Because of its simplicity, augmentation rhinoplasty with filler material has been used as alternative choice of the operative augmentation rhinoplasty. With development of various filler materials the duration of which is long, the augmentation rhinoplasty using filler material has wide usage. This article describes the choice of filler suitable for augmentation rhinoplasty. As skin and soft tissue are abundant at the nasal tip and root, they are easily elevated when filler material is injected. However, in case of nasal dorsum, especially supratip depression, there is a lack of skin and soft tissue, therefore, the filler material injected is redistributed into the nasal tip and dorsum. Ideal filler material for augmentation rhinoplasty should be located at the injection site without quantitative change. Fortunately, 3.3% PAAG(polyacrylamide gel) has hard consistency, but no component change, and has long duration. Therefore, it seems to be an ideal filler material among numerous filler materials currently sold.
Depression ; Rhinoplasty ; Skin

Raynaud's syndrome causes discolorization, ischemic claudication(pain) and necrosis of the digits through insufficiency in the circulation which is induced by intermittent spasms of the digital arteries. From January, 2002 to December, 2004, 10 patients were surgically treated for Raynaud's syndrome. 9 patients were female and 1 patient was male. 2 patients showed unilateral involvement, 8 patients were operated on both hands. 6 patients had necrotic changes on the finger tips due to the disease. Ages ranged from 21 to 60 with an average of 39.1. Ischemic pain, discolorization, and cold intolerance of the digits were the common symptoms. All patients were evaluated with color doppler before the surgery. Two different procedures were applied according to the severity of the disease: Patients with decreased circulation received, what we call a limited digital sympathectomy, i.e. stripping of the adventitia of the ulnar, radial and common digital arteries. An extended procedure, radical digital sympathectomy, was performed on patients with a complete block of circulation. Stripping of the adventitia in these patients also involved the proper digital arteries. Symptoms like discolorization, ischemic pain, and cold intolerance improved immediately after the surgery. The patients did not suffer from pain even with exposure to cold weather. We conclude that digital sympathectomy could improve the symptoms in Raynaud's patients who do not respond to conservative treatment such as calcium channel blocker and other vasodilators.
Adventitia ; Arteries ; Calcium Channels ; Female ; Fingers ; Hand ; Humans ; Male ; Necrosis ; Spasm ; Sympathectomy* ; Vasodilator Agents ; Weather

Pachydermodactyly is a rare distinct form of fibromatosis characterized by acquired, asymptomatic dense fibrosis and fibroblastic proliferation around one or more proximal interphalangeal joints. Intralesional triamcinolone injection may be helpful in improving the clinical appearance. A 20-year-old unemployed female patient gave a four years history of progressive swelling of the fingers affecting predominantly the proximal interphalangeal joints of index fingers of left hand and index, middle fingers of right hand. There was no pain and tenderness. Physical examination, complete blood count, antinuclear antibody, rheumatoid factor were unremarkable and radiograph of both hands showed soft tissue swelling only without bony abnormality. We excised the redundant soft tissue from the both sides of proximal interphalangeal joint with longitudinal elliptical fashion. After operation, the fingers of the patient showed marked improvement cosmetically. There were no motor or sensory changes. Pachydermodactyly was first reported in 1996 in Korea. Histologic features include an increased dermal accumulation of collagen and occasionally an increased number of fibroblast. We report for one patient with pachydermodactyly treated with longitudinal elliptical excision and obtained an improvement of clinical appearance.
Antibodies, Antinuclear ; Blood Cell Count ; Collagen ; Female ; Fibroblasts ; Fibroma ; Fibrosis ; Fingers ; Hand ; Humans ; Joints ; Korea ; Physical Examination ; Rheumatoid Factor ; Triamcinolone ; Young Adult

From 1996 to 2003, we reviewed 16 enophthalmos cases including 7 males(age 25 to 72 years) and 9 females (age 24 to 32 years) who have been treated in the Department of Plastic and Reconstructive Surgery, Guri and Seoul Hospital Hanyang Medical Center. We categorized the pattern of the facial bone fracture corresponding intra-orbital lesions and the operative methods(approaches and implant positioning) according to each lesions in the orbit. In preoperative and postoperative axial CT view, we measured the amount of exophthalmos at the orbital apex level. The most severe enophthalmos was observed in inferior and lateral wall defect and the differences between both globes was 5mm in CT measurement. In CT measurement, the most improved lesion was medial wall(3mm protrusion) and secondary most improved lesion was 4-wall-combined orbital lesion(2.7mm protrusion). In the other cases showed less 2mm differences in CT measurement except inferior and lateral wall lesion which showed 2.5mm difference. When the implant was located posterior to the mid-coronal line of globe, the mean improvement (2.16mm) was higher than other cases(1.7 mm).
Enophthalmos* ; Exophthalmos ; Facial Bones ; Female ; Humans ; Orbit ; Plastics ; Seoul

BACKGROUND AND OBJECTIVES: Meniere's disease (MD) is a clinical cluster of common symptoms by various causes rather than a single disease entity. Many causes such as autoimmune, allergy, vascular insufficiency have been thought to be related with Meniere's disease. We assumed that different pathologic mechanisms have contribution in each gender. With this premise, we compared clinical characteristics between male and female patients to determine if there is any difference indicating heterogeneous underlying pathology. MATERIALS AND METHODS: We reviewed medical records of 61 patients (43 female, 18 male) who were diagnosed as unilateral definite MD and underwent vestibular function test and audiologic evaluation (more than two times of pure tone audiometry during the follow-up period) from October 2005 to December 2011. RESULTS: The average duration of dizziness in females was longer than in males. In the worst ipsilateral pure tone audiometry, low frequency thresholds were lower in females than in males. Female had lesser hearing difference at all frequencies between the sides and showed more hearing fluctuation than male. There was no significant difference between male and female in the vestibular function test. CONCLUSION: These results are insufficient to suggest that the pathogenesis of MD differs between the genders. However, some differences between the genders prompt a need for future studies involving more patients.
Audiometry ; Dizziness ; Female ; Follow-Up Studies ; Hearing ; Humans ; Hypersensitivity ; Male ; Medical Records ; Meniere Disease ; Vestibular Function Tests

The etiology and pathophysiology of takotsubo cardiomyopathy have not yet been fully clarified. We report a case of takotsubo cardiomyopathy associated with severe hypocalcemia secondary to hypoparathyroidism. A 69-year-old woman presented with acute pulmonary edema caused by severe left ventricular dysfunction with apical ballooning compatible with takotsubo cardiomyopathy. Laboratory tests revealed severe hypocalcemia secondary to idiopathic hypoparathyroidism. Coronary angiography showed normal coronary artery function. Her symptoms and signs of heart failure improved dramatically with the correction of hypocalcemia through calcium and calcitriol replacement.
Aged ; Calcitriol ; Calcium ; Coronary Angiography ; Coronary Vessels ; Female ; Heart Failure ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Pulmonary Edema ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left

Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi that is characterized by focal or disseminated vasculitis and perivasculitis. Scrub typhus can have fatal complications, such as acute respiratory distress syndrome, septic shock, and acute kidney injury. However, there are few reports of fatal myocarditis caused by scrub typhus. We present a case of acute fatal myocarditis combined with acute kidney injury complicating scrub typhus.
Acute Kidney Injury ; Myocarditis* ; Orientia tsutsugamushi ; Respiratory Distress Syndrome, Adult ; Scrub Typhus* ; Shock, Septic ; Vasculitis