Nasal valve dysfunction can substantially impact nasal airflow and overall quality of life. This review provides a comprehensive examination of nasal valve dysfunction, including its mechanisms, classification, and surgical management. The nasal valves include internal and external valves, each of which plays a crucial role in regulating nasal airflow. Subclassification of the external nasal valve into alar and rim valves helps specify the site of obstruction when present and informs the choice of surgical intervention. Dynamic nasal valve obstruction, often characterized by inspiratory collapse of the nasal valve, must be distinguished from static obstruction, which refers to nasal valve stenosis. Accurate identification of the location and mechanism of nasal valve dysfunction is essential for effective management. Various surgical procedures target specific components of the nasal valve and can produce favorable functional outcomes. The selection of surgical procedures, whether individually or in combination, should be tailored to the characteristics of nasal valve dysfunction and the external nasal characteristics of the patient. Strict adherence to proper surgical techniques is imperative for achieving optimal treatment outcomes.

BACKGROUND: The effects of dexmedetomidine on the propofol-sparing effect and intraoperative hemodynamics during remifentanil-based propofol-supplemented anesthesia have not been well investigated. METHODS: Twenty patients undergoing breast surgery were randomly allocated to receive dexmedetomidine (group DEX) or placebo (group C). In the DEX group, dexmedetomidine was loaded (1 microg/kg) before anesthesia induction and was infused (0.6 microg/kg/h) during surgery. Anesthesia was induced with a target-controlled infusion (TCI) of propofol (effect site concentration, Ce; 3 microg/ml) and remifentanil (plasma concentration, Cp, 10 ng/ml). The Ce of TCI-propofol was adjusted to a bispectral index of 45-55, and Cp of TCI-remifentanil was fixed at 10 ng/ml in both groups. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded at baseline (T-control), after the loading of study drugs (T-loading), 3 min after anesthesia induction (T-induction), tracheal intubation (T-trachea), incision (T-incision), 30 min after incision (T-incision30), and at tracheal extubation (T-extubation). MAP% and HR% (MAP and HR vs. T-control) were determined and the propofol infusion rate was calculated. RESULTS: The propofol infusion rate was significantly lower in the DEX group than in group C (63.9 +/- 16.2 vs. 96.4 +/- 10.0 microg/kg/min, respectively; P < 0.001). The changes in MAP% at T-induction, T-trachea and T-incision in group DEX (-10.0 +/- 3.9%, -9.4 +/- 4.6% and -11.2 +/- 6.3%, respectively) were significantly less than those in group C (-27.6 +/- 13.9%, -21.7 +/- 17.1%, and -25.1 +/- 14.1%; P < 0.05, respectively). CONCLUSIONS: Dexmedetomidine reduced the propofol requirement for remifentanil-based anesthesia while producing more stable intraoperative hemodynamics.
Airway Extubation ; Anesthesia ; Arterial Pressure ; Breast ; Dexmedetomidine ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Piperidines ; Propofol

PURPOSE: The purpose of this study was to evaluate the clinical characteristics of developmental stuttering. METHODS: We retrospectively reviewed 28 children diagnosed with developmental stuttering from January 2001 to December 2010 who had been admitted to the Uijeongbu St. Mary's Hospital. RESULTS: We observed a strong male predominance. The M:F ratio was 13:1 in this study. And the onset age converged on 2-5 years (71.4%). Seven patients (25%) had a family history of language disorders. Among them, 5 cases (17.8%) was about to developmental stuttering. As for associated disorders, 5 patients (17.8%) had another language disorder as articulation disorder or developmental language delay; respectively 4 patients (14.2%) and 1 patient (3.6%). Three patients (10.7%) had psychologic disorder as ADHD or anxiety disorder; respectively 2 patients (7.1%) and 1 patient (3.6%). In addition, 2 patients (7.1%) had ankyloglossia including 1 case accompanying with articulation disorder. Another 2 patients (7.1%) had adenoid-hypertrophy also including 1 case accompanying with articulation disorder. The proportion of moderate-to-severe and severe cases was 63.6%. And we observed remarkable improvement of stuttering in 92.9% (13/14) patients during repetitive speech or text reading. CONCLUSION: Several distinctive characteristics of developmental stuttering were observed in this study. The value of this study is that it's the clinical report on developmental stuttering by pediatrician and we expect this study will contribute to the basis of forward investigation.
Age of Onset ; Anxiety ; Articulation Disorders ; Child ; Clinical Medicine ; Humans ; Language Disorders ; Male ; Mouth Abnormalities ; Retrospective Studies ; Stuttering

PURPOSE: Split thickness skin graft (STSG) is frequently used for reconstructing wounds. The treatment of split-thickness donor sites demands several factors: maintenance a moist condition, minimization of pain, promotion of re-epithelization and ease of care. We have performed a study to evaluate efficacy of Physiotulle® for donor site management. METHODS: A prospective study was conducted from June 2015 to December 2015 and included 20 patients undergoing surgery for reconstructive purposes with the use of STSG. The grafts harvested with a same manner and the donor sites were managed with one of the two dressing material: Physiotulle® or Bactigras®. We campared post-operative pain scale, bleeding of donor site, period of re-epithelization and donor site infection. RESULTS: All of 20 patients were well healed after application of Physiotulle® or Bactigras® dressing without any complications. Pain level was similar between two groups until 3 days after operation but Physiotulle® (4.1±0.233) showed significant (P<0.01) pain increasing on 7 days after operation compared with Bactigras® (2.9±0.277). The bleeding index score on 7 days after operation of Physiotulle® (2.5±0.167) was higher than Bactigras® (2.0±0.211) but there is no difference. Statistically (**P<0.01), the period of re-eopithelization of Physiotulle® (13.50±0.87) was significantly shorten than Bactigras® (17.25±0.65). CONCLUSION: Physiotulle® is effective in re-epithelization. We recommend applying ointment on donor site when exudate is minimized, about 7 days after operation to prevent aggravation of pain and bleeing of donor site.
Bandages ; Exudates and Transudates ; Hemorrhage ; Humans ; Prospective Studies ; Skin* ; Tissue Donors* ; Transplants* ; Wound Healing* ; Wounds and Injuries*

PURPOSE: The purpose of management of split thickness skin graft (STSG) donor site is to promote healing process and minimize pain and infection. There are many dressing materials for managing donor site. The study aimed to compare the effect on management of donor site between Biatain Ibu® (polyurethane foam with incorporated ibuprofen) and Mepilex® (polyurethane foam coated with silicone). Especially, we focused on manage of donor site pain and treatment satisfaction. METHODS: This prospective study was conducted on 30 patients underwent STSG from January 2015 to June 2015. The grafts harvested with a same manner and the donor sites were managed with Biatain Ibu® or Mepilex®. Donor site pain, treatment satisfaction, days for re-epithelization and complication were compared between the two groups. RESULTS: All of 30 patients were well healed and there was no complications. Pain level of Biatain Ibu® (2.32±0.929) was lower than Mepilex® (4.77±1.224). Treatment satisfaction of Biatain Ibu® (8.40±0.632) was higher than Mepilex® (7.33±0.487). There is no statistically differences (P=0.455) in the days for re-eopithelization between Biatain Ibu® (14.73±0.789) and Mepilex® (14.53±0.639). CONCLUSION: The Biatain Ibu® dressing represents a valuable alternative in the management of STSG donor site by providing an appropriate wound healing, reduction of pain and improving treatment satisfaction.
Bandages* ; Humans ; Ibuprofen* ; Prospective Studies ; Skin* ; Tissue Donors* ; Transplants* ; Wound Healing ; Wounds and Injuries*

PURPOSE: With the advances of knowledge in wound healing process and technology in various fields, dressing material of the split thickness skin graft (STSG) donor site was improved. Recently, biologic dressing materials attracted attention and these are used for wound management. The aim of the study was to compare the efficacy of Xe-derma® (porcine acellular dermal matrix) with Kaloderm® (cultured epithelial autografts) for treatment of the donor site. METHODS: From July 2015 to January 2016, 20 patients who had undergone STSG were enrolled. The grafts harvested with a same manner and the donor sites were managed with Xe-derma® or Kaloderm®. We compared days for re-epithelization, number of dressings, ease of application, ease of wound monitoring, pain level and complications. RESULTS: All patients managed by these dressing materials were well healed without any complications. There is no statistically difference (P=0.830) between the days for re-epithelization of Xe-derma® (11.10±0.944) and Kaloderm® (11.00±1.054). Number of dressings of Xe-derma® (1.2±0.421) was lower than Kaloderm® (2.3±0.483). Ease of application of Kaloderm® (7.40±0.516) was easier than Xe-derma® (6.36±0.343). Ease of wound monitoring of Xe-derma® (7.77±0.856) was easier than Kaloderm® (6.25±0.720). Xe-derma® was more painless in 1 day and 3 days after operation than Kaloderm®. CONCLUSION: Advantageous properties of Xe-derma® are improving wound healing, reducing pain by contact to the wound immediately after application and easy of wound monitoring due to its transparency. Therefore, we expected Xe-derma® can be used for management of various wound.
Bandages ; Biological Dressings* ; Humans ; Skin* ; Tissue Donors* ; Transplants* ; Wound Healing ; Wounds and Injuries

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the effect of pulmonary valve replacement (PVR) on exercise capacity and determine cardiopulmonary exercise (CPEX) parameters associated with improvement in right ventricle (RV) function. SUBJECTS AND METHODS: We retrospectively analyzed CPEX and magnetic resonance imaging parameters in a total of 245 patients who underwent PVR from January 1998 to October 2015. In addition, we analyzed the characteristics of the patients who showed improved exercise capacity after PVR. RESULTS: Twenty-eight patients met the inclusion criteria for the study. CPEX parameters after PVR showed no significant changes in all patients. However, baseline predicted peak oxygen uptake (VO2(peak)) (%) value was significantly lower in patients with significant improvement in exercise capacity after PVR, as compared to patients who showed decreased exercise capacity after PVR (60.83±10.28 vs. 75.81±13.83) (p=0.003). In addition, patients with improved exercise capacity showed a positive correlation between the change of right ventricular ejection fraction (RVEF) (%) and the change of anaerobic threshold (r=0.733, p=0.007); whereas, patients with decreased exercise capacity showed a negative correlation between the change of RVEF (%) and the change of predicted VO2(peak) (%) (r=−0.575, p=0.020). CONCLUSION: The importance of predicted VO2(peak) (%) in evaluating exercise capacity differentiated from other CPEX variables. The change of anaerobic threshold and predicted VO2(peak) (%) might be a useful predictor of the change in RV function after PVR.
Anaerobic Threshold ; Exercise Test ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Oxygen ; Pulmonary Valve* ; Retrospective Studies ; Stroke Volume ; Tetralogy of Fallot*

Patients with advanced hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) have an extremely poor prognosis. Although the Barcelona Clinic Liver Cancer guideline recommends sorafenib in advanced HCC with PVT, which has provided survival benefits of 2 or 3 months compared to the placebo group, many liver cancer centers in Asia still select multimodality approaches including transarterial chemoembolization, radiofrequency ablation, radiation therapy (RT) as well as systemic/intra-arterial chemotherapy. Recently advanced RT technologies have shown potential to improve survival without severe radiation-related toxicity. For locally advanced HCC patients with PVT, concurrent chemoradiotherapy (CCRT) has been applied as a loco-regional treatment and provides potential cures. We herein report our recent experience of a patient accompanying large HCC with PVT who successfully undergone CCRT followed by hepatic arterial infusion chemotherapy.
Asia ; Carcinoma, Hepatocellular* ; Catheter Ablation ; Chemoradiotherapy ; Drug Therapy ; Humans ; Liver Neoplasms ; Portal Vein* ; Prognosis ; Venous Thrombosis*

This paper described a collaborative exercise intended to see what kinds of short tandem repeat (STR) loci are used in different DNA typing laboratories in Korea and to compare their results for the demonstration whether uniformity of DNA profiling results from different laboratory could be achieved in Korea. Laboratories were asked to test five tissue DNAs using methods routinely used in each laboratory and to report the results to the coordinating laboratory. The exercise demonstrated that each laboratory was using different STR loci for the typing with different STR numbers, 2 VNTRs, 36 STRs and amelogenin in total, and the direct comparison of the results from all the laboratory for the 18 loci could not be done as only one laboratory submitted typing results. Among 21 loci for which several laboratories submitted typing results, results for 14 loci were the same and results for the other 7 loci were different depending on the participating laboratory. D1S80, F13A01, D16S539, D21S11, D18S51, D3S1744 were the loci with different typing results. Even in the cases where commercial kits were used, the results were not the same depending on the machines used, that is the capillary electrophoresis or the gel based electrophoresis. The reason for the different results, points about the standardization of the methods and the profiling data were described.
Amelogenin ; DNA ; DNA Fingerprinting ; Electrophoresis ; Electrophoresis, Capillary ; Korea ; Microsatellite Repeats

This paper described a collaborative exercise intended to see what kinds of short tandem repeat (STR) loci are used in different DNA typing laboratories in Korea and to compare their results for the demonstration whether uniformity of DNA profiling results from different laboratory could be achieved in Korea. Laboratories were asked to test five tissue DNAs using methods routinely used in each laboratory and to report the results to the coordinating laboratory. The exercise demonstrated that each laboratory was using different STR loci for the typing with different STR numbers, 2 VNTRs, 36 STRs and amelogenin in total, and the direct comparison of the results from all the laboratory for the 18 loci could not be done as only one laboratory submitted typing results. Among 21 loci for which several laboratories submitted typing results, results for 14 loci were the same and results for the other 7 loci were different depending on the participating laboratory. D1S80, F13A01, D16S539, D21S11, D18S51, D3S1744 were the loci with different typing results. Even in the cases where commercial kits were used, the results were not the same depending on the machines used, that is the capillary electrophoresis or the gel based electrophoresis. The reason for the different results, points about the standardization of the methods and the profiling data were described.
Amelogenin ; DNA ; DNA Fingerprinting ; Electrophoresis ; Electrophoresis, Capillary ; Korea ; Microsatellite Repeats