1988 to October 1997 we had performed surgeries for the ear elevation of 58 patients in 177 patients with total ear reconstruction, using various elevation methods; skin graft, local flap, and local with costal cartilage block. When the ear elevation was performed with skin graft, postoperative contraction of the grafted skin was inevitable. In cases with two skin flaps, it was difficult to stabilize and maintain the correct projection of the constructed ear. So we elevated the reconstructed ear by utilizing a costal cartilage block, two skin flaps to cover the posterior region and skin graft. We conclude that the local flap with costal cartilage block is one of the most favorable methods in ear elevation which can maintain the adequate projection and make natural looking auriculocephalic sulcus.
Absorption ; Cartilage ; Ear* ; Eyeglasses ; Humans ; Ribs ; Skin ; Transplants

The double eyelid operation is one of the most common cosmetic surgery performed in orientals, and there are numerous studies about surgical procedures of that. In the case of appropriate candidates, the non-incision technique makes excellent cosmetic results, with the advantages of shorter operating time, less morbidity, less pain, no scarring and easy revision of shape. But, usually the non-incision technique is recommended in the cases with thin upper eyelid, small amount of orbital fat, less redundant skin of upper eyelid and in whom a wide fold is not desired so on. Therefore, the disadvantages of this method are that it cannot be applied to all patients. The postoperative complications are disappearance or faded fold, formation of cyst or lumps, asymmetry etc. and the incidence of these complications is slightly higher than those of the incisional method. In this study, the double eyelid operation using the continuous buried suture method was performed in 210 patients for formation of double eyelid from Jan. 1993 to Dec. 1995. In conclusion very good results can be obtained by the continuous buried suture method even in the cases of puffy upper eyelid. This method can make a double eyelid shape in the fashion the patient wants and can be a new indication for correction of unilateral double eyelid. This method is safe, satisfactory and take shorter postoperative recovery time and it can reduce the incidence of postoperative complications.
Cicatrix ; Eyelids* ; Humans ; Incidence ; Orbit ; Postoperative Complications ; Skin ; Surgery, Plastic ; Sutures*

The widespread use of diagnostic radiography, especially using magnetic resonance imaging, has helped to increase the diagnosis of paralabral cysts in patients with chronic shoulder pain. These paralabral cysts are frequent in the anterior, the superior, and the posterior compartment of the shoulder joint but are rare in the inferior compartment. Paralabral cysts in the shoulder appear particularly in men in their third and fourth decades but rarely in elderly patients. We report a case of an inferior paralabral cyst in an elderly patient whom we treated through arthroscopic decompression.
Aged* ; Arthroscopy ; Decompression* ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography ; Shoulder Joint ; Shoulder Pain ; Shoulder*

The objectives of this study are to investigate how English keywords used in the Journal of Korean Society of Plastic and Reconstructive Surgeons coincide with precise MeSH terms, and to verify to what extent frequently used English keywords(n > 3) are used with precise MeSH terms. The English keywords were analyzed from 594 articles of JKSPRS published from Jan. 1998 to Mar. 2002. The authors investigated the frequently used keywords and the percentage of the keywords Which coincide with MeSH using MeSH browser. The total number of the English keywords used was 1638, and 80 kinds of keywords including 'Free flap' were used 3 or more times. The number of terms precisely coincident with MeSH was 209(12.7%), the number of terms not matching MeSH term but Entry term was 217(13.3%) and 1212 terms(74.0%) were not MeSH terms. The number of frequently used key word(n>3) immatched with MeSH, that coincide with KPRS*terms was 22 including 'Free flap' and 'Tip plasty'. Many of English keywords of JKSPRS* does not coincide with the MeSH. We must try to use precise MeSH term when we use the English keywords of the articles.
Subject Headings

PURPOSE: To report the clinical manifestations of patients with ocular tilt reaction (OTR) and the differential point from other disorders with abnormal head posture. METHODS: The clinical manifestations of four patients who complained of abnormal head posture and diplopia and who were diagnosed to have OTR from January, 2001 to January, 2002 were investigated. The diagnoses were made with alternate cover test, duction and version test, Lancaster test, Bielschowsky head tilt test, fundus photography, and brain MRI. RESULTS: All the four patients showed ipsilateral head tilt, ocular torsion, and vertical deviation. Type of their OTR was tonic OTR. Subjective tilting of visual vertical was observed in one patient. Only with the 3-step test, OTR could be misdiagnosed as an extraocular muscle palsy. The most important sign in differentiation from other disorders of abnormal head posture was ocular torsion. Duction and version examination and tilt of subjective visual vertical were also helpful for the differentiation. CONCLUSIONS: OTR should be considered in patients with ocular torsion, vertical deviation and ipsilateral head tilt. In patients with diplopia and head tilt, examination of ocular torsion should be performed with the 3-step test in order not to make a misdiagnosis of extraocular muscle palsy.
Brain ; Diagnosis ; Diagnostic Errors ; Diplopia ; Head ; Humans ; Magnetic Resonance Imaging ; Paralysis ; Photography ; Posture

Photographic standards in plastic surgery is an important problem that has been stressed in the discipline over the past several years. Clinical photographs should always be taken with the same camera lens, lens setting, lighting, film, and patient position to ensure reproducibility and to enable valid pre- and postoperative comparisons. However, no photographic standards in plastic surgery were established in Korean Society of Plastic and Reconstructive Surgeons. We analyzed that inappropriate photographs in the total publishing photographs were counted on the Journals of the Korean Society of Plastic and Reconstructive Surgeons from 1995 to 2000. The causes of inappropriate photographs were categorized as six groups. We found three characteristics from photograph published on this journals. First, the ratio of inappropriate photographs were not decreased for recent six years - 30.6% in 1995 and 29,7% in 2000. The mean proportion of poorly qualifying photographs in total photos was 29.3% during six years. Second, the subject malposition due to incorrect anatomic landmark and technical errors were 34.8%., 20.0%, respectively. The markedly different size of pre-and postoperative subject, inappropriate orientation of camera (horizontally or vertically), inadequate patient preparation, others were 15.3%, 14.9%, 7.9%, 7.1% in order. Third, the most patient identity in this publication was recognizable regardless of patient consent(1673/1761, 95.0%). In our conclusion, first, the ease photographic standards for plastic surgeon in Korea was guided in our study. Second, we thought that the ease of using digital photography may be able to correct the inappropriate photographs due to technical errors of amateur. Third, we proposed that new format of permission for patient photographic authorization and release will be needed because of prevention against sue for invasion of privacy or release of identity in Korea.
Anatomic Landmarks ; Humans ; Informed Consent ; Korea ; Photography ; Privacy ; Publications ; Surgery, Plastic*

PURPOSE: Although intraoperative radiotherapy (IORT) is known to be a method that can reduce local recurrence in locally advanced colorectal cancer, it is not widely used. The aim of this study was to report our experience with IORT for locally advanced rectal cancer. METHODS: From 1991 to 1994, nine patients with locally advanced rectal cancer received IORT. External beam radiotherapy was given postoperatively in five patients and preoperatively in three. Seven patients received chemotherapy. IORT was done with 6-MeV or 9-MeV electrons, and 12 Gy was irradiated at the tumor bed. The median follow-up period was 84 months (range, 15 to 208 months). RESULTS: The median age of patients was 51 years (range, 42 to 73 years). All patients had advanced clinical T-stage (cT3/4) cancer. The overall and the disease-free survival rates were 66.7% and 66.7% at 5 years, respectively. One patient developed a local recurrence near the anastomosis site, which was out of the IORT field. Four patients died before the last follow-up; three from distant metastasis and one from secondary primary cancer. Adverse effects related to IORT did not occur. CONCLUSION: Although the number of patients was small in this study, IORT is thought to be safe and effective in reducing local recurrence in locally advanced rectal cancer. However, the role of IORT should be refined in the era of preoperative radio-chemotherapy followed by total mesorectal excision.
Colorectal Neoplasms ; Disease-Free Survival ; Electrons ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Rectal Neoplasms ; Recurrence

The corneal curvatures after circumferential scleral resection were increased in the corneal meridian of scleral resection and were decreased in the corneal meridian perpendicular to scleral resection. After meridional scleral resection, the results of corneal curvature changes were opposite to those of circumferential scleral resection. The changes of corneal curvature were decreased with time.

OBJECTIVES: This study examined job satisfaction, empowerment, job stress, and burnout among tuberculosis management nurses and physicians in public healthcare institutions. METHODS: This was a cross-sectional study analyzing survey data collected from 249 nurses and 57 physicians in 105 public health centers, three public tuberculosis hospitals, and one tertiary hospital. The survey questionnaire comprised general characteristics, work-related characteristics, and four index scales (job satisfaction, empowerment, job stress, and burnout). The two-sample t-test was used to estimate the mean differences in the four index scales. Multiple regression analysis was used to determine whether general and work-related characteristics affected the four index scales. RESULTS: The job satisfaction and empowerment scores of the nurses were lower than those of the physicians. Except for the tuberculosis-specialized hospitals alone, the average job satisfaction scores of nurses were higher than those of physicians. Moreover, the nurses reported more job stress and burnout than did the physicians in tuberculosis departments in public healthcare institutions in Korea; in particular, the burnout reported by nurses was significantly higher than that reported by physicians at the National Medical Center. Marital status, nursing position, number of coworkers, the average number of days of overtime work per month, self-rated health, and hospital type were associated with the four index scales. CONCLUSIONS: Overall, nurses were more vulnerable to job stress and burnout than physicians. Reducing the workload of nurses by ensuring the presence of sufficient nursing staff and equipment, as well as by equipping facilities to prevent tuberculosis infections, should be considered priorities.
Cross-Sectional Studies ; Delivery of Health Care ; Hospitals, Chronic Disease ; Humans ; Job Satisfaction* ; Korea ; Marital Status ; Nursing ; Nursing Staff ; Power (Psychology) ; Public Health ; Tertiary Care Centers ; Tuberculosis* ; Weights and Measures

Central retinal artery occlusion (CRAO) causes severe visual loss in affected eye and vision does not recover in more than 90% of the patients. It is believed that it occurs by occlusion of the central retinal artery with small emboli from atherosclerotic plaque of internal cerebral artery. Retina is a part of the brain, thus basically CRAO is corresponding to acute occlusion of intracerebral artery and retinal ischemia is to cerebral stroke. Therefore, intra-arterial thrombolysis (IAT) has been considered as a treatment method in CRAO. Recently, we treated 2 patients diagnosed as CRAO and could achieve complete recanalization on fundus fluorescein angiogram with IAT. Of them, one recovered visual acuity to 20/25. We report our 2 CRAO cases treated with IAT and discuss technical aspects for IAT and management of patient. To the best of our knowledge, this is the first Korean report of IAT for CRAO.