• The korean journal of orthodontics
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• v.39 no.2
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• pp.72-82
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• 2009

Objective: The purpose of this study was to investigate the structural changes of the hyoid bone and upper airway after orthognathic surgery for skeletal class III anterior open bite patients, and make comparisons with normal occlusion. Methods: Pre- and post-operative computed tomography (CT) examinations were performed on 12 skeletal class III anterior open bite patients who were treated with mandibular setback osteotomy. Using the V-works $4.0^{TM}$ program, 3-dimensional images of the total skull, mandible, hyoid bone, and upper airway were evaluated. Results: In the Class III open bite group, the hyoid bone were all positioned anteriorly, compared to the Normal group (p < 0.05). The angle between the hyoid plane and mandibular plane in the Class III openbite group before surgery was greater than in the Normal group (p < 0.05), and the difference increased after surgery (p < 0.01). In the Class III openbite group, the volume of the upper airway decreased after surgery (p < 0.001) and the volume of the upper airway was smaller than the Normal group before and after surgery (p < 0.001). Conclusions: The narrow upper airway space in skeletal Class III openbite patients decreased after mandibular setback osteotomy. This may affect the post-surgical stability.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.9-17
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• 2019

Owing to the upward shift in age structure, there is an increasing number of spinal diseases specific to elderly patients. Elderly spinal patients typically have a poor general condition with several medical comorbidities, low bone mineral density, more extensive and severe degeneration, and less effective treatment outcomes than young patients. This is why spinal physicians need to establish interventional nonsurgical treatment modalities for elderly patients with spinal disease. The objective of this study was to define the spinal disorders problematic to elderly patients and discuss the nonsurgical treatments for each subject.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.1
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• pp.9-15
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• 2011

배경: 술 후 통증은 술 후 합병증의 발생가능성을 증가시키며 생체기능의 회복을 방해한다. 술 후 통증을 효과적으로 조절하기 위해선 통증의 정도를 객관적으로 평가하는 것이 필요하다. 술 후 통증은 수술의 침습도와 관련이 높을 가능성이 많다. 본 연구에서는 수술 침습도의 정도와 술 후 통증의 정도 사이의 상관관계를 확인하고자 한다. 방법: 총 153명의 환자를 수술의 침습도에 따라 4개의 그룹으로 나누었다(그룹 1: 악성종양 수술 (malignancy surgery), 그룹 2: 양악수술(bimaxillary surgery), 그룹 3: 양성 종양수술(benign cancer surgery) 그룹 4: 임플란트 & 골절 수술(implant & frature)) 수술이 끝나갈 무렵 fentanyl 700 ${\mu}g$, ketorolac 1,500 mg (총 용적 120 ml)가 포함된 자가통증조절장치를 정맥로에 연결하였다. 술 후 통증의 정도는 시각통증등급(visual analogue scale)을 이용하여 측정하였고 자가통증조절장치의 총 사용시간, 투여된 진통제의 양, bolus 투여 총 횟수를 측정하였다. 결과: 술 후 시각통증등급은 술 후 1일부터 3일까지 그룹 1, 2 군에서 유의하게 높았다. 또한 시각통증등급 3점 이상의 통증을 호소하는 환자의 비율 역시 그룹 1, 2 군에서 유의하게 높았다. 진통제 총 투여용량 및 자가로 주입한 진통제의 양 역시 그룹 1, 2군에서 3, 4 군에 비해 유의하게 높은 것을 확인하였다. 결론: 본 연구결과 외과적 수술의 침습도가 술 후 통증의 정도를 결정하는데 있어 중요한 요소임 을 확인하였다.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.255-259
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• 2006

The operation for esophageal cancer is both complex and challenging, and may be associated with significant morbidity and mortality compared to other oncologic surgeries. Minimally invasive surgeries have been applied on various kinds of surgery to enhance better recovery with minimal surgical complications. But for the esophageal cancer, it has not been actively applied yet. With improvement in instrumentations and increasing experience with endoscopic surgical techniques, minimally invasive surgical approaches to esophageal cancer are being explored to determine feasibility, results and potential advantages. We experienced eight cases of minimally invasive surgery for esophageal cancer and report here focusing on surgical techniques and tips.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.8-15
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• 2004

Purpose: This study was conducted to identify potential dangers involved in procedure and evaluate complications of percutaneous endoscopic gastrostomy (PEG) comparing to surgical gastrostomy (SG). Methods: A retrospective study of 66 children with feeding gastrostomy between 1994 and 2002 was done. Results: Of 66 children, 23 (mean age 29 months) had PEG and 43 (mean age 49 months) had SG. 31 cases of SG group had fundoplication for gastroesophageal reflux disease. PEG groups were followed up with an average 13 months and SG groups with 21 months. Major complications occurred in 33% of PEG group (8/23) and 55% of SG group (24/43). Major complications were significantly lower in PEG group than SG group and minor complications, too (p<0.05). Of major complications, aspiration pneumonia was the most common but paralytic ileus was significantly higher in SG group than PEG group. 8 patients died of underlying disease but not related to gastrostomy. Removals of stomata were done in 5 of PEG group and 3 of SG group. GER recurred in 25% of SG group with fundoplication and newly developed in 17% of SG group. GER persisted in 17% and newly developed in 5% of PEG group. Conclusion: The gastrostomy was a significant procedure with the potential to produce complications. PEG is recommended as an initial procedure in children requiring a feeding gastrostomy but should be considered a major undertaking.

• Journal of Biomedical Engineering Research
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• v.18 no.3
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• pp.301-306
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• 1997

Surgical removal of hepatic cancerous tissues have been widely performed due to its early detection. However, a patient can not survive if excessive hepatic tissues were removed. Therefore, quantitative evaluation of remaining hepatic function after surgery is a really important factor for surgeon. the currently used ICG Rmax and Lidocaine clearance tests have disadvantages such as tedium, complexity, and inability to estimate remaining hepatic function after surgery. While HEF has advantages such as simplicity, quickness, nonivasiveness, and quantification, its reliability has been doubtful. Thus, the program for calculation of HEF has been developed from serial gamma camera image data. And we compared the reliability of HEF with ICG Rmax and Lidocaine clearance test using 6normal and 18 abnormal rabbits with damaged livers. The correlation coefficient of HEF to ICG Rmax and MEGX was 0.91, 0.94, respectively. I was also found that the HEFs of normal and abnormal hepatic tissues was higher than 100% and lower than 80%, respectively. Thus we confirmed that HEF can be a good indicator distinguishing between abnormal tissues and normal ones. Finally, we could conclude that patients would survive if both the pre-and the post-operative HEF were greater than 60%.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.749-754
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• 2004

Off-pump coronary artery bypass grafting (Off-Pump CABG) has been proven to have less morbidity and to facilitate early recovery. High-risk surgical patients may have benefitted by avoiding the adverse effects of the cardiopulmonary bypass. We compared the effectiveness of Off-Pump CABG with that of coronary artery bypass using cardiopulmonary bypass (On-Pump CABG) in high-risk patients. Material and Method: 682 patients (424 Off-Pump CABG and 258 On-Pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Patients who were considered high risk were selected High risk is defined as the presence of one or more of nine adverse prognostic factors. Data were collected from 492 patients in Off-Pump CABG and 100 in On-Pump CABG for risk factors, extent of coronary disease, and in-hospital outcomes. Result： Off-Pump CABG group and On-Pump CABG group did not show differences in their preoperative risk factors. We used more arterial grafts in Off-Pump CABG group (p < 0.05). Postoperative results showed that operative mortality (0.5% in Off-Pump CABG versus 2.0% in On-Pump CABG), renal failure (2.6% in Off-Pump CABG versus 7.0% in On-Pump CABG), and perioperative myocardial infarction (1.5% in Off-Pump CABG versus 1.0% in On-Pump CABG) did not differ significantly. However, Off-Pump CABG had shorter mean operation time (p<0.05), lower mean CK-MB level (p <0.05), lower rate of usage of inotropics (p < 0.05), shorter mean ventilation time (p <0.05), lower perioperative stroke (0% versus 2.0%), and shorter length of stay (p < 0.05) than On-Pump CABG. On-Pump CABG had more distal grafts (p<0.05) than Off-Pump CABG. Although Off-Pump CABG and On-Pump CABG did not show statistical differences in mortality and morbidity was more frequent in CABG. Conclusion: Off-Pump CABG reduces morbidity and favors hospital outcomes. Therefore, Off-Pump CABG is safe, reasonable and may be a preferable operative strategy for high-risk patients.

• Journal of the Korean Society of Radiology
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• v.6 no.2
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• pp.83-91
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• 2012

The obesity is a medical condition in which excess body fat has accumulated to the extent. It may have an adverse effect on health, leading to reduced life expectancy and increased health problems such as lifestyle disease, hypertension, and diabetes. Furthermore, it may cause the mental illness such as depression, bipolar disorder, anorexia, hyperphagia, and so on by shrinking psychologically. So, it is regarded as the serious worldwide social problem. Recently, although there are many general obesity care methods with various approaches, these can't be the radical obesity care because of the side effects such as surgery aftereffect, drug addiction, and so on. For these reasons, a methodical approach with a consideration of individual obesity pattern is strongly demanded. In this study, complex obesity care and management system which is overcome the weakness of non-surgical obesity treatment is proposed. And the individually adapted obesity treatment system with the far-infrared therapy module, oxygen therapy module, color therapy module, and microwave therapy module was developed. The complex obesity treatment system which is proposed in this study, could improve the efficiency of treatment by suggesting the various treatment protocols. And proposed system could be the foundation of the high quality obesity treatment system.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.391-396
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• 2003

Background: Recently transilluminated powered phlebectomy was introduced and used as a method of surgical treatment for varicose vein in lower extremities. The advantage of transilluminated powered phlebectomy are minimal scar and good cosmetic effect. However, the disadvantages of transilluminated powered phlebectomy is that a high priced Trivex system must be used which increases the patient's expenses. Therefore, we performed a transilluminated powered phlebectomy using an existing arthroscopic equipment instead of Trivex system and observed the effect of treatment and efficiency of the treatment. Material and Method: From March, 2000 to February, 2003, 78 patients (113 limbs) underwent transilluminated powered phlebectomy with an arthroscopic equipment. Patient's disease history, the number of operative scars and complications were reviewed. Result: The operation was performed in 133 limbs of the 78 patients (34 men, 44 women) and the age of patients were ranged from 16 to 72 years with mean age of 41.8 years. Operative time ranged from 20 to 65 minutes (average 48.7 minutes) per limb. The number of operative scar per limb from 2 to 7 (average 4.9). Postoperative complications are transient ecchymosis (78 cases) that desappeared spontaneously, edema persisting longer than 3 weeks (6 cases), remnant varicose vein (4 cases), skin perforation during operative procedure (2 cases), and contact dermatitis due to compression stocking (4 cases) The mean hospitalization day was 3.09 days. Subjective mean satisfaction degree of operation by the patients using a visual analogue scale was 92.6%. Conclusion: Our findings demonstrated that transilluminated powered phleectomy using arthroscopic equipment was possible and had good cosmetic results with acceptable complications.

• The korean journal of orthodontics
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• v.29 no.3 s.74
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• pp.285-301
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• 1999

There is a need for more accurate prediction in surgical orthodontic treatment. Video imaging is an important technology in planning orthognathic surgery and educating patients about the esthetic results after treatment. Preoperative and postoperative lateral cephalogram of 30 patients who had one piece Le Fort I osteotomy advancement and mandibular set back by bilateral intraoral vertical ramal osteotomy with or without genioplasty were used in this study. The computer generated soft tissue line drawing prediction were compared with the actual postoperative cephalograms .The results are as follows. 1. 14 variables showed Statistically significant differences from 24 variables between computer predicted profile and post operative profile 2. Most of the differences were found in the maxilla-related soft tissue landmarks. 3. The predicted results were more accurate in the groups who had small amount of mandibular set back. 4. The predicted results were more accurate in the groups who had no genioplasty. Most of these differences were within 2mm ranges. Therefore profile change prediction by video imaging could be considered clinically acceptable.