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CHANGE OF LIP CANTING AFTER BIMAXILLARY ORTHOGNATHIC SURGERY (상하악 악교정수술 후 입술 기울기변화)

  • Lee, Jun-Hee;Hong, Jong-Rak;Kim, Young-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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    • pp.643-647
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    • 2007
  • Purpose: The purpose of study was to investigate the correlationship between lip canting change and occlusal canting change after bimaxillary orthognathic surgery, and the ratio of lip canting change and occlusal canting change after the surgery. Patients and methods: The subjects for this study was obtained from a group of 25 patients who took bimaxillary orthognathic surgery for occlusal canting correction at the Department of the Oral and Maxillofacial Surgery, Samsung Medical Center in Seoul, Korea between January 2000 and December 2005 and a patient's chart had to contain a resting frontal facial photograph in natural head position and a corresponding PA cephalogram in occlusion on the same day before the surgery and post-op 6 months later. The lip canting change was assessed with the angle each labial commissure and the bipupilary reference line. And, the occlusal caning change in the frontal plane was assessed with the angle between the each maxillary first molar occulasal surface and the bi-frontozygomatic suture reference line. Results: In angular measurement, average occlusal canting change was $3.09^{\circ}$ and standard deviation was $1.05^{\circ}$, average lip canting change was $1.56^{\circ}$ and standard deviation was $1.05^{\circ}$. In linear measurement, average occlusal canting change was 2.41mm and standard deviation was 2.75mm, average lip canting change was 1.18mm and standard deviation was 0.43mm. Lip canting correction ration to occlusal canting correction was 51.5(${\pm}8.4$)% in angular measurement and 48.8(${\pm}9.1$)% in linear measurement. Under Pearson's correlation analysis, Pearson's correlation coefficient was 0.869 in angular measurement and 0.887 in linear measurement(p-value < 0.01). High correlationship was shown between occlusal canting change and lip canting change. Conclusion: First, Bimaxillary orthognathic surgery can correct lip canting as well as occlusal canting. Second, The average amount of lip canting correction is $51.5{\pm}8.4%,\;48.8{\pm}9.1%$ of occlusal canting correction in the study.

Informational Needs of Postoperative Gastric Cancer Patients (위암 수술 후 환자의 정보 요구)

  • Kim, Ae-Ran;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Bae, Jae-Moon;Kim, Sung
    • Journal of Gastric Cancer
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    • v.9 no.3
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    • pp.117-127
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    • 2009
  • Purpose: Adequate health-related information provided by health professionals may help cancer patients overcome their uncertain situation and manage their healthcare. To provide information effectively, there is a need to understand the content of the patients' essential information. The purpose of this study was to identify recent informational needs of postoperative gastric cancer patients. Materials and Methods: Data were collected from 190 postoperative gastric cancer patients who attended the Stomach Cancer Patients' Day ceremony (18 November 2008) held by the Stomach Cancer Center of Samsung Medical Center with the use of a questionnaire which measured informational needs. A questionnaire with 37 items was comprised of domains of diagnostic tests, cancer therapy, prognosis, follow-up, sexual activity, stomach cancer-related information, and 7 single items. Results: The priorities of informational needs were the domains of prognosis, ways of healthcare during treatment (a single item), follow-up, stomach cancer-related information, cancer therapy, and diagnostic tests (in descending order). Items related to prognosis, diet, and management of their healthcare ranked in the top 10 informational need scores. As age decreased, the degree of informational needs about diagnostic tests, cancer therapy, sexual activity, and stomach cancer-related information increased. Conclusion: We suggest that prognosis-related information based on the accumulated institutional therapeutic outcomes and objective prognosis data should be incorporated in the current education program. Health professionals should provide comprehensible information content to cancer patients and caregivers and encourage patients to participate in their therapy with a more positive attitude.

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Validation of Electronic Foot Function Index in Patients with Foot and Ankle Disease: A Randomized, Prospective Multicenter Study (족부 족관절 질환 환자에서 전자식 족부 기능 지수의 인증: 임의 배정, 전향적, 다기관 연구)

  • Lee, Dong Yeon;Kim, Yu Mi;Lee, Jun Hyung;Kim, Jin;Kim, Ji-Beom;Kim, Bom Soo;Choi, Gi Won;Seo, Sang Gyo;Kim, Jun Beom;Park, Se-Jin;Kim, Yoon-Chung;Choi, Young Rak;Lee, Dong-Oh;Cho, Jae-Ho;Chun, Dong-Il;Kim, Hyong Nyun;Park, Jae-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.24-30
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    • 2019
  • Purpose: To evaluate the efficiency of the electronic foot function index (eFFI) through a prospective, random based, multi-institutional study. Materials and Methods: The study included 227 patients ranging in age from 20 to 79 years, visited for surgery in different 15 institutes, and agreed to volunteer. The patients were assigned randomly into a paper-based evaluated group (n=113) and tablet-based evaluated group (n=114). The evaluation was done on the day of hospital admission and the method was changed on the second day of surgery and re-evaluated. PADAS 2.0 (https://www.proscore.kr) was used as an electronic evaluation program. Results: There were no differences in age and sex in both groups. The intraclass correlation coefficient (ICC) evaluation revealed an eFFI ICC of 0.924, showing that both results were similar. The evaluation time was shorter in the tablet-based group than the paper-based group (paper vs tablet, $3.7{\pm}3.8$ vs $2.3{\pm}1.3minutes$). Thirty-nine patients (17.2%) preferred to use paper and 131 patients (57.7%) preferred the tablet. Fifty-seven patients (25.1%) found both ways to be acceptable. Conclusion: eFFI through tablet devices appears to be more constant than the paper-based program. In addition, it required a shorter amount of time and the patients tended to prefer the tablet-based program. Overall, tablet and cloud system can be beneficial to a clinical study.

Effect of Relaxin Expressing Adenovirus for Rat Skin Flap Viability (Relaxin을 분비하는 아데노바이러스가 피판의 생존에 미치는 영향)

  • Yun, In-Sik;Park, Yong-Sun;Cheon, Young-Woo;Jeon, Yeo-Reum;Lee, Won-Jai;Yun, Chae-Ok;Rah, Dong-Kyun
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.519-525
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    • 2010
  • Purpose: Of various effects of relaxin, we assumed that anti-fibrotic effects, neovascularization effects and vasodilatation effects of relaxin might enhance the survival rate of skin flap. In the current study, we used adenovirus expressing relaxin genes to examine whether these genes could enhance the survival rate of a skin flap. Methods: A total of 30 Sprangue-Dawley rats were divided into three groups: RLX group (10; relaxin virus injected group), CTR group (10; no gene coded virus injection group), and PBS group (10; PBS injected group). Each group was intradermally injected with the virus ($10^7$ PFU) and PBS 48 hours before and immediately before the flap elevation. A distally based flap $3{\times}9\;cm$ in size was elevated on the dorsal aspect of each rat. Following this, a flap was placed in the original location and then sutured using a #4-0 Nylon. A surviving area of the flap was measured and then compared on postoperative days 3, 7 and 10. Using a laser Doppler, the amount of blood flow was measured. On postoperative day 10, tissues were harvested for histologic examination and the number of blood vessels was counted. Results: There was a significant increase in the area of the flap survival in the RLX group on postoperative days 3 and 7. The Doppler measurement also showed significantly increased blood flow immediately after the operation and on postoperative days 7 and 10. The number of blood vessels was significantly greater in the RLX group in the tissue harvested on postoperative day 10. The VEGF concentration was significantly higher in the RLX group than others in the tissues harvested on postoperative day 10. Conclusion: Following an analysis of the effects of relaxin-secreting adenovirus on the survival of a flap, the surviving area of the flap and the blood flow also increased. A histopathology also showed an increase in the number of blood vessels and the concentration of VEGF.

A Study of Aortic Vasculopathy after Cardiac Allograft (동종 심장이식 후의 대동맥 혈관병증에 관한 연구)

  • Chung, Won-Sang;Chung, Yoon-Sang;Kim, Young-Hak;Kim, Hyuck;Kang, Jeong-Ho;Paik, Seung-Sam;Song, Dong-Seop;Jang, Hyo-Jun
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.135-140
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    • 2009
  • Background: Chronic rejection after a cardiac allograft usually occurs about six months after the operation. Vasculopathy due to chronic rejection causes atherosclerosis in the coronary artery of the transplanted heart and then this causes myocardial injury. We intended to discover and document those findings that occur in a transplanted ascending aorta. Material and Method: In rats weighting $200{\sim}300gm$ (Spraque-Dawley rat), we carried out heterotopic heart allo-transplantation with the modified Ono-Lindsey method and then the rats were administrated cyclosporine (10mg/kg/day). After three months survival, we acquired biopsy materials from the native ascending aorta and the allo-transplanted ascending aorta and we compared them. We classified each severity of 1) intimal thickening, 2) medial hyperplasia, 3) medial calcification, 4) medial inflammation and 5) chondroid metaplasia, which are specific biopsy findings for chronic rejection after a cardiac allograft. Each severity was classified, according to the opinion of one pathologist, in the native ascending aorta biopsies (n=9) and the allo-transplanted ascending aorta biopsies (n=13). The data of the control group and the study group were statistically analyzed with using the Mann-Whitney test (SPSS version 12.0 window). Result: The important changes of the allo-transplanted aorta were intimal thickening (p<0.0001), medial calcification (p=0.045), medial inflammation (p<0.0001) and chondroid metaplasia (p=0.045), but not medial hyperplasia (p=0.36). Conclusion: Cardiac allograft vasculopathy was seen in the transplanted ascending aorta, the same as was seen in the coronary artery, after allograft cardiac transplantation. We have reached the conclusion that chronic rejection also progresses in the aorta.

Clinical experience of a Hemipelvectomy in the End-Stage of the Pressure Sore (말기 압박궤양에 있어서 일측성 골반제거술의 임상례)

  • Lee, Sung-Su;Hong, Jong-Won;Chung, Yoon-Kyu;Oh, Jin-Rok;Hong, Joon-Pio
    • Archives of Reconstructive Microsurgery
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    • v.11 no.1
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    • pp.47-52
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    • 2002
  • One of the most common problems in cord injury is pressure sores. In the early stage of pressure sores, the wound can be covered by advancing or transpositioning a local myocutaneous flap. However, it can be a great challenge to treat end-stage paraplegic patient who underwent multiple prior flaps, where continuous treatment is needed to prevent recurrent pressure sore due to infection and metabolic drain. In these patients, a local myocutaneous flap may be very difficult for coverage of the wounds. Therefore, hemipelvectomy may be considered. The authors performed a hemipelvectomy on a 33 year-old male paraplegic patient who presented with multiple, large wounds seen in end-stage pressure sores. He had a compression fracture of the lumber spine 9 years ago during a motor vehicle accident. After a wide exicision of the wound, the anterior flap was used as a fillet-flap for reconstruction. On the sixth day postoperatively, secondary repair was done due to wound dehiscence and the postoperative results have been satisfactory thus far.

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Quality of Life after Esophageal Surgery for Esophageal Surgery (식도암 환자의 수술 후 삶의 질에 관한 연구)

  • Kim Chong-Wook;Moon Hye-Won;Kim Yong-Hee;Park Seung-Il
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.310-316
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    • 2006
  • Background: We study the QOL (quality of life) & functional improvement in patients underwent esophageal surgery for cancer by the viewpoint of the patient and would like make the guideline of recovery course. Material and Method: Between Dec. 1996$\sim$Aug. 2002, 250 patients were operated and 57 patients was enable interview, didn't have evidence of recurrence & survived more than 1 year postoperatively at Asan Medical Center. Questionnaire made by direct or telephone interview & include diet habitus, change of body weight, G-E (gastroesophageal) reflux, dumping symptom, change of daily life. Result: There were 53 men (93%), 4 women (7%) with mean age of $62.05{\pm}8.7$ (range: $37{\sim}94$). Operation method was Ivor Lewis operation in 43 case (75.4%), Esophagocolojejunostomy 4 case (7.1%), Mckeown operation 10 case (17.5%). In Diet habitus, 55 patients (96.5%) ate more than three times in a day with mean diet frequency was 3.5 times/day, 51 patients (89.5%) have been ate solid, regular diet, 5 patients (8.8%) enable to eat liquid diet. To compare with preoperative state, 32 patients (56.9%) had a diet speed more than 80%, 28 patients (39.1%) had a diet amount more than 80%. 32 patients (56.9%) had a little change of body weight within a 10%, 25 patients (43%) had a improvement rather than preoperative state. In G-E reflux, 4 patients (7%) had a reflux after every diet, 27 patients (47.4%) had a little reflux after diet. In dumping symptom. 7 patients (12.3%) had a diarrhea after meal. 38 patients (66.6%) had a normal activity 19 patients (33.3%) had a decreased activity. At present state, majority (53 patient-93%) of patient were satisfactory to the operation result, in spite of discomfort from time to time. In the emotional status, 50 patients (88%) had a well sleeping without disturbance. 65% of patients were comfortable in the psychology state. 39% of patients had a libido. Compare with their median age (63 y), it's a normal varient. Conclusion: QOL in patients underwent esophageal surgery for esophageal cancer nearly recovery to preoperative state.

Effects of Recombinant Human Epidermal Growth Factor (rhEGF) on Experimental Radiation-Induced Oral Mucositis in Rats (Rat의 방사선 조사성 구내염에 대한 Recombinant Human Epidermal Growth Factor (rhEGF)의 효과)

  • Jung Kwon-Il;Kim Sun-Hee;Moon Soo-Young;Kim Yeon-Wha;Hong Joon-Pio;Kim Hyun-Sook;Lee Sang-Wook
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.67-76
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    • 2006
  • Purpose: Oral mucositis is a common toxicity of radiation or chemotherapy, which is used a treatment for head and neck cancer. We investigated effects of recombinant human epidermal growth factor (rhEGF) on radiation-induced oral mucositis in rat model. Materials and Methods: Spraque-Dawley rats (7 per group) exposed to a single dose of 25 Gy (day 0) on their head, except for one group, were randomly divided into un-treated, vehicle-treated, and two rhEGF-treated groups. Rats were topically applied with rhEGF (15 or $30{\mu}g/oral$ cavity/day) or vehicle to their oral mucosa. Survival rate of rats, weight changes, and food intakes were examined from day 0 to 18 after radiation. Histology study was performed from oral mucosa of rats at day 7 and 18 after radiation. Results: rhEGF-treated groups (15 or $30{\mu}g/oral$) showed all survival rate 33%, whereas un-treated and vehicle-treated groups showed all survival rate 0% at the end of experiment. rhEGF-treated groups statistically had less weight loss compared to vehicle-treated group from day 2 to 7 after radiation. Food intake of rats with rhEGF treatment turned to increase at day 14 after radiation. At 7 day after radiation, un-treated and vehicle-treated groups showed severe pseudomembraneous or ulcerative oral mucositis. On the other hand, rhEGF-treated groups had no more than cellular swelling and degeneration of epidermal cells in oral mucosa of rats. Conclusion: These results suggest that rhEGF has significantly positive effects on radiation-induced oral mucositis in rats. rhEGF display a therapeutic potential on a clinical level.

Delayed Presentation of a Post-traumatic Mesenteric Arteriovenous Fistula: A Case Report (외상 후 지연성으로 발생한 장간막 동정맥루: 증례보고)

  • Cho, Jayun;Jung, Heekyung;Kim, Hyung-Kee;Lim, Kyoung Hoon;Chun, Jae Min;Huh, Seung;Park, Jinyoung
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.248-251
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    • 2013
  • Introduction: A post-traumatic mesenteric arteriovenous fistula (AVF) is extremely rare. Case Report: A previously healthy 26-year-old male was injured with an abdominal stab wound. Computed tomography (CT) showed liver injury, pancreas injury and a retropancreatic hematoma. We performed the hemostasis of the bleeding due to the liver injury, a distal pancreatectomy with splenectomy and evacuation of the retropancreatic hematoma. On the 5th postoperative day, an abdominal bruit and thrill was detected. CT and angiography showed an AVF between the superior mesenteric artery (SMA) and the inferior mesenteric vein with early enhancement of the portal vein (PV). The point of the AVF was about 4 cm from the SMA's orifice. After an emergent laparotomy and inframesocolic approach, the isolation of the SMA was performed by dissection and ligation of adjacent mesenteric tissues which was about 6 cm length from the nearby SMA orifice, preserving the major side branches of the SMA, because the exact point of the AVF could not be identified despite the shunt flow in the PV being audible during an intraoperative hand-held Doppler-shift measurement. After that, the shunt flow could not be detected by using an intraoperative hand-held Doppler-shift measuring device. CT two and a half months later showed no AVF. There were no major complications during a 19-month follow-up period. Conclusion: Early management of a post-traumatic mesenteric AVF is essential to avoid complications such as hemorrhage, congestive heart failure and portal hypertension.

Reconstruction of Long Term Neglected, Complicated Scalp and Calvarial Defects with Subdural Abscess Using Latissimus Dorsi Myocutaneous Free Flap: A Case Report (장기간 방치된 경막하 농양을 동반한 복합 두피 및 두개골 결손 환자에서 광배근 유리 근피부피판을 이용한 치험례)

  • Noh, Yongjoon;Lee, Sang Hyung;Jeong, Eui Cheol;Park, Ji Ung
    • Archives of Craniofacial Surgery
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    • v.12 no.2
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    • pp.107-110
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    • 2011
  • Purpose: There have been few case reports regarding treatment plans for long-term, neglected scalp defects and calvarial defects with subdural abscess. The purpose of this case report is to present our experience with a free latissimus dorsi musculocutaneous flap for scalp and calvarial defects and to discuss flap options in comparison with a literature review. Methods: A 60-year-old man who fell down from a four-story-height that resulted in a craniotomy in 1979; he visited our outpatient clinic for a chronic, purulent scalp and calvarial defects with unidentified artificial bone. The artificial bone was removed by a neurosurgeon and reconstructed with a free latissimus dorsi musculocutaneous flap. The deep temporal artery was used as a recipient artery. The postoperative flap status was excellent until the 6th day post-operation when the patient experienced a seizure, and an arterial insufficiency occurred at the flap probably due to an arterial spasm. Emergency exploration with arterial re-anastomosis was performed and the flap status was stabilized. Results: Complete wound healing was achieved after 3 weeks without infectious and systemic postoperative complications. During the 6 month follow-up period, there were no complications. Conclusion: We suggest the latissimus dorsi myocutaneous free flap as a good treatment option for a chronic, purulent, complicated scalp with calvarial defect, as a well as treatment for an acute traumatic defect.