Biomedical subjects

Kun Hwang

Publications and source records attributed to Kun Hwang.

52 records · Page 3Linked to original sources

PubMed2004

Blepharoptosis caused from compression of levator muscle by fractured orbital roof fragment.

The authors report two cases of blepharoptosis caused by compression of the levator muscle by fractured orbital roof fragment; both were improved by surgical treatments. In one case, because neurosurgeons were concerned with the contusional hemorrhage of the right frontal lobe during the early admission period, they missed the orbital roof fracture. The patient underwent surgery on the 18th post-trauma day. In the other case, the early diagnosis was made, and the surgical treatment were performed on the 10th post-trauma day. The authors think if the blepharoptosis is not improved in several days and the fractured fragment is suspected to compress the levator in computed tomography scan, surgical decompression is necessary and should be performed as soon as possible.

Adult↗

PubMed2004

Innervation of the corrugator supercilii muscle.

The frowning forehead is unwanted, generally because it gives an impression of anger and displeasure. The frown is formed mainly by the repeated contraction of the corrugator supercilii muscle. We studied the relevant nerve supply to the muscle in detail to enhance selective neurotomy. A bicoronal incision extending downward to the preauricle was made and the subgaleal dissection proceeded in 19 hemifaces of cadavers. The temporal branch of the facial nerve was divided into 2 to 4 smaller branches at the zygomatic arch. There were commonly 3 branches. The temporal branch is located 10 mm lateral to the supraorbital notch or foramen 2.8 to 25 mm above the supraorbital rim. It contains 4 to 7 thin rami (5 on average). A plexus mainly from the inferior ramus partly from the middle ramus of the temporal branch of the facial nerve enters the corrugator supercilii muscle in the supraorbital area. Because the temporal branch had multiple interconnection among its own rami, selective blocking of the middle ramus cannot promise the elimination of the frown line.

Forehead↗

PubMed2004

The lateral cutaneous branch of the fourth intercostal nerve relating to transaxillary augmentation mammoplasty.

This study is aimed to clarify the emerging point and course of the lateral branch of the fourth intercostal nerve and its supplying territory of the nipple-areolar complex. The branch nerves were dissected in the 16 breasts of 8 Korean cadavers through transaxillary and midsternal approach. An Agris-Dingmam dissector was useful for dissection and retraction. The emerging points of the lateral cutaneous branch of the fourth intercostal nerve through the intercostal spaces were within the bound of an ellipse with the major axis 26 mm and minor 10 mm. The center of the ellipse was located laterally 33 mm from a conjugate point of the lateral boarder of pectoralis major muscle and the fifth rib, and superiorly 8 mm from the upper margin of the fifth rib. Knowledge of the exact site of the emerging nerve branch is conducive to avoiding nerve injury during submammary or transaxillary subpectoral dissection for augmentation mammoplasty.

Adult↗

PubMed2004

Multiple malignant melanomas at different burn scar areas: a case report.

BACKGROUND: Malignant changes in burn scars occasionally develop, the majority being squamous cell carcinoma. Malignant melanomas (MMs) arising in burn scars occur rarely. OBJECTIVE: To present the case of a patient with a multiple MM developed at different burn scar areas. METHODS: A case report and review of literature are given. RESULTS: One was a large pigmented nodular lesion with central ulceration on right flank. It was widely excised and revealed lentigo MM. After that, we took notice another small pigmented lesion on right arm. It was also reported lentigo MM. CONCLUSION: This case provided a valuable lesson. Another kind of tumor may be present even if one tumor is found by pathologic observation, especially in burn scar patients. Clinicians should carefully observe burn scars, chronic ulcers, and other pigmented lesions.

Burns↗

PubMed2003

Lateral septoaponeurotic artery: source of bleeding in blepharoplasty performed in asians.

In standard blepharoplasty, the orbital septum is opened commonly to enter the preaponeurotic space. This is to anchor the leading edge of the levator palpebral fascia to the skin of a proposed supratarsal fold and to remove supraorbital fat. Incision of the orbital septum is involved occasionally with accidental injury to an inconstant arterial branch at its lateral side, which causes severe bleeding. Anatomic knowledge of the vessel on the orbital septum is conducive to preventing accidental arterial injury. The authors encountered a relatively large artery running vertically at the lateral side of the orbital septum in 50 eyelids of 230 blepharoplasty patients (460 eyelids). They investigated the branch by injecting red latex into the ophthalmic arteries in 20 hemidissected faces of fresh cadavers. At the lateral aspect of the orbital septum, a branch of the superior lateral palpebral artery, which we named the lateral septoaponeurotic artery (LASA), was confirmed in five of 13 specimens. The LASA originates from the superior lateral palpebral artery just after it divides into peripheral and marginal arcades. The LASA pierces the levator aponeurosis and orbital septum at the upper level of the tarsal plate. It anastomoses with a branch of the supraorbital artery at the superior aspect of the orbit. The authors think severe bleeding occurs when the LASA is injured during blepharoplasties. Cautious treatment of the lateral septoaponeurotic vessel minimizes undesirable complications.

Arteries↗

PubMed2003

Growth difference of multilayer onlay cartilage grafts in rabbit ears.

Successful survival and growth of autogenous cartilage graft has been well proved in the experimental studies of Dupertuis and Peer. However, it is still unknown whether multilayer cartilage graft has the same survival and growth as a single-layer graft. The authors studied any difference of survival and growth rate between single and multilayer cartilage grafts in rabbits. Single, double, and triple layers of autogenous cartilage grafts were inserted into three separate pockets in a single rabbit ear. The three grafts were left in place for 6 months. They performed this procedures in 10 rabbit ears. Proliferating activity of chondrocytes was measured with a method of proliferating cell nuclear antigen immunolabeling. The authors found that there were more proliferating cell nuclear antigen-positive cartilage cells in the graft than in the host bed, but no difference in weight and thickness of the graft among the three groups.

Animals↗

PubMed2003

Innervation of calf muscles in relation to calf reduction.

Plump and muscular calves, a so-called radish-like leg, embarrass young women and cause a feeling of inferiority in Korea. Damage to motor nerves innervating a muscle makes the muscle paralyzed and dystrophic, with loss of muscle volume. The authors studied the morphometry of the motor branches of the tibial nerve innervating the gastrocnemius and soleus muscle and sensory medial sural cutaneous nerve in popliteal fossa. Dissection and exploration of the tibial nerve were performed in the popliteal fossae of 70 legs (of 18 males and 17 females) of embalmed Korean cadavers. The main branch of the tibial nerve innervating medial and lateral gastrocnemius muscle originated 3 cm above and below the popliteal crease. The medial gastrocnemius muscle had an additional nerve (49%). The medial sural cutaneous nerve came off the nerve into the medial gastrocnemius muscle (30%) and diverged 5.5 mm from the tibial nerve. The nerve into the soleus muscle originated from the nerve innervating the lateral gastrocnemius muscle (30%) and was 12.3 mm away from it. Surgeons should keep in mind that the medial sural cutaneous nerve originates from the nerve to medial gastrocnemius in 30% and the nerve to soleus muscle originates from the nerve to lateral gastrocnemius in 30%.

Cadaver↗

PubMed2002

Pseudomelanoma after laser therapy.

An 18-year-old man had a melanocytic nevus on the chin that had been treated with three different lasers at a private clinic for 2.5 years. This lesion was excised and sent to a pathologist. The initial histological diagnosis was reported as compound nevus coexistent with changes suspicious of malignant melanoma. The reevaluation of histology together with the clinical information that the lesion had been pretreated with laser resulted in a revised diagnosis of pseudomelanoma. It is important to be aware of this benign pseudomelanoma, which can arise as a complication of laser therapy, to avoid subjecting patients to unnecessary surgical procedures or other forms of adjuvant treatment.

Adolescent↗

PubMed2002

Identity of "orbitozygomatic muscle".

Our exploration disclosed 17 (40%) stranded muscles of 42 hemifacial specimens of Korean cadavers. We name this distinct muscle "Orbitozygomatic Muscle (OZM)" that is either an aberrant orbicularis oculi muscle or a separate muscle. A triangular space bounded superiorly by the lowest edge of the orbicularis oculi muscle (OOM), laterally by Zygomaticus Minor, and inferiorly by OMZ gives way to neurovascular bundle and suborbicularis oculi fat pad (SOOF).

Adult↗

PubMed2002

Roberts syndrome, normal cell division, and normal intelligence.

Roberts-SC phocomelia syndrome (RS) is an autosomal recessive disorder of symmetric limb defects, craniofacial abnormalities, pre- and postnatal growth retardation, and mental retardation. Patients with RS have been reported to have premature separation of heterochromatin of many chromosomes and abnormalities in the cell-division cycle. No case has been reported who had normal intelligence and normal cell division with typical clinical features of the RS. We report a case of a six-year-old male of clinical and radiologic findings of typical RS with normal cell division and normal intelligence. Although he showed growth retardation, his intelligence was normal. Van Den Berg and Francke later reported that 79 out of 100 cases of Roberts syndrome had premature cell separation (PCS). We think that this case may demonstrate severe expression of the Roberts syndrome even though PCS is not exhibited. The limb involvement of this case was symmetrical, and he showed phocomelia of upper limbs, equinus valgus deformity of ankle, aplasia of fibula, and shortness of fifth toes while his hands and feet were normal with 5 rays each. Craniofacial abnormalities of this case were typical; he showed scaphocephaly, mild hypertelorism, mandibular hypoplasia, dysplastic helix of ear, narrowing of external auditory canal, and cleft palate with wide gap. This report supports the theory that normal intelligence can make social-personal adjustment possible even if all of the stigmata of Roberts syndrome is present.

Arm↗

PubMed2002

Alloplastic template fixation of blow-out fracture.

Alloplasts are widely used to reconstruct the orbital defects. The alloplastic material, however, is not uncommonly infected, displaced, and extruded, and forms an epithelial pseudocyst around it. To prevent the depressed fractured bone of the orbital floor from dropping down into the maxillary sinus, an en block fragment of the depressed fracture of the orbital floor was restored after being attached to an alloplastic sheet template which was fixed to the intact orbital floor. This procedure is simple and secure, and intramaxillary packing is not needed to buttress the depressed fractured bone into the sinus.

Adolescent↗

PubMed2002

Treatment of condyle fracture caused by mandibular angle ostectomy.

A prominent mandibular angle is considered to be unattractive in Asian countries because it gives the face a square and muscular appearance. Successful correction by angle ostectomy has been reported, but one of the serious complications of angle reduction ostectomy is fracture of the mandibular condyle. If the ostectomy line is misdirected vertically, the condyle may be fractured. The authors experienced two cases of condylar fracture during angle reduction. Case 1 was a pulled-out condylar fracture, where an L-shaped miniplate was then attached by external approach, and intermaxillary fixation (IMF) with arch bar was used on postoperative day 14. With release of the IMF, a systematic approach for a jaw-opening exercise was begun. On postoperative day 21, the elastics were placed to assist in guiding protrusion of the mandible anteriorly 24 hours a day. After postoperative day 28, it was possible to completely abandon daytime elastic fixation. The exercise was modified to lateral movement. Case 2 was green-stick condylar fracture, with the IMF with arch bar applied on postoperative day 10. After releasing the IMF, the exercise involved the daily use of several tongue blades, and range of motion increased by wedging additional blades until postoperative day 21. More aggressive stretching was continued with 22 blades on postoperative day 28. On the removal of the arch bar, the occlusion was stable and followed by more aggressive stretching and physical therapy. Both cases were successfully restored and had good results. The authors believe the exercise protocols and algorithms they used may serve as a standard procedure of treatment in condylar fracture caused by angle ostectomy.

Adult↗

PubMed2002

Masks depicting hemifacial microsomia and cleft lip.

All masks are created by craftspeople. Accordingly, most masks are generally predictable in dimensions, and the portraitures usually depict the faces and heads of humans. The authors found some masks representing the features of craniofacial anomalies, such as hemifacial microsomia and, rarely, cleft lip. Reviewing the legends of wearing masks with a medley of grotesque features, the authors could deduce the tone of society in those days. A mask, "crooked mouth," of Native Americans shows typical lineament of hemifacial microsomia. The deformity of the face was legendarily regarded as resulting from trauma caused by either "one's fault" or a "curse of God." "Yangban" (noblemen of aristocratic class) customarily wore the cleft lip mask in age-old Korean masquerade revels. Laymen ridiculed Yangban by making cleft lip masks for them. The authors presume that the victims of craniofacial deformities were treated contemptuously at that time.

Cleft Lip↗

PubMedDate not supplied

Cosmetic lateral canthoplasty.

BACKGROUND: Although there are patients who want cosmetic lateral canthoplasty to lengthen the lateral palpebral fissure of the lateral canthal area, no recommendable operational procedure exists that results in an acceptable scar formation. Because of the round eyeball shape, lengthening and widening of the lateral palpebral fissure should not be in the lateral direction, but rather in the posterior direction to keep the surface between the bulbar conjunctiva and the palpebral conjunctiva in contact. METHODS: The authors believed that using an upper crus flap of the upper eyelid margin as a transposition flap would enable lengthening of the lower eyelid width and posterior deepening of the lateral canthal area. This was thought possible by transverse back-cutting of the palpebral conjunctiva on the lateral fornix area. RESULTS: The authors have performed cosmetic lateral canthoplasty in more than 200 cases to increase the width of the lateral palpebral fissure. All the results were satisfactory and aesthetically acceptable. CONCLUSIONS: The reported surgery makes the eyes appear larger and brighter. The authors think this procedure is a good and convenient method although it is not perfect.

Adolescent↗

PubMedDate not supplied

Dermofat graft in deep nasolabial fold and facial rhytidectomy.

Fat and dermis or the combined tissues are used commonly in augmentation of the nasolabial fold. Guyuron obtained the dermofat graft from either the suprapubic or the groin region. The thickness of the preauricular skin was measured in seven Korean cadavers, five male and two female. We used the dermofat graft out of the preauricular skin remnant after facial rhytidectomy to augment the deep nasolabial fold in a patient. The average thickness of the epidermis was 56 +/- 12 microm, the dermis was 1820 +/- 265 microm thick, and the subcutaneous tissue was 4783 +/- 137 microm. More dense connective tissues, such as SMAS, are seen in the preauricular skin. The dermofat graft was easily obtained and prepared from the leftover preauricular skin after dissection of the lax skin in face lifting. This technique could be employed effectively and successfully to alleviate a deep nasolabial fold and concomitant facial rhytidectomy in an Asian with a thick preauricular skin.

Adipose Tissue↗

PubMedDate not supplied

Foot polydactyly and polysyndactyly: genetic implications in two families.

The purpose of this study was to determine the genetic characteristics of foot polydactyly and identify its inheritance pattern by analyzing familial pedigree. Five cases from 2 Korean families were studied: 1 is a family whose members have been affected for 4 generations and the other for 2 generations. Using peripheral blood samples, we performed chromosomal analysis using the banding technique with Giemsa stain and karyotyping. We investigated the shape and structure of 46 chromosomes, looking for translation, deletion, inversion, ring chromosome, and isochromosome abnormalities. All peripheral blood samples demonstrated no chromosomal abnormalities, though the genetic nature of foot polydactyly and a new genetic locus was identified recently by other studies. Familial pedigree analysis suggested that polydactyly was inherited as an autosomal dominant trait in the first family. The mode of inheritance for the second family could not be determined due to an insufficient number of family members. The result of this study brought us to the conclusion that, while genetic factors play a major role in polydactyly, other factors may contribute to its occurrence.

Adult↗