Psoriatic arthritis is an uncommon disease in the community and probably occurs in no more than 5 percent of the general psoriatic population. The authors experienced a patient who had the findings of mutilating type of psoriatic arthritis with severe joint deformities. A 30 year-old man was admitted to our hospital due to multiple joint pain and deformities with wheel chair bound state. We report a case of mutilating type in the psoriatic arthritis with brief review of literatures.
Adult ; Arthralgia ; Arthritis, Psoriatic* ; Congenital Abnormalities ; Humans ; Joints ; Wheelchairs

No abstract available.
Histocompatibility Antigens* ; Histocompatibility* ; Humans ; Young Adult*

PURPOSE: We report a case of the granulocytic sarcoma located at the conjunctival fornix in a 10-year-old girl with acute myeloid leukemia, who was in complete remission after bone marrow transplantation. METHODS: A 10-year-old girl had a 1-week history of firm, dark brown conjunctival mass at lower fornix and mild lid swelling of the right eye. Several months previously she had had some chalazions at lower lid and a history of acute myeloid leukemia that was currently in complete remission after bone marrow transplantation. Other ocular manifestations were not specific. Excision of the conjunctival mass and a biopsy for diagnostic and therapeutic purposes were performed. RESULTS: The 12 x 6 x 5 mm-sized mass was totally excised. The pathologic examination was consistent with granulocytic sarcoma. Three weeks after the biopsy, the patient had a relapse of acute myeloid leukemia. She died 2 months later while undergoing intensive therapy. CONCLUSIONS: This condition should be considered in the diagnosis of granulocytic sarcoma in patients with a history of acute myeloid leukemia.
Biopsy ; Bone Marrow Transplantation ; Chalazion ; Child ; Conjunctiva* ; Diagnosis ; Female ; Humans ; Leukemia, Myeloid, Acute ; Recurrence ; Sarcoma, Myeloid*

OBJECTIVE: The incidence of subarachnoid hemorrhage (SAH) worldwide varies considerably. In spite of many reports about the incidence of SAH, there has been no report about the incidence of SAH on the basis of the Korean population. The purpose of this hospital-based study was to assess the actual incidence rates of aneurysmal SAH in Gwangju city and Jeollanamdo province. METHODS: All cases of SAH confirmed by computerized tomography (CT) between January 2007 and December 2007 were selected for analysis. For the data collection, three major training hospital and ten general hospitals working the CT in Gwangju city and four major general hospitals in Jeollanamdo province participate in this study. RESULTS: According to the official census of Korea, the population was 1,413,444 in Gwangju city and 1,929,836 in Jeollanamdo province in 2007. There were 163 patients in Gwangju city and 266 patients in Jeollanamdo province confirmed SAH by CT in 2007. The crude and the age- and sex-adjusted annual incidence rates per 100,000 population for all ages in Gwangju city were 11.5 and 12.4 for aneurysmal SAH and in Jeollanamdo province were 13.8 and 10.8. The incidence was higher in women and increased with age. The gender distribution varied with age. At young ages, the incidence was higher in men while after the age of 40 years, the incidence was higher in women. CONCLUSION: In the present study, the age- and sex-adjusted annual incidence rates is 11.8 in Gwangju city and Jeollanamdo province. The incidence was higher in women and increased with age.
Aneurysm ; Censuses ; Data Collection ; Female ; Hospitals, General ; Humans ; Incidence ; Korea ; Male ; Risk Factors ; Subarachnoid Hemorrhage

BACKGROUND: The costal cartilage allows for versatile and stable cartilage supply for rhi-noplasty but disadvantages remain; to minimize these, the 10th costal cartilage was used. We present our experience with the use of the 10th costal cartilage as autologous graft material for rhinoplasty. METHODS: Sixty-four patients whose 10th costal cartilage had been used for correction of severe caudal nasal deviation, secondary cleft lip nasal deformity, and secondary rhi-noplasty with difficulty using the septal and auricular cartilages were enrolled in this study from November 2008 to December 2012. To evaluate the efficacy and safety of this method in rhinoplasty, donor-site morbidity, scarring, and postoperative results, including availability of graft material and complications, were assessed. RESULTS: The mean time for cartilage harvesting was 18 minutes, and the mean length of the harvested cartilage was 2.4 cm. The harvested cartilage was used for columellar struts and tip onlay grafts. The natural curvature of the 10th costal cartilage was used, depending on the purpose of the strut. It could be applied without carving in 38 cases (59%). Although revision was performed in three patients, there were no graft-related complications. CONCLUSIONS: The 10th costal cartilage can be harvested safely and quickly, and its han-dling procedure is simple. As such, it is a good option as an autologous graft for rhinoplasty.
Cartilage* ; Cicatrix ; Cleft Lip ; Congenital Abnormalities ; Ear Cartilage ; Humans ; Inlays ; Rhinoplasty* ; Ribs* ; Transplants*

BACKGROUND: This study aimed at overcoming the disadvantages of septal extension grafts and keeping the nasal tip as natural as possible by using different forms of the graft and additional supporting methods depending on the case. METHODS: Among 458 patients who received a septal extension graft from March 2008 to September 2011, 107 patients were selected who underwent at least a 6-month follow-up. Patients were categorized according to the primary objective of the operation; an upturned tip correction or tip lengthening, tip lengthening with tip projection, or retracted columella correction. Each group of patients received a different type of septal extension graft out of 3 different types of grafts based on the purpose of the operation. The evaluation of the results was made from by comparing preoperative and postoperative photographs of the tip angle, projection, and nasolabial angle. RESULTS: The average tip angle for the patients in the upturned tip correction group was reduced to 98.3 from 124.9 degrees. For the patients in the tip lengthening with tip projection group, the average tip angle was reduced to 96.8 from 122.4 degrees and the average tip projection was increased to 27.5 from 23.2 mm. The average nasolabial angle for the patients in the retracted columella correction group was increased to 94.6 from 74.8 degrees. CONCLUSIONS: Sufficient nasal tip lengthening and projection could be achieved by applying a septal extension graft using the graft best suited for the group of patients categorized by surgical objective.
Asian Continental Ancestry Group* ; Follow-Up Studies ; Humans ; Methods ; Nasal Cartilages ; Nose ; Rhinoplasty* ; Transplants*

Based on a thorough understanding of facial structure around the superficial musculoaponeurotic system (SMAS), some types of sub-SMAS techniques have emerged to allow more harmonious rejuvenation procedures in the lower face and midface. These techniques are the Hamra composite facelift, the Stuzin extended SMAS technique, the Barton high SMAS technique, and the Ramirez subperiosteal facelift, each of which involves a specific dissection plane and is informed by distinct rationales with reasonable support. Each patient presents a unique facial structure and undergoes an individual rate of aging. The facial structures of East Asian faces, in particular, differ from those of Western faces. While emphasizing that the theory of structural mid-cheek anatomy is an essential part of facial rejuvenation, we would like to discuss the advantages and disadvantages of various sub-SMAS facelift techniques and to propose the most suitable techniques for a variety of individual faces.
Aging ; Asian Continental Ancestry Group ; Facial Muscles ; Humans ; Rejuvenation ; Rhytidoplasty* ; Superficial Musculoaponeurotic System

Periauricular paresthesia may afflict patients for a significant amount of time after facelift surgery. When performing face and neck lift surgery, temple and posterior auricular flap dissection is undertaken directly over the auriculotemporal, great auricular, and lesser occipital nerve territory, leading to potential damage to the nerve. The auriculotemporal nerve remains under the thin outer superficial fascia just below the subfollicular level in the prehelical area. To prevent damage to the auriculotemporal nerve and to protect the temporal hair follicle, the dissection plane should be kept just above the thin fascia covering the auriculotemporal nerve. Around the McKinney point, the adipose tissue covering the deep fascia is apt to be elevated from the deep fascia due to its denser fascial relationship with the skin, which leaves the great auricular nerve open to exposure. In order to prevent damage to the posterior branches of the great auricular nerve, the skin flap at the posterior auricular sulcus should be elevated above the auricularis posterior muscle. Fixating the superficial muscular aponeurotic system flap deeper and higher to the tympano-parotid fascia is recommended in order to avoid compromising the lobular branch of the great auricular nerve. The lesser occipital nerve (C2, C3) travels superficially at a proximal and variable level that makes it vulnerable to compromise in the mastoid dissection. Leaving the adipose tissue at the level of the deep fascia puts the branches of the great auricular nerve and lesser occipital nerve at less risk, and has been confirmed not to compromise either tissue perfusion or hair follicles.
Adipose Tissue ; Fascia ; Hair Follicle ; Humans ; Mastoid ; Neck* ; Paresthesia ; Perfusion ; Rhytidoplasty ; Skin ; Subcutaneous Tissue

OBJECTIVE: This study was conducted to elucidate the associations of HLA with systemic sclerosis (SSc) in Koreans. METHODS: HLA associations with SSc according to SSc-specific autoantibody status and clinical subsets (diffuse and limited) were investigated. HLA-A, B, and C antigens were typed by the serological method using microlymphocytotoxicity test, and HLA-DR by DNA typing method using PCR-reverse hybridization and PCR-SSCP in 56 Korean patients with SSc and 226 healthy controls. For SSc patients, anti-Scl-70 and anicentromere antibodies were tested by double immunodiffusion and indirect immunofluorescence, respectively. RESULTS: The results of HLA class I antigen typing showed that the frequencies of HLA-A24, B52 and B62 were increased, whereas those of A33, B44 and B58 were decreased in SSc patients compared to healthy controls. The frequency of HLA-DR2 was significantly increased, whereas that of HLA-DR13 was decreased in patients with SSc compared to controls. Among HLA-DR2 alleles, both HLA-DRB1*1501 and *1502 were increased in SSc patients compared to controls. According to clinical status, HLA-DRB1*1501 was increased in limited SSc patients and that of DRB1*1502 was increased both in diffuse and limited SSc patients compared to controls. According to autoantibody status, HLA- DRB1 1502 was significantly increased in anti-Scl-70-positive SSc patients and that of DRB1 1501 was increased in anti-Scl-70-negative SSc patients compared to controls. The association of HLA-DR2 alleles with SSc according to clinical subsets and anti-Scl-70 antibody status revealed that the frequency of HLA- DRB1 *1501 was significantly increased in anti-Scl-70-negative limited SSc patients compared to controls. CONCLUSIONS: These results suggest that different HLA-DR2 alleles are associated with different types of SSc in Koreans. HLA-DRB1 1502 shows strong association with anti-Scl-70-positive SSc, and DRB1 1501 with anti-Scl-70-negative limited SSc. It is concluded that the pathogenesis of SSc in Koreans is in part, based on the same genetic background.
Alleles ; Antibodies ; Asian Continental Ancestry Group ; DNA Fingerprinting ; Fluorescent Antibody Technique, Indirect ; HLA-A Antigens ; HLA-A24 Antigen ; HLA-DR Antigens ; HLA-DR2 Antigen ; HLA-DRB1 Chains ; Humans ; Immunodiffusion ; Scleroderma, Systemic*

PURPOSE: We classified patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction into six groups according to graft material and age, and clinical, radiological, and second look arthroscopic results were compared and analyzed. MATERIALS AND METHODS: From January 2006 to December 2009, 57 patients underwent arthroscopic ACL reconstruction and second look arthroscopic examination. We divided patients according to graft materials into the autogenic hamstring tendon group (group 1) and the allogenic tibialis tendon group (group 2), and according to age into three groups (A, B, and C). The mean age at follow-up for second look arthroscopy was 34 years old. Fifty four patients were male and three patients were female, and mean follow-up period was 21.8 months. The result was clinically evaluated using a KT-1000 arthrometer under anesthesia, and the subjective and objective score of International Knee Documentation Committee (IKDC), and radiologically evaluated using the Telos(TM) stress test. We observed graft tension, synovialization and gross findings through a second look arthroscopic examination. RESULTS: The clinical and radiographic results in patients in group 1 and group A showed excellent finding, however, no statistically significant difference was observed. Second look arthroscopic examination in group 1 and group A showed excellent finding. In particular, the formation of synovialization showed excellent finding (50% or more synovialization) in 75% of patients in group 1A who were young and used an autogenic tendon graft, and 45% of patients in group 2C (over 50 years old and allogenic graft), and they were significantly different (p=0.046). There was significant difference in that tension of graft was excellent in group 1A (less than 3 mm). Through the IKDC evaluation method, 93% of cases that showed normal formation of synovialization and 50% of cases that showed inadequate formation of synovialization showed 'like normal' abnormality, so that was correlation was observed between synovialization and IKDC evaluation (p=0.001). CONCLUSION: Patients who used autogenic hamstring tendon and who were young showed excellent synovial membrane formation. In the old age group, autogenous graft will be more optimal.
Anesthesia ; Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction ; Arthroscopy ; Exercise Test ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Synovial Membrane ; Tendons ; Transplants