Applied Anatomy of Pectoralis Major Muscle: Surface Anatomy Related to Female Breast

The most important factor for breast augmentation is to dissect the accurate size of implantation pockets. This study was performed to investigate the anatomical association of the pectoralis major muscle(PMM) with the female breast shape for improving the success rate of mammoplasty. This study included 60 women(120 breasts) in their twenties to thirties who were imaged by CT between September 2006 and December 2007. On reconstructed 3D CT images, 6 points in the area of the PMM were selected as fiducial points, and the PMM contour and the correlation of the PMM with the nipple were analyzed using the imaginary lines connecting individual points. As the volume increased, the lateral and inferior borders of the PMM moved to the superomedial side from the nipple. As the ptosis degree increased, the density became lower, and the lateral and inferior borders of the PMM moved to the superomedial side of the nipple. However, there was no significant correlation between age and PMM contour. The results of this study suggest that the PMM contour may change according to the volume, ptosis and density of the breast. This study can provide objective information for breast surgery, thereby increasing the success rate of mammoplasty.

Augmentation of Pyriform Margin Using Porous High-Density Polyethylene Sheet In Unilateral Cleft Lip Nasal Deformity

PURPOSE: The common deformity after the correction of unilateral cleft lip nasal deformity is nasal asymmetry, and it is caused by the hypoplasia of the pyriform aperture. To correct this, many procedures have been applied, but still many problems are present. Authors performed the inlay and onlay insertion of porous high density polyethylene sheet(1mm thickness Medpor(R) sheet) in the hypoplastic pyriform margin of cleft side and obtained satisfactory results. METHODS: 11 cases were performed and the mean follow up period was 15.1 months. Their mean age was 23.6 years. Under general anesthesia, bilateral pyriform margin was exposed. Medpor(R) sheets in "match stick" like shaped were inlay inserted, and kidney shaped were onlay inserted fixating with two 6mm titanium screws. After the surgery, the results was evaluated by photogrammetric analysis. On the basal view, the distance from the subalare and labiale superius' to the transverse baseline connecting the both cheilions was measured from the cleft side and the non-cleft side. Then, the postoperative symmetry was assessed by obtaining the cleft side against the non-cleft side as proportion index, defined as lateral and medial upper lip contour index. RESULTS: There were 2 infections. The cause was because the inserted implant was too long and thus protruded to the base of nasal cavity. The lateral upper lip contour index was from 95.49 to 103.27, and medial upper lip contour index was from 90.92 to 100.49, it was statistically increased, and thus the symmetry was improved. However clinically mild depression remained at nostril floor. CONCLUSION: Authors performed porous high density polyethylene sheet inlay and onlay insertion for the hypoplasia of the pyriform margin in unilateral cleft lip nasal deformity. It was found that depressed pyriform margin and upper lip were corrected effectively except for the nostril floor, for which an additional soft tissue augmentation would be necessary. The inlay insertion has risk of protrusion, thus the guideline of the use of artificial prosthesis should be observed strictly.

Medial Epicanthopexy Using Transverse Short Incision and Medial Canthal Tendon Shortening Procedure

The authors found that the results of severe epicanthal fold were excellent after repairing the transposition of the flap and transnasal wiring of the medial canthal tendon. Instead of using the flap transposition and transnasal wiring, we made a 4mm horizontal incision at the epicanthal region and shortened the medial canthal tendon in conjunction with double fold operation of 9 females aging from 16 to 29 (average, 20.6). Ten minutes after the injection of 1% lidocaine-1 : 100,000 epinephrine, an incision was made. Dissection of the medial canthal tendon was made in a careful and intensive manner in order to avoid injuring the angular artery. After full skeletonization of the tendon, an average of 4-6 mm of the tendon was resected and sutured with 4-0 clear nylon. Skin was sewed with two layers of 6-0 nylon. Steri-strips were applied to the wounds for a period of three months. Photogrammetric analysis of three proportional indices was carried out 6-19 months (average 6.04 months) after the surgery with the use of Photoshop. The proportional indices had intercanthal distance x 100/palpebral fissure width, and upper and lower interepicanthal distance x 100/palpebral fissure width. Postoperative proportional indices of the three levels were decreased statistically: from 159 to 150 at the medial canthus; from 168 to 164 at lower epicanthus; and from 195 to 181 at upper epicanthus. However, these indices increased slightly with time: from 143 to 150 at the medial canthus; from 152 to 164 at lower epicanthus; and from 160 to 181 at upper epicanthus. The resultant scar was short and inconspicuous except for one case which had revealed a white color. A short horizontal incision and shortening of the medial canthal tendon are supposed to be effective techniques to reduce the epicanthal fold, but not a way to completely eliminate the fold with minimal scar. The reason to why the results appeared to worsen with time was probably due to the relapse at the tendon repair. Therefore, over-resection and rigid fixation of the tendon would overcome the relaps

In vitro study on the effects of the flouride on the remineralization of acid etched enamel / 대한치과교정학회지

Remineralization of acid-etched enamel across the time has been one of the curiosities in the context of the orthodontic biomechanics(Arends J. et al., IRL Press, 1, 1985), nevertheless, is so far controversial. It was the aim of this study to observe the remineralization patterns of acid-etched enamel across the time and whether the existence of fluoride might carry out any modifications. The intact buccal surfaces of the first bicuspids which was extracted for orthodontic treatment were ground smooth, and etched with a 38w/w% phosphoric acid for 60 seconds, The surface was observed by the scanning electron microscope and surface microhardness was measured after immersion in the fluoride or non-fluoride containing remineralizing solution for 0 hour, 12 hours, 1 day, 3 days, 7 days, 14 days, 28 days, and 42 days. The following results and conclusions were drawn; 1. Surface microhardness increased in both fluoride containing and non-fluoride containing solution group with time lapse. 2. In fluoride containing solution group, the surface microhardness sharply increased at the 12 hours group, on the other hand, surface microhardness increased at 3 days in non-fluoride containing solution group. 3. The difference in microhardness value between two groups manifested gradual decrease. 4. Scanning electron microphotographs disclosed that the fluoride containing solution group generated spiculate sub?stances in the 12 hours group, which was increased in number and size with time lapse. 7 days later, spherical composure was began to be produced, The spiculate substances so much increased in number that the etched enamel surface looked like flat in 42 days. 5. In non fluoride-containing solution group, there was no surface change at 42 days, perceivable in scanning electron microphotographs which could be defined as remineralization though the surface was a little rougher than the incipient etched surface. These results demonstrate that the action of the fluoride is exceedingly pertinent in the remineralization of acid-etched enamel and the remineralization process goes uninterruptedly with time lapse.

Gastric Xanthoma / 대한소화기내시경학회지

Authors analysed 42 cases of gastric xanthoma, confirmed by gatroscopic biopsy, at Kangnam Sacred Heart Hospital, College of Medicine, Hallym University from March 1986 to December 1988 The results were as follows; 1) The prevalence of gastric xanthome was 0.9% in 7699 consecutive gastroacopies. 2) The prevalence of gastric xanthoma increased with age. 3) The frequent locations of gastric xanthoma were the antrum (56%) and the lower bady (29%). 4) The most frequent gastroduodenal lesion associated with gastric xanthoma was chronic superficial gastritis (77%). 5) The average level of cholosterol was 169.9 mg/dl, triglyceride was 102.6 mg/dl, and no conelation existed between the serum cholesterol or triglyceride level and the presence of gastric xanthoma.

One Case of Menetrier's Disease / 대한소화기내시경학회지

Menetrier's disease is a rare disease characterized by the presence of large rugal folds involving part or all of the stomach. Patients with hypertrophic gastropathy often have distressing abdominal symptoms, weight loss and edema due to gastric protein loss. The 48-year-old male patient was admitted to the Hangang Sacred Heart Hospital with cheif complaints of indigestion and epigastric pain. The diagnosis of Menetriers disease is established by radiologic, endoscopic, and pathologic examination. He was treated with soft diet, antacid, H2- receptor antagonist, and IV albumin. We report a case of Menetriers disease with brief review of literatures.