There is room for debate in appropriate diagnosis and treatment due to physiological and anatomical differences in pediatric facial bone fractures from that of adult's. The objectives of this article is to analyze for our clinical cases and to suggest the appropriate management of facial bone fracture in children. The study included 56 children who had treatment for the craniofacial fractures form March, 1990 to February, 1998. Their ages ranged from 3 to 15. There were 38 males and 18 females. Physical examination, simple x-rays, ultrasonograms and routine CT scans were used for diagnosis. Materials were classified into 28 nasal bone fractures, 4 nasoethmoidal fractures, 6 orbital fractures, 8 mandible fractures, and 10 zygoma fractures. Patients were treated with conservative treatment in 9 cases, with closed reduction in 28 cases and open reduction only, and 14 patients with open reduction and internal fixation using microplates and screws. 3 patients needed autogenous calvarial bone graft. Plates and screws were removed in postoperative 3-6 months. All patients had successful union of fractured bones without no specific complications, and normal bony growths were noticed during the 7 years follow up. We conclude that surgeons should be careful in diagnosis and management for the pediatric facial fracture due to anatomical variations and differences in fracture aspects. First, it is mandatory for surgeous to get accurate diagnosis and identify children's fracture and displacement through routine CT check up along with physical examination. Second, it is important to perform the minimally invasive technique or conservative treatment for the children with mild displacement so that it reduces the incidence of growth retardation which may be caused by extensive operation. However, application of rigid fixation is necessary in case of extensive bony displacement or bony defects because of poor coorporation in postoperative care. Third, plates and screws which were used for the internal fixation should be removed at 3-6 months after the surgery. Fourth, if bone graft is needed, it is better to use autogenous graft than allogeneous graft. Fifth, care for dentition and follow up for growth are necessary for growing children.
Child ; Dentition ; Diagnosis ; Facial Bones* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mandible ; Nasal Bone ; Orbital Fractures ; Physical Examination ; Postoperative Care ; Tomography, X-Ray Computed ; Transplants ; Ultrasonography ; Zygoma

Augumentation rhinoplasty using autogenous cranial bone graft (outer table) can be used more successfully than other methods. In patients with congenital or posttraumatic severe saddle nose deformity and lateral deviation, cranial bone graft is an excellent method of augumentation. The advantages of cranial bone graft compared with traditional method of bone graft are summarized as follows; 1. Easy to reach donor site 2. Abundance of material 3. Little pain and functional disability 4. Shorter hospitalization period 5. Inconspicuous donor scar 6. No secondary deformity of donor site 7.Appropriate curvature can be obtained by proper selection of donor site. With the above advantages, we conclude that augumentation rhinoplasty using split cranial bone graft is a good method in correction of congenital or posttraumatic deformity of nose.
Cicatrix ; Congenital Abnormalities ; Hospitalization ; Humans ; Methods ; Nose ; Rhinoplasty* ; Tissue Donors ; Transplants*

As the use computed tomographic (CT) scanning spread, the diagnosis of blowout fractures of the medial orbital wall increased. Now, the diagnosis of blowout fracture in the medial wall are not uncommon. Conventionally, the surgery of blowout fractures in medial orbital wall was performed by the various approach with external incision. The conventional method had seveal possible disadvantages, including an external scar, incomplete reduction, increased mobidity rate and general anesthesia. Recently, endoscopic reconstruction of the medial orbital wall has provided good functional and cosmetic results. We performed endoscopic transnasal reduction surgery without external incision in 12 cases of medial blowout fracture under local anesthesia. The fractured bony fragments were removed after the intranasal ethmoidectomy and the entrapped medial rectus was released. And then a sheet of silicone late or uncinate process were placed on the fracture site. For the maintain of the position of fractured wall, Merocel packing or urinary ballon catheter were used in orbital fracture site for 1-3 weeks. There were no specific complications related to this procedure. Result of the surgery in all cases were satisfactory. In this article, we discussed the surgical procedure, the benifit of the transnasal endoscopic approach, the indications for surgery, and possible comlications.
Anesthesia, General ; Anesthesia, Local ; Catheters ; Cicatrix ; Diagnosis ; Orbit* ; Orbital Fractures ; Silicones

PURPOSE: Penile size has been a focus of interest in the life and the culture throughout human history. It has been a longstanding question whether there is any relation between penile size and the dimensions of body extremities. We measured the standard length of the penis and investigate whether any body extremity is a predictive index of penile size in Korea men. PATIENTS AND METHODS: A series of 655 males above 17 years of age were examined during a 4-month period. Stretched penile length, penile circumference, and length and characteristics of various body parts and features (1st finger, 2nd finger, 3rd finger, 1st toe, 2nd toe, 3rd toe, ear, mouth, nose, height, weight, and baldness) were investigated by one examiner. To see the relation among the penile length and circumference and various body dimensions, univariate and multivariate statistical methods such as correlation analysis and multiple linear regression were applied. RESULTS: The mean values standard deviations were 46.6 +/- 18.4 for age, 10.0 +/- 2.0 cm for the length of the penis, and 8.5 +/- 1.0 cm for the circumference of the penis. In a correlation coefficient analysis, the length of the penis was slightly correlated with penile circumference. Additionally, the circumference of the penis was slightly correlated with penile length, patient height, weight, and 3rd toe and 1st toe length, in decreasing order. In a multivariate analysis, the coefficients of determination from multiple linear regression were 13% and 15% for the length and the circumferences of the penis, respectively. CONCLUSIONS: Human body index including the size or characteristics of body extremities is not enough to predict the penile size.
Ear ; Extremities ; Fingers ; Human Body ; Humans ; Korea ; Linear Models ; Male ; Mouth ; Multivariate Analysis ; Nose ; Penis ; Toes

The purpose of this study was to evaluate the position of tongue and hyoid bone in relation to vertical facial patterns in the adult and child. Lateral cephalograms taken in adults(63 cases, 11.7 years in average age) and children(69 cases, 22.6 years in average age) were traced and measured about position and posture of tongue and hyoid bone using the horizontal and vertical reference lines. The angle of mandibular plane to SN plane was employed to classify the samples into groups of hypodivergent and hyperdivergent. The comparison of the tongue/hyoid bone measurements between hypodivergent group and hyperdivergent group in the adult and child were statistically executed with Student's t-test. The results were as follows; 1. The tongue height was lower in the hyperdivergent group than in hypodivergent group, and higher in children than in adults. 2. The vertical height of hyoid bone was higher in hypodivergent group than in hyperdivergent group and also higher in children than in adults. 3. The anteroposterior position was of no significant difference in relation to age or vertical facial pattern. 4. The inclination of hyoid bone in relation to cranial base was steeper in children than in adults.
Adult ; Child ; Humans ; Hyoid Bone* ; Malocclusion* ; Posture ; Skull Base ; Tongue*

BACKGROUND: There is a long-standing controversy whether melanocytes in vitiligo of more than 1 year duration are actually lost or still present. Resolving this matter is essential in understanding the underlying pathology and for the development of the treatment. On previous immunohistochemical and ultrastructural studies of vitiligo lesions, damage of melanocyte and keratinocyte in early lesions were reported and complete absence of melanocyte in long standing lesions were known. OBJECTIVE: This study aimed to determine the existence of the differences in pathologic changes in melanocytes according to the duration of the lesion. METHODS: We investigated the vitiliginous skin samples from 31 patients with early(less than 1 year duration) vitiligo and 30 patients with long standing(l to 5 years duration) vitiligo under the electron microscopy. RESULTS: Multiple degenerative changes in melanocytes were observed in the early and long standing lesions. In long standing lesions, degeneration of melanocytes including pyknotic, in-dented nuclei, vacuolated cytoplasms and blunted dendrites were more pronounced than early lesions. Even in long standing lesions, definite or presumptive melanocytes were observed in 16(53.3%) of 30 cases. CONCLUSION: Our results suggest that the melanocytes of vitiligo lesions were damaged and that the percentage of degenerative changes increase in accordance with the duration of the lesion. However, in long standing lesions as well as in early lesions, some residual melanocytes can be observed ultrastructurally.
Cytoplasm ; Dendrites ; Humans ; Keratinocytes ; Melanocytes ; Microscopy, Electron ; Pathology ; Skin ; Vitiligo*

BACKGROUND: We studied gender difference in prevalence, risk factors, medical management, workplace activities for the prevention of work-related musculoskeletal diseases (WMSDs), and the role of gender in analysis of the factors affecting the prevalence of WMSDs. METHODS: In 3, 339 workers at 29 workplace, questionaire survey was conducted. The questionaire was consisted of personal factors, perceived workload and ergonomic factors (modified KOSHA code H-30), perceived job stress (modified Karasek model). musculoskeletal symptoms, medical management, workplace activities for the prevention of WMSDs. RESULTS: Female workers' overall prevalence of WMSDs (37.4%) was higher than that of male workers (18.9%), and there are many differences in the prevalence by the involved site of the body. The rate of personal risk factors, perceived workload, ergonomic risk factors, and the perceived job stress were higher in female workers than those of male workers. In gender-sensitive multivariate analysis, female worker's prevalence of WMSDs was higher in regular workers (OR=2.08), manufacturing, professional, service workers (OR, 2.25, 3.89, 3.26, respectively)). It was also associated with higher perceived workload (OR, 1.48~1.74), higher ergonomic risk (OR, 1.86~3.65), high job demand (OR=1.62), and low social support by co-workers (OR=1.29). The prevalence of WMSDs of male workers was higher in people living with dependent (OR=1.39), manufacturing workers (OR=1.54), but lower in service workers (OR=0.54). It was also associated with high workload (OR=1.98), higher ergonomic risk (OR, 3.26~5.55), and lower job control (OR=1.39). CONCLUSION: These results showed that female workers' high prevalence of WMSDs is the reflection of 'gendered' workplace, i.e. all aspects of WMSDs have profound association with gender from risk factors to medical management. Therefore, gender-sensitive analysis can reveal more realistic factors affecting WMSDs, and provide more valuable implications in prevention of WMSDs.
Female ; Humans ; Male ; Multivariate Analysis ; Musculoskeletal Diseases* ; Prevalence ; Risk Factors

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients*

No abstract available.
Free Tissue Flaps*

OBJECTIVES: To investigate the symptom prevalence and the primary intervention of work-related musculoskeletal diseases(WMSDs) and their related factors among manufacturing workers. METHOD: A self-administered questionnaire survey was conducted on 2,457 workers, at 22 enterprises in Chungnam province, Korea, from September 1 to December 1, 2003. The contents of the questionnaire included general and work-related characteristics, musculoskeletal symptoms and workers' past one-year experience of primary interventions. RESULTS 1. The overall symptom prevalence of the musculoskeletal diseases was 23.9%. The WMSD symptom prevalences at the neck/shoulder, arm/elbow, hand/wrist and back/leg were 14.8%. 2.7%. 7.3% and 12.0%, respectively. 2. In multivariate analysis, all WMSD symptom prevalences were high in the high workload, high force & high repetitiveness, and 'high job strain' groups. The WMSD symptom prevalence at neck/shoulder was also high in females and the group experiencing low social support from the supervisor. 3. The rates of the primary interventions were as follows : 13.7% for health education, 5.8% for health counselling, 18.8% for preventive exercise, 24.7% for ergonomic intervention, and 9.8% for administrative intervention. 4. In multivariate analysis, the size of the enterprises and the type of occupational health management system(OHMS) were significantly associated with all primary interventions except health counselling(p<0.05). The other individual-level predictive factors were as follows. Those for the health education were male and union presence. Those for the health counselling were older age(> or =40 years), irregular employment, and the active group of Karasek's job strain model. Those for the preventive exercise were male, older age, longer tenure and regular employment. Those for the ergonomic intervention were longer tenure, job of physical force and/or repetitiveness, high job stain and the group experiencing high social support from the supervisor. The predictive factor for the administrative intervention was male (p<0.05). CONCLUSIONS: To establish an effective strategy for the primary prevention of WMSDs, approaches are needed which consider the individual nature of small and medium sized enterprises. IAlso necessary is to promote the participation of labor and management because the activation of the primary intervention was associated with the type of OHMS and union presence. Moreover the reduction of workload and increased intervention into the high risk group could be effective in the prevention of WMSDs.
Chungcheongnam-do ; Employment ; Female ; Health Education ; Humans ; Korea ; Male ; Multivariate Analysis ; Musculoskeletal Diseases ; Occupational Health ; Prevalence* ; Primary Prevention ; Questionnaires