In case of severe blepharoptosis, frontalis muscle suspension with fascia or frontalis transfer has been popular for decades, but these static procedures have some disadvantages such as lagophthalmos, lid lag and remnant ptosis. Twenty-six patients with severe blepharoptosis who underwent frontalis suspension, frontalis transfer, or levator resection at Yonsei University Severance Hospital from 1980 to 1988 were studied. The follow-up period of patients ranged from 10 to 18 years with a mean of 12 years. Surveys and clinical results were obtained, In our review of postoperative complications, lagophthalmos persisted in sleep and even in forced eye closure in most patients 2 to 6 months after operation. But no recurrence was noted. In conclusion, undercorrection of ptosis is more desirable than overcorrection. As well levator resection can be considered in selected cases to prevent complications.
Blepharoptosis* ; Fascia ; Follow-Up Studies* ; Humans ; Postoperative Complications ; Recurrence

BACKGROUND: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis. METHODS: The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value. RESULTS: The mean age and ages at menopause were 59.1(+/-6.2) and 50.7 (+/-2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis. CONCLUSION: The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.
Bone Diseases, Metabolic* ; Diagnosis ; Female ; Femur Neck ; Humans ; Korea ; Mass Screening* ; Menopause ; Osteoporosis* ; Prevalence ; ROC Curve ; Sensitivity and Specificity ; Spine

OBJECTIVE: This study is proposed to examine the relationship between bone loss after hormone replacement therapy for one year and initial bone markers. METHODS: One hundred postmenopausal women were studied for one year. At first visit, measurements were made of bone mineral density(BMD) at the lumbar spine and femoral neck, and of serum osteocalcin and urine deoxypyridinoline. After hormone replacement therapy was done for one year, BMD was rechecked. RESULTS: Serum osteocalcin was correlated with the rate of bone change(r=0.150, 0.262) and urine deoxypyridinoline was weakly correlated(r=-0.003, 0.038). The changes of femoral BMD in women with higher concentration of osteocalcin and deoxypyridinoline were significant different from those in women with normal concentration. At the lumbar spine, no significant differences were showed. In women with higher concentration of osteocalcin, the incidence of subjects with increased spine BMD was increased up to around 71.1%, which showed not significant increase compared with normal concentration of osteocalcin. And the incidence of increased spine BMD in women with higher concentration of osteocalcin was marked increased compared with the incidence of normal concentration. The level of the osteocalcin with increased spine BMD was 11.5+/-6.6 ng/ml, and the level with decreased spine BMD was 9.2+/-4.7 ng/ml, respectively. And the level of the deoxypyridinoline was 7.2+/-4.2 pmol/ mol cr in women with increased spine BMD and 7.2+/-2.7 pmol/ mol cr in women with decreased spine BMD, which was not statistically different. The concentration of deoxypyridinoline with increased and decreased in BMD in spine and femur was not statistically different. but the concentration of osteocalcin was 12.2 +/-5.5 ng/ml in significantly increased in BMD and 8.5 +/-4.5ng/ml in significantly decreased in BMD, which was showed significant different. CONCLUSION: Present study indicates that the serum osteocalcin more reflcets bone turnover changes at the menopause than deoxypyridinoline, however, the clinical utility of measurements of osteocalcin only to response to therapy is uncertain.
Bone Density* ; Female ; Femur ; Femur Neck ; Hormone Replacement Therapy* ; Humans ; Incidence ; Menopause ; Osteocalcin ; Spine

Surgical excision of the subcutaneous tissues, with or without skin excision in the axillary hair-bearing area, has been the treatment of choice for Treating axillary a osmidrosis for the several decades. However, long periods of postoperative immobilization of a shoulder joint, partial necrosis of skin flaps or hematoma and the possibility of unsightly scars are frequent complications. For the purpose of reducing these complications, we performed ultrasonic aspiration of subcutaneous fat of the axilla, including the apocrine gland, using ultrasonic liposuction technique under confirmation of endoscopy via one small skin incision. From November 1997 to December 1998, a total of 134 patients (93 women and 41 men) received surgery for bilateral axillary osmidrosis on an outpatient basis. Sixty patients were evaluated more than 6 months after surgery. Among these patients, 6patients complained of a persistent foul odor(10%). Five patients received secondary ultrasonic aspiration for persistent foul odor and were then cured. We concluded that our method has several advantages such as 1) preservation of skin flap vascularity for the prevention of flap necrosis and axillary hair, 2) minimal scarring and bleeding, 3) shorter operation time and postoperative immobilization of the shoulder joint, 4) increased patient comfort, and 5) a safer operative method for recurred cases as a secondary method.
Apocrine Glands ; Axilla ; Cicatrix ; Endoscopy ; Female ; Hair ; Hematoma ; Hemorrhage ; Humans ; Immobilization ; Lipectomy ; Necrosis ; Odors ; Outpatients ; Shoulder Joint ; Skin ; Subcutaneous Fat ; Subcutaneous Tissue ; Ultrasonics*

BACKGROUND: To describe the fast experience of case-leased advanced cardiac life support(ACLC) course in Korea. METHODS: We have given case-based ACLC course to 13 nurses(6 emergency nurses, 4 coronary care unit muses, 3 professors) and 17 physicians(4 emergency physicians, 12 emergency residents, 1 intem). We performed the case-based ACLS course according to 1992 American Heart Association guidelines and recommendations for advanced cardiac life support by american ACLS instructors(1 pulmonologist, 4 critical care nurses). We performed final theoretical written test and 2 times written survey (immediate and 100th day after the course) about the course. RESULTS: On final written test, all practitioners answered at leasts 70% of the questions correctly. There was no significant difference between nurses and physicians(86.2+/-3.6 of physicians and 82.5+/-6.8 of nurses, p=0.06). 90%of participants considered that case-based advanced cardiac life support was acceptable. 100th day after the course, 93%of participants answered that ACLS course have been helpful on his/her job and also want retraining of ACLS course. 70%of participants considered that ideal ACLS training committee in Korea is the Korean Society of Emergency Medicine. CONCLUSION: Case-based ACLS course is a useful educational method far physicians and nurses in Korea. In the future, we should organize Korean resuscitation committee and then make guidelines for ACLS, and then continuously educate physicians and nurses.
Adult* ; Advanced Cardiac Life Support ; Alprostadil ; American Heart Association ; Coronary Care Units ; Critical Care ; Emergencies ; Emergency Medicine ; Humans ; Korea* ; Resuscitation

No abstract available.
Carotid Artery, Common* ; Rupture*

BACKGROUND: To provide some fundamental physiological basis for the physical training of pilots to improve orthostatic intolerance, cardiorespiratory responses to the symptom-limited maximal exercise loading were studied in pilots and non-pilots, and the results were compared. METHOD: Cardiorespiratory reponses to the symptom-limited maximal exercise loading by Bruce protocol was studied in 11 pilots and 11 matched controls (non-pilots). RESULTS: Comparisons of various data at maximal exercise in the pilots with those in the controls revealed that RR, VE/M2, VE/VO2, VE/VCO2, VT/VC and VE/MVV as well as HR, VO2, O2 pulse and AT showed no significant difference. CONCLUSION: The fact that the aerobic power in the pilots is not superior to that in the controls seems to emphasisze the necessity of aerobic endurance training along with muscular strength training to improve orthostatic tolerance of pilots flying modern high-performance aircrafts.
Aircraft ; Diptera ; Orthostatic Intolerance ; Resistance Training

There are several characteristics of the nasal tip of Orientals. The skin is thick with severe tension and a bulbous nasal tip, the nostrils are wide, and the projection of the nose is limited due to a poorly developed alar cartilage with a short columella. Until now, in order to well outline the nasal tip and project the nose, the alar cartilage was realigned, the domes of the cartilage sutured together, silicone or cartilage was used to improve the appearance of the tip. However, it was difficult to achieve satisfactory results in Orientals due to a short columella and a acute nasolabial angle. From May 1998 to March 2000, the authors attempted to realign the alar cartilage with an open rhinoplasty approach and used the septal cartilage to project the nasal tip and lengthen the columella by designing the increased nasolabial angle in 20 cases. The cartilage was then inserted in the alar cartilage and fixed on the anterior nasal spine. The results, considered satisfactory in all patients without any complications, are as follows: 1. The changes of nasolabial angles were from 88.7 degrees to 95.3 degrees, 2. The average increase in columellar height was 3.5 mm, 3. The average decrease of the alar width was 3.0 mm, 4. The changes of the angle between the long axis of the external naris was from 92.2 degrees to 71.5 degrees. This procedure is an effective method in improving nasolabial angle and columella length.
Axis, Cervical Vertebra ; Cartilage* ; Humans ; Nose ; Rhinoplasty ; Silicones ; Skin ; Spine ; Transplants*

Although many methods have been developed to correct the aging process of the head and neck, the correction of nasolabial folds still remains a difficult area. The difficulty of correcting nasolabial fold is due to the anatomical location and the difference of aging process. From March 2000 to February 2001, the authors operated on 10 aging face patients using face lift with SMAS and FAME(Finger-assisted malar fat pad elevation) technique. The authors repositioned the SMAS-platysma flap posterosuperiorly and used finger dissection of the malar fat pad enabling a 3-dimensional correction and repositioning of the fat pad without detachment of the zygomatic ligament. The finger dissection of the malar fat pad attached to the skin enables a more anatomical correction of the malar fat pad with a more natural looking layer and longer lasting results in addition to decreased hematoma, edema and postoperative pain compared to previous methods.
Adipose Tissue ; Aging ; Edema ; Fingers ; Head ; Hematoma ; Humans ; Ligaments ; Nasolabial Fold ; Neck ; Pain, Postoperative ; Rhytidoplasty* ; Skin

No abstract available.