It is common to find a nose with a hump, lower nasal tip and a radix among Koreans. A common procedure as an aesthetical improvement for such feature, involves rasping of the hump, while lifting the tip and the bridge at the same time. As for the hump, en bloc resection is a well-known, traditional surgical method, but it may cause an open roof deformity, which leads to a high possibility of infection if dorsal augmentation using silicone was performed through it as it connects the nasal cavity and dorsum. To overcome this complication, the hump on the bony portion and cartilaginous has been improved by a modified autospreader graft. Also, the graft can also be used for tip-plasty in dorsal augmentation using silicone, septal extension graft, strut and onlay graft. As a result of constant monitoring for a year, the reformation of the hump and infection was not found.
Congenital Abnormalities ; Inlays ; Lifting ; Methods ; Nasal Cavity ; Nose ; Rhinoplasty ; Silicon ; Silicones ; Transplants*

PURPOSE: A pancreaticoduodenectomy is the procedure of choice for managing a periampullary malignancy. This is a complex procedure accompanied with some morbidity. In order to improve postoperative clinical results, we tried to apply a binding pancreaticojejunostomy and Endo GIA stapler during pancreaticoduodenectomy. According to the clinical outcomes, compare this trial with a conventional procedure. METHODS: We evaluated retrospectively clinical results of 30 patients who had received pancreaticoduodenectomy from Jan. 2003 to Dec. 2004 in the Pusan National University Hospital. These cases were divided into two groups; Group I comprised of 16 patients receiving this procedure and Group II comprised of 14 patients receiving conventional procedure. RESULTS: There were some differences in the mean operation time and the amount of blood loss between two groups, but significant difference only in an aspect of blood loss (P=0.042). Postoperative complications were as these: Group I, pancreatic fistula was in 12.5%, intraabdominal bleeding in 6.2%, wound infection in 12.5%; Group II, pancreatic fistula was in 35.7%, intraabdominal bleeding in 21.4%, wound infection & intraabdominal abscess in 7.1%. In Group I, there was a lower morbidity rate than in Group II, but there was a significant difference in the development of a pancrea-tic fistula as a pancreatic parenchymal texture (P=0.021). CONCLUSION: Although there was a small number of cases, it appears that a pancreaticoduodenectomy with the application of a binding pancreaticojejunostomy and Endo GIA stapler can produce good results, also need to get more clinical results.
Abscess ; Busan ; Fistula ; Hemorrhage ; Humans ; Pancreatic Fistula ; Pancreaticoduodenectomy* ; Pancreaticojejunostomy* ; Postoperative Complications ; Retrospective Studies ; Wound Infection

Laser riidectomy with combined application of the Argon and the Nd-YAG laser was performed on 25 eyes of 24 patients with primary narrow angle glaucoma(19 eyes) or pupillary block glaucoma(6 eyes). Patients were followed for from a minimum of one month to maximum of six months and were evaluated the postoperative intraocular pressure, the iridectomy patency, the number of burst and the postoperative complication. In our study, the results obtained are as follows: 1. Pantency rates of iridectomy site were 100%. 2. Postoperative intraocular pressure were well controlled except one eye. 3. Numbers of burst were obviously decreased. 4. The bleeding during the iridectomy was noted in one eye(4%). 5. Immediate postoperative intraocular pressure elevation was seen in one eye(4%).
Argon* ; Hemorrhage ; Humans ; Intraocular Pressure ; Iridectomy* ; Lasers, Solid-State* ; Postoperative Complications

Laser riidectomy with combined application of the Argon and the Nd-YAG laser was performed on 25 eyes of 24 patients with primary narrow angle glaucoma(19 eyes) or pupillary block glaucoma(6 eyes). Patients were followed for from a minimum of one month to maximum of six months and were evaluated the postoperative intraocular pressure, the iridectomy patency, the number of burst and the postoperative complication. In our study, the results obtained are as follows: 1. Pantency rates of iridectomy site were 100%. 2. Postoperative intraocular pressure were well controlled except one eye. 3. Numbers of burst were obviously decreased. 4. The bleeding during the iridectomy was noted in one eye(4%). 5. Immediate postoperative intraocular pressure elevation was seen in one eye(4%).
Argon* ; Hemorrhage ; Humans ; Intraocular Pressure ; Iridectomy* ; Lasers, Solid-State* ; Postoperative Complications

BACKGROUND/AIMS: Kidney transplantation (KT) reportedly provides a significant survival advantage over dialysis in diabetic patients. However, KT outcome in diabetic patients compared with that in non-diabetic patients remains controversial. In addition, owing to recent improvements in the outcomes of KT and management of cardiovascular diseases, it is necessary to analyze outcomes of recently performed KT in diabetic patients. METHODS: We reviewed all diabetic patients who received living donor KT between January 2008 and December 2011. Each patient was age- and sex-matched with two non-diabetic patients who received living donor KT during the same period. The outcomes of living donor KT were compared between diabetic and non-diabetic patients. RESULTS: Among 887 patients, 89 diabetic patients were compared with 178 non-diabetic patients. The incidence of acute rejection was not different between the diabetic and non-diabetic patients. Urinary tract infection and other infections as well as cardiovascular events occurred more frequently in diabetic patients. However, diabetes, cardiovascular disease, and infection were not significant risk factors of graft failure. Late rejection (acute rejection after 1 year of transplantation) was the most important risk factor for graft failure after adjusting for diabetes mellitus (DM), human leukocyte antigen mismatch, rejection and infection (hazard ratio, 56.082; 95% confidence interval, 7.169 to 438.702; p < 0.001). Mortality was not significantly different between diabetic and non-diabetic patients (0 vs. 2, p = 0.344 by log-rank test). CONCLUSIONS: End-stage renal disease patients with DM had favorable outcomes with living donor kidney transplantation.
Cardiovascular Diseases ; Diabetes Mellitus ; Dialysis ; Humans ; Incidence ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Leukocytes ; Living Donors* ; Mortality ; Risk Factors ; Transplants ; Urinary Tract Infections

PURPOSE: To ascertain the incidence of proximal humeral epiphyseal ossification centers, as shown on chest radiographs, in neonates and infants. MATERIALS AND METHODS: The distribution of corrected age(CA) of the infantswas from 24 weeks of gestational age to 6 months of postnatal age. They were obtained from inborn and outborn infants without developmental problems. Proximal humeral epiphyseal ossification centers were evaluated by two radiologists from a total of 440 chest radiographs. Of these, 196 were of the female chest and 244 were of themale. Corrected ages based on postnatal age are expressed as weeks before two months of age and as months after two months of age. The ossified or nonossified epiphyses of the humeral heads were plotted against corrected age. From these graphs, the percentages of ossification according to their corrected age was observed. RESULTS: 37weeks of corrected age in which 9.1%(1/11) was ossified was the earliest age of humeral epiphyseal ossification in the female. While 35 weeks of CA in which 6.3%(1/16) was ossified was the earliest age in the male. In full-term neonates(=40 weeks of CA), 20%(6/30) of epiphysis was ossified in the female and 23.3%(7/30) in the male. The female group of 43-44 weeks of corrected age showed ossification of 50% and the male group of 44-45 weeks of corrected age showed ossification of 50%. By five months of corrected age, 100% of epiphyses, both in the female and in the male, were ossified. CONCLUSION: Humeral ossification centers are seen from 35-37 weeks of correctedage. By five months of age, all humeral epiphyses are ossified.
Epiphyses ; Female ; Gestational Age ; Humans ; Humeral Head ; Incidence* ; Infant* ; Infant, Newborn* ; Male ; Radiography, Thoracic ; Thorax

BACKGROUND/AIMS: Experimental studies using porcine non- heart beating donors to ameliorate graft injuries in liver transplantation has been conducted. Recently, it has been reported that cellular calcium may have an important role in ischemic injury, which consists of damage during ischemia and impairment at the time of reperfusion. therefore, it is possible that calcium channel blocker might prevent warm ischemic injury of the graft in liver transplantation when administered to the donor before harvesting and to the recipient at reperfusion. the purpose of this study was to investigate the protective effect of a calcium channel blocker diltiazem (DTZ) on hepatic ischemic injury using a porcine model. METHODS: Twenty pigs weighing 20 to 30 kg were enrolled in this study. Cardiac death was induced by direct cardiac injection of potassium chloride. The perfusion of UW (University of Wisconsin) solution started after 30 min of cardiac arrest. Orthotopic liver transplantation was perforated. Group A (experimental group) was administrated of DTZ at a dose of 70microgram/kg bolus iv injection before hepatic ischemia, perfused of 70microgram/L in UW solution and thereafter infused continuously 70microgram/L in 5% dextrose solution. RESULTS: Two ones death occurred among the ten transplant pigs. 24 hour survival rates were 80%. DTZ administrated group showed the hepatic blood flow and arterial ketone body ratio better compared with untreated controls (p<0.05). In addition, the increase of plasma lactate level was suppressed after ischemia (p<0.05). CONCLUSION: Our results suggest that DTZ has a protective effect on ischemic induced hepatic damage and might be useful in the prevention of primary graft failure caused by warm ischemia in liver transplantation.
Calcium ; Calcium Channels ; Death ; Diltiazem ; Glucose ; Heart ; Heart Arrest ; Humans ; Ischemia ; Lactic Acid ; Liver Transplantation* ; Liver* ; Perfusion ; Plasma ; Potassium Chloride ; Reperfusion ; Survival Rate ; Swine ; Tissue Donors* ; Transplants ; Warm Ischemia

PURPOSE: The aim of this study is to analyze the clinical results of thermo-irradiation treatment for surgically unresectable advanced hepatoma with or without hepatic arterial chemo-embolization (HACE), chemotherapy (CT) and interferon (IFN) therapy. MATERIALS AND METHODS: Between February 1990 and December 1992, 45 patients with surgically unresectable advanced hepatomas were treated by thermo-irradiation with or without hepatic arterial chemo-embolization and other treatment modalities. Among them, We analyzed retrospectively 25 patients who received more than three times of hyperthermias. Mean age was 50 years (range: 18-71 years) and male to female ratio was 20:5. In the study, treatment was administered as follows: 3 patients received radiation therapy (RT) and hyperthermia (HT). 3 received RT+HT+CT. 3 received RT+HT+HACE. 1 received RT+HT+CT+HACE. 2 received RT+HT+CT+IFN. 10 received RT+HT+HACE+IFN. 3 received RT+HT+CT+HACE+IFN. Radiation therapy was done by a 6 MV linear accelerator. Patients were treated with daily fractions of 180 cGy to doses of 11 Gy-50Gy (median 30Gy). Local hyperthermia was done by HEH-500C(Omron Com Japan), 30-45 min/session, 2 session/wk and the number of HT sessions ranged from 3 to 17 (median 7 times). 15 patients of 25 were followed by abdominal CT scan or abdominal ultra-sonogram. The following factor were analyzed : Age, histologic grade, sex, number of hyperthermia, total RT does, hepatic arterial chemo-embolization. RESULTS: Of 25 patients. There were observed tumor regression (partial response and minimal response) in 6 (24%), no response in 8 (32%), progression in 1 (4%) and not evaluable ones in 10 (40%) radiographically. The over all 1-year survival was 25% with a mean survival of 33 weeks. The treatment modes of partial and minimal responsive patients (PR+MR) were as follows: Two were treated with RT+HT+HACE, 2 were done with RT+HT+HACE+IFN Remaining 2 were treated with RT+HT+CT+HACE+IFN. The significant factor affecting the survival rate were RT dose (more than 25Gy), HACE, number of HT (above 6 times), responsiveness after treatment (PR+MR). Age, sex, histologic differentiation, chemotherapy, interferon therapy were not statistically significant factors affecting the survival rate. Conclusion : Although follow-up duration was short, the thermo-irradiation with/without hepatic arterial chemo-embolization was well tolerated and there were no serious complications. In future, it is considered the longer follow up and prospective, well controlled trails should be followed to evaluate the efficacies of survival advantage.
Carcinoma, Hepatocellular* ; Drug Therapy ; Female ; Fever ; Follow-Up Studies ; Humans ; Hyperthermia, Induced ; Interferons ; Male ; Particle Accelerators ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Tomography, X-Ray Computed

PURPOSE: A spinal cord partial block technique (PBT) with dynamic multileaf collimator (dMLC) for the reduction of the spinal cord dose while keeping the tumor dose unchanged has been developed and its effectiveness has been examined. MATERIALS AND METHODS: Conventional 3-D conformal therapy treatment plan is deigned prior to the PBT application. Beam parameters such as, number of beams, beam directions were determined during 3-D conformal therapy planning process. The shape and the weight of the partial block for optimizing the dose distribution are designed with the forward intensity modulated radiation therapy (fIMRT). Eight cases of lung cancer, in which it was found to be impossible to deliver enough doses to targets with the conventional technique because the doses of the normal lungs or the spinal cords were over the tolerance limit, are used to verify the usefulness of this technique. Comparison of the dose volume histogram (DVH) is performed to compare the treatment plan. RESULTS: PBT plan cauld reduce the maximum dose to the spinal cord up to 29.7% and the mean dose to the lungs up to 11.1%. CONCLUSION: All of the cases showed that the PBT plans are better than the conventional 3-D plans and the spinal cord doses or the normal lung doses can be reduced to tolerance limit
Lung Neoplasms* ; Lung* ; Spinal Cord

PURPOSE: There are some methods for preventing massive intraoperative blood loss during major hepatic resection such as temporary vascular occlusion, but this can consequently lead to ischemia and reperfusion injury in the remnant liver. The purpose of this study is to assess ischemia-reperfusion (I/R) injury in a porcine hepatectomy model with continuous or intermittent inflow occlusion of a prolonged duration. METHODS: We performed right hepatic lobectomy in a porcine model with a liver ischemia lasting 120 mins; there was continuous (n=4) or intermittent (8 subsequent periods of 12 min ischemia and 3 min recirculation; n=4) inflow occlusion, and this was followed by 6 hours of reperfusion. We assessed hepatocytic injury by the serum levels of liver enzymes (AST, ALT, LDH), and we assessed the hepatocellular functions by the indocyanine green clearance test, inflammatory reactions by the serum levels of IL-6, and injury to the SECs (sinusoidal endothelial cell) by hyaluronic acid uptake. We compared these parameters during a preischemic period, a ischemic period and reperfusion period between the two groups. RESULTS: There were significant differences in the serum AST levels, IL-6 levels and HA uptake between the continuous and intermittent occlusion groups. In the intermittent occlusion group, we observed 1) less severe hepatocytic injury (p= 0.041) ; 2) more preserved HA uptake meaning less I/R injury (p=0.031) ; and 3) less inflammatory responses in the reperfusion period (p=0.045). CONCLUSION: During prolonged hepatic ischemia in a porcine model, the intermittent inflow occlusion method seemed to cause less hepatocellular injury and less SEC injury when compared to the continuous occlusion method. This means that we can expect less reperfusion injury in the intermittent inflow occlusion during a major hepatic resection with a prolonged ischemia.
Hepatectomy ; Hyaluronic Acid ; Indocyanine Green ; Interleukin-6 ; Ischemia ; Liver* ; Reperfusion ; Reperfusion Injury*