Characteristics of hard seltzer and their effect on the tooth surface / 대한구강보건학회지

Objectives@#To investigate the effect of commercially available hard seltzer on the tooth enamel surface. @*Methods@#Some commercially available hard seltzer were purchased at the market and the characteristics of the beverages were surveyed. Subsequently, Cloud hard seltzer mango was selected for the hard seltzer group (group 4), Jeju Samdasoo for the mineral water group (group 1), Coca-Cola for the cola group (group 2), and Cloud Original for the beer group (group 3). The specimens were immersed in the experimental beverage for 30 minutes, then the surface microhardness and surface condition of the specimens were evaluated. @*Results@#The average pH of the twelve types of hard seltzer in this study were 3.51±0.01 (before stirring) and 3.46±0.01 (after stirring). The pH of experimental beverage were 7.92±0.03 (group 1), 2.55±0.01 (group 2), 4.41±0.01 (group 3), and 3.31±0.01 (group 4). Paired t-test of the surface microhardness of enamel before and after beverage immersion found no significant difference in group 1 (P>0.05), but a significant difference was observed in groups 2, 3, and 4 (P<0.05). One way ANOVA of the surface microhardness change values (∆VHN, before - after immersion) among groups found a statistically significant difference between groups 1 and 3 (9.20±34.82 ∆VHN and 20.20±6.52 ∆VHN) and groups 2 and 4 (82.90±18.08 ∆VHN and 67.10±18.27 ∆VHN) (P<0.05).On scanning electron microscopy, hard seltzer group showed rough and ruined surface condition. @*Conclusions@#This study found a risk of dental erosion due to the low pH of hard seltzer. Therefore, it is suggested that when ingesting hard seltzer, dental erosion should be considered for oral health.

Effect of fermented milk product on composite resin surface / 대한구강보건학회지

Objectives@#The present study was carried out to identify the effects of commercially available fermented milk on the surfaces of composite resins. @*Methods@#The experiment included 6 groups: Fermented milk (Group 3), fermented milk supplemented with 3% calcium (Group 4), specimens coated with fluoride and then treated with fermented milk (Group 5), specimens coated with fluoride and then treated with fermented milk supplemented with calcium (Group 6), mineral water (Group 1), and carbonated beverage (Group 2). The prepared specimens were immersed in the experimental solution to analyze the effects of the test fluid on the surfaces of the composite resin specimens. The degree of microhardness on each specimen surface was subsequently measured. The results were obtained using scanning electron microscopy. @*Results@#The pH values of the experimental solutions in an increasing order were: Group 2 (2.34 ±0.08), Group 3 and Group 5 (3.45±0.03), Group 4 and Group 6 (4.04±0.06), and Group 1 (7.72 ±0.17). Significant differences in the Vickers hardness number (△VHN) were found between the groups when measured before and after immersion in the experimental solution in the following order: -11.48±1.45 (Group 2), -9.54±1.15 (Group 3), -9.21±1.21 (Group 4), -8.14±0.84 (Group 6), -8.10±0.92 (Group 5), and -1.71±0.57 (Group 1) (P<0.05). Scanning electron microscopy findings of the composite resin surfaces in Groups 5 and 6 revealed smooth surfaces similar to those in Group 1 ( negative control). In contrast, Groups 3 and 4 showed rough surfaces with severe cracks between the crystals, similar to those of Group 2 (positive control). @*Conclusions@#The intake of fermented milk may attenuate the surface microhardness of composite resins. To slow down the reduction in microhardness following fermented milk consumption, coating the composite resin surfaces with fluoride and adding calcium supplement to the fermented milk could be considered.

Effect of fermented milk product on composite resin surface / 대한구강보건학회지

Objectives@#The present study was carried out to identify the effects of commercially available fermented milk on the surfaces of composite resins. @*Methods@#The experiment included 6 groups: Fermented milk (Group 3), fermented milk supplemented with 3% calcium (Group 4), specimens coated with fluoride and then treated with fermented milk (Group 5), specimens coated with fluoride and then treated with fermented milk supplemented with calcium (Group 6), mineral water (Group 1), and carbonated beverage (Group 2). The prepared specimens were immersed in the experimental solution to analyze the effects of the test fluid on the surfaces of the composite resin specimens. The degree of microhardness on each specimen surface was subsequently measured. The results were obtained using scanning electron microscopy. @*Results@#The pH values of the experimental solutions in an increasing order were: Group 2 (2.34 ±0.08), Group 3 and Group 5 (3.45±0.03), Group 4 and Group 6 (4.04±0.06), and Group 1 (7.72 ±0.17). Significant differences in the Vickers hardness number (△VHN) were found between the groups when measured before and after immersion in the experimental solution in the following order: -11.48±1.45 (Group 2), -9.54±1.15 (Group 3), -9.21±1.21 (Group 4), -8.14±0.84 (Group 6), -8.10±0.92 (Group 5), and -1.71±0.57 (Group 1) (P<0.05). Scanning electron microscopy findings of the composite resin surfaces in Groups 5 and 6 revealed smooth surfaces similar to those in Group 1 ( negative control). In contrast, Groups 3 and 4 showed rough surfaces with severe cracks between the crystals, similar to those of Group 2 (positive control). @*Conclusions@#The intake of fermented milk may attenuate the surface microhardness of composite resins. To slow down the reduction in microhardness following fermented milk consumption, coating the composite resin surfaces with fluoride and adding calcium supplement to the fermented milk could be considered.

Prevention of dental erosion in early dental caries by application of remineralizing substance to fermented beverage / 대한구강보건학회지

Objectives@#The purpose of this study was to investigate the possibility of preventing dental erosion caused by fermented milk in early carious teeth by applying 0.2% sodium fluoride to the tooth surface and adding 0.5% calcium to the drink. @*Methods@#We selected the experimental drink Yakult, which is the best-selling domestic fermented milk drink. A total of five groups were selected as experimental groups (mineral water, fermented milk, 0.2% NaF+fermented milk, 0.2% NaF+(fermented milk+0.5% Ca), and 0.2% NaF+Distilled water groups). After forming the artificial early caries, the pH cycling was administered for five days to derive surface microhardness and scanning electron microscope (SEM) image results. @*Results@#When comparing the surface microhardness before and after treatment in each group, significant differences were found among the four groups (P0.05). A comparison of the difference in surface microhardness before and after pH cycling among the groups revealed a significant difference (P0.05). The 0.2% NaF+fermented milk and fermented milk groups showed significant differences from the other groups (P0.05) showed smoother surfaces than the 0.2% NaF+fermented milk and fermented milk groups. @*Conclusions@#Based on these results, it was confirmed that if 0.5% calcium was included in the fermented milk along with the fluoride mouth rinsing program in schools using 0.2% fluoride every week when drinking fermented milk, it is possible to effectively prevent dental erosion even in early carious teeth.

Prevention of dental erosion in early dental caries by application of remineralizing substance to fermented beverage / 대한구강보건학회지

Objectives@#The purpose of this study was to investigate the possibility of preventing dental erosion caused by fermented milk in early carious teeth by applying 0.2% sodium fluoride to the tooth surface and adding 0.5% calcium to the drink. @*Methods@#We selected the experimental drink Yakult, which is the best-selling domestic fermented milk drink. A total of five groups were selected as experimental groups (mineral water, fermented milk, 0.2% NaF+fermented milk, 0.2% NaF+(fermented milk+0.5% Ca), and 0.2% NaF+Distilled water groups). After forming the artificial early caries, the pH cycling was administered for five days to derive surface microhardness and scanning electron microscope (SEM) image results. @*Results@#When comparing the surface microhardness before and after treatment in each group, significant differences were found among the four groups (P0.05). A comparison of the difference in surface microhardness before and after pH cycling among the groups revealed a significant difference (P0.05). The 0.2% NaF+fermented milk and fermented milk groups showed significant differences from the other groups (P0.05) showed smoother surfaces than the 0.2% NaF+fermented milk and fermented milk groups. @*Conclusions@#Based on these results, it was confirmed that if 0.5% calcium was included in the fermented milk along with the fluoride mouth rinsing program in schools using 0.2% fluoride every week when drinking fermented milk, it is possible to effectively prevent dental erosion even in early carious teeth.

Inhibition of dental erosion through addition of calcium to commercial plum beverages / 대한구강보건학회지

OBJECTIVES: We examined the effect of commercial plum beverages on dental erosion and whether the addition of calcium to these beverages would inhibit dental erosion. METHODS: We analyzed three groups as follows: Maesil 1 group (Chorok Maesil), Maesil 2 group (Sunkist plum), both of which were selected from commercially-available plum beverages, and Calcium-added maesil group (addition of 3% calcium to Chorok Maesil). For negative and positive control groups, Jeju Samdasoo and Coca Cola were selected, respectively. The characteristics of the experimental beverages were analyzed, and the specimens were immersed in the experimental beverage. The degree of erosion was measured by Vickers hardness number (VHN) and scanning electron microscope images. RESULTS: Positive control group had the lowest pH (2.50±0.03), followed by Maesil 2 (pH 2.59±0.01), Maesil 1 (pH 2.81±0.02), calcium-added maesil (pH 4.19±0.01), and negative control group (pH 7.57±0.06). Significant differences were found in surface microhardness between positive control, Maesil 1, Maesil 2 and calcium-added maesil group before immersion and at 30 minutes after immersion (P<0.05), and change in VHN (positive control group, −80.94±20.63; Maesil 1 group, −69.33±24.88; and Maesil 2 group, −78.49±18.60 in comparison with negative control group, −6.57±26.73). There was no significant difference (P<0.05) in change in VHN between calcium-added maesil (−13.02±17.33) and negative control group. CONCLUSIONS: Plum beverages can potentially induce dental erosion due to their low pH. However, adding calcium to these beverages can reduce the risk of dental erosion. Therefore, the risk of dental erosion must be considered during consumption of plum beverages, and the addition of calcium into plum beverages may be considered as a way to prevent dental erosion.

Effects of commercial dry syrups on tooth surfaces / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to investigate the effects of dry syrups on bovine tooth surfaces. METHODS: Each specimen of the extracted bovine teeth enamel was treated with two types of dry syrup (experimental group), mineral water (negative control group), and liquid syrup (positive control group) (n=12 per group). The specimens were immersed for 1, 5, and 10 minutes and subsequently analyzed for surface microhardness changes using a Vickers hardness tester. RESULTS: The surface microhardness of sound enamel decreased as the immersion time increased. In addition, the microhardness difference (ΔVHN) among the groups after immersion for 10 minutes in both liquid syrup and two types of dry syrup was higher than that after immersion in mineral water (P0.05). CONCLUSIONS: These results imply the erosive potential of dry syrup on tooth surfaces. The longer the contact time with teeth, greater is the risk of dental erosion. Therefore, it is recommended that the mouth be rinsed with water after drinking the syrup.

Effects of commercial plum beverage on the dentin surface of bovine teeth / 대한구강보건학회지

OBJECTIVES: We investigated the effects of commercial plum beverage on the dentin surface that could be exposed to caries, gliopathy, and abrasion to investigate the inhibitory effects of dentin corrosion.METHODS: The experimental beverages were Jeju Samdasoo (Group 1, negative control), Coca-Cola (Group 2, positive control), Chorok Maesil (Group 3), and Chorok Maesil with 3% calcium lactate added (Group 4). The specimens were prepared and divided into 4 groups of 12 each. The pH of the experimental beverages was measured using a pH meter, and specimen surface hardness was assessed according to the Vickers hardness number (VHN). The specimens were immersed in the experimental beverage for 1, 3, 5, 10, and 15 minutes. Then, we obtained the average VHN by measuring surface microhardness. Measures of surface microhardness were compared using the paired t-test before and after 15 minutes of immersion in each of the four beverages. Between-group differences in surface microhardness were compared using one-way analysis of variance and the Tukey test after the analysis.RESULTS: After 15 minutes of immersion in the experimental beverages, there was no significant difference in surface microhardness in group 1 (P>0.05). There were significant differences in groups 2, 3, and 4 (P < 0.05). The difference in surface microhardness before and after immersion for 15 minutes was highest in group 3 (−18.1±2.55), followed by group 2 (−13.0±3.53) and group 4 (−7.79±4.47). In group 1, the difference was −1.52±4.30. Moreover, there was a significant difference in each group (P < 0.05). After 10 minutes of immersion, surface microhardness tended to rapidly decrease.CONCLUSIONS: Patients who regularly ingest a commercially available plum drink with low pH should be provided dietary guidance on the risk of dental erosion. Calcium additives should be considered when producing plum beverage products.

The relationship between musculoskeletal pain and social-psychological factors among dental practitioners / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to investigate the relationship between musculoskeletal pain and social psychological factors among dental practitioners. METHODS: A total of 497 dental practitioners who worked in 20 dental clinics and hospitals between June 9 and June 30, 2011 were enrolled in this study. The participants' stress level was measured using the PWI-SF (Psychosoical Well-Being Index-Short Form), a psychosocial health measurement tool, and their musculoskeletal pain was measured using a table that was revised and supplemented by the Korea Occupational Safety Health Agency. Statistical analysis was carried out through frequency analysis, chi-square test, and correlation analysis, using the Statistical Package for the Social Sciences (SPSS) software, version 18.0. RESULTS: Analyzing the relationship between musculoskeletal pain and social-psychological factors of dental practitioners revealed satisfaction has a significant effect on the level of musculoskeletal pain experienced (P<0.05). Notably, salary satisfaction showed a significant influence on the degree of leg musculoskeletal pain (r=−0.140) and lower back pain (r=−0.204; P<0.05) experienced. Satisfaction in their own welfare (r=−0.157) and amount of time spent working (r=−0.135) showed a significant influence on the degree of leg musculoskeletal pain experienced (P<0.05). The level of pain experienced was higher as the level of stress risk increased (P<0.05). CONCLUSIONS: The level of musculoskeletal pain experienced by dental practitioners was highly related to social-psychological factors. In order to reduce the human and economic losses due to musculoskeletal diseases, continuous preventive care must be provided. Social psychological factors, such as details of job satisfaction and stress, should be taken into account along with physical management of musculoskeletal disorders.

Effects of dentifrice containing 1,500 ppm F (NaF) on dental erosion / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to evaluate the effect of a dentifrice containing 1,500 ppm F (NaF) and 2% bamboo salt on dental erosion caused by ingestion of acidic beverages. METHODS: Specimens of extracted bovine teeth enamel were embedded in a resin and polished. Experimental specimens were subjected to one of the six treatments (n=10 per treatment group): the experimental group consisted of 1,500 ppm F (NaF)+2% bamboo salt; 1,500 ppm F (NaF); 1,000 ppm F (NaF)+2% bamboo salt; 1,000 ppm F (NaF); free fluoride+2% bamboo salt; and free fluoride. The specimens were exposed to the experimental dentifrice, an acidic beverage, and artificial saliva. The treated specimens were analyzed using a Vickers surface hardness test and scanning electron microscopy (SEM). Surface hardness and SEM were compared before and after the chemical pH cycling sequences for 12 days. RESULTS: Group 1 (1,500 ppm F+2% bamboo salt) showed the highest surface hardness, followed by group 2 (1,500 ppm F), group 3 (1,000 ppm F+2% bamboo salt), group 4 (1,000 ppm F), group 5 (free fluoride+2% bamboo salt), and group 6 (free fluoride), in that order. Upon observing the surface by SEM, when bamboo salt was used and when the NaF concentration was higher, the enamel was denser and the surface was more highly remineralized. CONCLUSIONS: The use of a higher concentration of NaF and bamboo salt resulted in a higher preventive effect on tooth erosive potential. The addition of bamboo salt to dentifrice containing a high concentration of NaF can contribute to preventing dental erosion.

Effects of commercial tea beverages containing citric acid on tooth surfaces / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to evaluate the erosive potential of tea beverages containing citric acid on tooth surfaces. METHODS: Specimens of extracted bovine teeth enamel were embedded in resin and polished. The specimens were subjected to one of three treatments (n=10 per treatment group): mineral water, brewed black tea, or black tea beverage. Tooth specimens were exposed to the treatment for 30 minutes and then analyzed using Vickers surface hardness testing and scanning electron microscopy. RESULTS: After 30 minutes of treatment, there were statistically significant differences between the hardness of the enamel pre- and post-treatment in both, the brewed black tea and black tea beverage groups (P0.05).On observation using a scanning electron microscope, the tooth surfaces exposed to the black tea beverage containing citric acid were rougher than the tooth surfaces in the other two groups. CONCLUSIONS: This study demonstrates the erosive potential of citric acid-containing tea beverages on tooth surfaces. Thus, there is need to caution people regularly consuming tea beverages containing citric acid, regarding the possibility of tooth surface erosion.

Comparative remineralization effects of human and artificial saliva compositions on incipient dental caries / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to compare enamel remineralization effects of human whole saliva and currently available artificial saliva compositions, using teeth exposed to chemical pH cycling conditions, and to obtain data that can inform future design and manufacturing of additional artificial saliva compositions. METHODS: Seventy-two specimens of bovine tooth enamel were embedded in resin, then polished and exposed to a lactate/carbopol buffer system for 48-52 hours. Specimens were allocated into six experimental groups (n=12 specimens per group) by randomized blocks, such that each group contained an equivalent proportion of specimens at each Vickers hardness number (VHN) stratum: deionized water as a negative control, human whole saliva and artificial saliva compositions A, B, C and D. Surface hardness was measured before and after 15 days of chemical pH cycling. Surface microhardness was measured (Fm-7, Future-tech Corp, Japan) before and after treatment with test saliva compositions. One-way ANOVA, with post hoc Tukey test, was used to evaluate statistical differences with a significance threshold of P<0.05. RESULTS: The intragroup changes in microhardness (ΔVHN) for treatment with each saliva composition were (in ascending order of ΔVHN): ―0.39±16.08 (deionized water control), 7.32±11.52 (artificial saliva B), 39.18±11.94 (artificial saliva C), 3.83±13.81 (artificial saliva D), 62.44±29.23 (artificial saliva A) and 102.90±25.89 (human whole saliva). Enamel treated with human saliva, or with artificial saliva compositions A, C, or D, demonstrated comparatively greater microhardness than enamel treated with deionized water or artificial saliva B. There was no difference in surface hardness between enamel treated with artificial saliva B and enamel treated with deionized water. CONCLUSIONS: Our study suggests that human saliva and artificial saliva compositions A, C, and D are effective remineralization solutions for use in pH cycling.

Antimicrobial effect of Prunus mume extracts against cariogenic bacteria / 대한구강보건학회지

OBJECTIVES: This study was conducted to determine whether Prunus mume extracts have an antimicrobial effect against Streptococcus mutans (S. mutans) and Streptococcus sobrinus (S. sobrinus). METHODS: The study used crushed and dried Prunus mume, to which 80% methanol was added to obtain extracts. The extracts then underwent a demarcation process, sequentially using hexane, chloroform, and ethyl acetate, all of which have different polarities, followed by a reduction in pressure . The disc diffusion method was then used to measure the clear zone diameter to identify the antimicrobial effect of Prunus mume extracts using the different solvents. The methanol extracts that presented antimicrobial activity against S. mutans and S. sobrinus were then selected, and their optical densities (3, 6, 9, 12, and 24 h after cultivation) were measured to identify growth retardation effects based on extract concentration (0.01, 0.1, 1, and 5 mg/ml). RESULTS: A clear zone was observed in methanol and ethyl acetate for S. mutans when the antimicrobial effect of Prunus mume extracts of each solvent against oral microorganisms was measured via the disc diffusion method. A clear zone was observed in hexane, chloroform, methanol, and ethyl acetate, when the extracts were tested for antimicrobial activity against S. sobrinus. The extract concentration of 1 mg/ml retarded growth with a statistical significance (P<0.05) from 6 h onwards, as determined when the optical density was measured hourly and the growth curves of S. mutans and S. sobrinus were plotted. CONCLUSIONS: Prunus mume extracts retarded the growth of S. mutans and S. sobrinus with increase in time and concentration. Therefore, Prunus mume extracts hold the potential to be used for developing an oral antimicrobial agent to control dental caries.

Perioperative Hypertension Management during Facelift under Local Anesthesia with Intravenous Hypnotics

Perioperative hypertension is a phenomenon in which a surgical patient's blood pressure temporarily increases throughout the preoperative and postoperative periods and remains high until the patient's condition stabilizes. This phenomenon requires immediate treatment not only because it is observed in a majority of patients who are not diagnosed with high blood pressure, but also because occurs in patients with underlying essential hypertension who show a sharp increase in their blood pressure. The most common complication following facelift surgery is hematoma, and the most critical risk factor that causes hematoma is elevated systolic blood pressure. In general, a systolic blood pressure goal of 65 mm Hg are recommended. This article discusses the causes of increased blood pressure and the treatment methods for perioperative hypertension during the preoperative, intraoperative, and postoperative periods, in order to find ways to maintain normal blood pressure in patients during surgery. Further, in this paper, we review the causes of perioperative hypertension, such as anxiety, epinephrine, pain, and postoperative nausea and vomiting. The treatment methods for perioperative hypertension are analyzed according to the following 3 operative periods, with a review of the characteristics and interactions of each drug: preoperative antihypertensive medicine (atenolol, clonidine, and nifedipine), intraoperative intravenous (IV) hypnotics (propofol, midazolam, ketamine, and dexmedetomidine), and postoperative antiemetic medicine (metoclopramide and ondansetron). This article focuses on the knowledge necessary to safely apply local anesthesia with IV hypnotics during facelift surgery without the assistance of an anesthesiologist.

Anthropometric Measurement for the Nipple Areola Complex

PURPOSE: Although the demand for the mammoplasty including reduction or reconstruction is remarkably increasing, the anthropometric measurement for the breast, especially about the nipple areola complex(NAC) of Korean women has not been reported recently. Therefore, the anthropometric measurement about the NAC was performed to suggest the standard size of NAC for Korean women. METHODS: Two hundred and twenty five female volunteers in 20's through 50's were included for the study. Questionnaires including the diameter of NAC, the diameter, height of nipple, age, marital status, delivery and lactation history were distributed to the volunteers and collected. RESULTS: The mean values of our study are as follows: the areola diameter is 30.93+/-10.07mm, the nipple diameter is 10.21+/-4.14mm and the height of nipple is 6.54+/-3.74mm. The diameter of nipple areola complex(NAC) is bigger in old ages. If the volunteers have the history of marriage, delivery and lactation, it is bigger, as well. The height of nipple closely related to individual characters except the correlation between height of nipple and age. CONCLUSION: It is important to have standard data for the nipple areola complex in order to have good aesthetic results of mammoplasty. Despite the importance, there are a few measurement data for the nipple areola complex(NAC) of Korean women. The result of our study is not the absolute parameter for breast surgery, however it can be used as the standard size for NAC in the Korean female during breast surger

Cleft Palate and Congenital Alveolar Synechiae Syndrome: A Case Report and Literature Review

Cleft palate and congenital alveolar synechia is a rare syndrome. Only eight cases have been previously reported. It consists of a spectrum of facial anomalies always including cleft palate and congenital alveolar synechiae without other abnormalities. This report described an unusual case of congenital alveolar synechial band spanning posterior alveolar of the two jaws with cleft palate. Previously reported cases showed bilaterally or anteriorly located fibrous band. In our department, a new born revealed unilateral posterior synechia. Under brief intravenous sedation, synechium was divided using bipolar diathermy in the nursery at 3 days of age because of poor feeding. This division allowed full jaw opening after brief passive exercise. The patient is growing and maturing as expected with no complications. This patient is supposed to be the first reported case of isolated unilateral alveolar synechium combined with cleft palate in the worldwide.

Oncoplastic Techniques For Treatment of Inferiorly Located Breast Cancer

PURPOSE: Breast conserving surgery(BCS) for breast cancer has a common treatment protocol. Oncoplastic surgery represents a form of BCS which combines both a cosmetic mammoplasty approach and oncologic resection for the treatment of breast cancer. Depending on the tumor site, BCS can make an unsatisfactory cosmetic result, especially in inferiorly placed tumors. This study describes the use of oncoplastic techniques for inferiorly located breast tumors in immediate partial mastectomy reconstruction. METHODS: From September of 2006 to February of 2008, these techniques were used in 11 patients at the OO hospital. After BCS was preceded, breast reshaping by oncoplastic techniques were selected depending on the location and size of the tumor within the breast as well as the size of breast itself. Oncoplastic techniques after partial mastectomy included 'Wise pattern (inverted T)' reduction mammoplasty, 'vertical pattern' mammoplasty, 'J-pattern' mammoplasty. In order to improve the cosmetic outcome, repositioning of the nipple areola complex(NAC) or reshaping of the contralateral breast may be considered additionally. RESULTS: These techniques have been used in 11 patients. The mean age was 51 and the average follow- up period was 8 months. Eleven of these patients underwent the 'Wise pattern(inverted T)' reduction mammoplasty(n=6), 'vertical pattern' mammoplasty(n=3) and 'J-pattern' mammoplasty(n=2). There was one wound dehiscence during the follow-up periods. This complication was treated by conservative approach. The overall cosmetic result was evaluated in 6 months. The majority of patients were satisfied at the cosmetic result. CONCLUSION: Oncoplastic techniques in inferiorly located breast tumors could be a reasonable and safe option for breast cancer patients who desire conserving surgery with esthetical breast.

Wound Healing Effect of the Chitosan Sponge

Chitosan is a polysaccharide obtained by deacetylating chitin which is the major constituent of the exoskeleton of crustaceous water animals. Chitosan has many useful biological properties such as biocompatibility, biodegradability, hemostatic effect, antimicrobial activity and the ease of chemical modification. In order to evaluate the efficacy of chitosan as a wound dressing material, authors prepared chitosan as a sponge form and compared it with ointment dressing material, amniotic membrane and hydrocellular dressing material through the animal experiment. Four round( 3 cm) full thickness skin defect were made bilaterally on the dorsolateral aspect of the New Zealand white rabbit's trunk and four groups of dressing material -chitosan sponge, ointment dressing material, amniotic membrane and hydrocellular dressing material-were applied on the wound and evaluated grossly and histopathologically. We compared gross finding by means of percentage of wound contraction, percentage of wound epithilization and percentage of wound healed by tracing the remained wound area every week and wound biopsy were performed every other day. Chitosan sponge group and amniotic membrane group show statistically higher percentage of wound contraction and higher percentage of wound healed than the other groups (p < 0.05). Hydrocellular dressing material group shows statistically lower percentage of wound epithelization than the others(p < 0.05). During the inflammatory phase (postwounding day 1-5) chitosan sponge group and amniotic membrane group absorbed exudate effectively and demonstrate less inflammatory cell infiltration, which induce faster angiogenesis and fibroblast proliferation than the other groups. This study suggest chitosan has a potential as a new dressing material because of high absorbency of exudate, promotion of wound contraction and reduction of inflammatory reaction during the inflammatory phase of wound healing.

The Treatment of Palpebral Bags by Repositioning of Orbital Fat into a Subperiosteal Pocket

Baggy eyelids or palpebral bags of the lower eyelids are mainly caused by weakening of the orbital septum, atrophy of the orbicilaris oculi muscle and slackness of the skin. These palpebral bags are usually combined with a depression along the inferior orbital rim which is called a tear trough groove and a tear trough groove can be divided into a nasojugal groove and a palpebromalar groove. Excision of the protruded orbital fat as a treatment for palpebral bags may contribute in the long term to the senile enophthalmos due to a volume reduction of the intraorbital adipose tissue. Authors treated palpebral bags and tear trough grooves by reposition of orbital fat flaps into a subperiosteal pocket of the inferior orbital rim. Myocutaneous flaps from the lower eyelids were elevated through subciliary incisions to expose the inferior orbital rim and subperiosteal pockets were made on the orbital rim. The orbital fat flaps protruded through the incised orbital septum near the arcus marginalis were repositioned into the subperiosteal pockets by two or three horizontal mattress sutures. Nine patients with palpebral bags and tear trough grooves were operated with this technique and follow-up range was between 6 to 14 months(an average of 11 months). Palpebral bags and tear trough grooves were corrected well and youthful looking eyes were obtained. The main advantages of this technique are that; the first, we can get wide operative field and easy repositioning of orbital fat into the subperiosteal pocket through the transcutaneous approach than the transconjunetival approach, the second, subperiosteal repositioning of the orbital fat can make more even and smooth skin surface over the periorbital region than the supraperiosteal repositioning of the orbital fat due to coverage of the irregular fat lobules by the periosteum and the third, lower blepharoplasty can be combined with this technique.