Treatment of zygoma fracture with displacement at the multiple ariticulations frequently results in incomplete fracture reduction because of difficulties involved in the application of vector force during the reduction procedure. The vector force in opposite to the vector force of injury may not exert adequately through the skin incisions of open reduction. We treated 46 patients of isolated zygoma fracture with transcutaneous screw pin reduction and external fixation. After insertion of a transcutaneous screw pin through the fractured zygoma segment, the vector force of reduction could be applied easily by tracting screw pin along with the opposite force to the injury vector. The external fixation could easily immobilize the fracture segment for a period from 9 to I4 days. In all patients accept one, we could perform fracture reduction accurately without malunion or any other complication. Aside from the direct application of vector froce in the desired direction, advantages of this method are shorter operation time, no incision scar, and no implantation of internal fixation.
Cicatrix ; Humans ; Skin ; Zygoma*

Zygomatic arch is a prominent structure among facial bone and this is the major cause of vulnerability from the facial trauma. The fracture of zygomatic arch has been treated by ancillary methods of closed reduction approaching through temporal incision or intraoral incision. But, these methods gas a limitation of reduction force vector and it has a difficulty in maintaining the secure fixation of the reduced unstable fractured bones. All 22 cases of zygomatic fracture were reduced by transcutaneous screw and fixed with external fixation device successfully. There was no post-operative complication, such as non union, malunion, and visible scar. This method also has advantages of less post-operative edema and pain.
Cicatrix ; Edema ; External Fixators ; Facial Bones ; Zygoma* ; Zygomatic Fractures

Craniosysostosis is a congenital anomaly which should be corrected at an early age. The correction should be both for shape as well as to assure normal growth of the brain. In the past, many patients of craniosysostosis underwent corrective suturectomy only for the purpose of removing constructive forces on the brain. However, recurrence is frequent and further deformity in the shape of the skull and face often develop. The particular patient in this article had undergone a simple suturectomy in the neurosurgery department. For 12 years, he had suffered from not only the deformed shape of the skull but also from medical refractory epileptic convulsions. Therefore, the patient underwent total cranial remodeling for correction of a deformed forehead and skull following correction of the bone contour. Unexpectedly, the epileptic convulsions of the patient markedly improved with the new shape. Based upon these results, the authors suggest that secondary total cranial remodeling can improve the convulsions by affecting the epileptic focus which may have been caused by previous operational scars on the dura.
Brain ; Cicatrix ; Congenital Abnormalities ; Craniosynostoses* ; Forehead ; Humans ; Neurosurgery ; Recurrence ; Seizures* ; Skull

Recently, virtual reality (VR) and augmented reality (AR) have received increasing attention, with the development of VR/AR devices such as head-mounted displays, haptic devices, and AR glasses. Medicine is considered to be one of the most effective applications of VR/AR. In this article, we describe a systematic literature review conducted to investigate the state-of-the-art VR/AR technology relevant to plastic surgery. The 35 studies that were ultimately selected were categorized into 3 representative topics: VR/AR-based preoperative planning, navigation, and training. In addition, future trends of VR/AR technology associated with plastic surgery and related fields are discussed.
Eyeglasses ; Glass ; Plastics* ; Surgery, Plastic*

The aim of this study was to investigate the effect of hypoxia-reoxygenation on the proliferation of fibroblast, and to elucidate the role of oxygen free radicals in this process. Malme-3 fibroblast, derived from human skin fibroblast, was used for this study. The hypoxia or reoxygenation condition was made by exposing cultured cells to the environment of 95% N2, 5% CO2 or 95% room air, 5% CO2, respectively. Cell proliferation was estimated by the cell numbed, and DNA synthesis was measured by the [3H]-thymidine uptake. Release of oxygen free radicals was measured by the means of Ohkawa's method of lipid peroxidation. The effect of oxygen free radicals was confirmed by using dimethylthiourea(DMTU) and alpha-tocopherol, two known oxygen free radical scavengers. The results are as follows: 1. The dissolved oxygen of the culture medium was 8.97+/-1.23 ppm in the normal condition. When the culture dish was exposed to the hypoxic condition for 3 or 6 hours, the dissolved oxygen of the culture medium decreased markedly to the level of 3.10+/-0.46 ppm or 2.37+/-0.47 ppm, respectively 2. The number of cultured cells increased in a hypoxia duration-dependent manner up to 6 hours when the cells were cultured for 24 hours after hypoxia. The same pattern was observed in the cells cultured for 48 hours after hypoxia. Lipid peroxidation in the culture increased after the exposure to hypoxia-reoxygenation. DMTU or alpha-tocopherol blocked the increase in lipid peroxidation induced by the exposure to hypoxia-reoxygenation. 3. [3H]-thymidine uptake of the cultured cells increased after the exposure to hypoxia-reoxygenation. 4. DMTU or alpha-tocopherol blocked the proliferation of fibroblasts induced by the exposure to hypoxia-reoxygenation. The increase in lactate dehydrogenase (LDH) activity was also noted after the exposure to hypoxia-reoxygenation, and this increase was blocked by DMTU or alpha-tocopherol. These results indicate that the hypoxia-reoxygenation induces the proliferation of fibroblasts, and that oxygen free radicals play an important role in this process. Moreover, oxygen free radical scavengers may be of potential therapeutic value in preventing fibrosis.
alpha-Tocopherol ; Anoxia ; Cell Line* ; Cell Proliferation ; Cells, Cultured ; DNA ; Fibroblasts* ; Fibrosis ; Free Radical Scavengers* ; Free Radicals ; Humans* ; L-Lactate Dehydrogenase ; Lipid Peroxidation ; Oxygen* ; Skin

Current diagnosis and surgical correction of craniofacial surgery would benefit from accurate and standardized data of computed tomography (CT). The ability of CT to identify bony and soft tissue features makes it particulrary useful for the management of craniofacial skeletal anomalies. Development of computer technology make it easy to store the large volume data of medical digital data and to manipulate the data at the office of surgeon. Digital data produced by modern modalities has its own advantages compare with conventional film datas; Accuracy, permanent storage, reproducibility. and etc. So the storage and archiving of the digital data of craniofacial field would have the utmost significance for the futher development of the craniofacial surgery. The raw data of thirty craniofacial CT data were transferred from a CT system to a personal computer via Ethernet TCP/IP connection. The transmission of DICOM data to the personal computer was successful and the transmitted images and their header information were displayed by DICOM viewing programs. This method of transfer and storage of digital data was useful for managing digital images and convenient for physicians in the hospital without PACS.
Diagnosis ; Humans ; Microcomputers*

OBJECTIVES: Clinical documents (CDs) have evolved from traditional paper documents containing narrative text information into the electronic record sheets composed of itemized records, where each record is expressed as an item with a specific value. We defined medical record (MR) items to be information entities with a specific value. These entities were then used to compile form-based clinical documents as part of an electronic health record system (EHR-s). METHODS: We took a reusable bottom-up developmental approach for the MR items, which provided three things: efficient incorporation of the local needs and requirements of the medical professionals from various departments in the hospital, comprehensive inclusion of the essential concepts of the basic elements required in clinical documents, and the provision of a structured means for meaningful data entry and retrieval. This paper delineates our experiences in developing and managing medical records at a large tertiary university hospital in Korea. RESULTS: We collected 63,232 MR items from paper records scanned into 962 CDs. The MR item database was constructed using 13,287 MR items after removing redundant items. During the first year of service users requested changes to be made to 235 (1.8%) attributes of the MR items and also requested the additional 9,572 new MR items. In the second year, the attributes of 70 (0.5%) of the existing MR items were changed and 3,704 new items were added. The number of registered MR items increased by 72.0% in the first year and 27.9% in the second year. CONCLUSIONS: The MR item concept provides an easier and more structured means of data entry within an EHR-s. By using these MR items, various kinds of clinical documents can be easily constructed and allows for medical information to be reused and retrieved as data. The success of the use of MR items in a large tertiary university hospital system provides evidence that verifies our approach as being an efficient means of user-oriented and structured data entry, enabling the easy reuse of medical records.
Electronic Health Records ; Electronics ; Electrons ; Medical Records

The tie-over dressing is a time consuming work because the long silk sutures get tangled and one must spend time on securing the ends. However it is a necessary procedure for a better take of the skin graft. The skin graft was prepared as a split-thickness graft with or without meshing. After hemostasis of the recipient defect, the prepared skin was placed and tailored for the defect. The skin stapler hold the skin margin, split-thickness graft and a round rubber band in one stitch. And the mesh gauze with ointment was applied over the grafted skin and the bulky moist dressing was applied with fluffy gauze and cotton. Over the bulky dressing the rubber bands crossed over and fixed on the other side of the surrounding edge on the normal skin area by the skin stapler. In case of need, splint and compressive dressing with elastic bandage was applied. From January, 2002 to September, 2002, in 15 patients, this method has been used and proven satisfactory. Skin graft was well taken and the time for tie-over dressing can be reduced markedly. We can ensure the adherence of a skin graft to the bed of the wound by continuous pressure dressing. This technique is simple, fast, and no needs of any special device or dressing materials.
Bandages* ; Compression Bandages ; Hemostasis ; Humans ; Rubber* ; Silk ; Skin* ; Splints ; Sutures ; Transplants ; Wounds and Injuries

The pathogenesis of craniosynostosis is the early bone fusion of the sutures. Conventional treatment focused on creating a bony gap in which distraction osteogenesis could be a contradictive procedure. There are few reports on the long-term follow-up of distraction in craniosynostosis and into the continuity of bone tissue. This study was performed to investigate if this continuity of the regenerated bone tissue, which can possibly have inhibitory potentials for bone growth, affects growth after distraction osteogenesis with long- term follow-up results. For the study, the authors realigned all CT scans into a same position using a software program using landmarks from the image for comparison in terms of growth ratio for patients with craniosynostosis. From January 2000 to October 2002, the authors performed distraction osteogenesis on 5 patients with craniosynostosis. Three patients had unilateral coronal craniosynostotis and 2 with unilambdoidal craniosynostosis. The follow-up period was from 13 months to 33 months after full distraction. 3D CT images were obtained preoperatively, after full distraction and at the last follow-up. The result was that the regenerated calvarial bone seems to grow in the same growth ratio as the normal side up to 2 years on follow-up in the patient with unilateral craniosynostosis. According to these results, we conclude that the regenerated bone grows as normal bone even after distraction osteogenesis.
Bone and Bones ; Bone Development* ; Craniosynostoses* ; Follow-Up Studies ; Humans ; Methods ; Osteogenesis, Distraction* ; Sutures ; Tomography, X-Ray Computed

PURPOSE: Malignant fibrous histiocytoma (MFH) is mainly a soft tissue sarcoma containing fibroblast-like cells and histiocytic cells. MFH in bone accounts for 5% of all malignant bone tumors. MFH of the maxilla is extremely rare and difficult to diagnose due to its scarcity. Treatment mainstay is a complete surgical excision. Radiation therapy is also available when surgery alone is incomplete. Prognosis is not clear but can be devastating. Authors report one case of MFH developed in the maxilla. METHODS: A 24-year-old man firstly diagnosed as fibrous dysplasia based on CT findings. Considering facial contour, partial excision was done. But pathology report confirmed malignant fibrous histiocytoma and secondary wide excision was done including zygoma and grossly all affected area. After surgery, radiation therapy was continued. RESULTS: There are no evidence of tumor recurrence after clinical and radiological treatment. CONCLUSION: MFH of maxilla is very rare and this can leads to misdiagnosis in many clinicians. Surgeon should differentiate this disease from fibrous dysplasia and pathology and MRI are accurate methods for diagnosis of MFH.
Diagnosis ; Diagnostic Errors ; Facial Bones ; Histiocytoma, Malignant Fibrous* ; Humans ; Magnetic Resonance Imaging ; Maxilla* ; Pathology ; Prognosis ; Recurrence ; Sarcoma ; Young Adult ; Zygoma