There are many women who want larger and brighter eyes that will give a favorable impression. Surgical methods that make the eye larger and brighter include double eyelidplasty, epicanthoplasty, as well as lateral canthoplasty. Double eyelidplasty produces changes in the vertical dimension of the eyes, whereas epicanthoplasty and lateral canthoplasty create changes in the horizontal dimension of the eyes. Epicanthoplasty, a surgical procedure which enlarges the eye horizontally, is performed at the inner corner of the eye, whereas lateral canthoplasty enlarges the outer edge of the eye. In particular, if the slant of the palpebral fissure is raised and the horizontal dimension of the palpebral fissure is short, adjusting the slant of the palpebral fissure through lateral canthoplasty can achieve an enlargement of eye width and smoother features. Depending on the patient's condition, even better results can be achieved if this procedure is performed in conjunction with other procedures, such as double eyelidplasty, epicanthoplasty, eye roll formation surgery, fat graft, and facial bone contouring surgery. In this paper, the authors will introduce in detail their surgical method for a cosmetic lateral canthoplasty that lengthens the lateral canthal angle and corrects the outer tail of the eyes, in order to ease the unfavorable impression.
Facial Bones ; Female ; Humans ; Methods ; Tail* ; Transplants ; Vertical Dimension

From 1989 to 1996, push back palatoplasty, 2-flap palatoplasty and Furlow's palatoplasty were the main procedures of cleft palate repair in our institute. To compare the maxillary growth state of patients in each palatoplasty group, evaluation of dental occlusion and cephalometric analysis were performed in total 50 patients. The results were as follows: 1. Normal control group was composed of 17 children who didn't have cleft lip or cleft palate. Mean values of cephalometric data in the normal control group were 6.19 cm in SN length, 1.17cm in ONA length, 7.29cm in effective maxillary length 53.88degree in SNO angle, and 82.41 degree in SNA angle. 2. Fourteen patients who underwent push-back palatoplasty showed anterior crossbite in all cases. SNO angle and SNA angle were significantly decreased compared to the normal control group, which indicated significant impairment of maxillary growth. 3. In seventeen patients who underwent 2-flap palatoplasty, 7 patients showed anterior crossbite. Cephalometric parameters showed no significant difference compared to the normal control group. 4. Nineteen patients underwent Furlow's palatoplasty. In this group, 3 patients had anterior crossbite. Cephalometric parameters showed no significant difference compared to the normal control group. Although this report was based on data acquired from patients before the age of complete maxillary growth, our results suggested that each palatoplasty would have a different influence on maxillary growth.
Child ; Cleft Lip ; Cleft Palate ; Dental Occlusion ; Facial Bones* ; Humans ; Malocclusion

Multiple biliary papillomatosis involves an epithelial field change of the intrahepatic and extrahepatic portions of the biliary tree. Pathologically it is benign, occasionally with dysplasia, but the clinical behavior is regarded as having a low-grade malignant potential. Such malignancy is rare but the prognosis is poor if it is impossible to remove the tumor completely. Here, we report one case of multiple biliary papillomatosis in the biliary tree.
Biliary Tract ; Papilloma* ; Prognosis

The synchondrosis between the sixth and seventh costal cartilage is usually used for the base frame in autogenous ear reconstruction. If the synchondrosis is loose, a variety of modifications can be devised. This report introduces new methods for these problems. In cases of incomplete synchondrosis, only the surface of the base block margin was smoothly tapered without carving for the removal of the conchal deepening. The secure fixation of the two segments (helix and antihelix) to the base block using fine wire sutures gave stability to the unstable basal frame. After confirming that all the segments were assembled in one stable piece, the remaining conchal deepening of the basal framework was removed, and the outer lower portion of the basal cartilage was trimmed along its whole length. A total of 10 consecutive patients with microtia, ranging from 8 to 13 years old, were treated from 2008 to 2009. The follow-up period was 6 months to 2 years. Despite incomplete synchondrosis, the stable frameworks were constructed using the authors' method and aesthetically acceptable results were achieved. The proposed method can provide an easy way to make a stable cartilage framework regardless of the variable conditions of synchondrosis.
Cartilage ; Congenital Abnormalities ; Ear ; Ear Cartilage ; Follow-Up Studies ; Humans ; Sutures

The purpose of this study was to investigate the anatomic and functional changes of submucous cleft palate operated with Furlow palatoplasty. A total of 36 patients with submucous cleft palate underwent Furlow palatoplasty from 1993 to 1998. The mean follow-up period was 5 years 3 months. Midfacial growth was measured using lateral cephalograms in 18 patients, whose age was older than 8 years of age. Speech analyses were performed in 25 patients by the same speech pathologist for the degrees of nasality and articulation. The parameters obtained in the lateral cephalogram were compared with a healthy population in Korea. ANS-PNS was in 61.1% within the clinical normal range for the age group. SNA and SNB were in 55.6% within the normal range. ANB was in 72.2% and Ba-PNS was 50.0% within the range. The postoperative nasality scores of open vowels and round vowels were 24.2% and 25.2%, respectively, which were lower than preoperative scores. The mean articulation accuracy value was 92.9% which was higher than preoperative value. Our results suggest that Furlow palatoplasty is a useful procedure as the initial treatment of the submucous cleft palate and has the advantages in both aspects of speech results and facial growth.
Cleft Palate* ; Follow-Up Studies ; Humans ; Korea ; Reference Values

It is often possible to diagnose a pheochromocytoma only when a disastrous cardiac complication like a hypertensive crisis, episodes of unexpected left ventricular failure, myocarditis, arrhythmias, myocardial infarction and sudden death appears secondarily. We revealed that a patient who had been treated with a reversible left ventricular systolic dysfunction with cardiogenic indeed had a pheochromocytoma. Upon initial admission, a 35 years old man had upper respiratory tract infection and abdominal discomfort. Blood pressure was 140/90 mmHg and EKG showed transiently paroxysmal supraventricular tachycardia. Eight hours after admission, he appeared to be in cardiogenic shock. Echocardiography showed extensive global hypokinesia with severe left ventricular systolic dysfunction. Following conservative management he progressively recovered normal cardiac function although we did not discern the etiology of the left ventricular systolic dysfunction. He was readmitted six months later due to episodic headache and high blood pressure. Fortunately, due to the history of reversible left ventricular systolic dysfunction with cardiogenic shock, we were able to quickly assess him as having a pheochromocytoma. The laboratory data and radiological findings were compatible with this tumor, which was subsequently successfully removed through surgery. We suggest that the diagnosis of pheochromocytoma should be considered in young patients presenting with acute heart failure of non-specific origin.
Adult ; Arrhythmias, Cardiac ; Blood Pressure ; Death, Sudden ; Diagnosis ; Echocardiography ; Electrocardiography ; Headache ; Heart Failure ; Humans ; Hypertension ; Hypokinesia ; Myocardial Infarction ; Myocarditis ; Pheochromocytoma* ; Respiratory Tract Infections ; Shock ; Shock, Cardiogenic* ; Tachycardia, Supraventricular

BACKGROUND: Atherosclerosis is the most important disease that may cause ischemic syndrome in many organs including heart. It is supposed that apoptosis of vascular smooth muscle cells(VSMCs) is closely related to the progression and rupture of atheromatous plaque. Recent studies have documented evidence for elevated level of nitric oxide(NO) within advanced human atheroma and evidence of regression of atheroma by NO. So this study is designed to evaluate whether exogenous NO from NO donors can induce apoptosis of cultured rat VSMCs and which proapoptotic gene(s) is involved in this type of apoptosis. METHODS: Rat VSMCs were cultured and used for experiment at passage 5 through 7. For NO donor, sodium nitroprusside (SNP) and S-nitroso-N-acetylpenicillamine(SNAP) of 0.5, 1, 2, 4mM were exposed to subconfluent VSMCs. The cells were harvested at 6, 12, 24, 48, 72hours after exposure of NO donors. Apoptosis was to be identified by 4, 6-diamidino-2-phenylindole dihydrochloride(DAPI) staining of nuclei and in-situ nick end labeling(TUNEL). The amount of fragmented DNA was analyzed semiquantitatively by diphenylamine(DPA) assay. Immunocytochemical(ICC) staining and western bolt analyses were designed to detect apoptosisrelated gene products, such as Bax-a, Fas and Bcl-2. RESULTS: 1) Decreased mitotic activity was shown after 12 hours exposure of exogenous NO donors, and condensation and margination of chromatin was identified agter 24 hours exposure, by DAPI staining. 2) Percent DNA fragmentation assessed by DPA method was 0,2,9,48,45% at 0,6,12,24,48 hours after exposure of 2mM of NO donors respectively. 3) The expression of Bax-a and Bcl-2 proteins was demonstrated in apoptotic cells by ICC staining. 4) The expression of Bax-a protein in cells under 24 hours exposure of NO donors was elevated by more than 18% of control level on densitometric analysis of western blot. The level of Bcl-2 was suppressed by 26% of control. So, Bax-a/Bcl-2 ratio in cells under exposure of NO donors was elevated to 2.0 from 1.2 of control level. CONCLUSIONS: Exogenous NO from NO donors can induce apoptosis of cultured rat VSMCs, and it is considered that bax-a and bcl-2 genes are involved in this type of apoptosis.
Animals ; Apoptosis* ; Atherosclerosis ; Blotting, Western ; Chromatin ; DNA ; DNA Fragmentation ; Genes, bcl-2 ; Heart ; Humans ; Muscle, Smooth, Vascular* ; Nitric Oxide ; Nitroprusside ; Plaque, Atherosclerotic ; Rats* ; Rupture ; Tissue Donors

Temporomandibular joint(TMJ) and dental occlusion are important in functional aspect as well as in cosmetic aspect for craniofacial surgery such as orthognathic and traumatic surgery. During these operations, appropriate maxillomandibular fixation(MMF) is especially necessary to conserve or reconstruct, dynamic TMJ and functional occlusion. Arch bar is one of the most popular method to gain proper MMF. Seventeen patients including 5 patients with mandibular fracture, 12 patients with orthognathic surgery(6 patients had relatively normal occlusion, however 6 patients had facial anomalies such as hemifacial microsomia with irregular occlusal plane.) were joined in this study. Arch bar was contoured on the dental cast, which was prepared for model surgery, prior to apply it on the facial anomaly patient. On using pre-contoured arch bar, patients felt better during the procedure and surgeons saved time. Moreover, well-contoured arch bar promises precise transmission of force on the bone, which implies surgeons do not need to worry about the occlusion while fixing bony structures. Authors suggest how to apply arch bar to satisfy basic theories about dental row and occlusion based on the experience. In addition, it is proposed to contour arch bar on the dental impression prior to apply it on the patient who has irregular and complex occlusal plane.
Cosmetics ; Dental Occlusion ; Facial Asymmetry ; Humans ; Jaw Fixation Techniques ; Mandibular Fractures ; Surgery, Oral ; Temporomandibular Joint

BACKGROUND: In Korea, a screening panel of cells from abroad without Di(a) positive cells has been commonly used when a patient has an unexpected antibody screening test. It has been reported that Di(a) occurs with a frequency of 6.14 to 14.5% among Koreans. However, the current popular antibody screening panels contain no Di(a) positive cells. In this study, we evaluate the clinical usefulness of the Di(a) Cell Panel (Diagnostic Grifols, Barcelona, Spain) for Koreans. METHODS: A total of 3,372 pretransfusion samples were employed for unexpected antibody screening testing using panels of cells by the DG Gel microtube column agglutination system, including additional Di(a) cells (Diagnostic Grifols, Barcelona, Spain). The positive cases in this system were confirmed again with DiaMed Di(a) antigen positive panel cells (DiaMed Ag, Cresssier, Morat, Switzerland) and this was followed by sequence- based Diego genotyping. RESULTS: The positive detection rate of an unexpected antibody screening test using SeraScan Diana I and II was 1.07% (36/3372), and seven samples were reactive (1+~2+) with the SeraScan Di(a) panel cells (0.21%). However, among the 5 available genotyped samples, two cases were typed as Di(a-b+). CONCLUSION: Even though there is discrepancy between the genotype and the two antibody screening kits, the addition of Di(a) positive cells as unexpected antibody screening panel cells is recommended.
Agglutination ; Genotype ; Humans ; Korea ; Mass Screening

BACKGROUND: Ischemic preconditioning(IP) is known to be effective in the protection of myocardial necrosis, arrhythmia, and the restoration of the myocardial function in the ischemia-reperfusion state of the heart. However the exact mechanism is not clearly understood. The purpose of this study was to elucidate the trigger mechanism of IP on the restoration of the myocardial function after ischemia-reperfusion. MATERIAL AND METHOD: By connecting a Langendorff perfusion apparatus with an isolated heart of a rat, the normal temperature of the heart was maintained. The experiment was conducted in seven groups, which were divided according to the preconditioning stimuli and blockage methods: Group I(n=10) was a group without IP, Group II(n=10) a group of three-minute IP, Group III(n=10) a group of PEIP, Group IV(n=10) a group of clonidine IP, Group V(n=10) a group of IP after reserpine, Group VI(n=10) a group of PE & prazosin IP, and Group VII(n=10) a group of clonidine & yohimbine IP. Hemodynamic parameters of DP, LVEDP, +/-dP/dT and the changes of perfusion in the coronary artery were evaluated. RESULT: Developed pressure and +dP/dT changed per unit time. After 20 minutes of reperfusion, those of Group II and III were 63.1+/-3.7%, 64.8+/-4.6% and 64.5+/-4.6%, 63.8+/-4.4%, which improved more significantly than those of Group I(P<0.05). However, there were no significant differences between the Groups V and VI, and Group I. CONCLUSION: The Brief ischemic preconditioning and pharmacological preconditioning using alpha-receptor sympathomimetics have protecting effects on the restoration of myocardial function after reperfusion. And the protecting effect of preconditioning seems to be related to sympathetic neurotransmitters and to the selective action of the alpha1-adrenergic receptor.
Animals ; Arrhythmias, Cardiac ; Clonidine ; Coronary Vessels ; Heart ; Hemodynamics ; Ischemic Preconditioning ; Ischemic Preconditioning, Myocardial* ; Necrosis ; Neurotransmitter Agents ; Perfusion ; Prazosin ; Rats* ; Reperfusion ; Reserpine ; Sympathomimetics ; Yohimbine