BACKGROUND: Midface concavity is a relatively common facial feature in East Asian populations. Paranasal augmentation is becoming an increasingly popular procedure for patients with mild concavity and normal occlusion. In this study, we evaluate clinical outcomes following a series of paranasal augmentation. METHODS: A retrospective review was performed for patients with Class I occlusion who had undergone bilateral paranasal augmentation using custom-made silicone implants, between October 2005 and September 2013. Patient charts were reviewed for demographic information, concomitant operations, and postoperative complications. Preoperative and postoperative (1-month) photographs were used to evaluate operative outcome. RESULTS: The review identified a total of 93 patients meeting study criteria. Overall, aesthetic outcomes were satisfactory. Five-millimeter thick silicone implant was used in 81 cases, and the mean augmentation was 4.26 mm for this thickness. Among the 93 patients, 2 patients required immediate implant removal due to discomfort. An additional 3 patients experienced implant migration without any extrusion. Nine patients complained of transient paresthesia, which had resolved by 2 weeks. There were no cases of hematoma or infection. All patients reported improvement in their lateral profile and were pleased at follow-up. Complications that arose postoperatively included 9 cases of numbness in the upper lip and 3 cases of implant migration. All cases yielded satisfactory results without persisting complications. Sensations were fully restored postoperatively after 1 to 2 weeks. CONCLUSION: Paranasal augmentation with custom-made silicone implants is a simple, safe, and inexpensive method that can readily improve the lateral profile of a patient with normal occlusion. When combined with other aesthetic procedures, paranasal augmentation can synergistically improve outcome and lead to greater patient satisfaction.
Asian Continental Ancestry Group ; Follow-Up Studies ; Hematoma ; Humans ; Hypesthesia ; Lip ; Paresthesia ; Patient Satisfaction ; Postoperative Complications ; Retrospective Studies ; Sensation ; Silicon* ; Silicones*

Soft tissue filler injection has been a very common procedure worldwide since filler injection was first introduced for soft tissue augmentation. Currently, filler is used in various medical fields with satisfactory results, but the number of complications is increasing due to the increased use of filler. The complications after filler injection can occur at any time after the procedure, early and delayed, and they range from minor to severe. In this review, based on our experience and previously published other articles, we suggest a treatment algorithm to help wound healing and tissue regeneration and generate good aesthetic results with early treatment in response to the side effects of filler. Familiarity with the treatment of these rare complications is essential for achieving the best possible outcome.
Algorithms ; Biocompatible Materials/*therapeutic use ; Connective Tissue/*surgery ; Face/surgery ; Guided Tissue Regeneration/*methods ; Humans ; Hyaluronic Acid/administration & dosage ; Injections ; Skin Aging ; Surgery, Plastic/*methods ; Tissue Engineering/*methods ; Wound Healing

Calves can be easily seen in daily life and are an important part of the body contour. Asymmetric calves can develop from unbalanced distribution and deposition of fat and muscles between the legs. Calf asymmetry may be due to congenital factors, disease (e.g., poliomyelitis, cerebral palsy, or infection), spinal cord injury, or the effects of surgical treatment and may have severe adverse psychological and social implications. Generally, an asymmetric calf is diagnosed when the difference of the longest circumference between both calves is more than 2 cm. Several surgical methods have been introduced for the correction of an asymmetric calf. Implant insertion or fat injection is used to augment a hypotrophic calf. Selective neurectomy, liposuction, muscle resection, radiofrequency, and botulinum toxin injection are used to treat a hypertrophic calf. With the development of microsurgery, the authors planned to use a latissimus dorsi musculocutaneous free flap (LDMC free flap) with silicone implant to add calf volume to obtain natural calf contour. The authors present the first successful case of correction of a severely asymmetric calf using an LDMC free flap and customized silicone implant.
Botulinum Toxins ; Cerebral Palsy ; Free Tissue Flaps* ; Leg ; Lipectomy ; Lower Extremity ; Microsurgery ; Muscles ; Poliomyelitis ; Silicones* ; Spinal Cord Injuries ; Superficial Back Muscles*

Botulinum toxin type A has an inhibitory action not only on neuromuscular junctions, but also postganglionic sympathetic and cholinergic autonomic parasympathetic acetylcholine release at the secretary end of the salivary gland. Use of botulinum toxin to treat sialorrhea was first reported in 1997 by Bushara. Parotid duct or gland injuries with parotid fistula are uncommon but troublesome complications of surgical trauma. Here, we report two patients with constant leakage of serous fluid and a swelling cheek after facelift surgery. Each patient underwent an amylase test, starch iodine test, and sialography. After diagnosis of parotid fistula, a total of 50 units botulinum toxin was injected into the parotid gland. Facial bandage, scopolamine, and minimizing temporomandibular joint motion were instructed. Leakage volume decreased gradually, and symptoms subsided within 2 weeks. Neither functional problems nor complications occurred. In conclusion, a parotid fistula after facial surgery can be treated effectively with botulinum toxin; this treatment option should be considered before proceeding with invasive surgical treatment.
Acetylcholine ; Amylases ; Bandages ; Botulinum Toxins ; Botulinum Toxins, Type A* ; Cheek ; Diagnosis ; Fistula* ; Humans ; Iodine ; Neuromuscular Junction ; Parotid Gland ; Rhytidoplasty* ; Salivary Glands ; Scopolamine Hydrobromide ; Sialography ; Sialorrhea ; Starch ; Temporomandibular Joint

Primary leiomyosarcomas of the stomach are very rare tumors originating from mesenchymal tissues and account for only 1% of all malignant gastric neoplasm. We present here a case of primary gastric leiomyosarcoma in a 79-year-old man who presented with a 10 day history of epigastric pain and gastric subepithelial tumor. Endoscopic examination showed a 5 cm in diameter, subepithelial tumor located in the body of the stomach. Radiological investigations showed nonspecific findings except for the primary gastric lesion. Complete histological evaluation including immnuohistochemical staining after complete surgical resection revealed a true leiomyosarcoma of the stomach. One year later, the patient presented with dyspepsia. Endoscopic and radiological evaluation showed a recurrent leiomyosarcoma with multiple liver metastases. Our experience suggests that a careful clinical follow-up after surgical resection should be recommended in patients with gastric leiomyosarcomas because of their aggressive clinical behavior.
Aged ; Benzeneacetamides ; Dyspepsia ; Follow-Up Studies ; Humans ; Leiomyosarcoma ; Liver ; Neoplasm Metastasis ; Piperidones ; Stomach ; Stomach Neoplasms

PURPOSE: Inferior vena cava (IVC) filter is commonly practiced to prevent pulmonary embolism during endovascular therapy of deep vein thrombosis (EndoDVT). When the thrombus is trapped inside the filter during intervention, its removal is quite challenging. The purpose of this study is to determine retrieval rates of IVC filter after EndoDVT and its characteristics. METHODS: Patients who underwent EndoDVT in Inha Unversity Hospital from June 2004 to May 2009 were reviewed retrospectively. Retrievable IVC filter was inserted before EndoDVT. EndoDVT was done by catheter directed thrombolysis or pharmacomechanical thrombectomy using urokinase. IVC filter retrieval was decided according to computed tomography after 2 weeks. RESULTS: 126 patients were treated with EndoDVT. Optease (n=101) and Tulip (n=25) IVC filters were inserted. IVC filters were retrieved in 42.9% (54/126). There was no IVC filter related complication during its insertion and removal. IVC filter was not retrieved in 72 patients. Reasons for its failure include residual thrombosis in IVC filter (n=28), high risk for recurrent DVT (n=34), massive pulmonary embolism (n=8), and death (n=2). Residual thrombus inside IVC filter disappeared in 5 patients during 6-month follow up. CONCLUSION: IVC filters retrieval rate after EndoDVT was 42.9%. This can be improved by thorough patient follow up and extended retrievability.
Catheters ; Follow-Up Studies ; Humans ; Pulmonary Embolism ; Retrospective Studies ; Thrombectomy ; Thrombosis ; Tulipa ; Urokinase-Type Plasminogen Activator ; Vena Cava Filters ; Vena Cava, Inferior ; Venous Thrombosis

The successful treatment of community-acquired pneumonia requires appropriate, empirical antimicrobial therapy. The etiology and antimicrobial susceptibility of major pneumonia pathogens can differ by country. Therefore, the ideal treatment guidelines for community-acquired pneumonia should be based on the studies performed in each country. We developed a treatment guideline for community-acquired pneumonia for immunocompetent adults in Korea. This guideline was developed by the joint committee of the Korean Society for Chemotherapy, the Korean Society of Infectious Diseases, and the Korean Academy of Tuberculosis and Respiratory diseases.
Adult ; Anti-Bacterial Agents ; Communicable Diseases ; Humans ; Joints ; Korea ; Pneumonia ; Tuberculosis

A successful therapy of community-acquired pneumonia requires appropriate empirical antimicrobial therapy. Etiology and antimicrobial susceptibility of major pathogens of pneumonia can differ by country. Therefore, an ideal treatment guideline of community-acquired pneumonia should be based on the studies performed in each country. We developed a treatment guideline for community-acquired pneumonia in immunocompetent adults in Korea. This guideline was developed by the joint committee of the Korean Society for Chemotherapy, the Korean Society of Infectious Diseases, and the Korean Academy of Tuberculosis and Respiratory diseases.
Adult ; Communicable Diseases ; Community-Acquired Infections ; Humans ; Joints ; Korea ; Pneumonia ; Tuberculosis

A successful therapy of community-acquired pneumonia requires appropriate empirical antimicrobial therapy. Etiology and antimicrobial susceptibility of major pathogens of pneumonia can differ by country. Therefore, an ideal treatment guideline of community-acquired pneumonia should be based on the studies performed in each country. We developed a treatment guideline for community-acquired pneumonia in immunocompetent adults in Korea. This guideline was developed by the joint committee of the Korean Society for Chemotherapy, the Korean Society of Infectious Diseases, and the Korean Academy of Tuberculosis and Respiratory diseases.
Adult ; Communicable Diseases ; Community-Acquired Infections ; Humans ; Joints ; Korea ; Pneumonia ; Tuberculosis

Although cholelithiasis is an uncommon condition in infants, a recent study documented the increasing detection of this disorder. This increase may be explained by the wide use and improvement in abdominal ultrasound. Choledocholithiasis with cholestatic jaundice in infants usually requires therapeutic intervention, even though the incidence of spontaneous resolution has been reported to be higher in infants than adults. Choledocholithiasis in children has traditionally been managed surgically with open common duct exploration. Recently, endoscopic stone removal was accepted as a standard therapy in pediatric choledocholithiasis. We report a case of the successful removal of common bile duct stone using endoscopic papillary balloon dilation (EPBD), in a 28-month-old infant with Down's syndrome.
Infant ; Child ; Adult ; Male ; Female ; Humans ; Incidence