The upper lip is a functionally and aesthetically important area of the face. Therefore, reconstruction of an upper lip defect needs sufficient consideration to ensure functional and aesthetic recovery. Several methods, such as wedge resection, rotation flaps, advancement flaps, and myomucosal advancement flaps, have been used to reconstruct vermilion defects. However, it is challenging to reconstruct a vermilion defect because of the possibility of residual asymmetry or scars and restrictions to normal lip movement after the reconstruction. We present the case of a 51-year-old female that had an upper lip vermilion defect caused by a dog bite. The lip defect was reconstructed using a mucosal V-Y advancement flap. This mucosal flap was based on the orbicularis oris muscle with a branch of the superior labial artery to ensure sufficient blood supply. Therefore, flap survival was excellent, and there was no constriction of the flaps. Moreover, the color and contour were matched to the adjacent lip tissue, and re-establishment of the white roll and adequate lip volume were achieved. This mucosal V-Y advancement flap technique represents a reliable method to repair mucosal defects without vascular compromise of the flap.

The mentum plays an important role in the aesthetics of the face, and genioplasty is performed to improve an unbalance of the mentum. Among the various surgical approaches, setback genioplasty is used to create an aesthetic jaw-end appearance by moving the mentum backward when it protrudes more than normal. However, conventional setback genioplasty may be aesthetically disadvantageous because the profile of the mentum could become flat. This case study attempted to overcome the limitations of conventional setback genioplasty by rotating the position of the menton and pogonion.We devised a new method for setback genioplasty by rotating the segment anteroinferiorly. Using virtual surgery, we were able to specify the range of surgery more accurately and easily, and the surgery time was reduced. This case report showed the difference in chin soft tissue responses between conventional setback genioplasty and setback genioplasty with rotation.

BACKGROUND: Postoperative infection occurs when bone graft material is dislodged into the maxillary sinus cavity and most of the patients are often uncomfortable with the drainage and irrigation procedures to eradicate the infection. In this case report, we share a technique in treating patients with such condition. MATERIAL AND METHODS: A 47-year-old patient was referred after sinus elevation using the crestal socket osteotome, bone graft, and implant insertion at a local clinic. Clinical and radiographic findings confirmed the diagnosis of right maxillary sinusitis. A surgical and medical treatment regimen was applied. RESULTS: By using this technique for irrigation, we were able to achieve successful results, and the patient was satisfied due to less discomfort during the irrigation process. CONCLUSION: This method is a patient-friendly technique for sinus irrigation. It is not only limited to sinus grafted patients, but also maxillary sinusitis patients in any other type of odontogenic infection.
Diagnosis ; Drainage ; Humans ; Maxillary Sinus* ; Maxillary Sinusitis* ; Methods ; Middle Aged ; Transplants*

BACKGROUND/AIMS: The objective of this study was to compare the degree of hepatic enhancement and image quality using contrast media of different iodine concentrations with the same iodine dose. METHODS: From July 2011 to June 2013, 50 patients with chronic liver disease who underwent baseline and follow-up 128-slice multidetector computed tomography(MDCT) using contrast media with 350 mg I/mL (group A) and 400 mg I/mL (group B) iodine concentrations were included in this prospective study. The patients were randomly allocated to one of two protocols: 350 mg I/mL initially and then 400 mg I/mL; and 400 mg I/mL initially and then 350 mg I/mL. The bolus tracking technique was used to initiate the arterial phase scan. The computed tomography values of hepatic parenchyma, abdominal aorta and portal vein were measured. The degrees of hepatic and vascular enhancement were rated on a 4-point scale for qualitative assessment. The paired Student t test was used to compare outcome variables. RESULTS: The mean hepatic enhancement was significantly higher in group B than in group A during the portal (p = 0.025) and equilibrium phases (p = 0.021). In all phases, group B had significantly higher mean liver-to-aorta contrast (p < 0.05) and mean visual scores for hepatic and vascular enhancement (p < 0.001). CONCLUSIONS: This study showed that a higher iodine concentration (400 mg I/mL) in contrast media was more effective at improving hepatic enhancement in portal and equilibrium phase images and overall image quality using 128-slice MDCT in chronic liver disease patients.
Aorta, Abdominal ; Contrast Media ; Follow-Up Studies ; Humans ; Iodine* ; Liver Diseases* ; Liver* ; Multidetector Computed Tomography* ; Portal Vein ; Prospective Studies

OBJECTIVE: This study aimed to examine clinical practice patterns in the management of pregnant women admitted with threatened preterm labor (TPL) in Korea. METHODS: Data from women admitted with a diagnosis of TPL were collected from 22 hospitals. TPL was defined as regular uterine contractions with or without other symptoms such as pelvic pressure, backache, increased vaginal discharge, menstrual-like cramps, bleeding/show and cervical changes. Data on general patient information, clinical characteristics at admission, use of tocolytics, antibiotics, and corticosteroids, and pregnancy outcomes were collected using an online data collections system. RESULTS: A total of 947 women with TPL were enrolled. First-line tocolysis was administered to 822 (86.8%) patients. As a first-line tocolysis, beta-agonists were used most frequently (510/822, 62.0%), followed by magnesium sulfate (183/822, 22.3%), calcium channel blockers (91/822, 11.1%), and atosiban (38/822, 4.6%). Of the 822 women with first-line tocolysis, second-line tocolysis were required in 364 (44.3%). Of 364 with second-line, 199 had third-line tocolysis (37.4%). Antibiotics were administered to 29.9% of patients (284/947) with single (215, 22.7%), dual (26, 2.7%), and triple combinations (43, 4.5%). Corticosteroids were administered to 420 (44.4%) patients. Betamethasone was administered to 298 patients (71.0%), and dexamethasone was administered to 122 patients (29.0%). CONCLUSION: Practice patterns in the management of TPL in Korea were quite various. It is needed to develop standardized practice guidelines for TPL management.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Back Pain ; Betamethasone ; Calcium Channel Blockers ; Dexamethasone ; Diagnosis ; Female ; Humans ; Korea ; Magnesium Sulfate ; Muscle Cramp ; Obstetric Labor, Premature* ; Physician's Practice Patterns ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Premature Birth ; Retrospective Studies* ; Tocolysis ; Tocolytic Agents ; Uterine Contraction ; Vaginal Discharge

Segniliparus species is a novel genus that is reported to be the new emerging respiratory pathogens. Here, we report a very rare case of S. rugosus pulmonary infection in an immunocompetent patient with non-cystic fibrosis. The organism was identified by 16S rRNA gene sequencing. The patient was successfully treated with antibiotics.
Anti-Bacterial Agents ; Fibrosis* ; Genes, rRNA ; Humans ; Nontuberculous Mycobacteria ; Respiratory Tract Infections ; Sequence Analysis, RNA

BACKGROUND: We investigated the prevalence of latent tuberculosis infection (LTBI) among the health care workers (HCWs) and analyzed its risk factors in South Korea. METHODS: A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant and tuberculin skin test (TST), QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay, and chest radiography were performed. RESULTS: A total of 493 participants, 152 (30.8%) doctors and 341 (69.2%) nurses were enrolled in eight tertiary referral hospitals. The mean age of the subjects was 30.6 years old, and 383 (77.7%) were female. Of the 152 doctors, 63 (41.4%) and 36 (23.7%) were positive by TST and by QTF-GIT, respectively, and among the 341 nurses, 119 (34.9%) and 49 (14.4%) had positive TST and QFT-GIT results, respectively. Overall, the agreement between the two tests was 0.22 by the chance corrected proportional agreement rate (kappa coefficient) in 493 subjects. Experience of working in tuberculosis (TB)-related departments was significantly associated with positive LTBI test results by QFT-GIT assay, not by TST. In multivariate analysis, only age was independently associated with increased risk of a positive TST result, while age and experience of working in TB-related departments (odds ratio, 2.29; 95% confidence interval, 1.01-5.12) were independently associated with increased risk of a positive QFT-GIT result. CONCLUSION: A high prevalence of LTBI was found among South Korean HCWs. Considering the association between the experience of working in TB-related departments and high risk of LTBI, QFT-GIT may be a better diagnostic test for LTBI than TST in HCWs.
Delivery of Health Care ; Demography ; Diagnostic Tests, Routine ; Female ; Health Personnel ; Humans ; Interferon-gamma Release Tests ; Latent Tuberculosis ; Multivariate Analysis ; Prevalence ; Surveys and Questionnaires ; Republic of Korea ; Risk Factors ; Skin Tests ; Tertiary Care Centers ; Thorax ; Tuberculin ; Tuberculin Test ; Tuberculosis

INTRODUCTION: Tegaserod has been used for treatment of irritable bowel syndrome (IBS) but there is no data regarding its effect on Korean patients. The aim of this study was to evaluate the effect of tegaserod on symptoms and quality of life (QOL) in Korean female IBS patients with constipation and to evaluate the usefulness of the IBS-QOL in clinical study. METHODS: A prospective, open labeled, multicenter study was performed. Female patients fulfilling Rome II criteria for IBS received 6 mg of tegaserod twice a day for 4 weeks. The efficacy on IBS symptoms and QOL was assessed using 7-point scaled symptom questionnaire and IBS-QOL questionnaire, respectively. RESULTS: A total of 81 female patients (range 18-73 years of age) were enrolled in this study. Tegaserod therapy significantly reduced the overall symptom scores after 4 weeks (p <0.01). The improved symptoms included abdominal discomfort or pain, hard or lumpy stool, straining during a bowel movement, feeling of incomplete bowel movement, and abdominal fullness or bloating. The IBS-QOL of responders to tegaserod treatment was also significantly improved after 4 weeks (p <0.01). Furthermore, improvement of symptom scores significantly correlated with improvement of the IBS-QOL scores (r = -0.60, p <0.001). CONCLUSIONS: Tegaserod 6 mg given twice daily improved the QOL as well as the bowel symptoms in Korean female IBS patients with constipation. The IBS-QOL can be used as a reliable end-point in clinical study.
Constipation ; Female ; Humans ; Indoles ; Irritable Bowel Syndrome ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Rome ; Sprains and Strains

A teratoma is the most common benign germ cell tumor that develops in the mediastinum. Patients with a mediastinal teratoma are usually asymptomatic. However, a spontaneous rupture of a mediastinal teratoma into the pleural cavity or adjacent organs can cause severe chest pain, hemoptysis, acute dyspnea, etc. Complications such as recurrent pneumonia, pericardial effusion, pleural effusion and great vessel invasion can sometimes occur. We encountered a case of a patient with an abrupt onset of dyspnea after persistent shoulder pain for one month. The X-ray examinations revealed a unilateral mediastinal mass with contralateral pleural effusion. Subsequent evaluations confirmed a spontaneous rupture of the teratoma into the contralateral pleural cavity.
Chest Pain ; Dyspnea ; Hemoptysis ; Humans ; Mediastinum ; Neoplasms, Germ Cell and Embryonal ; Pericardial Effusion ; Pleural Cavity ; Pleural Effusion* ; Pneumonia ; Rupture, Spontaneous ; Shoulder Pain ; Teratoma*

While endovascular aneurysm repair (EVAR) is prevailing for the treatment of abdominal aortic aneurysm (AAA) in modern vascular practice, PURPOSE: we conducted nationwide questionnaire survey to investigate the current status of AAA treatment and their results in Korea. METHOD: We reviewed the replies from 28 hospitals (33 departments) to the questionnaire inquiring annual number, clinical features, mode of treatment and results of AAA patients during the period from Jan. 2000 to Jul. 2004. Results: 980 AAA patients were reported including 292 ruptured AAA (29.8%) and 688 non-ruptured AAA (70.2%). For treatment of AAA, 834 (85.1%) surgical repairs (SRs) and 111 (11.3%) endovascualr aneurysm repairs (EVARs) were performed while 35 patients (3.6%) died of AAA rupture before operation. The locations of AAA were infrarenal in 889 (90.7%), juxtarenal in 62 (6.3%), and suprarenal in 29 patients (3.0%). Among 834 patients undergoing SR, 577 patients (69.2%) had non-ruptured AAAs and 257 patients (30.8%) had ruptured AAAs. Mean operative mortality rate was 4.1% after elective SRs, 30.7% after SR for ruptured AAAs, and 2.3% after EVARs. The reported brand name of stent graft devices were various including domestic custom-made in 56 (50.5%), imported brand in 18 (16.2%) while 37 (33.3%) stent grafts were not reported their brand name. The frequencies of type I and III endoleaks after EVAR were reported 5.8% and 5.8% respectively in 86 patients with an available data. CONCLUSION: SR has been used as a major treatment option in Korea for the treatment of AAA patients while EVAR is increasing. The mortality rate of SR of AAA was comparable to western multi-center trial reports but mortality or morbidity rates of EVAR were unable to know in this questionnaire survey.
Aneurysm ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Endoleak ; Humans ; Korea* ; Mortality ; Questionnaires* ; Rupture ; Treatment Outcome