Treatment of Axillary Osmidrosis with Power- Assisted Lipoplasty(PAL)

Axillary osmidrosis is caused by excessive apocrine gland secretion, which causes an unpleasant odor. Axillary osmidrosis causes difficulty in social activities and personal handicap. Many surgical procedures have been introduced for treatment of axillary osmidrosis. Most of them are based on the surgical excision of subcutaneous tissue including apocrine glands. However, these methods also have complications such as wide surgical scar, skin necrosis, hematoma, seroma. For this reason, developing a new treatment that is as effective as surgery but causes fewer complications is reasonable. We have used the technique of power-assisted lipoplasty(PAL) as a method of treatment for axillary osmidrosis. From July 2003 to June 2004, a total of 45 patients(26 men and 19 women) had been treated with this procedure for axillary osmidrosis. Forty patients(88.89 percent) had good results, and 2 patients(4.47 percent) had poor results. The power-assisted lipoplasty(PAL) for axillary osmidrosis has the advantages of a high success rate with minimal complications and rapid recovery for daily activity. Therefore, power-assisted lipoplasty(PAL) is a viable option for treatment of axillary osmidrosis.

Clinical Experience of Minimal Incision Rhytidectomy with Lateral SMASectomy

To overcome the facial aging, various facial rejuvenation techniques have been presented but each of them has some shortcomings respectively. Extended SMAS technique is not easy to apply and has high risk of facial nerve injury. Moreover, Orientals have some anatomical characteristics different from Caucasians; thicker facial skin, more conspicuous postoperative scar and less cervical deformity such as gobbler neck deformity. Considering these facts, we performed minimal incision rhytidectomy with lateral SMASectomy in 25 patients with aging faces. Based on our experiences, this technique is considered as an easy and quick method with minimal postoperative scar and no risk of facial nerve injury. And lateral SMASectomy is excellent for the correction of deep nasolabial fold, jowl and saggy jaw line. As a result, minimal incision rhytidectomy with lateral SMASectomy is suitable and recommendable facial rejuvenation for Koreans.

Resurfacing in Penile Paraffinoma by Groin Flap

Paraffinoma induces many unexpected complications such as tissue necrosis, granuloma formation, hypersensitivity, embolism and even carcinoma. The treatment modality is known to be primary repair, flap surgery, skin graft, radiotherapy and high frequency current treatment after the excision of the lesion. Although these methods can remove the paraffinoma and resurface penile shaft, various complications such as skin tension after surgery, hypertrophic scars, difficulty of erection, and deficiency of bulkiness are frequently occurred. Groin flap is the proper method for the patients who want simultaneously soft tissue reconstruction and augmentation of penis. A 32 year-old male patient who visited our clinic had firm mass, abscess, skin necrosis, and dyspareunia after the injection of paraffin into penis 3 months ago. Reconstruction was executed using right side of the groin flap after the radical resection of the whole tissues ruined by infections and infiltration of paraffin. The penile bulkiness, erectile function and duration of erection was all satisfactory. The follow-up period was 7 months after the surgery and no specific complication was developed. Groin flap is the satisfactory method to enhance penile bulkiness as well as resurface the lesion.

Tissue Engineered Neocartilage using Polyglycolic Acid(PGA) and Chondrocyte

Neomorphogenesis using tissue engineering technique by cell transplantation with biodegradable polymer has been introduced as a new method to achieve organ replacement or to create new tissues. Using this tissue engineering technique, neocartilage formation can be possible when isolated chondrocyte is combined with biocompatible and biodegradable polymer scaffolds. The purposes of this study are to investigate whether chondrocyte-polyglycolic acid(PGA) polymer can be designed to induce cartilage formation in a predetermined shape, to analyze the properties of neocartilage by histologic and immunohistochemical study. Chondrocytes were isolated from the articular cartilage of swine shoulder joint and seeded onto four PGA polymers(disc shape, diameter;1cm, thickness; 0.3 cm) at a concentration of 5 x 107 chondrocytes per cm3. Chondrocyte-PGA polymers were implanted into left side of subcutaneous pockets on the dorsa of 4 athymic mice. PGA polymers without chondrocyte were implanted into the right side of subcutaneous pockets of the same animals as a control study. The chondrocyte-PGA polymers were harvested 2, 4, 6 and 8 weeks after implantation and investigated grossly, histologically and immunohistochemically. Chondrocytes were also cultured in Ham's F-12 medium under 5% CO2 incubator at 37degrees C and analyzed by histologic and immunohistologic study. The analysis confirmed the following results: 1. In vitro study, it was confirmed by Hematoxylin-Eosin (H-E) stain and toluidine blue stain that histologic findings of cultured chondrocyte corresponded to normal chondrocyte. 2. After 4 weeks of implantation of chondrocyte-PGA polymer, specimens changed in gross finding to pearly white opalescence and firm on palpation and this findings were accentuated progressively. But PGA polymers without chondrocyte could not maintain its shape and were resolved gradually. 3. The appearance of normal immature cartilage was detected at 2 weeks of implantation of chondrocyte-PGA polymer in H-E stain and toluidine blue stain. Maturation process of cultured chondrocyte was observed by steps in the 4th, 6th and 8th week. 4. Using the immunohistochemistric study, the presences of Type II collagen and CD44 were confirmed in cultured chondrocytes. This finding meant that neocartilage could inherit the original properties of chondrocyte. 5. Nipple-shaped cartilage discs which could assure the mechanical and histologic properties of normal cartilage were successfully created. It seems to be possible to apply this method to other kinds of manufacture with various shaped-PGA polymer. This study showed not only new cartilage formation could be possible using chondrocyte and PGA polymer but also engineered tissue could be one of the modalities to treat the patients suffering from the shortage of tissue in the future. With further prudent researches, tissue engineering technique can be a distinguished armament in reconstruction of human body including cartilage.

Clinical Experience of Power- Assisted Lipoplasty(PAL)

Many people desire body contouring. Liposuction is a powerful tool for plastic surgeons in body contouring and widely used in many countries. The ideal liposuction technique allows greater volumes to be aspirated while minimizing blood loss, operative time, and complication. The mechanism of liposuction involves mechanical suctioning, followed by destruction of fat tissue by cannula movement. In PAL, a cannula powered by compressed nitrogen gas or an electric power source reciprocates between 2000 and 4000 cpm with a 2-3mm amplitude. We have treated 12 patients by PAL during 2001 January-September with excellent results. PAL made surgeons less fatique and discomfort, and resulted in shorter operation times, and decreased seroma formation and less scars at the incision site. PAL is also effective in fibrous fat aspiration in case of gynecomastia, superficial suction, large volume removal, and secondary liposuction. Conclusively the technique is safe, fast and capable of producing results comparable to those achieved with traditional or ultrasonic-assisted lipoplasty.

The Clinical Use of Various Nasal Implants in Rhinoplasty

From an aesthetic surgical point of view, rhinoplasty is one of most important field. The nose of asian is characterized by thin and weak nasal septal cartilage, wide and small alar cartilage, bulbous nasal tip due to excessive fibrous tissue and thick skin. Conventional rhinoplasty is not enough to get a satisfactory result. In order to produce optimal nasal shape, it is extremely important to augment the tip along with nasal dorsum in most of the patients. From March of 1997 to June of 1999, total 162 patient underwent open rhinoplasty with various nasal implants. Surgical approach was done through the transcolumella incision and alar rim incision. The nasal dorsum was augmented with silicone implant, and columella shape was controlled by 0.85-mm thickness porous high-density polyethylene sheet(Medpor). Porous high-density polyethylene sheet was 4mm width and was placed between the medial crura. The nasal tip was corrected by Polytetrafluoroethylene(Gore-Tex) implant. Reverse pyramidal shaped onlay graft of Polytetrafluoroethylene(Gore-Tex"") implant was not palpable on nasal tip skin. We obtained harmonious nasal shape and high patient satisfaction. There was two infection and one exposure of Polytetra- fluoroethylene(Gore-Tex) implant, but there was no other major complications. We believe that this method is stable, reliable, predictable, valuable technique for rhinoplasty, but we think that further follow up and study are needed.

The Effect of Topical Application of Capsaicin on the Flap Survival

Capsaicin is the principal pungent component of Capsicum fruits. Biological effect of capsaicin is various and complicated. This study was undertaken to define the effect of topical application of capsaicin on flap survival in rat. Fourty Sprague Dawley rats were divided into four groups. With ten rats in each group, group A was only flap elevation group, as the control, group B was applied 0.025% capsaicin ointment for 7 days after skin flap elevation, group C was applied 0.075% capsaicin ointment for 7 days after skin flap elevation, group D was elevated two skin flap and one flap was control, the other flap was applied 0.075% capsaicin ointment for 7 days. Group A demonstrate 46.2+ 2.5% flap survival rate. Group B demonstrate 48.8+/-7.8% of flap survival rate, group C demonstrate 53.3+/-7.0% of flap survival rate. Control flap on group D demonstrate 43.5+/-3.5% of flap survival rate, 0.075% capsaicin applied flap demonstrate 52.9+/-7.2% of flap survival rate. Compared to the control group, increase in survival rate in group B was not statistically significant. The mean flap survival rate in group C was significantly increased than control group (p < 0.05). Compared to the control flap in group D, 0.075% capsaicin applied flap showed significantly higher flap survival rate. Based upon this data, local application of 0.075% capsaicin ointment demonstrate significantly increased value of survival area and survival rate on skin flap in rat (p < 0.05). And further studies may be needed for the evaluation of correct action mechanisms of capsaicin.

Mandibular Angle Contouring at the Time of Face Lift

Many people want to receive facial rejuvenation with surgical treatment, but the post operative result is not always satisfying following classic soft tissue surgery. The reasons for dissatisfaction are many. We were particularly interested in the skeletal disharmony which is frequent in orientals. Since many orientals have flat and quadrangular facial contours, they often don't obtain the harmony of the facial skeleton and soft tissue despite successful surgery. So, to correct facial contour, mandibular angle contouring can be performed at the time of face lift. Seven patients had mandibular angle resection performed during facial rhytidectomy from October of 1996 to October of 1998 at Kangbuk Samsung Hospital, and they were followed from 4 months to 24 months. At the time of face lift, we tried the retromandibular approach for mandibular angle resection when it was indicated, instead of the intraoral approach which does not leave a noticeable scar and does not have the risk of facial nerve injury. Because of a restricted operative field, the intraoral approach has the disadvantages of a long operation time and a high risk of complications. The retromandibular approach with rhytidectomy incision showed neither noticeable scar nor developed a facial nerve injury. In conclusion, we found that mandibular angle contouring by retromandibular approach is easy and the result is more normal with a shorter recovery time. There were no complications and aesthetic results were quite satisfactory.

MRI of Breast Implant-related Complications

PURPOSE: To assess the usefulness of MRI in the preoperative diagnosis of breast implant-relatedcomplications. MATERIALS AND METHODS: Thirty four breast implants in 17 patients were examined. Eight breasts hada history of repeated surgery due to rupture and in eight others, simultaneous interstitial silicone injection hadbeen performed. MR images of the 34 implants were prospectively analyzed for implant-related complications,without prior clinical information, and the findings were compared with the results of surgery. RESULTS: Theimplant-related complications seen on MRI were infections in three cases, seromas in two, and implant malpositionin two. The linguine sign was seen in eight cases and intraparenchymal silicone in 17. Among the 32 removedimplants, rupture was genuine in ten cases (nine, extracapsular; one, intracapsular). In evaluating the MRfindings of implant rupture, the linguine sign showed 80% sensitivity, 100% specificity and 93.8% accuracy.Intraparenchymal silicon also revealed high sensitivity (90%), but relatively low specificity and accuracy (63.7%and 71.9%, respectively); this was due to the difficulty of differentiating granulomas still present after aprevious rupture from injected silicone material. MRI was useful for visualization of implant migration, thedirect relationship of extended or extruded silicone in extracapsular rupture and the localization of siliconegranulomas, as seen on multiplanar images. The extent of infection was clearly demonstrated on contrast enhancedscan. There was relatively good correlation between the degree of contracture seen on physical examination andthat seen on MRI. CONCLUSION: MRI was an effective and useful method for the preoperative evaluation ofimplant-related complications; degree of contracture was successfully predicted.

Clinical Experiences about the Removal of the Silicone Gel Implants in the Breasts

We report the results of the clinical and histologic and radiologic findings of the 17 patients who visited our hospital for the removal of the breast implants. Their mean ages were 45.9 and they visited our hospital 11.4 years after their operation of the breast implantation. In the 8 cases of the 17 patients, the contractures were seen and masses were palpated in the 4 cases. We also could find 1 case of the infection and 1 case of the abscess. There were the cases of the granuloma, siliconoma, calcification too. We find the radiologic examination before the removal of the implants in the 11 cases and could find the finding of rupture at the 9 cases (14 implants) but we confirmed that the number of the ruptured implants were 7 postoperatively. We reinserted new implants in the 12 cases and used saline filled textured implants. the number of the patients who want to remove the silicone gel implants is increasing with the reports of the doubt on the safety of the silicone gel. But there were on clear evidences of harmful effects of the silicone gel at now. We have to study more and need more experiences to used the more exact information to the patients.

CLINICAL OBSERVATIONS OF THE AXILLARY OSMIDROSIS

No abstract available.

A clinical analysis of infant hand burns by electric rice cooker

No abstract available.