A Case of Congenital Short Trachea Combined with Laryngeal Cleft / 소아알레르기및호흡기학회지

Congenital short trachea is a rare congenital anomaly in which the trachea is composed of reduced number of cartilage rings, which result in an abnormally high position of the carina and an abnormal course of the main bronchi. Hazards of congenital short trachea in infants and children include inadvertent bronchial intubation, because it causes bronchiostenosis, pulmonary interstitial emphysema, pneumomediastinum, pneumothorax, and ipsilateral atelectasis. Laryngeal cleft is a rare condition, as well. Symptoms range from mild stridor to massive aspiration and respiratory distress, depending on the severity of the cleft. Until now, a case with combination of these two rare congenital defects has not been reported. Herein, we report a 13 month-old boy who has congenital short trachea with laryngeal cleft.

A Case of Severe Chicken Meat Allergy Diagnosed by Oral Food Challenge / 소아알레르기및호흡기학회지

Anaphylaxis is a severe systemic allergic reaction that can be fatal in some patients. Identifying the cause of anaphylaxis is very important, because this disease is preventable. Food is one of the most frequent causes of anaphylaxis. Allergy to chicken meat is uncommon, and only a few cases have been reported on anaphylaxis to chicken meat. We herein report on a 7 year-old girl who had anaphylaxis to chicken meat, which was diagnosed with an oral food challenge.

A Study on Preferred Morphologic Feature and Proportion of Facial Aesthetic Subunit by Korean General Public

PURPOSE: As the influence of mass media increases, the general standard of attractiveness or beauty of a face also changes. The primary purpose of the study is to find out the factors of the attractive and beautiful face recognized by public. METHODS: We picked out standard model photography and operated with Adobe(R) Photoshop(R) and Monariza(R) virtual plastic surgery program. The contour of face, eye, nose, forehead, zygoma, chin and proportion of upper, middle, lower face were changed. The interview survey was conducted through structured standard photo for 310 respondents. That was utilized in the final analysis. Multiple regression analysis was executed by SPSS 12.0. It was used to deal with statistical data and all the other necessary analysis. RESULTS: According to general characteristics of the respondents, many differences were found in preferred face and facial aesthetic subunits. The younger generation preferred the lozenge and inverted triangle shape contour. The respondents over 40 of age preferred the egg shape contour. In chin and zygoma contour, the respondents at the age of 20 preferred distinctly small chin and relatively small lower face. On the other hand, the respondents over 40 of age preferred the wide zygoma relatively. In the proportion of upper, middle, lower face, 51.0% of respondents answered 1:1:1. If they want to have an aesthetic operation, they preferred protruding forehead. Also they preferred the small chin and V-shaped chin in frontal view. CONCLUSION: Many respondents preferred to have a plastic surgery for the better facial subunit. The statistical evidence from this study suggests that the harmony and balance of facial aesthetic subunits make attractive and beautiful face.

Reconstruction of Hand Using Peroneal Perforator Free Flap in High-Voltage Electrical Burn Patients

PURPOSE: The hand is frequently affected area in high voltage electrical burn injury as an input or output sites. Electrical burn affecting the hand may produce full thickness necrosis of the skin and damage deep structures beneath the eschar, affecting the tendon, nerve, vessel, even bone which result in serious dysfunction of the hand. As promising methods for the reconstruction of the hand defects in electrical burn patients, we have used the peroneal perforator free flaps. METHODS: From March 2005 to June 2006, we applied peroneal perforator free flap to five patients with high tension electrical burn in the hand. Vascular pedicle ranged from 4cm to 5cm and flap size was from 4x2.5cm to 7x4cm. Donor site was closed primarily. RESULTS: All flaps survived completely. There was no need to sacrifice any main artery in the lower leg, and there was minimal morbidity at donor site. During the follow-ups, we got satisfactory results both in hand function and in aesthetic aspects. CONCLUSION: The peroneal perforator flap is a very thin, pliable flap with minimal donor site morbidity and is suitable for the reconstruction of small and medium sized wound defect, especially hand with electrical burn injury.

The Management of Chronic Wound with Modified Portable Negative Pressure Therapy

PURPOSE: V.A.C. is a new concept which is closed dressing with negative pressure to promote wound healing. It has been widely used as the treatment of chronic and acute wounds such as pressure sores, burns, stasis ulcers, and other complicated wounds. However It has disadvantages such as high cost and the need of specific equipment. In this article, we described new method to overcome these disadvantages. METHODS: We made newly innovated equipment with 50cc syringe and spring to create negative pressure. From May 2006 to May 2007, we applied it to two patients with chronic wound. RESULTS: The treatment period was 5 weeks for one case and 3 weeks for the other case. Both patients were healed completely without admission and wound healing was accelerated. During follow-ups, there were no complications. The mean cost for single dressing was 9,590 won. CONCLUSION: Modified portable negative therapy using newly innovated equipment could accelerate wound healing better than conventional dressing. It lowers the number of dressings, saves cost of treatment, and enables treatment as outpatient basis.

The Usability of Perforator-based Fasciocutaneous Flap for Trochanteric Pressure Sore

PURPOSE: Myocutaneous flap was widely used for trochanteric pressure sore but it had many drawbacks such as donor site morbidity, dog-ear deformity and functional muscle sacrifice. We have performed fasciocutaneous flap based on perforating vessels and succeeded in overcoming its drawbacks. METHODS: We experienced 11 cases of perforator-based fasciocutaneous flap for the coverage of trochanteric pressure sore in 9 patients, 2 cases of which were bilateral. The ambulatory status of patient group is as follows: 6 of them used a wheelchair, 2 of them are free walking, 1 of them use a wheelchair or crutches. Flap was supplied by cutaneous perforating vessel of descending branch of the lateral circumflex femoral artery and the third perforating artery of the deep femoral artery. The size of wounds were from 4x6.5cm to 10x13cm. RESULTS: We did not find any flap loss or congestion except 2 partial wound dehiscences and 1 wound infection. Donor site morbidity was not found. We observed no recurrence of the pressure sore during the 2.5 year follow-up period. CONCLUSION: We considered that perforator-based fasciocutaneous flap could overcome the traditional drawbacks of the conventional myocutaneous flap and its modified flap for trochanteric pressure sore. And this flap has many advantages for covering trochanteric pressure sore without any donor site deformity and morbidity, which would greatly improve the aesthetic result.

Primary Cutaneous Anaplastic Large Cell Lymphoma: A Case Report

PURPOSE: Anaplastic large cell lymphoma, has the following three characteristics of a malignant lymphoma; 1) An irregular large nucleus, called pathologic atypical cells, 2) Eosinophilic cytoplasm, 3) Immunologically positive for Ki-1. Anaplastic large cell lymphoma occurs mostly in the lymph nodes, but about 40% has been observed to occur in other tissues. Skin is the one of the main sources of origin and it is called 'primary cutaneous anaplastic large cell lymphoma'. METHODS: A 69-year-old male patient with an erythematous nodule, sized 1.5 X 1.7 cm on his right hand dorsum was excised under local anesthesia and on biopsy was diagnosed as 'Dermatofibrosarcoma Protuberans'. Three months after the local excision and biopsy, same natured mass reoccurred in the same region, and then spontaneous regressed after three weeks. However, metastatic large mass of 4.0 X 5.0 cm, of same nature was observed on the elbow. The large mass was operated with wide excision and biopsy. RESULTS: On final diagnosis, with an immunofluorescent stain with CD30(Ki-1), 'Primary cutaneous large cell lymphoma' was made. After follow up for three years, we did not observed recurrence and metastasis. CONCLUSION: We have reported that we have diagnosed primary cutaneous large cell lymphoma and treated without recurrence and metastasis.

Inverted Nipple Correction through Modified Broadbent-Woolf Method

Inverted nipple can be a cause of great distress, leading to potential breast feeding problems, and repeated irritation and inflammation. Many surgical and non-surgical procedures have been described for reshaping the nipple and areola so that it once again projects out from the breast. The aim of the study presented here is to show a reliable and effective method for treating inverted nipple particularly the more serious cases of Grade II and III as classified in the Han and Hong classification of nipple inversion. We added to vertical Z-plasty based on the Broadbent- Woolf method to the correction of inverted nipple This is a simple procedure with very few recurrence of inversion after treatment particularly for women no longer breast feeding. We saw good results with patients during the 6 to 18 months follow up period. 5 patients(9 inverted nipples) were treated. All patients had congenital nipple inversion. Each patient had no plans to breast feed in the future. There was no recurrence and sensory change, no postoperative hematoma or any seroma complications. All patients had good aesthetic results and their overall satisfaction was high. We considered that this method was effective and simple for correction of the inverted nipple.