• 대한두개안면성형외과학회지
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• 제11권2호
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• pp.91-94
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• 2010

저온 열처리법은 두개안면골 종양의 절제 후 재건에 있어 간단하고, 믿을만하며, 모양이 우수하고, 경제적이면서 또한 오랫동안 유지가 가능한 방법이다. 이 방법은 종양 재발의 걱정없이 생물학적으로 융합이 가능함과 동시에 기계적인 강도가 높은 장점을 가지고 있다. 따라서 두개안면골의 양성종양뿐만 아니라 절제가 가능한 악성종양의 경우에도 재건 시 우선적으로 고려해볼 만한 방법으로 사료된다.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.711-714
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• 2006

Purpose: Contralateral reduction mammaplasty at the time of breast reconstruction using autogenous tissue gives aesthetically improved results in the patients with mammary hypertrophy or ptosis. It also reduces required flap size for reconstruction and permits discarding zones of poor perfusion, decreasing flap size-related problems such as partial flap loss or fat necrosis. Considering the high rate of bilaterality of breast cancer, it also provides a good opportunity for exploration and occult cancer diagnosis in such high risk group patients. Methods: We retrospectively reviewed 45 consecutive patients who underwent simultaneous breast reconstruction and contralateral reduction mammaplasty was performed about surgical technique, pathologic diagnosis, and subsequent treatment. Results: Three occult breast cancers were found in 45 patients(6.7%); one was microinvasive, and the other two were invasive carcinomas and their mean diameter was 1.2 cm. One patient underwent subsequent breast conserving mastectomy, adjuvant radiation and chemotherapy. The others underwent only radiation and hormone therapy. They were followed up for 10 to 42 months without evidence of recurrence or metastasis. Conclusion: Occult breast cancer diagnosed in reduction mammaplasty specimen will lead to good prognosis due to its early detection. Treatment options depend on pathologic finding, stage, marginal status, and the timing of diagnosis. We recommend adequate markings for orientation and margins, excision with sufficient margin, and confirmation by frozen biopsy for suspected lesions.

• The Korean Journal of Pain
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• 제11권2호
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• pp.220-225
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• 1998

Background: The patients of facial hyperhidrosis have been known that they had much difficulties in interpersonal relationships and social activities due to excessive hidrosis when they were in stress, hot weather, or having meals. Previous drug therapy and stellate ganglion block have only temporary effects. The surgical method, $T_1$ sympathetomy has the risk of Hornor's syndrome. For that reasons, the sympathicotomy of proximal and distal portions of $T_2$ sympathetic ganglion with electroresectoscope used in transurethral resection seemed to be appropriate procedure, and we would like to report the results of our procedure. Method: Under the general anesthesia with semi-sitting position, and the portal was made through the small incision along the upper border of the 4th rib at the crossing point of mid-axillary line. After the partial collapse of lung by insufflation of 300 to 500 ml of $CO_2$, $T_2$ sympathetic ganglion was identified and resected proximally and distally with electro-cauterization. Finally the lung was expanded by limiting flow until the airway pressure reached 30 to 40 cm$H_2O$, and the wound was closed after removal of electroresectoscope. Result: There was no postoperative complication requiring surgical interventions. The facial sweating was stopped immediately after the operation and all the patients appeared to be satisfied. Conclusion: $T_2$ sympathicotomy with TUR electroresectoscope is thought be the minimal invasive and highly successful method in the treatment of facial hyperhidrosis. But longer terms follow-up will be needed to prove this result.

• 음성과학
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• 제8권2호
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• pp.23-37
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• 2001

The primary sound produced by the vibration of vocal folds reaches the velopharyngeal isthmus and is directed both nasally and orally. The proportions of the each component is determined by the anatomical and functional status of the soft palate. The oral sounds composed of oral vowels and consonants according to the status of vocal tract, tongue, palate and lips. The nasal sounds composed of nasal consonants and nasal vowels, and further modified according to the status of the nasal airway, so anatomical abnormalities in the nasal cavity will influence nasal sound. The measurement of nasal sounds of speech has relied on the subjective scoring by listeners. The nasal sounds are described with nasality and nasalization. Generally, nasality has been assessed perceptually in the effect of maxillofacial procedures for cleft palate, sleep apnea, snoring and nasal disorders. The nasalization is considered as an acoustic phenomenon. Snoring and sleep apnea is a typical disorders due to abundant velopharynx. The sleep apnea has been known as a cessation of breathing for at least 10 seconds during sleep. Several medical and surgical methods for treating sleep apnea have been attempted. The uvulopalatopharyngoplasty(UPPP) involves removal of 1.0 to 3.0 cm of soft palate tissue with removal of redundant oropharyngeal mucosa and lateral tissue from the anterior and sometimes posterior faucial pillars. This procedure results in a shortened soft palate and a possible risk following this surgery may be velopharyngeal malfunctioning due to the shortened palate. Few researchers have systematically studied the effects of this surgery as it relates to speech production. Some changes in the voice quality such as resonance (nasality), articulation, and phonation have been reported. In view of the conflicting reports discussed, there remains some uncertainty about the speech status in patients following the snoring and sleep apnea surgery. The study was conducted in two phases: 1) acoustic analysis of oral and nasal sounds, and 2) evaluation of nasality.

• Journal of Gastric Cancer
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• 제11권1호
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• pp.55-58
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• 2011

The simultaneous occurrence of a gastrointestinal stromal tumor (GIST) and a gastric adenocarcinoma is uncommon, and has rarely been reported in the literature. The present report describes the case of a 74-year-old male patient who initially presented with an adenocarcinoma that had invaded the antral mucosa. Computed tomography then revealed the presence of a suspected GIST, in the form of a $2{\times}2$ cm mass at the hilum of the spleen. In view of the advanced age of the patient, a surgical approach that would minimize risk and maximize quality of life was preferred. The patient therefore underwent simultaneous laparoscopy-assisted distal gastrectomy for the adenocarcinoma and wedge resection for the GIST. This approach was only chosen after confirming that it would be possible to preserve three or more of the short gastric arteries that supply the area below the wedge resection site. This may be considered a feasible apapproach to the management of the simultaneous occurrence of a mid-to-low gastric body adenocarcinoma and a high gastric body GIST.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7563-7567
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• 2014

Background: Hepatocellular carcinoma (HCC) is the first cause of death in cirrhotic patients, mostly due to viral hepatitis with HCV or HBV infection. This study was performed to estimate the true prevalence of viral hepatitis-related HCC and the demographic and clinical-pathological associations with the two virus types. Materials and Methods: This cross sectional observational study enrolled clinical data base of 188 HCC patients and variables included from baseline were age, sex, area of residence, clinical-pathological features such as underlying co-morbidity, presence or absence of liver cirrhosis, macrovascular involvement, tumor extension and metastasis, liver lobes involved, serum alpha-fetoprotein level, and hepatitis serologies. Results: Overall prevalence of HCV- and HBV-related HCC was 66.0% and 34.0%, respectively. Patients with HCV were more likely to develop HCC at advanced age ($52.4{\pm}11.9$ vs. $40.7{\pm}12.09$ years), with highly raised serum AFP levels (${\geq}400ng/ml$) 78.2% (HBV 67.1%), large tumor size (HCV-66% >5 cm, HBV-59.3%), and presence of portal vein thrombosis (8.06%, HBV 1.56%). A binominal multivariate analysis showed that HCV-HCC group were more likely to be cirrhotic (OR=0.245, 95%CI: 0.117, 0.516) and had more than two times higher rate of solitary macrovascular involvement (OR=2.533, 95%CI: 1.162, 5.521) as compared with HBV associated HCC. Conclusions: Statistically significant variations were observed from baseline to clinical-pathological characteristics in HCV vs HBV associated HCC. Our study suggests prompt and early screening for high risk patients so that the rate of progression of these chronic viral diseases to cirrhosis and cancer can be decreased.

• Asian Pacific Journal of Cancer Prevention
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• 제16권13호
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• pp.5163-5167
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• 2015

Background: Colon polyps need to be excised upon detection during colonoscopy due to the risk of malignancy irrespective of their size. In our study, we retrospectively evaluated the clinicopathological characteristics of polyps detected during colonoscopy. Materials and Methods: We assessed 379 patients with polyps detected during colonoscopy between January 2010 and May 2012. The demographics, complaints, colonoscopy findings (shape, place and size of the polyp) and histopathological findings were recorded. We carried out statistical analysis using PASW 18.0 for Windows. Results: There were 227 males (59.9%) and 152 females (40.1%) in the trial. The mean age was 53.8 years (32-90). The most common complaint was rectal bleeding (36.1%), followed by abdominal pain (35.4%). Polyps were detected most commonly in the rectosigmoid region (43.8%), followed by the descending colon (17.4%). Some 239 patients had a single polyp (63.1%) while 140 were found to have multiple polyps (36.9%). While tubular adenoma was the most common pathological type, occurring in 181 patients (47.8%), tubulovillous adenoma (14.2%) and hyperplastic polyp (12.7%) followed, occurring in 54 and 48 patients respectively. While 313 patients (82.6%) did not feature dysplasia, 37 patients (9.7%) exhibited low-grade dysplasia, 28 (7.7%) had high-grade dysplasia and 4 had cancer (1.1%). The rates of villous components and dysplasia were detected to be high among pedunculated polyps and polyps larger than 1 cm (p<0.001). Conclusions: Due to the fact that large-diameter polyps with malignant potential are commonly located in the left colon and have a high prevalence among the middle-aged individuals, it would be appropriate to screen this population at regular intervals via rectosigmoidoscopy.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4693-4697
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• 2013

Background: Malignant transformation arising in mature cystic teratoma (MCT) is one of the most serious complications of MCT. Squamous cell carcinoma is the most common malignant change. Some clinical findings such as advanced age group and large tumor size are significant risk factors of malignant transformation. This study was conducted in order to evaluate characteristics, cell types, treatment and outcome of malignant transformation arising from dermoid cysts in our institution. Materials and Methods: A retrospective chart review was performed. General characteristics, operative data, procedure, operative finding and operative outcome were analyzed. Statistical assessment was performed with SPSS version 17.0, using mean, mode, median and percentage to describe those data. Results: During the 10 years period, 11 cases of malignant transformation from a total of 753 cases (1.46% incidence) of MCT were reviewed. Mean age of the patients was 41.2 years (SD 4.34, range 24-70). The most common presenting symptom was a palpable mass (8 cases; 72.7%). Primary surgical staging was performed in 4 patients (36.4%). Re-staging was conducted in the other 4. Complete cytoreduction was obtained in 45.5% (5 cases) and optimal surgical resection was obtained in 36.4% (4 cases). Mean tumor size was 14.1 cm. (SD 1.55, range 6-20). Squamous cell carcinoma was found in 36.4% (4 cases) and mucinous cancer in the other 4. More than half of them were stage Ia (54.5%, 6 cases). All patients whose stage more than Ia received chemotherapy (45.5%). Mean disease free survival was 5.53 years (1.32, 0.3-10). Conclusion: According to our study, the incidence of malignant transformation was consistent with previous studies. The common malignant transformation histologic types are both squamous and mucinous carcinoma which differed from previous reports. Early detection for early stage disease and optimal surgery are important for long term survival.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.34-41
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• 2017

Background The current indications of cardiac implantable electronic devices (CIEDs) have expanded to include young patients with serious cardiac risk factors, but CIED placement has the disadvantage of involving unsightly scarring and bulging of the chest wall. A collaborative team of cardiologists and plastic surgeons developed a technique for the subpectoral placement of CIEDs in young female patients via a transaxillary approach. Methods From July 2012 to December 2015, subpectoral CIED placement via an axillary incision was performed in 10 young female patients, with a mean age of 25.9 years and mean body mass index of $20.1kg/m^2$. In the supine position, with the patient's shoulder abducted, an approximately 5-cm linear incision was made along one of the deepest axillary creases. The submuscular plane was identified at the lateral border of the pectoralis major, and the dissection continued over the clavipectoral fascia until the subpectoral pocket could securely receive a pulse generator. Slight upward dissection also exposed an entrance to the subclavian vein, allowing the cardiology team to gain access to the vein. One patient with dilated cardiomyopathy underwent augmentation mammoplasty and CIED insertion simultaneously. Results One case of late-onset device infection occurred. All patients were highly satisfied with the results and reported that they would recommend the procedure to others. Conclusions With superior aesthetic outcomes compared to conventional methods, the subpectoral placement of CIEDs via a transaxillary approach is an effective, single-incision method to hide operative scarring and minimize bulging of the device, and is particularly beneficial for young female or lean patients.

• 한국식품영양학회지
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• 제27권3호
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• pp.358-368
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• 2014

The purpose of this study was to compare the validity of obesity indices among the body mass index (BMI), waist circumference (WC), and body fat percentage (BF%), and to determine which is the most useful index to predict the risk of chronic diseases of elderly people. This study was conducted as a cross-sectional study at welfare centers in Seoul. The total number of subjects was 261 (68 men and 193 women) with age ${\geq}60$ years. The distribution of obesity using 3 obesity indices in the subjects with hypertension, diabetes, or arthritis was BF%>WC>BMI in elderly men and WC>BF%>BMI in elderly women. In elderly women, odds ratios (ORs) for hypertension in BMI and WC quartiles were significantly increased in quartile 2 and 3 (p<0.05). The ORs for hypertension, hyperlipidemia, and arthritis in BF% quartiles were significantly increased in quartile 3 and 4 (p<0.05). The BF% was sensitive obesity index for predicting the occurrence of chronic disease in men, and the WC was sensitive index in women. Our results suggested maintaining BMI less than $23.5kg/m^2$, WC less than 82 cm, and BF less than 35% in order to prevent chronic diseases in elderly women.