Tennison was the first to recognize and to preserve the Cupid's bow by lowering the peak in the margin of the cleft. Randall had modified the Tennison's repair based on accurate measurements. Bardach's technique evolved from the basic concept of triangular flap cleft lip repair described by Tennison-Randall method. Precise measurements are used to define the dimensions of the equilateral triangular flap, which is created on the cleft side and is inserted into an equilateral triangular defect on the noncleft side. Two symmetrical vertical distances on either side of the cleft are thus formed. It is essential that the incisions in the skin correspond precisely with those on the muscles and mucosa, and that all layers are sutured with the use of the triangular flap, thus preventing vertical scar contracture. This procedure produces a symmetric, balance lip with a well-defined Cupid's bow, a symmetric vermilion, and a properly aligned orbicularis oris muscle. We had treated three patients with unilateral incomplete cleft lip by using Bardach's triangular flap method. The operation scars could be reduced comparing to Millard method because Bardach's method did not use the columella base and the alar base incision. And the flap design was more simple and accurate comparing to Tennison-Randall method. On the other hand, the postoperative scars on the philtrum pointed as a disadvantage of triangular flap method were cosmetically acceptable because the three patients had incomplete cleft lip. We have experienced that Bardach's triangular flap is a recommendable technique for the repair of unilateral incomplete cleft lip.
Purpose : Vesicoureteral reflux(VUR) is the major risk factor of urinary tract infection(UTI) in children and may result in serious complications such as renal scarring and chronic renal failure. The purpose of this study was to evaluate the relationship between VUR and renal scar formation, the usefulness and correlation of various imaging studies in reflux nephropathy, and the spontaneous resolution of VUR. Methods : We retrospectively reviewed 106 patients with VUR with no accompanying urogenital anomalies in the Department of Pediatrics, Bundang CHA Hospital during the period from Jan. 1996 to Mar. 2005. Ultrasonography and $^{99m}Tc$-dimercaptosuccinic acid(DMSA) scan were performed in the acute period of UTI. Voiding cystourethrography(VCUG) was performed 1 to 3 weeks after treatment with UTI. Follow-up DMSA scan was performed 4 to 6 months after treatment and a follow-up VCUG was performed every 12 months. Results : The mean age at detection of VUR was $13.8{\pm}22.2$ months and the male to female ratio was 2:1. The incidence of renal scarring showed a tendency of direct correlation between severity of VUR(P<0.001) and abnormal findings of renal ultrasonography(P<0.01). 63.2%(24 of 38 renal units) of renal parenchymal defects present in the first DMSA scan disappeared on follow-up DMSA scans. Follow-up DMSA scans detected renal scars in 7(14%) of 50 renal units with ultrasonographically normal kidneys. Meanwhile, ultrasonography did not show parenchymal defects in 7(36.8%) of 19 renal units where renal scarring was demonstrated on a follow-up DMSA scan. The spontaneous resolution rate of VUR was higher(75%) in cases with low grade(I to III) VUR(P<0.01). Conclusions : The presence and severity of VUR and abnormal findings of renal ultrasonography significantly correlated with renal scar formation. DMSA scan was useful in the diagnosis of renal defects. Meanwhile renal ultrasonography was an inadequate method for evaluating renal parenchymal damage. Therefore, follow-up DMSA scans should be performed to detect renal scars even in children with low-grade VUR and normal renal ultrasonography.
Kim, Dong-Woo;Park, Dae-Song;Lee, Sang-Chil;Kim, Sung-Yong;Lim, Ho-Yong;Yeom, Hak-Yeol;Kim, Hyeon-Min
Maxillofacial Plastic and Reconstructive Surgery
/
v.33
no.6
/
pp.497-504
/
2011
Purpose: Patients who had a subcondylar fracture with a displaced or deviated condylar segment were treated with a retromandibular approach (RMA) or an endoscope-assisted transoral approach (EATA) in our department of oral and maxillofacial surgery. The clinical results of the approaches were compared. A comparative study of specific approaches for subcondylar fractures has not been published before in Korea. Methods: Twenty-one patients with subcondylar fractures of the mandible were included. Ten patients were treated with the retromandibular approach and 11 were treated with an endoscope-assisted transoral approach. We examined patient age, gender, fracture sites, classifications, period of maxillomandibular fixation, facial nerve (FN) or greater auricular nerve (GAN) injuries, maximal mouth opening, deflection, occlusal changes, number of plates, follow-up period, and other complications. Preoperative computed tomography and pre-operative, post-operative, and follow-up panoramic views were taken of each patient. Results: Mean maximal mouth openings were similar between the two approaches. FN and GAN injuries were more frequent in the RMA group but the deflective rate with mouth opening was higher in the EATA than that in RMA group. Two cases of post-operative infection occurred in the EATA group, and occlusal changes were observed in one case for both approaches. Conclusion: The RMA offers more direct access and visualization of the surgical field but it can cause scars and retractive injuries of the FN and GAN. But, EATA did not result in consequent nerve injuries or scars postoperatively, but unfavorable fractures such as $medial$$override$ condyles were more difficult to reduce endoscopically. Except cases of an expected difficult reduction, the treatment of choice for a displaced subcondylar fracture may be an EATA.
Purpose : Tuberculosis, a major public health problem, is an important cause of childhood infectious diseases. To decrease the tuberculosis morbidity rate, BCG vaccination and chemoprophylaxis are performed. Recently 2TU PPD skin test was introduced as a diagnostic method for tuberculous infection. We studied the positive conversion rate of 2TU PPD test after percutaneous multiple puncture BCG vaccination. Methods : Four hundred seventy six infants from well baby clinic of Samsung Cheil Hospital were enrolled. They were immunized with percutaneous multiple puncture technique BCG(Japan BCG laboratory, Japan) at 1 month of age. Approximately 6 months later, tuberculin skin test using RT23 2TU PPD was performed. Induration size, family history of tuberculosis and number of BCG scars were evaluated. Induration greater than or equal to 5mm was defined as positive conversion. Results : Among 476 infants, 248(52.1%) were male and 228(47.9%) were female. PPD skin tests were performed $6.2{\pm}0.5$($mean{\pm}S.D.$) months after BCG vaccination. Mean induration size was $7.3{\pm}3.2mm$ and positive conversion rate was 85.5%. Total number of BCG scars was $15.5{\pm}3.2$. Conclusion : The seroconversion rate by 2TU PPD test after percutaneous multiple puncture BCG vaccination was high. But, more comparative studies with various age groups may be needed for 2TU PPD test used as diagnostic method of tuberculosis in the hospitals.
Statement of problem: Second-generation indirect composite resins have been improved flexural strength, compressive strength, hydrolytic degradation resistance, wear resistance compared to first-generation indirect composite resins, but there are still some problems as hydrolysis and low wear resistance. Some manufacturers claim that wear resistance of their materials has been improved, but little independent study has been published on wear properties of these materials and the properties specified in the advertising materials are largely derived from in-house or contracted testing. Purpose: This study was to evaluate the wear of indirect composite resins (SR Adore, Sinfony, Tescera ATL) and gold alloy against the human enamel. Material and method: Extracted human incisors and premolars were sectioned to $2{\times}2{\times}2mm$ cube and embedded in the clear resin and formed conical shaped antagonist to fit the jig of pin-on-disk tribometer. Total 20 antagonists were stored in distilled water. Five disk samples, 24mm in diameter and 1.5mm thick, were made for each of three groups of indirect composite resins and gold alloy group, and polished to #2,000 SiC paper on auto-polishing machine. Disk specimens were tested for wear against enamel antagonists. Wear test were conducted in distilled water using a pin-on-disk tribometer under condition (sliding speed 200rpm contact load 24N, sliding distance 160m). The wear of the enamel was determined by weighing the enamel antagonist before and after test, and the weight was converted to volumes by average density. The wear tracks were analyzed by scanning electron microscopy and surface profilometer to elucidate the wear mechanisms. Statistical analysis of the enamel wear volume, wear track depth and wear tract width of disk specimens were accomplished with one-way ANOVA and the means were compared for significant differences with Scheffe's test. Results: 1. The enamel wear was most in gold alloy, but there were no statistically significant differences among all the groups (P>.05). 2. In indirect composite resin groups, the group to make the most shallow depth of wear tract was Sinfony, followed by Tescera ATL, SR Adoro (P<.05). Gold alloy was shallower than Sinfony, but there was no statistically significant difference between Sinfony and gold alloy (P>.05). 3. The width of wear tract of SR Adore was larger than the other groups (P<.05), and there were no statistically significant differences among the other groups (P>.05). 4. SEM analysis revealed that Sinfony and gold alloy showed less wear scars after test, Tescera ATL showed more wear scars and SR Adore showed the most. Conclusion: Within the limits of this study, Sinfony and gold alloy showed the least wear rates and showed similar wear patterns.
Journal of the Korean Society of Food Science and Nutrition
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v.20
no.6
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pp.629-636
/
1991
Yellowtail fishes(Seriola quinqueeradiata) were submitted to the storages using ice-cooling($0^{\circ}C$), partial freezing($-3^{\circ}C$) and freezing $-20^{\circ}C$) method. Changes in the structures of muscle during storage at different temperatures were investigated. The ice-cooling and partial freezing storage caused early decomposition of glycogen granules and mitochondrial inner membrane, but it was accorded to much slower manner comparing with that of ice-cooling storage. The scars of ice crystals were appeared after three days of storage. The number and size of the crystal increased as progressing of the storage. They were circular and mostly located between fibers. When using the freezing storage, glycogen granules were mostly found from the muscle cell even after fourteen days of storage. Mitochonidral inner membrane maintained their integrity. The scars of ice crystals were also found, however, different from those of partial freezing storage. Their existing sites were random and their shapes were irregular. In many cases, they located in the fiber and had keen edges. Fibers were broken mostly at the Z-lines on fourteen days of storage. From these results, it was concluded that partial freezing storage can repress autolytic enzymic action and can reduce the physical damage from ice crystals which is caused by freezing.
This study was conducted to evaluate Geometridae (Lepidoptera) species as pests and the damage they cause in citrus orchards in Jeju, Korea. Seven geometridae species occurred in citrus orchards: Ascotis selenaria, Ectropis excellens, Menophra senilis, Biston panterinaria, Ourapteryx nivea, Odontopera arida and Hypomecis punctinalis. Among them, A. selenaria was most abundant, followed by E. excellens and M. senilis. Most Geometridae larvae fed on citrus leaves, but A. selenaria larvae ate fruits and leaves. Fruit damage of Citrus unshiu appeared as gnawed scars caused by young larvae feeding on fruit surface. Fruit damage on Shiranui fruits appeared as a wide hole or deep scars caused by feeding by mature larvae (6th instar). Citrus leaves damage due to Geometridae larvae was high during May to June. Fruit damage started in late June as the spring-shoots of citrus hardened and increased sharply in late July. In the field experiment, fruit damage in the late season reached 4.2% in both 2008 and 2009 and reached 5.2% in 2010. In citrus orchards, A. selenaria larvae started to appear in mid-May and their populations peaked in mid June, late July, and early to mid-September. Adult males of A. selenaria had a maximum peak in mid-May, and two other peaks in early to late July and late August to early September. A. selenaria male adults were collected in a pheromone traps constantly throughout Jeju Island.
Lee, Ki Eung;Koh, Jang Hyu;Seo, Dong Kook;Lee, Jong Wook;Choi, Jae ku;Jang, Young Chul
Archives of Plastic Surgery
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v.36
no.5
/
pp.629-636
/
2009
Purposes: Wide scars occurring on the lower face and neck are a source of both functional and esthetic problems. Consequently, we can use skin grafts, pedicled flaps, free flaps, and tissue expansion for the reconstruction of this area. Compared with other reconstruction techniques, tissue expansion is advantageous in that it enables the maintenance of a color and texture similar to that of the adjacent tissue. However, the conventional method of tissue expansion has been reported to lead to an unnatural cervicomental angle and to the deformity of adjacent structures. We have therefore made efforts to prevent these problems through the use of several operative procedures. Methods: Forty-one patients with lower facial and cervical scars underwent tissue expansion. The tissue expansion was performed using a rectangular-shaped Nagosil$^{(R)}$ tissue expansion device. On insertion of the tissue expander, the intermediate area of superficial fat layer was dissected and then the tissue expander was inserted to make a flap that was as thin as possible. In advancement of the flap, a capsule-formed by the tissue expander-was used for the interrupted fixed suture of the flap to the fascia of the platysma muscle of the neck. This procedure was performed multiple times and also performed between the flap and the periosteum of the mandible, such that the tension was removed during the suture of the flap margin. Finally, the patients were fitted with a Jobst$^{(R)}$ facial garment in order to stabilize the operation site at least twelve months. Results: The most prevalent location of the scar was the cheek (15 cases), followed by the chin in 14 cases and the neck in 12 cases. The mean size of scar was $55.7{\pm}39.4cm^2$. Conclusions: Using our procedures, we have experienced no significant deformities and have also achieved a more natural cervicomental angle in the patients.
Kahyun Kim;In Hee Kim;Geon Jung Kim;SungJoon Lim;Ji Young Yoon;Jong Won Kim;Yong Min Kim
Journal of Korean Foot and Ankle Society
/
v.27
no.3
/
pp.93-98
/
2023
Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally invasive plate osteosynthesis (MIPO) for distal tibia shaft fractures. Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were enrolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively. Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respectively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001). Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.
The goal of reduction mammaplasty is a breast with natural contour and volume, aesthetically situated scars, and a well-placed, sensate nipple and areola. The most successful techniques achieve this through the excision of tissue from the lower part of the breast based on some variation. However, the Mckissock's vertical bipedicle technique is the popular method for reduction mammaplasty. As an alternative modified Mckissock's method, we have found the use of only an inferior dermal flap with a keyhole pattern to be a simple and safe method for obtaining satisfactory aesthetic results. We have used inferior dermal flap for 4 patients recently and obtained the advantages as below compare to the Mckissock's method. 1. Rich blood supply to the broad based inferior flap. 2. More easy transposition of the nipple and areola. 3. More good operation field for resection of breast tissue. 4. Short operation time. 5. Can applied to the gigantomastia.
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