The ideal breast reduction should create beautiful breasts with limited scars. Unfortunately, no surgeon has ever been able to produce such a result. Most recent breast reduction techniques tend to produce minimal breast scars and avoid the classic inverted-T incision. The vertical mammaplasty can be used in mild to moderate cases of breast reduction, producing consistently good, stable results with limited scars. This technique uses adjustable preoperative markings, an upper pedicle for the areola, and a central breast reduction with limited skin undermining. The shape of the breast is created by suturing of the gland and does not rely on the skin. The adjunctive use of liposuction in fatty breasts can be considered safe and efficient. We have performed reduction mammaplasty using the vertical mammaplasty technique in 12 patients. Overall number and extent of complications were small, and patient satisfaction was high for this procedures. The advantages of vertical mammaplasty technique compared with other methods are as follows ; 1. The markings are adjustable to nearly all patients. 2. Stable contours are produced because the gland is strongly sutured. 3. Few postoperative complications occur. 4. Limited scars(only vertical scars) are created 5. The procedure is easy to learn and perform.
Breast ; Cicatrix ; Female ; Humans ; Lipectomy ; Mammaplasty* ; Patient Satisfaction ; Postoperative Complications ; Skin

This study evaluated the anti-asthmatic activities of 2,6-di-tert-butyl-4-hydroxymethylphenol (DBHP) that is a potent phenolic antioxidant in edible vegetable oil. The effects of DBHP on bronchial asthma were evaluated by determining the specific airway resistance (sRaw) and tidal volume (TV) during the immediate asthmatic response (IAR) and the late-phase asthmatic response (LAR) in guinea pigs with aerosolized ovalbumin-induced asthma. Recruitment of leukocytes and the levels of biochemical inflammatory mediators were determined in the bronchoalveolar lavage fluids (BALFs), and histopathological surveys performed in lung tissues. DBHP significantly inhibited the increased sRaw and improved the decreased TV on IAR and LAR, and also inhibited recruitment of eosinophils and neutrophils into the lung, and release of biochemical inflammatory mediators such as histamine and phospholipase A₂ from these infiltrated leukocytes, and improved pathological changes. However, anti-asthmatic activities of DBHP at oral doses of 12.5 to 50 mg/kg was less than those of dexamethasone (5 mg/kg, p.o.) and cromoglycate (10 mg/kg, p.o.), but more potent or similar to that of salbutamol (5 mg/kg, p.o.). These results in the present study suggest that anti-asthmatic effects of DBHP in the guinea pigs model of OVA-induced asthmatic responses principally are mediated by inhibiting the recruitments of the leukocytes and the release of biochemical inflammatory mediators from these infiltrated leukocytes.
Airway Resistance ; Albuterol ; Animals ; Asthma ; Bronchoalveolar Lavage Fluid ; Cromolyn Sodium ; Dexamethasone ; Eosinophils ; Guinea Pigs* ; Guinea* ; Histamine ; Leukocytes ; Lung ; Neutrophils ; Ovalbumin* ; Phenol ; Phospholipases ; Tidal Volume ; Vegetables

BACKGROUND: The present study was aimed at defining the topological characteristics of the carotid intima-media thickness (IMT) in hypertensives, and to delineate whether the characteristics were different from those of non-hypertensive vascular risk factors. METHODS: B-mode carotid ultrasonography was performed in 33 participants who were devoid of stroke, ischemic heart disease, and carotid plaques. Longitudinal carotid images were obtained at 6 angular sites, 0 degree indexed adjacent to the external carotid artery (ECA) side from axial image crossing both internal carotid artery (ICA) and ECA, and then 45 degrees, 90 degrees, 180 degrees, 225 degrees, and 270 degrees. From the level of the flow divider, with an interval of 5 mm, up to 15 mm proximally, all the carotid IMT was measured. The IMT was then analyzed according to the levels and angles and compared according to either of hypertension or non-hypertension vascular risk factors. RESULTS: The carotid IMT showed asymmetric distributions in both the hypertension and non-hypertension risk groups. The IMT difference according to hypertension was observed better in the right carotid artery than the left. The right carotid IMT in the hypertension group showed significantly higher values at the most levels, and especially at 0 degree and 180 degrees of angular sites. CONCLUSIONS: It is important to understand the different topological characteristics of the carotid IMT according to the presence of hypertension, for a better reproducibility and predictability of the ultrasonic carotid IMT measurement.
Carotid Arteries ; Carotid Artery, External ; Carotid Artery, Internal ; Carotid Intima-Media Thickness* ; Hypertension ; Myocardial Ischemia ; Risk Factors ; Stroke ; Ultrasonics ; Ultrasonography

The purpose of this study was to improve bone formation and shorten the period involved in distraction osteogenesis using sodium fluoride (NaF). This has been used in managing osteoporosis for several decades. This study was carried out on 40 New Zealand white rabbits. Twenty animals were used for a control group (no medication) and 20 for the experimental group. NaF 1 mg/kg/day was administered to each experimental animal via drinking water beginning 4 weeks prior to surgery and continued until sacrifice for examination. A distraction device was applied to the left mandible along a plane perpendicular to the direction of osteotomy. After a 5-day latent period, the mandibles were lengthened at 1 mm per 24 hours for 10 days. Five rabbits from each group were sacrificed on the 1st day, 2nd week, 4th week and 8th week of the consolidation period. After lengthening, all the rabbits developed a severe cross-bite. By the 4th week, cortical continuity was seen. Bone densities at the site of bony lengthening were measured by quantitative computer tomography (QCT) and dual X-ray absorptiometry (DXA). The results were as follows: the measurements of the experimental group were significantly higher than of the control group by the 1st day of the consolidation period (p>0.05) and insignificantly higher after the 2nd week. Histologically, in the experimental group, there were more osteoblasts, increased and thickened trabeculae and more mature lamellar bones than in the control group. This study showed that osteogenesis of the experimental group was significantly higher during and immediately after distraction. Our study suggested that the use of NaF could improve bone formation and decrease the period of distraction osteogenesis if a safe dose and method of fluoride administration can be determined for growing humans.
Absorptiometry, Photon ; Animals ; Bone Density ; Drinking Water ; Fluorides ; Humans ; Mandible* ; Osteoblasts ; Osteogenesis ; Osteogenesis, Distraction* ; Osteoporosis ; Osteotomy ; Rabbits* ; Sodium Fluoride* ; Sodium*

This retrospective study was undertaken to provide information when considering aspects of future prevention and quantifying demand fir medical services. And it comprised 835 patients with facial bone fractures in various accidents and treated in the department of Plastic and Reconstructive Surgery, the Yeungnam University Hospital during the past five years from January 1991 to December 1996. The medical records of this 835 patients(1,210 fractures) were reviewed and analyzed in order to obtain the clinical pattern and understand the therapeutic tendency. The following results were obtained; 1. The greatest number of patients were sustained facial bone injuries between midnight and 3:00. The monthly incidence showed in September at the most and at the least in December. The increase of facial bone injuries of 11.3% per year was shown. 2. The mean age of patients was 30 years. The most prevalent age group was at third decade(31.9%). Males were predominated more than female(3.6 : 1). 3. The most common cause was traffic accidents(41.6%) followed by violence, fall, industrial accidents and others. 4. The most common fracture was found in the nose(35.1%) followed by mandible(22.6%), zygoma(21.1%), and maxilla(11.2%). 5. Associated injuries were as following order of frequency; ophthalmologic injury(21.0%), other facial bone fractures(18.2%), head injury(10.2%). 6. Open reduction was used for 53.9% of total cases while 40.6% of total cases required closed reduction, and 5.5% of total cases treated conservatively. The complication rate was 18.5% and complications were as following order of frequency; facial asymmetry(37.2%), diplopia and enophthalmos(19.4%), and local infection(12.8%).
Accidents, Occupational ; Diplopia ; Facial Bones* ; Head ; Humans ; Incidence ; Male ; Medical Records ; Plastics ; Retrospective Studies ; Violence

The records of the patients with orbital wall fracture were reviewed from March 1997 through February 2001 in the department of plastic and reconstructive surgery, Yeungnam university medical center. One hundred thirty nine patients with blow out fracture were repaired by using porous polyethylene(Medpor(R)) or titanium dynamic mesh. Surgical effect of titanium dynamic mesh was evaluated and compared with that of Medpor(R) in the reconstruction of orbital wall fracture after follow up period of six months. The incidence of the orbital wall fracture was more common in men than in women. The traffic accident was most common cause of the fracture and the most common combined fracture was nasal bone fracture. The sites of fractures were the orbital floor in 51 patients, the medial wall in 18 patients, and both the medial wall and floor in 38 patients. Medpor(R) is easy to handle, shape, contour and position. Titanium dynamic mesh is good device in that it has for good structural stability, excellent strength, high biocompatibility and can be fixed easily. In conclusion, Medpor(R) was suitable for local defect in small fracture and titanium dynamic mesh was suitable for large defect in compound fracture
Academic Medical Centers ; Accidents, Traffic ; Female ; Follow-Up Studies ; Fractures, Open ; Humans ; Incidence ; Male ; Nasal Bone ; Orbit ; Orbital Fractures ; Plastics ; Polyethylene* ; Titanium*

BACKGROUND AND OBJECTIVES: Since statins and angiotensin receptor blockers are a frequently prescribed combination in patients with atherosclerotic cardiovascular diseases, we tested the interactive effects of simvastatin and losartan on atherosclerosis in apolipoprotein E (apoE)-/- mice. MATERIALS AND METHODS: Apolipoprotein E-/- mice were fed a high-fat, high-cholesterol (HFHC) diet for 12 weeks, with and without simvastatin (40 mg/kg) and/or losartan (20 mg/kg). The mice were divided into 5 groups and were fed as follows: regular chow (control diet, n=5), HFHC diet (n=6), HFHC diet with losartan (n=6), HFHC diet with simvastatin (n=6), and HFHC diet with both losartan and simvastatin (n=6). RESULTS: Losartan treatment in apoE-/- mice significantly decreased atherosclerotic lesion areas in whole aortic strips stained with Oil Red O. The plaque area measured at the aortic sinus level was reduced significantly by 17% (HFHC; 346830.9+/-52915.8 microm2 vs. HFHC plus losartan; 255965.3+/-74057.7 microm2, p<0.05) in the losartan-treated group. Simvastatin and simvastatin plus losartan treatments reduced macrophage infiltration into lesions by 33% (HFHC; 183575.6+/-43211.2 microm2 vs. HFHC plus simvastatin; 120556.0+/-39282.8 microm2, p<0.05) and 44% (HFHC; 183575.6+/-43211.2 microm2 vs. HFHC plus simvastatin and losartan; 103229.0+/-8473.3 microm2, p<0.001, respectively). In mice fed the HFHC diet alone, the smooth muscle cell layer in the aortic media was almost undetectable. In mice co-treated with losartan and simvastatin, the smooth muscle layer was more than 60% preserved (p<0.05). Given alone, losartan showed a slightly stronger effect than simvastatin; however, treatment with losartan plus simvastatin induced a greater inhibitory effect on atherosclerosis than either drug given alone. Serum lipid profiles did not differ significantly among the groups. CONCLUSION: Losartan displayed anti-atherosclerotic effects in apoE-/- mice that were equivalent to or greater than the effects of simvastatin. Combined treatment with these drugs had greater effect than either drug alone.
Angiotensin Receptor Antagonists ; Animals ; Apolipoproteins ; Atherosclerosis ; Azo Compounds ; Cardiovascular Diseases ; Diet ; Humans ; Losartan ; Macrophages ; Mice ; Mice, Knockout ; Models, Animal ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Simvastatin ; Sinus of Valsalva

The purpose of this study was to analyze the structure form of the head and face using 3-dimensional computerized tomography in Korean adults. We examined CT images of 100 Koreans (50 males and 50 females) between 22 and 46 years of age. The data of the 2-dimensional CT images were sent to the personal computer in the form of DICOM (Digital Image Communication in Medicine) files and transformed to the 3-dimensional CT images using V-worksTM 4.0 program (Cybermed, Korea). The authors could have 50 soft and 50 bony tissue 3-D images of the female patients by changing the contrast from same data. We could also have 50 soft and 50 bony tissue 3-D images of the male patients by the same method. To define the structural elements, we identified the key points of upper face (eurion, frontotemporale), mid face (zygion, malar eminence), and lower face (anterior mandible, posterior mandible) in the soft tissue and skeletal images, respectively. We measured the distance between the key points and evaluated the angular relationships in construction a geometric form corresponding to these points. We were able to get the quantitative data of facial form variants and the characteristics of facial structure of Korean adults. The cranium of the male Korean is wider and higher than that of female. The facial contour is also more projected than female. Application of these concepts to surgery may be helpful in determining the plan of the intervention and evaluation of the results of procedures.
Adult ; Anthropometry* ; Female ; Head ; Humans ; Imaging, Three-Dimensional ; Male ; Mandible ; Microcomputers ; Skull

Visceral fat has been reported to be associated with nonalcoholic fatty liver disease (NAFLD) and the metabolic syndrome (MetS). We assessed the prevalence of both NAFLD and the MetS, measured visceral fat thickness VFT), and estimated the physical activity indexes of 224 relatively healthy hospital workers. We also investigated the associations between both VFT and physical activity index and each of NAFLD and the MetS. The MetS was diagnosed according to the guidelines outlined by the Adult Treatment Panel III, and NAFLD was diagnosed by ultrasonography. Subjects with hepatitis B and C infections and those reporting moderate alcohol consumption were excluded from the study. The prevalence of the MetS was 11.6% and that of NAFLD was 41.5%. Many subjects with the MetS had NAFLD (73.1%), and some subjects with NAFLD (20.4%) also had several components of the MetS (p=0.001). VFT was significantly increased by both the addition of components of the MetS and the severity of NAFLD (p<0.001). In addition, VFT was independently associated with NAFLD (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.19) in subjects with more than 2 components of the MetS. In contrast, habitual physical activity was reversely associated with NAFLD (OR, 0.29; 95% CI, 0.10-0.87). In conclusion, an increased visceral fat content and reduced physical activity could be not only biological markers but also therapeutic targets in the treatment of NAFLD and the MetS.
Adult ; Alcohol Drinking ; Blood Pressure ; Comorbidity ; Fatty Liver/*physiopathology ; Female ; Humans ; Hyperinsulinism/complications ; *Intra-Abdominal Fat ; Male ; Metabolic Syndrome X/*physiopathology ; Middle Aged ; Multivariate Analysis ; Odds Ratio

BACKGROUND AND PURPOSE: At least 100 Ryanodine receptor type 1 (RYR1) mutations associated with malignant hyperthermia (MH) and central core disease (CCD) have been identified, but 2 RYR1 mutations accompanying multiminicore myopathy in an MH and/or CCD family have been reported only rarely. METHODS: Fifty-three members of a large MH family were investigated with clinical, histopathologic, RYR1 mutation, and haplotyping studies. Blood creatine kinase (CK) and myoglobin levels were also measured where possible. RESULTS: Sequencing of the entire RYR1 coding region identified a double RYR1 mutation (R2435H and A4295V) in MH/CCD regions 2 and 3. Haplotyping analysis revealed that the two missense heterozygous mutations (c.7304G>A and c.12891C>T) were always present on a common haplotype allele, and were closely cosegregated with histological multiminicores and elevated serum CK. All the subjects with the double mutation showed elevated serum CK and myoglobin, and the obtained muscle biopsy samples showed multiminicore lesions, but only two family members presented a late-onset, slowly progressive myopathy. CONCLUSIONS: We found multiminicore myopathy with clinical and histological variability in a large MH family with an unusual double RYR1 mutation, including a typical CCD-causing known mutant. These results suggest that multiminicore lesions are associated with the presence of more than two mutations in the RYR1 gene.
Alleles ; Biopsy ; Clinical Coding ; Creatine Kinase ; Haplotypes ; Humans ; Malignant Hyperthermia ; Muscles ; Muscular Diseases ; Myoglobin ; Myopathies, Structural, Congenital ; Myopathy, Central Core ; Ophthalmoplegia ; Ryanodine ; Ryanodine Receptor Calcium Release Channel