Many people want to receive facial rejuvenation with surgical treatment, but the post operative result is not always satisfying following classic soft tissue surgery. The reasons for dissatisfaction are many. We were particularly interested in the skeletal disharmony which is frequent in orientals. Since many orientals have flat and quadrangular facial contours, they often don't obtain the harmony of the facial skeleton and soft tissue despite successful surgery. So, to correct facial contour, mandibular angle contouring can be performed at the time of face lift. Seven patients had mandibular angle resection performed during facial rhytidectomy from October of 1996 to October of 1998 at Kangbuk Samsung Hospital, and they were followed from 4 months to 24 months. At the time of face lift, we tried the retromandibular approach for mandibular angle resection when it was indicated, instead of the intraoral approach which does not leave a noticeable scar and does not have the risk of facial nerve injury. Because of a restricted operative field, the intraoral approach has the disadvantages of a long operation time and a high risk of complications. The retromandibular approach with rhytidectomy incision showed neither noticeable scar nor developed a facial nerve injury. In conclusion, we found that mandibular angle contouring by retromandibular approach is easy and the result is more normal with a shorter recovery time. There were no complications and aesthetic results were quite satisfactory.
Cicatrix ; Facial Nerve Injuries ; Humans ; Rejuvenation ; Rhytidoplasty* ; Skeleton

No abstract available.
Burns* ; Hand* ; Humans ; Infant*

No abstract available.

We report the results of the clinical and histologic and radiologic findings of the 17 patients who visited our hospital for the removal of the breast implants. Their mean ages were 45.9 and they visited our hospital 11.4 years after their operation of the breast implantation. In the 8 cases of the 17 patients, the contractures were seen and masses were palpated in the 4 cases. We also could find 1 case of the infection and 1 case of the abscess. There were the cases of the granuloma, siliconoma, calcification too. We find the radiologic examination before the removal of the implants in the 11 cases and could find the finding of rupture at the 9 cases (14 implants) but we confirmed that the number of the ruptured implants were 7 postoperatively. We reinserted new implants in the 12 cases and used saline filled textured implants. the number of the patients who want to remove the silicone gel implants is increasing with the reports of the doubt on the safety of the silicone gel. But there were on clear evidences of harmful effects of the silicone gel at now. We have to study more and need more experiences to used the more exact information to the patients.
Abscess ; Breast Implantation ; Breast Implants ; Breast* ; Contracture ; Granuloma ; Humans ; Rupture ; Silicone Gels*

In the orthopaedic field, some elective surgeries such as joint replacement, spinal surgery and limb salvage procedures for musculoskeletal tumors frequently need various amounts of blood transfusions. However, homologous transfusion occasionally results in various side effects, such as allergic reaction, febrile reaction, and the transmission of infectious diseases such as syphilis, hepatitis and AIDS, ctc. Recently, these complications especially in elective surgery might result in medicolegal or social problems. Risks from transfusions in elective surgery can be minimized with prebanked autologous transfusion. To evaluate the necessity of prehanked autogenous transfusion, fifty five patients who had unilateral hybrid total knee arthroplasty (noncemented at the femoral side and cemented at the tibial and patellar sides) were operated on by the same surgeon from April 199S to July 1997 and had autogenous shed blood transfusion were evaluated for postoperative blood loss, amount of autogenous shed blood, amount of transfusion, hemoglobin and hematocrit. The results were as follows: 1. The distribution of preoperative hemoglobin was from 9.6g/dL to 16.5g/dL (average: 1.8g/dL). 2. The distribution of the amount of blood loss for three days postoperatively was from 156ml to 2001 ml (average: 798ml). 3. The distrihution of the amount of transfusion of autogenous shed blood was from 30ml to 600ml (average: 448ml). 4. There were two patients who had febrile reactions above 38 after transfusion of autogenous shed blood. 5. Forty-six patient(84%) had a homologous transfusion and the average amount of transfusion was 1.9 pint. 6. Total amount of homologous transfusion was decreased according to the increased amount of hemoglobin and the amount of transfusion was statistically decreased above the level of I 3g/dL(Students t-test, P=0.0005). 7. There were no significant differences in the amount of homologous transfusion between age, sex, type of disease, type of implants. In conclusion, most of our patients(84%) needed homologous blood transfusion in unilateral hyhrid total knee arthroplasty and the amount of transfusion decreased in patients who had hemoglobin above 13.0g/dL. So we recommend preparing banked autogenous hlood preoperatively in patients who have a lower hemoglobin level in unilateral hyhrid total knee arthroplasty.
Arthroplasty* ; Blood Transfusion* ; Communicable Diseases ; Hematocrit ; Hepatitis ; Humans ; Hypersensitivity ; Joints ; Knee* ; Limb Salvage ; Postoperative Hemorrhage ; Social Problems ; Syphilis

PURPOSE: Pancreatic injury is rare in abdominal trauma patients (3%~12%). but it could result in significant morbidity and even mortality. Early and adequate decision making are very important in the management of patients with traumatic pancreatic injury. The purpose of this study was to assess the kinds of management and outcome through the review of our experience of pancreatic injury with multiple trauma. METHODS: We reviewed 17 patients with traumatic pancreas injury via electronic medical records from Jan. 2002 and April. 2011. We collected demographic findings; the type, location and grade of pancreas injury, the treatment modality, and patient's outcomes, such as complications, length of hospital stay (LOS), and mortality. RESULTS: Total 17 patients were reviewed, and man was 13 (88%). Traffic accident was the most common cause of injury. Pancreas neck was the most common injured site, and occured in 5 patients. Ductal injury was detected in 7 cases. Eleven patients were treated by surgical procedure, and in this group, 3 patients underwent the endoscopic retrograde pancreas drainage procedure coincidently. ERPD was tried in 8 patients, and failed in 2 patients. The major complications were post-traumatic fluid collection and abscess which accounted for 70% of all patients. The hospital stay was 35.9 days, and it was longer in patient with ductal injury (38.0+/-18.56 vs. 34.5+/-33.68 days). Only one patient was died due to septic shock associated with an uncontrolled retroperitoneal abscess. CONCLUSION: Early diagnosis is the most important factor to apply the adequate treatment option and to manage the traumatic pancreas injury. Aggressive treatment should be considered in patients with a post-operative abscess.
Abscess ; Accidents, Traffic ; Decision Making ; Drainage ; Early Diagnosis ; Electronic Health Records ; Humans ; Length of Stay ; Neck ; Pancreas ; Shock, Septic

Alfa-interferon(IFN) has become the major therapeutic modality for chronic viral hepatitis. The spectrum of side effects is one of the main drawbacks of this treatment. Alfa-INF is known to lead to neuropsychiatric sym ptoms. Neuropsychiatric toxicity, including cognitive dys function, irritability, personality changes and emotional instability cause interpersonal problems, discontinuation of work and domestic discord. Other more serious IFN- induced signs of neurotoxicity include delirium, depres sion and seizures. The psychiatric side effects fell into three categories: an organic personality syndrome charac terized by irritability, and short temper; an organic affective syndrome marked by extreme emotional lability, depression and tearfulness; and a delirium marked by clouding of consciousness, agitation, paranoia, and suicial potential. These complications are thought to be revers ible with dose reduction or cessation of therapy. There fore it is important that physicians, patients and their families are informed about the potential risk of the emotional and psychiatric disturbances that can occur during alfa-INF therapy. We report three patients who had neuropsychiatric complications during long-term interferon alfa therapy.
Consciousness ; Delirium ; Depression ; Dihydroergotamine ; Hepatitis* ; Humans ; Interferon-alpha* ; Interferons* ; Paranoid Disorders ; Seizures

From an aesthetic surgical point of view, rhinoplasty is one of most important field. The nose of asian is characterized by thin and weak nasal septal cartilage, wide and small alar cartilage, bulbous nasal tip due to excessive fibrous tissue and thick skin. Conventional rhinoplasty is not enough to get a satisfactory result. In order to produce optimal nasal shape, it is extremely important to augment the tip along with nasal dorsum in most of the patients. From March of 1997 to June of 1999, total 162 patient underwent open rhinoplasty with various nasal implants. Surgical approach was done through the transcolumella incision and alar rim incision. The nasal dorsum was augmented with silicone implant, and columella shape was controlled by 0.85-mm thickness porous high-density polyethylene sheet(Medpor). Porous high-density polyethylene sheet was 4mm width and was placed between the medial crura. The nasal tip was corrected by Polytetrafluoroethylene(Gore-Tex) implant. Reverse pyramidal shaped onlay graft of Polytetrafluoroethylene(Gore-Tex"") implant was not palpable on nasal tip skin. We obtained harmonious nasal shape and high patient satisfaction. There was two infection and one exposure of Polytetra- fluoroethylene(Gore-Tex) implant, but there was no other major complications. We believe that this method is stable, reliable, predictable, valuable technique for rhinoplasty, but we think that further follow up and study are needed.
Asian Continental Ancestry Group ; Cartilage ; Follow-Up Studies ; Humans ; Inlays ; Nose ; Patient Satisfaction ; Polyethylene ; Polytetrafluoroethylene ; Rhinoplasty* ; Silicones ; Skin ; Transplants

Mycoplasma pneumoniae is the most common etiologic agent of pneumonia in school-aged children and young adults. It involves not only the respiratory system but includes extrapulmonary complications such as exanthem, hemolysis, arthritis, hepatic dysfuction, cardiac disease, and central nervous system disease. The pathogenesis of extrapulmonary involvements may be an autoimmune phenomena. Recent studies suggest that bronchial asthma can be initiated by Mycoplasma pneumoniae infection. We experienced a five-year-old girl suffering simultaneously from Guillain-Barr syndrome and initial bronchial asthmatic attack after mycoplasma pneumonia. She was admitted with lower-leg pain and weakness for three days. Ten days before admission, she was coughing and showed on a chest X-ray, pneumonic infitrations of both subhilar peribronchial areas. The titers of anti-mycoplasma antibody and cold hemagglutinin were 1:80 and 1:32, respectively. With a progression of paralysis to the upper extremities, she showed dyspnea, dysphagia and right facial palsy on the second hospital day. We performed a tracheostomy and started artificial ventilation. Unexpectedly, she showed continuous dyspnea, poor lung aeration and revealed severe hypoxemia in serial arterial gas analysis. Intravenous theophylline, high-dose corticosteroid and intravenous immunoglobulin therapy resulted in a progressive improvement of lung condition. She recovered completely from neurologic and pulmonic complications after five weeks.
Anoxia ; Arthritis ; Asthma* ; Central Nervous System ; Child ; Cough ; Deglutition Disorders ; Dyspnea ; Exanthema ; Facial Paralysis ; Female ; Heart Diseases ; Hemagglutinins ; Hemolysis ; Humans ; Immunization, Passive ; Lung ; Mycoplasma pneumoniae ; Mycoplasma* ; Paralysis ; Pneumonia ; Pneumonia, Mycoplasma* ; Respiratory System ; Theophylline ; Thorax ; Tracheostomy ; Upper Extremity ; Ventilation ; Young Adult

PURPOSE: To describe the angiographic findings of patients with recurrent hemoptysis after bronchial artery embolization (BAE) according to the point at which relapse occurred. MATERIALS AND METHODS: From 125 patients who underwent BAE due to hemoptysis between 1996 and 2000, we selected 18 of 23 who underwent additional BAE due to recurrent bleeding after initial BAE . Depending on the point at which relapse occurred, they were divided into two groups (I and II, according to whether additional BAE was performed within two weeks of initial BAE or more than two weeks after this). We retrospectively compared the two groups in terms of angiographic findings, number of embolized arteries, and character of feeding arteries at initial and additional BAE. RESULTS: Nine patients in group I (additional BAE: n=10) and nine in group II (additional BAE: n=13) were admitted for recurrent hemoptysis within two weeks of initial BAE and more than two weeks after this, respectively. In group I(n=29) and II(n=31), angiography demonstrated two direct and 27 indirect, and two direct and 29 indirect signs of hemorrhage, respectively. No statistically significant differences were observed (x2=0.005, p=0.945). Among the embolized feeder ressels in group I (n=30) there were 20 bronchial artery and 10 non bronchial systemic collaterals, while for group II(n=35), the corresponding totals were 21 and 14. Again, no statistically significant differences were encountered(x2=0.308; p=0.579). In group I, feeders were newly developed in one case(10%), previously embolized in five(50%), and missed in four(40%), while in group two the corresponding figures were none, twelve(92.3%), and one(7.7%). No significant differences were noted, though the incidence of previously embolized feeders in Group II was very high (x2=5.383, p=0.068). CONCLUSION: Among patients in whom hemoptysis after BAE recurred at different times, the angiographic findings and number of embolized arteries were not significantly different, but differences in the nature of the feeder were noted. Patients in whom hemoptysis recurred more than two weeks after BAE showed more recanalization of previously embolized feeders than those in whom there was recurrence within two weeks.
Angiography ; Arteries ; Bronchial Arteries ; Hemoptysis* ; Hemorrhage* ; Humans ; Incidence ; Recurrence ; Retrospective Studies