• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.48.1-48.7
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• 2019

Background: Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors. Methods: Positional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery. Results: Maxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values. Conclusion: The horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권3호
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• pp.230-234
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• 2006

Purpose: This study presents radiographic and laboratory analysis and comparison of bone resorption rate of grafted endochondral bone and intramembranous bone on the aspect of height and volumetric change. Patients and Methods: 18 partially edentulous patients who needed alveolar ridge augmentation for implant placement during the years 2002 to 2004 were selected for this study. Group A consisted of 5 males & 3 females who were treated with intraoral(intramembranous) bone and Group B consisted of 8 males & 2 females who were treated with iliac(endochondral) bone. Non-standard periapical X-ray was taken at day 1, 2 month, 4 months, 8 months after the surgery. Resorption rate of grafted bone were measured on these X-rays and compared. Also we calculated volume of grafted bone with models which was fabricated at 1.5 months, 6 months. Results: There was bone resorption in both groups. Group B showed more bone resorption than Group A. In Group A, the resorption rate according to the radiographic measurements was 9.81 %, and resorption rate according to volumetric measurement was 16.5 %. In group B, the resorption rate according to the radiographic measurements was 15.9 %, and resorption rate according to volumetric measurement was 30.6 %. Significant difference is on radiographic resorption of post-op 2, 4, 8 months on two groups (P < 0.05). Also significant difference is on volume resorption on two groups (P < 0.05). Conclusion: We found that more bone resorption occurred with iliac(endochondral) bone and when we use intraoral bone, that bone can maintain their vitality for alveolar ridge augmentation.

• 임상간호연구
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• 제21권3호
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• pp.309-318
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• 2015

Purpose: The purpose of this study was to examine the effects of foot mats on reducing levels of fatigue, discomfort, lower extremity edema and skin temperature in scrub nurses during surgery. Methods: This study employed one group repeated measures design in which 16 scrub nurses (ages 22-38) stood on steel footstools (SF) during scrub as the conventional test and stood on SF with foot mats as the experimental test. Levels of fatigue, discomfort, lower extremity edema and skin temperature were measured before the first surgical hand scrub and right after the first surgery of the day for 3 consecutive days in both tests. Results: The changes in levels of fatigue and discomfort were significantly different between tests (p<.001~.033). Edema, determined by the differences in circumferences of the ankles and calves before and after the surgery was also significantly different between groups (p=.001~.011). However, the change in skin temperature on the foot tops of both feet was not different between tests (p=.351~.467). Conclusion: The results of this study show that using foot mats on top of the steel footstool is effective in reducing the levels of fatigue, discomfort and lower extremity edema in scrub nurses during surgery.

• Journal of Gastric Cancer
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• 제5권4호
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• pp.281-287
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• 2005

목적: UICC 분류에 의한 2기 위암환자의 임상병리학적 특징에 대하여 알아보고 수술 후 보조요법으로서의 항암, 방사선 치료가 5년 생존율에 미치는 효과에 대하여 알아보고자 하였다. 대상 및 방법: UICC에 의한 병리학적 분류로 병기2기로 판정된 954명을 대상으로 하였다. 항암치료는 수술 후 3주째부터 5-Fluorouracil $400mg/m^2/day$와 Leucovorin $20mg/m^2/day$를 사용하였으며 방사선 치료는 총 4,500 cGy를 25회로 나누어 시행하였다. 결과: 임상병리학적 인자들의 생존율분석에서 환자의 나이, 수술방법, 종양의 크기와 항암 및 방사선 치료가 의미 있는 예후 인자로 분석되었다. 수술 후 항암 방사선 치료에 따른 생존율 분석에서 보조요법을 시행하지 않은 425예의 5년 생존율은 67.9%, 항암 치료 군 187예는 79.8%, 항암방사선 치료 군 342예는 83.6%로 조사되어 통계적으로 유의한 차이를 보였으며(P<0.0001) 항암치료 군과 항암방사선 치료 군과의 생존율 비교에서는 항암방사선 치료 군에서 생존율의 향상을 보여주기는 하였으나 통계적으로 유의하지는 않았다(P=0.1264). 결론: 2기 위암환자에서 환자의 나이, 수술방법, 종양의 크기 및 수술 후 보조적인 항암 및 방사선 치료가 5년 생존율에 영향을 주는 의미 있는 예후인자로 조사되었다. 수술 후 보조요법의 시행이 통계적으로 의미 있는 생존율을 보였으나 임상병리학적 인자들을 고려한 무작위 연구를 통해 그 의미를 검증해야 할 것으로 생각된다.

• Journal of Chest Surgery
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• 제43권4호
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• pp.454-457
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• 2010

42세 남자 환자가 종합 검진상 발견된 좌측 6번 늑골의 후궁(posterior arc)의 종괴로 내원하였다. 흉부 컴퓨터 전산화 단층 촬영 및 뼈 스캔(bone scan)에서 뼈연골종(osteochondroma)으로 의심되었고, 흉강경하 늑골 절제술을 시행하였다. 수술 과정 중 혈관 및 신경 손상은 없었다. 환자는 수술 후 4일째 합병증 없이 퇴원 하였다. 조직학적 결과는 양성 섬유성 조직구종(benign fibrous histiocytoma)이었다. 본 증례를 통하여 흉강경을 이용한 늑골의 절제는 후측방 절개술을 통한 늑골 절제술에 비해 미용적인 면에서 장점이 있으며, 손쉽게 수행 가능함을 알 수 있었다.

• Journal of Gastric Cancer
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• 제22권4호
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• pp.395-407
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• 2022

Purpose: This study aimed to investigate the relationship between clinical and laboratory parameters and complication status to predict which patients can be safely discharged from the hospital on the third postoperative day (POD). Materials and Methods: Data from a prospectively maintained database of 2,110 consecutive patients with gastric adenocarcinoma who underwent curative surgery were reviewed. The third POD vital signs, laboratory data, and details of the course after surgery were collected. Patients with grade II or higher complications after the third POD were considered unsuitable for early discharge. The performance metrics were calculated for all algorithm parameters. The proposed algorithm was tested using a validation dataset of consecutive patients from the same center. Results: Of 1,438 patients in the study cohort, 142 (9.9%) were considered unsuitable for early discharge. C-reactive protein level, body temperature, pulse rate, and neutrophil count had good performance metrics and were determined to be independent prognostic factors. An algorithm consisting of these 4 parameters had a negative predictive value (NPV) of 95.9% (95% confidence interval [CI], 94.2-97.3), sensitivity of 80.3% (95% CI, 72.8-86.5), and specificity of 51.1% (95% CI, 48.3-53.8). Only 28 (1.9%) patients in the study cohort were classified as false negatives. In the validation dataset, the NPV was 93.7%, sensitivity was 66%, and 3.3% (17/512) of patients were classified as false negatives. Conclusions: Simple clinical and laboratory parameters obtained on the third POD can be used when making decisions regarding the safe early discharge of patients who underwent gastrectomy.

• Clinical and Experimental Reproductive Medicine
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• 제43권2호
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• pp.119-125
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• 2016

Objective: The aim of this study was to report a case series of in vitro matured (IVM) oocyte freezing in gynecologic cancer patients undergoing radical surgery under time constraints as an option for fertility preservation (FP). Methods: Case series report. University-based in vitro fertilization center. Six gynecologic cancer patients who were scheduled to undergo radical surgery the next day were referred for FP. The patients had endometrial (n=2), ovarian (n=3), and double primary endometrial and ovarian (n=1) cancer. Ex vivo retrieval of immature oocytes from macroscopically normal ovarian tissue was followed by mature oocyte freezing after IVM or embryo freezing with intracytoplasmic sperm injection. Results: A total of 53 oocytes were retrieved from five patients, with a mean of 10.6 oocytes per patient. After IVM, a total of 36 mature oocytes were obtained, demonstrating a 67.9% maturation rate. With regard to the ovarian cancer patients, seven IVM oocytes were frozen from patient 3, who had stage IC cancer, whereas one IVM oocyte was frozen from patient 4, who had stage IV cancer despite being of a similar age. With regard to the endometrial cancer patients, 15 IVM oocytes from patient 1 were frozen. Five embryos were frozen after the fertilization of IVM oocytes from patient 6. Conclusion: Immature oocytes can be successfully retrieved ex vivo from macroscopically normal ovarian tissue before radical surgery. IVM oocyte freezing provides a possible FP option in patients with advanced-stage endometrial or ovarian cancer without the risk of cancer cell spillage or time delays.

• 한국임상수의학회지
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• 제34권2호
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• pp.98-102
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• 2017

A 7-year-old, intact, female Siberian husky presented with vomiting and diarrhea after a fight with a dog with which it lived. The bitch was diagnosed with pyometra and severe dehydration. The patient received IV fluid therapy for 2 day pre- and post-operatively. Four days post-surgery, the patient had a decreased level of consciousness and suffered a tonic-clonic generalized seizure. On magnetic resonance imaging and histopathological findings, a diagnosis of laminar cortical necrosis caused by fluid overload was made. This case provides important information on the potential for fluid overload in a dehydrated patient giving rise to critical condition and death.

• Journal of Veterinary Science
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• 제24권6호
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• pp.76.1-76.6
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• 2023

An 11-year-old neutered male Miniature Poodle with a stage 3 apocrine gland adenocarcinoma was started on chemotherapy with toceranib phosphate after surgery. Beginning on day 10 of toceranib, the dog's foot pads became erythematous and hyperkeratinized. The dog complained of pain, inability to walk, depression, and loss of appetite. The symptoms resolved when toceranib was discontinued and reappeared when toceranib was resumed. Grade 3 palmar-plantar erythrodysesthesia was identified as an adverse event of toceranib based on the VCOG-CTCAE and Naranjo scale. Although very rare in veterinary medicine, clinicians should consider that palmar-plantar erythrodysesthesia can occur after toceranib administration.

• Journal of Chest Surgery
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• 제13권4호
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• pp.490-494
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• 1980

Myasthenia gravis is a neuromuscular disorder manifested by fatigability and weakness of voluntary muscles. The basic defect in the myasthenia is reduction of available acetylcholine receptors at neuromuscuiar junctions by an autoimmune attack. Removal of the thymus gland now play an Important role in the management of this disease. We have two experiences of thymectomy for myasthenic patients. The 31-year-old housewife(J.H) was admitted to the Taegu Presbyterian Medical Center because of bilateral ptosis, mastication and swallowing difficulties. The presence of thymoma was strongly suggested by roentgenographic studies. A 99.8 gm thymoma was removed completely by total thymectomy. On the 2nd postoperative day respiratory failure developed. Tracheostomy was performed and ventilatory assist was given for 3 days. The patient was completely recovered with antichollestrase drug only. C.N. was 17-year-old girl who has the symptoms of bilateral ptosis and diplopia for 3 years. Tensilon test was positive and antichollnestrase was given for several months, but the patient showed no improvement. After thymectomy she was free from myasthenic symptoms with out anticholinestrase drug.