No abstract available.
Melanoma* ; Proliferating Cell Nuclear Antigen*

According to photothermolysis, the FPDL(flashlamp-pumped pulsed dye laser) treatment theoretically causes no epidermal damage, however, we have observed blister, crust and scars in clinical experiences, and we have also found that FPDL has limited effect on adults, specially, thick-skinned Asian people with rich melanin pigment. In order to explain these effects, we took biopsies and made a histologic observation and analyzed the results statistically. The biopsies were taken from 15 patients who received first treatment and stained with H&E and NBTC(nitroblue tetrazolium chloride). We measured epidermal melanin content, epidermal damage, vessel wall coagulation depth, RBC coagulation depth, mean vessel diameter and evaluated clinical results at post-treatment 6 weeks. The vessel diameter and darkness of lesion color were increased with ages. Complete vessel coagulation was restricted to small vessels. With increasing epidermal melanin content, epidermal damage increased accordingly. The clinincal results were enhanced with increasing coagulation depth of vessel walls, and deteriorated with increasing epidermal melanin content. The clinical result was not significantly correlated with RBC-coagulation depth or energy used. We observed that melanin pigments have an adverse effect on clinical results. The FPDL treatment can be a choice of treatment to children with light colored lesion, but has a limitation to Asian adults with rich melanin pigment. Therefore, repetitive treatment is necessary for improvement of clinical results.
Adult ; Asian Continental Ancestry Group ; Biopsy ; Blister ; Child ; Cicatrix ; Darkness ; Humans ; Lasers, Dye* ; Melanins

No abstract available.
Cleft Lip*

We introduce a new silicone implanting method to correct facial depression caused by trauma or congenital anomaly. It resulted in good facial aesthetics in patients with facial depression. From August 1997 to January 1999, 5 patient (3 males and 2 females), in ages from 19 to 34 years, underwent silicone implantation for facial depression using our method. Three males were injured by traffic accident and had facial depression with or without bone defect. Two females had congenital forhead depression and requested aesthetic contouring. An impression of the face was taken with alginate backed with quick setting plaster. When set, a further stone plaster model was taken from the alginate-plaster, which was removed after fixation. Wax was then carved into the patient's stone model to fill the depression. Another stone cover was taken to cover this was-stone model. Then wax was melted away and medical implant grade room temperature vulcanized silicone adhesive was squeezed into the empty space. After cured, this precisely-shaped silicone imlant was inserted into the patient. We did not experience major complicaion such as infection, implant extrusion during 4 to 18 months' follow-up periods. All patients were satisfied with the results. The clinical result of this technique would be useful for accurate and excellent aesthetic implantation.
Accidents, Traffic ; Adhesives ; Depression* ; Esthetics ; Female ; Follow-Up Studies ; Humans ; Male ; Silicones*

Orthognathic surgery became more popular because people are more interested in facial profile changes and are more receptive to surgery. As people seek beauty as well as function in maxillofacial surgery, patient's aesthetic demand becomes higher. Considering these big changes, one of the major reasons is surgery-first orthognathic approach(SFOA), which removes pre-surgical orthodontic treatment. Pre-surgical orthodontic time has been a great barrier to patients in terms of time and social rehabilitation. By SFOA, patients can get surgery as soon as they make up their mind; Patients from abroad can get surgery and get back to their country; They can go back to their work more easily because their occlusion is more acceptable. Surgery first orthognathic approach is still developing in practice and principle. However, as it is based on patient's need, it will play a greater part in the field of orthognathic surgery. Surgery first orthognathic approach together with aesthetic two jaw surgery are expected to change the paradigm in orthognathic surgery.
Beauty ; Humans ; Orthognathic Surgery ; Surgery, Oral

Due to its safety and softness, autologous fat transplantation has been commonly performed for soft tissue correction. However, the injected fat is absorbed resulting in the reduction of volume of the graft by 40- 60% within a few months. Thus, there was an attempt to use adipocytes differentiated from preadipocytes in vitro for transplantation. Differentiated adipocytes were biocompatible and matured with gradual volume increase at transplantation site in clinical study(unpublished data). In addition, they did not induce immune rejection in response to nonself lymphocytes in a mixed lymphocyte reaction(MLR)(unpublished data). The purpose of this study is to differentiate mouse preadipocytes following labeling into adipocytes to establish an animal model for allogenic transplantation. Preadipocytes isolated from inguinal and retroperitoneal fat pad of C57BL/6 mice were proliferated with growth medium by passage 3 and differentiated into adipocytes with different culture conditions after labeled with BrdU. At most suitable conditions, above 90% of preadipocytes were differentiated and BrdU labeling did not affect differentiation rate and function of differentiated adipocytes. These results demonstrate that BrdU-labeled adipocytes resulting from this in vitro differentiation protocol are useful for allogenic transplantation study.
Adipocytes ; Allografts ; Animals ; Bromodeoxyuridine ; Intra-Abdominal Fat ; Lymphocytes ; Mice* ; Models, Animal ; Transplants

The popularity of elective day surgery has increased significantly over the past two decades. Potential advantages of day surgery are alleviation of parental burden on time and money, less social disruption for the child and family due to the shorter period hospitalization and the absence of overnight stay. Between January of 1996 and December of 2000, we studied 391 cases that underwent day surgery (age 1 mo.-15.0 yrs). This practice is reviewed with regard to initial assessment, preparation for surgery, postoperative complications and management, and immediate follow-up by telephone visit. Up to 28% of all pediatric plastic surgical cases were performed on day-care basis mainly in laser therapy and excision of benign soft tissue mass. The incidence of postoperative minor medical complications was 3.1 In addition, we reviewed 14 patients who underwent ambulatory surgery with syndactyly and/or polydactyly of the hand. Then we compared 3 parameters (hospital charge, postoperative complications and degree of postoperative satisfaction in parents) with those of 84 inpatient children who underwent the same surgical procedures. As results, ambulatory surgery group is more economical than inpatient surgery group with postoperative satisfaction higher than inpatients surgery group with negligible complications.And based on a 5-year experience of authors, day-surgery system in pediatric plastic surgery is safe, effective and in the best interest of a select but significant proportion of children requiring elective operation.
Ambulatory Surgical Procedures* ; Child ; Follow-Up Studies ; Hand ; Hospitalization ; Humans ; Incidence ; Inpatients ; Laser Therapy ; Parents ; Polydactyly ; Postoperative Complications ; Surgery, Plastic* ; Syndactyly ; Telephone

The superficial temporal fascia is a thin, pliable, well- vascularized flap that is useful in elevation of the reconstructed ear of the microtia. However, the elevation of the superficial temporal fascial flap by conventional T or zigzag incisions in temporal region frequently leaves a conspicuous scar, hair thinning and alopecia. To overcome these problems, we harvested the superficial temporal fascia as a random pattern flap using only a retroauricular skin incision line for the ear elevation. Thereafter, the cartilage framework was elevated including superficial temporal fascia and superficial mastoid fascia underneath: dissection plane was continuous with the superficial temporal fascial flap harvest and dissection was performed just beneath the superficial mastoid fascia under the framework. A carved costal cartilage block was grafted at the posterior wall of the concha and covered with the harvested superficial temporal fascial flap, followed by a full-thickness skin graft. From June 2001 to December 2001, 9 patients (male 8 and female 1), who ranged from 9 to 26 years in age, underwent ear elevation using this method. The skin grafts was successful and the appropriate auriculocephalic angle was preserved in all cases. We did not find any complications such as infection, graft loss or cartilage extrusion in the 3 to 9 months follow-up period and the patients were satisfied with their cosmetic results. This method was easy to perform and did not leave any other scar in the temporal hear-bearing area and the results have been favorable.
Alopecia ; Cartilage ; Cicatrix ; Ear* ; Fascia* ; Female ; Follow-Up Studies ; Hair ; Humans ; Mastoid ; Skin ; Transplants

Glycogen storage diseases are inherited disorders of carbohydrate metabolism caused by a deficiency of enzymes that are involved in degradation of glycogen in the liver. The accumulation of glycogen occurs in the liver and other organs. Type Ia is the most common form and clinically may manifest of glycogen storage disease itself rather than growth hormone deficiency. But in this case the patient showed exceptional extreme growth retardation. Growth hormone stimulation test with clonidine and L-dopa revealed that the patient had growth hormone deficiency. Therefore, we report of a case of glycogen storage disease type Ia with the presence of GH deficiency with review of literature. A 16-year-old male was admitted for the evaluation of hepatomegaly and extreme short stature. The height was 113.5cm, less than third percentile of same age group, and compatible with fiftieth percentile of height of 6 years of age. After laboratory work up including liver biopsy, he was diagnosed with type I glycogen storage disease. The patient was presented with metabolic acidosis, hyperuricemia, and hypoglycemia. Hypoglycemia was managed with frequent feeding with high starch diet and intravenous glucose infusion. Metabolic acidosis was treated with sodium bicarbonate. Secondary hyperuricemia was treated with allopurinol. The patient is being followed at out-patient clinic with clinical improvement after of GH administration.
Acidosis ; Adolescent ; Allopurinol ; Biopsy ; Carbohydrate Metabolism ; Clonidine ; Diet ; Glucose ; Glycogen Storage Disease* ; Glycogen* ; Growth Hormone ; Hepatomegaly ; Humans ; Hyperuricemia ; Hypoglycemia ; Levodopa ; Liver ; Male ; Outpatients ; Sodium Bicarbonate ; Starch

Various techniques of unilateral cleft lip repair are being developed. Nowadays, rotation-advancement flap technique is most widely used for the repair of unilateral cleft lip. This procedure places a premium on the conservation of tissue and preservation of natural landmarks. Millard's technique however occasionally can produce a scar that crosses the philtrum obliquely in the upper third of the philtral unit. In Mohler's technique, the marking of the medial segment has been altered in uppermost portion by utilizing tissue from the columellar base. That is to say, cutback on columellar tissue is utilized at approximately 90 degrees. After full-thickness release of the medial lip segment, the C flap is advanced into donor defect of the columellar base and is also used to lengthen the shortened columella. This results in the placement of a scar that will simulate the mirror image of the non-involved phitral column. And another advantage of this technique is the possibility of primary nasal correction including wide dissection of alar cartilage through cutback incision on columellar base without need of additional incision for nasal dissection. In addition, preoperative nasal molding was performed with a special NAM(nasoalveolar molding) appliance by orthodontist during preoperative period. The authors performed 27 cases of the correction of the unilateral cleft lip using this technique between July 2000 and December 2001. All the patients showed satisfactory results by achieving enough rotation of medial lip segment without scar that crosses the philtral column and satisfactory correction of primary nasal deformity.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Fungi* ; Humans ; Lip ; Preoperative Period ; Tissue Donors