The Usefulness of Airway Tube Merocel(R) on Treatment of Nasal Bone Fracture

PURPOSE: Nasal packing materials are almost inserted at the end stage of closed reduction of nasal bone for postoperative bleeding control and stabilization of nasal bone. Conventionally, vaseline gauze was used for packing of nasal cavity. These days, Surgeons have tried to apply Merocel(R) into the nasal cavity more easily. It is difficult for patients to continue keeping the nasal packs for more than a week due to breathing difficulty. Moreover, nasal packing itself can also cause headache, dry mouth, stuffiness, etc. METHODS: We performed a prospective study from March 1, 2008 to July 31, 2008. One hundred patients were divided into "Merocel(R) packing group" and "Merocel(R) and Airway Tube Merocel(R) packing group". Using two kinds of materials to each group after closed reduction, we observed and compared the amount of bleeding between two groups. We recorded patient's uncomfortable symptoms which were divided into four groups each 6, 24, 48 hours after nasal packing. RESULTS: The result of the bleeding amount of Air Tube Merocel(R) group after 6 hours of nasal packing is that 3 people belong to mild group, 38 people moderate group, and 9 people severe group. After 6 hours of nasal packing, 11 patients have no complains. 16 patients were mild, 21 patients were moderate, 2 patients were severe. After 24 hours of nasal packing, no complain(18 patients), mild(24 patients), moderate(6 patients), severe(0 patient). After 48 hours of nasal packing, no complain(25 patients), mild(20 patients), moderate(5 patients), severe(0 patient). CONCLUSION: Regarding the amount of bleeding, there are no difference between two groups. In case of Air Tube Merocel(R) group, patient's discomfort is gradually improved after 24 hours of nasal packing, After 48 hours of nasal packing, most of the patients do not experience headache, dry mouth, stuffiness, etc. Therefore, Air Tube Merocel(R) can be useful for bleeding control. Moreover, it helps patients to breathe through nose more easily and reduce discomfort.

Calcifying Aponeurotic Fibroma Occurring on the Chin: A Case Report

PURPOSE: Fewer than 100 cases of calcifying aponeurotic fibroma have been reported in the literature since this entity was initially described by Keasbey in 1953 who called it calcifying juvenile aponeurotic fibroma. The tumor is a slowly growing, painless mass. In most cases the mass is poorly circumscribed and causes neither discomfort nor limitation of movement. Most lesions occur in children, with a peak incidence ages of 8-14 years. There is no evidence of any increased familial prevalence. Predilection sites are palm, finger, toe, but it also occurs in the wrist, forearm, elbow, upper arm, neck, abdominal wall, lumbar paravertebral area, leg and ankle. We herein describe a rare case of calcifying aponeurotic fibroma occurring on the chin with review of the literature. METHODS: A 14-year-old male had painless, slowly growing mass(phi2.5cm) on a chin for a year. The tumor was excised elliptically under local anesthesia and the excisional site was repaired directly. Due pathological examination was processed. RESULTS: Histological examination revealed an ill- defined fibrous growth that extends with multiple processes into the surrounding tissue with centrally located foci of calcification. The tumor is composed of short spindled plump fibroblasts with round or ovoid nuclei separated by collagenous stroma, showing vaguely palisading pattern. Diagnosis of calcifying aponeurotic fibroma was conferred. Postoperatively, the patient did well, and the lesion had not recurred. CONCLUSION: Fewer than 100 cases of calcifying aponeurotic fibroma have been reported in the literature. The most common occurring sites are palm, finger & toe, but it has been reported in the wrist, forearm, elbow, upper arm, neck, abdominal wall, lumbar paravertebral area, leg and ankle. Two cases of calcifying aponeurotic fibroma occurring on the neck have been reported in the literature. To the authors knowledge, our case of calcifying aponeurotic fibroma occurring on the chin is the first to be reported.

The Association between Obesity Indices and Physical Fitness

BACGROUND: Physical fitness is defined as the ability to carry out work necessary for muscle exercise satisfactorily. Generally, obese person have been considered to have low physical performance. In addition, obesity has been known to be a risk factor of cardiovascular disease such as hyperlipidemia, hypertension, and coronary arterial disease. Based on previous epidemiologic studies, abdominal obesity, especially, visceral obesity, is thought to be more important risk factor for cardiovascular disease rather than obesity itself. Therefore, the interest on assessment of abdominal visceral fat has been increasing. The aim of this study was to see the difference in physical fitness and blood pressure according to obesity degree assessed by BMI, and compare the anthropometric obesity indices with abdominal visceral fat accumulation measured by abdominal CT (Computed Tomogram). METHODS: Four hundred thirty-two subjects, who participated in the exercise program for more than one month duration at the 'Clinic for Obesity' in St. Mary's Hospital from November 1998 to June 2000, were included in the analysis. They were categorized into 4 groups [severe obesity group (BMI 30), obesity group (25 BMI <30), overweight group (23 BMI<25), normal group (BMI<23)] according to their BMI. Blood pressure, anthropometric obesity indices and physical fitness (V02 max, back muscle strength, sit up, forward bending, vertical jump, side step, balance) were measured by one skillful exercise trainer. Among them, one hundred thirty-one subjects performed abdominal CT to assess visceral fatness. We compared anthropometric indices (waist to hip ratio, body mass index, abdominal circumference, skin foldness) with abdominal visceral fat accumulation measured by CT. RESULTS: Blood pressure, cardiovascular endurance, muscular endurance, muscle strength, speed and balance were significantly different among the four groups categorized by BMI in both sexes, but flexibility and agility were not significant. In women, the correlation coefficients between visceral fat area measured by abdominal CT and each of waist to hip ratio, BMI, abdominal circumference, and skin foldness adjusted for age were 0.487, 0.479, 0.464, 0.31, respectively (P<0.01). However in men, there were no significant correlations. CONCLUSION: Obesity tended to increase blood pressure, and reduce physical performance. Only in women, obesity related indices reflected the abdominal visceral fat accumulation.