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BACKGROUND: Nasal pyramid fractures accompanied by saddle nose deformities are not easily corrected by closed reduction. We used an absorbable plate as a perpendicular strut to support the collapsed "keystone area" and obtained good results. METHODS: Between September 2008 and June 2011, 18 patients who had nasal pyramid fractures with saddle nose deformities underwent surgery. Pre- and postoperative facial computed tomographic images and photographs were taken to estimate outcomes. The operative technique included the mucoperichondrial dissection of the nasal septum, insertion of an absorbable plate prepared to an appropriate length to support the "keystone area", and fixation of the absorbable plate strut to the cartilaginous septum. RESULTS: Functional and esthetic outcomes were satisfactory in all patients. Eleven patients assessed the postoperative appearance of the external nose as 'markedly improved' and 7 patients as 'improved'. The 5 surgeons scored the results as a mean of 4.5 on a 5-point scale. CONCLUSIONS: The use of an absorbable plate as a perpendicular strut requires no additional procedures because the plate is gradually absorbed. The mechanical strength provided by a buttress between the "keystone area" and the maxillary crest lasts for a long time before the strut is absorbed.
Assuntos
Humanos , Implantes Absorvíveis , Anormalidades Congênitas , Fraturas Fechadas , Osso Nasal , Septo Nasal , NarizRESUMO
BACKGROUND: During the planning of a thoracodorsal artery perforator (TDAP) free flap, preoperative multidetector-row computed tomographic (MDCT) angiography is valuable for predicting the locations of perforators. However, CT-based perforator mapping of the thoracodorsal artery is not easy because of its small diameter. Thus, we evaluated 1-mm-thick MDCT images in multiple planes to search for reliable perforators accurately. METHODS: Between July 2010 and October 2011, 19 consecutive patients (13 males, 6 females) who underwent MDCT prior to TDAP free flap operations were enrolled in this study. Patients ranged in age from 10 to 75 years (mean, 39.3 years). MDCT images were acquired at a thickness of 1 mm in the axial, coronal, and sagittal planes. RESULTS: The thoracodorsal artery perforators were detected in all 19 cases. The reliable perforators originating from the descending branch were found in 14 cases, of which 6 had transverse branches. The former were well identified in the coronal view, and the latter in the axial view. The location of the most reliable perforators on MDCT images corresponded well with the surgical findings. CONCLUSIONS: Though MDCT has been widely used in performing the abdominal perforator free flap for detecting reliable perforating vessels, it is not popular in the TDAP free flap. The results of this study suggest that multiple planes of MDCT may increase the probability of detecting the most reliable perforators, along with decreasing the probability of missing available vessels.
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Humanos , Masculino , Angiografia , Artérias , Retalhos de Tecido Biológico , Tomografia Computadorizada MultidetectoresRESUMO
OBJECTIVE: We wanted to evaluate the feasibility and usefulness of a newly designed balloon sheath for gastrointestinal guidance and access by conducting a phantom study. MATERIALS AND METHODS: The newly designed balloon sheath consisted of an introducer sheath and a supporting balloon. A coil catheter was advanced over a guide wire into two gastroduodenal phantoms (one was with stricture and one was without stricture) ; group I was without a balloon sheath, group ll was with a deflated balloon sheath, and groups III and IV were with an inflated balloon and with the balloon in the fundus and body, respectively. Each test was performed for 2 minutes and it was repeated 10 times in each group by two researchers, and the positions reached by the catheter tip were recorded. RESULTS: Both researchers had better performances with both phantoms in order of group IV, III, II and I. In group IV, both researchers advanced the catheter tip through the fourth duodenal segment in both the phantoms. In group I, however, the catheter tip never reached the third duodenal segment in both the phantoms by both the researchers. The numeric values for the four study groups were significantly different for both the phantoms (p < 0.001). A significant difference was also found between group III and IV for both phantoms (p < 0.001). CONCLUSION: The balloon sheath seems to be feasible for clinical use, and it has good clinical potential for gastrointestinal guidance and access, particularly when the inflated balloon is placed in the gastric body.
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Humanos , Imagens de Fantasmas , Gastroenteropatias/terapia , Obstrução da Saída Gástrica/terapia , Estudos de Viabilidade , Obstrução Duodenal/terapia , /instrumentaçãoRESUMO
A 49 years old male patient suffering from liver cirrhosis and diabetes mellitus was admitted with complaints of chest pain and hematemesis. Three years ago, the patient received a transfusion of unknown blood components, presumed platelet concentrates. During the pretransfusion testing, we found irregular antibodies with the antibody-screening test and identified the antibody as anti-Xga. An antiglobulin test was done as a part of a cross-match and all compatible units of packed red cells were transfused. No transfusion reaction was observed.
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Humanos , Masculino , Pessoa de Meia-Idade , Anticorpos , Incompatibilidade de Grupos Sanguíneos , Plaquetas , Dor no Peito , Teste de Coombs , Diabetes Mellitus , Hematemese , Cirrose Hepática , Hepatopatias , FígadoRESUMO
BACKGROUND: Several studies on the frequency and distribution of unexpected antibodies of Koreans have been done by some investgators. But more studies are necessory to grasp the real frequency and distribution. We hoped to investigate the frequency and distribution of unexpected antiboddis of Koreans. METHODS: We performed 188 unexpected antibody identification tests to evaluate the distribution of unexpected antibodies from May 1997 to June 1998. The sera we tested are antibody screening positive ones sent from 11 hospitals and 1 blood center. We also analized the frequecny of unexpected antibodues from the data of Dongsan Medical Center's antibody screening tests. RESULTS: The frequency of unexpected antibody of this study (using tube method) was 1.0%. Both anti-Lea and anti-E (with anti-c) antibodies were the most frequent antibodies up to 31 cases (33.0%) each. Among the identified antibodies from Dongsan Medical Center which used tube method, anti-Lea antibody was the most frequent antibody (41.3%). Otherwise among the identified antibodies from other two hospitals which used gel card method, anti-E (with anti-c) antibody was the most frequent antibody (45.5%). The cause of all four cases of hemolytic disease of newborn was anti-E antibody. About half of the specimens' antibodies were not identified due to the problemes of identification cells, tested sera, test methods. CONCLUSION: Anti-Lea and anti-E (with anti-c) antibodies were the most frequent ones in Korean people. But the prequency was varied according to antibody screenig test methods. Anti-E antibody is the most important unexpected antibidy for hemolytic disease of newborn in Korea. To decrease the missed cases of antibody identification tests both Korean and foreign identification cells, enzyme method should be used.
Assuntos
Recém-Nascido , Anticorpos , Eritroblastose Fetal , Força da Mão , Esperança , Coreia (Geográfico) , Programas de RastreamentoRESUMO
BACKGROUND: A recently identified Flaviviridae-like agent, termed hepatitis G virus (HGV), has been recognized as a non A-E hepatitis agent, but its relation to liver disease and transmission mode are not well understood. We investigated HGV infection rate in Korea and tried to clarify its relation to the liver disease. METHODS: 145 blood donors, 39 hemodialysis patients and 22 hepatitis C virus (HCV) infected persons were investigated for the presence of HGV by nested reverse transcriptase polymerase chain reaction (nested RT-PCR) with primers from the 5' UTR of HGV and some liver function tests. In each PCR assay, one positive and two negative controls were included. RESULTS: HGV-RNA was detected in 11 (7.6%) of 145 young voluntary blood donors and in 5 (12.8%) of 39 hemodialysis patients and in 8 (36.4%) of 22 HCV infected patients. All HGV RNA positive hemodialysis patients have a past history of transfusion, but they had a remarkably shorter duration of hemodialysis than those of HGV-negative patients. HCV infected patients with HGV-RNA tended to be younger than those without HGV-RNA. In all 15 HGV-RNA infected individuals without hepatitis B and C infection, alanine amino transferase was not increased except in 2 cases. Liver function tests did not show a significant difference between HGV-RNA positive patients and negative patients. CONCLUSIONS: Hepatitis G virus infection rate was much higher in Korea than other countries, so we suggested that group life could be another transmission mode other than blood transfusion. But even in infected cases, HGV did not seem to cause hepatitis and a high proportion cleared the virus after a relatively short time.
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Humanos , Regiões 5' não Traduzidas , Alanina , Doadores de Sangue , Transfusão de Sangue , Vírus GB C , Hepacivirus , Hepatite B , Vírus da Hepatite B , Hepatite C , Hepatite , Coreia (Geográfico) , Hepatopatias , Testes de Função Hepática , Reação em Cadeia da Polimerase , Diálise Renal , Reação em Cadeia da Polimerase Via Transcriptase Reversa , RNA , TransferasesRESUMO
BACKGROUND: Investigation of the factors affecting blood donation practice is essential to develop the ways of making blood donation campaign, as well as efficient and facilitating blood donation practice. A few studies has been made concerning the factors affecting blood donation in Korea. METHODS: 637 participants were examined using self-administered questionnaires including demographic variables, experience, knowledge and attitude for blood donation and others. RESULTS: 51.5% of participants had experienced the blood donation. Students who donated blood in high school days showed tendency to donate blood more than those who didn t donate blood in high school days. Students who had more knowledge and desirable attitude about blood donation experienced more blood donations. CONCLUSION: It is necessary for adolescents to take the opportunity of blood donation. It is important to clarify factors affecting blood donation practice and to encourage the public education and campaign which enable public has accurate knowledge and positive attitude about blood donation.
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Adolescente , Humanos , Doadores de Sangue , Educação , Coreia (Geográfico) , Inquéritos e QuestionáriosRESUMO
A newly developed third generation enzyme immunoassay(Lucky HCD 3.0 EIA) for hepatitis C virus(HCV) antibodies was added with the envelope(E1E2)/NS4 fusion proteins and expanded NS5 proteins as well as the core/NS3 fusion proteins. Authors evaluated the HCD 3.0 EIA with the previously available second generation EIA(HCD 2.0) in 10,435 Red Cross blood donors. Among 10,435 donors who were screened for the presence of HCV antibodies by HCD 2.0 assay, 22(0.21%) sera were repeatedly reactive. All of these sera were tested for further testing. Only 13 of all tested sera were reactive by HCD 3.0 EIA, and nine sera were not reactive. Nine of 13 HCD 3.0 positive sera were reactive by recombinant immunoblot assay(Lucky-Confirm). Also seven of these 13 sera had detectable HCV genomic RNA by reverse transcriptase-polymerase chain reaction(RT-PCR). None of nine HCD 3.0 negative samples had detectable immunoblot assay and HCV genomic RNA. It is concluded that the new HCV EIA can decrease a significant false positivity of second generation EIA in a blood donor population. This new assay correlates well with detection of HCV-RNA by RT-PCR and identifies donors who are truly infected.