ABSTRACT
PURPOSE: Most of the bilateral structures in our body are not perfectly balanced, such that one side is preferred than the other or it has physiological superiority. Eyes also have an imbalance; the eye with sensory and motional superiority compared to the other is called dominant eye. Authors of this study focused on analyzing the correlation between the dominant eye and levator palpebrae superioris muscle. METHODS: The subject of this study was 42 patients with no ptosis and with no past history of blepharoplasty. Hand dominance was identified through questionnaire and dominant eye was identified by hole-in-the-card dominance test (Dolman's test) in all patients. The function of levator palpebrae superioris muscle was measured by MLD (marginal limbal distance). During the measuring procedure, frontalis muscle was not inhibited to avoid the eyelid skin hooding. RESULTS: Out of 42 patients, 27 patients(64.3%) were right ocular dominant, 15 patients(35.7%) were left ocular dominant, 36 patients(85.7%) were right hand dominant and 4 patients(9.5%) were left hand dominant. Out of 27 right ocular dominant patients, right MLD was larger than the left in 26 patients(96.3%). It was larger in average of 0.47mm(p<0.001) in 27 right ocular dominant patients. Also, left MLD was larger than the right in 11 patients (73.3%) out of 15 left ocular dominant patients. It was larger in average of 0.57mm(p=0.003) in 27 left ocular dominant patients. MLD on the side of the dominant eye was larger in average of 0.50mm(p<0.001) than the MLD of non-dominant eye side. Right MLD was larger than the left in average of 0.28mm(p=0.010) in right hand dominant patients, and left MLD was larger than the right in average of 1.15mm(p=0.025) in left hand dominant patients. CONCLUSION: The function of levator palpebrae muscle differs in right and left, and the difference correlates with the dominant eye. Also, the function of levator palpebrae muscle is stronger in the dominant eye. We were able to present statistical evidence regarding the difference of the function in right and left levator palpebrae muscle. This may be a factor worth consideration in terms of balancing the eyes during the blepharoplasty.
Subject(s)
Humans , Blepharoplasty , Dominance, Ocular , Eye , Eyelids , Hand , Muscles , Surveys and Questionnaires , SkinABSTRACT
Usually the open rhinoplasty is used to correct the plunging nasal tip, but it can increase patient's psychological trauma and lengthen the operation time. In this study, the authors present a simple and effective surgical procedure to correct the plunging nasal tip with minimal morbidity. Between April 2005 and February 2006, we performed our nasal tip plasty in 6 patients who were concerned about the long nose with plunging nasal tip. We used the suture method after cephalic resection of the alar cartilage and caudal resection of the septal cartilage through endonasal approach. After that, we evaluated the nasal profile and compared the result with preoperative photographs. We followed these patients for 1 to 4 months. We could achieved good nasal tip projection, improvement of the columellolabial angle and shortening of long nose. The result were relatively satisfactory and there were no complications such as visible scar, alar deformity or asymmetry. Our tip plasty through endonasal approach could reform the plunging nasal tip properly and easily without external scar. We believe that this procedure could be applicable for correcting the plunging nasal tip and an alternative technique which helps to form the harmonious nasal profile with augmentation rhinoplasty.
Subject(s)
Humans , Cartilage , Cicatrix , Congenital Abnormalities , Nose , Rhinoplasty , SuturesABSTRACT
Korean small eyes are characterized in thickness and pseudoptosis of the skin of the upper eyelid. They also have a large amount of subcutaneous and preaponeurotic fat. The hypertrophic orbicularis oculi muscles and the lower positioned transverse ligaments are included in their structural characteristics. These special features act as various burden factors in Korean double eyelid operation. Just burden factors restrict the movement of the upper eyelid and so Korean eyes looks like Ptosis (pseudoptosis). For creation of double fold eyelid, we performed continuous 2-loop single stitch buried suture to make an en bloc fixation with dermis, levator aponeurosis and Muller muscle through three small incisions. And then we tried to eliminate the burden factors through small sized lateral incision. After removal of the external sutures at postoperative 3 days, we obtained our intended double fold lines such as in-fold, in-ward fold and out fold successfully and only experienced minor complications such as edema, ecchymosis and loss of fold. And also the range of excursion in the upper eyelid improved without levator shortening or any other operation such as a sling. The objective of this article is to share our experience and to introduce our method of treating Korean pseudoptotic eyes by using 2-loop en bloc fixation through three small incisions with various reviews of literature.
Subject(s)
Dermis , Ecchymosis , Edema , Eyelids , Ligaments , Muscles , Skin , SuturesABSTRACT
PURPOSE: The presence of epicanthal fold and the absence of supratarsal fold are characteristics of Korean eyelids. There has been many surgical procedures to eliminate medial epicanthal fold but those procedures focus on the lengthening of horizontal palpebral fissure and the shortening of intercanthal distance so that the shape of eye had tendency to be sharp. The authors suggest that the supermedial shifting of epicanthal fold enhance the aesthetic result. METHODS: From Sep 2006 to May 2007, total 17 women(mean age 22) with Type III epicanthal fold underwent epicanthoplasty using author's modified Uchida method. The design for epicanthoplasty was drawn superolaterally along epicanthal fold and split V-W plasty was done to shift the epicanthal fold superomedially. Also non-incisional double-eyelid operation was underwent. RESULTS: The epicanthal fold was shifted in superomedially, intercanthal distance was shortened and double-eyelid was achieved. The patients were satisfied with the result and no major complication was noted. CONCLUSION: This method can be effective in correcting the epicanthal fold of Korean eyelid by shifting the epicanthal fold superomedially to make the shape of eye aesthetically without noticeable scar.
Subject(s)
Humans , Cicatrix , Eyelids , Sterilization, TubalABSTRACT
PURPOSE: Pilomatrixoma is a benign, usually asymptomatic tumor. It presents clinically as a solitary superficial subcutaneous nodule measuring between 0.5 cm and 5 cm in diameter on the head or upper extremeties and has not been reported after skin graft. The objective of this article is to report our experience in treating pilomatrixoma which occurred after split thickness skin graft on the lower extremity. METHODS: A 56-year-old female was treated in August 2005 with a 0.5 X 0.5 cm firm subcutaneous nodule at recipient site of split thickness skin graft on the left medial thigh. The tumor was successfully removed by complete excision and histologic examination was followed. RESULTS: The diagnosis was pilomatrixoma which was characterized by a dual population of proliferating basophilic cells and diagnostic shadow cells. CONCLUSION: The tumor was successfully treated by complete resection. The authors report this very rare case of pilomatrixoma which occurred at recipient site of split thickness skin graft.
Subject(s)
Female , Humans , Middle Aged , Basophils , Diagnosis , Head , Lower Extremity , Pilomatrixoma , Skin , Thigh , TransplantsABSTRACT
PURPOSE: Perceiving the experience that MRD1 is increased after small-incision double-eyelid operation, it has been statistically verified the improvement of MRD1 retrospectively. Therefore, we suggest new interpretation for Korean-specific small eye and more definite classification for ptosis. METHODS: In operation, we made 3 small incisions according to the line designed on upper eyelid and removed some soft tissues including connective tissues. Then, figure-of-8 continuous buried ligation was performed through the incision windows. This study is a retrospective study, measures MRD1 changes and excursion distance change of eyelid margine and eyebrow using pre- and post-operative photos of 14 patients. RESULTS: Postoperative photos were taken on the 4th day and all of 14 patients had an improvement in MRD1 statistically. The excursion distance of upper eyelid was improved in half of patients, though not in the range of statistical verification. It was statistically confirmed that the movement of eyebrow was reduced after operation. CONCLUSION: It is thought that MRD1 improvement without any operation on levator complex means that soft tissue including connective tissue eliminated in operation restricts the movement of upper eyelid. It is defined such factors as burden factors and such phenomenon as burdened eyelid. It is thougt that Korean's small eye is mainly burdened eyelid and cosmetic improvement may be obtaind even by removing such burden factors.
Subject(s)
Humans , Blepharoptosis , Classification , Connective Tissue , Eyebrows , Eyelids , Ligation , Retrospective StudiesABSTRACT
PURPOSE: The history of biometry dates back to ancient Greek. The ideal body ratio from biometry is used as a guideline in many works of art. Biometry is also used as a medical standard to determine normal or abnormal. Since the biometry of face is so complicated, many surgeons tend to regard preoperative evaluation as a bother and substitute medical records with some photographs. We introduce a new method to measure MRD1 and levator function using digital photographs, which becomes widely used lately. METHODS: MRD1 can be measured with the primary- gaze-view photo which is magnified by PhotoshopR 7.0.1. The distance from coneal reflex of ring flash to upper eyelid margin is converted to mm-unit using the piece of ruler attached on the patient's face. Levator function can be measured with up-gaze-view photo and down-gaze-view photo which are superimposed on another. The excursion distance of upper eyelid margin (a) and the excursion distance of eyebrow (b) are measured respectively. The levator function can be assessed through subtraction of two values (a-b). This method is simple and precise and can be applied directly to patient without photos. RESULTS: Using magnified digital photos and computer, this method can reduce personal error and instrumental error. Taking some digital photos doesn't take long time, so it can reduce the effort of preoperative evaluation and discomfort of patients. CONCLUSION: Digital photo-biometry is useful for retrospective study. Especially reducing personal error, it is useful when the number of specimens is huge. New levator function test is much more useful for Asian- specific eyes than Berke's method allowing frontalis muscle compensation.
Subject(s)
Humans , Biometry , Compensation and Redress , Eyebrows , Eyelids , Medical Records , Reflex , Retrospective StudiesABSTRACT
The shape of supratarsal fold in double eyelid operation can be generally divided into two types: infold and outfold. Infold means that the double eyelid line commences beneath the medial epicanthus and extends wider laterally. Outfold means that the double eyelid line commences above the medial epicanthus and extends parallel to the lateral side. In the case of the young Korean generation, the infold eyelids are recognized much closer to the natural-looking eyelid type. The statistics suggested that 68% of the 20s women had the infold type naturally. To the ordinary Korean people, the preferred one has been recognized as the infold which looks more natural because most of the unartificial double eyelids belong to the infold group. In addition, the survey by the before-operation images showed the tendency to prominently prefer the infold. This research was studied based on the target of 979 women among the random consultation-patients, whose ages are from 17 to 30 years old. The average age of the target women was 22.4. The preference study of these patients was conducted through showing various shapes of double eyelid made by a pin and referring them to the before/after-operation images of other patients. The eyelid shapes were classified into the following three types. Infold, Inward fold and Outfold. In this classification, inward fold means that the double eyelid line commences above the medial epicanthus and extends wider laterally. The results of this survey suggested that inward fold accounted for the most, 421 persons(43.0 percent), followed by the Infold 296 (30.2 percent) and the outfold 262(26.8 percent). This result is opposite to the statistics that the ordinary people commonly prefer the infold type because the shape looks natural and unartificial.
Subject(s)
Adult , Female , Humans , Classification , EyelidsABSTRACT
In plastic and reconstructive craniomaxillofacial surgery, careful preoperative planning is essential to get a successful outcome. Many craniomaxillofacial surgeons have used imaging modalities like conventional radiographs, computed tomography(CT) and magnetic resonance imaging(MRI) for supporting the planning process. But, there are a lot of limitations in the comprehension of the surgical anatomy with these modalities. Medical models made with rapid prototyping (RP) technique represent a new approach for preoperative planning and simulation surgery. With rapid prototyping models, surgical procedures can be simulated and performed interactively so that surgeon can get a realistic impression of complex structures before surgical intervention. The great advantage of rapid prototyping technique is the precise reproduction of objects from a 3-dimensional reconstruction image as a physical model. Craniomaxillofacial surgeon can establish treatment strategy through preoperative simulation surgery and predict the postoperative result.
Subject(s)
Comprehension , Models, Anatomic , Plastics , ReproductionABSTRACT
The 64-year-old female patient with cough and intermittent hemoptysis of six months duration visited our hospital. On chest computed tomography, a small, ovoid, 1.3cm sized and well enhanced lesion was detected on the distal trachea. Two multiple lobulated lesions on the sigmoid and transverse colon were revealed on the colonoscopy. The histological findings showed small and medium sized lymphocytes infiltration, CD20 and CD79a positive staining and multiple lymphoepithelial lesions on the distal trachea and colon tissues. Herein, a case of primary MALT lymphoma, with involvement of the trachea and colon, which was treated with rituximab (CD20 anti-monoclonal antibody), cyclophosphamide, adriamycin, vincristine and prednisolone (CHOP regimen), is reported.
Subject(s)
Female , Humans , Middle Aged , Colon , Colon, Sigmoid , Colon, Transverse , Colonoscopy , Cough , Cyclophosphamide , Doxorubicin , Hemoptysis , Lymphocytes , Lymphoma, B-Cell, Marginal Zone , Prednisolone , Thorax , Trachea , Vincristine , RituximabABSTRACT
BACKGROUND: Recently, inorganic arsenic trioxide (As2O3) was reported to induce complete remission in a high proportion of patients with refractory acute promyelocytic leukemia (APL). To illustrate cellular and molecular mechanisms of As2O3 in the treatment of APL, many experimental studies were performed on APL-derived cell lines in vitro. Previous studies showed that As2O3 inhibited proliferation and induced apoptosis in the APL-derived cell lines. This study was done to clarify the in vitro mechanisms of As2O3-induced apoptosis in APL-derived NB4 cell lines. METHODS: To determine the effects of As2O3 in the various concentrations, NB4 cells were cultured with 0.1 to 2micro M/L of As2O3. To assay the apoptosis in NB4 cell lines, DNA fragmentation assay and TUNEL were performed. To find out the molecular change of As2O3- induced apoptotic NB4 cell lines, RT-PCR and Western blot analysis for PML-RARalpha chimeric protein expression and flow cytometry for bcl- 2/bax expression were performed. To clarify the caspase activation pathway, Western blot analysis and flow cytometry for procaspase expression were performed. RESULTS: As2O3 induces apoptosis on NB4 cells in relatively high concentration (0.5 to 2 micro M/L) for 2 days. After 2 days of culture the PML-RARalpha chimeric protein expression decreased rapidly by Western blot and RT-PCR analysis and bcl-2 expression also decreased by flow cytometry. The expression of bax by flow cytometry showed a marked increase in high concentration (2micro M/L) but there was no change in low concentration (0.5micro M/L). In the Western blot analysis, the amount of pro`enzyme of caspase-3 was significantly decreased in the cells with high concentration (2micro M/L) compared with that in the cells with low concentration (0.5micro M/L). As2O3 induces proteolytic processing of pro-caspase 7 but not pro-caspase 9 and 8. CONCLUSION: Apoptosis of APL-derived NB4 cell lines was induced by As2O3 and progressed rapidly in higher concentrations. During apoptosis, activation of caspase-7 pathway and degradation of PML-RARalpha chimeric protein, decrease in bcl-2 and increase in bax were shown.
Subject(s)
Humans , Apoptosis , Arsenic , Blotting, Western , Caspase 3 , Caspase 7 , Cell Line , DNA Fragmentation , Flow Cytometry , In Situ Nick-End Labeling , Leukemia, Promyelocytic, AcuteABSTRACT
All-trans retinoic acid (ATRA) therapy induces complete remission in acute promyelocytic leukemia (APL) via differentiation of the APL cells. Recent clinical trials in China and United states showed that arsenic trioxide (ATO) is an effective and relatively safe drug in the treatment of APL. The patient was 29-year-old woman with APL who had been treated heavily with allogeneic bone marrow transplantation (BMT) in 4 years ago and reinduction chemotherapy plus donor lymphocyte infusion (DLI) after relapse in 2 years ago. After diagnosis for relapse, she had been treated with ATRA, but unfortunately failed. She was treated with ATO at the dose of 10 mg/day intravenously for 6 weeks. Complete remission was achieved at 3 weeks and the cumulative dose of ATO during induction was 420mg. She had complete remission without severe adverse effects except mild impairment of liver function and is following up for 6 months. We report a case of remission induction by ATO in ATRA refractory APL patient who experienced multiple relapse after allogeneic BMT, chemotherapy and DLI.
Subject(s)
Adult , Female , Humans , Arsenic , Bone Marrow Transplantation , Bone Marrow , China , Diagnosis , Drug Therapy , Leukemia, Promyelocytic, Acute , Liver , Lymphocytes , Recurrence , Remission Induction , Tissue Donors , Tretinoin , United StatesABSTRACT
Recently the internal rigid fixation with plates and screws became popular procedure. In the cases of the zygomatic fracture, it is sufficient to fix more than 2 point in many studies. Therefore, the internal rigid fixation requires the aggressive incision to expose the zygoma, such as coronal incision. Since many patients are afraid of this aggressive operation, we have provided a simple and effective method which is a 3-dimensional one point fixation on the zygomaticofrontal suture with X-shaped(6-hole) miniplate for the treatment of zygomatic fractures. From March 1995 to september 1995, we treated 13 cases of zygomatic fractures by open reduction and X-shaped miniplate fixation on the zygomaticofrontal suture. The results were as follows: 1) plane to plane contact on each side of the fracture with one point X-shaped miniplate. 2) 91.8% correction on Water's views, and 93.3% correction on zygomatic arch view with one point fixation. 3) patients were satisfied with these procedures because of minimal incision, mild edema and low operation price (short operation & anesthetic time, one plate & 6 screws cost).
Subject(s)
Humans , Edema , Sutures , Zygoma , Zygomatic FracturesABSTRACT
We report a case of recurrent subacute necrotizing lymphadenitis with pancytopenia in 21-years-old-woman. She was admitted to our hospital 4-years interval with fever and abdominal pain. Laboratory findings of the last admission showed pancytopenia, such as WBC 700/microliter, hemoglobin 6.0mmol/L (9.7g/dL), hematocrit 28.8%, and platelet 54,000/microliter. Abdominal CT showed hepatosplenomegaly, enlarged conglomerated lymph nodes in splenic hilum, lesser sac, celiac root, and paraaortic areas. Bone marrow biopsy showed hypocellular marrow (20%) with increased number of megakaryocyte, myeloid hyperplasia, and hemophagocytic histiocytes suggesting infectious process. We performed exploratory laparotomy, and pathologic finding revealed subacute necrotizing lymphadenitis-Kikuchi disease-. She was recovered on 26th hospital day with conservative treatment.
Subject(s)
Abdominal Pain , Biopsy , Blood Platelets , Bone Marrow , Fever , Hematocrit , Histiocytes , Histiocytic Necrotizing Lymphadenitis , Hyperplasia , Laparotomy , Lymph Nodes , Lymphadenitis , Megakaryocytes , Pancytopenia , Peritoneal Cavity , Tomography, X-Ray ComputedABSTRACT
The double eyelid operation is one of the most common cosmetic surgery performed in orientals, and there are numerous studies about surgical procedures of that. In the case of appropriate candidates, the non-incision technique makes excellent cosmetic results, with the advantages of shorter operating time, less morbidity, less pain, no scarring and easy revision of shape. But, usually the non-incision technique is recommended in the cases with thin upper eyelid, small amount of orbital fat, less redundant skin of upper eyelid and in whom a wide fold is not desired so on. Therefore, the disadvantages of this method are that it cannot be applied to all patients. The postoperative complications are disappearance or faded fold, formation of cyst or lumps, asymmetry etc. and the incidence of these complications is slightly higher than those of the incisional method. In this study, the double eyelid operation using the continuous buried suture method was performed in 210 patients for formation of double eyelid from Jan. 1993 to Dec. 1995. In conclusion very good results can be obtained by the continuous buried suture method even in the cases of puffy upper eyelid. This method can make a double eyelid shape in the fashion the patient wants and can be a new indication for correction of unilateral double eyelid. This method is safe, satisfactory and take shorter postoperative recovery time and it can reduce the incidence of postoperative complications.