• Archives of Plastic Surgery
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• v.45 no.6
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• pp.557-563
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• 2018

Background Numerous Dupuytren's fasciectomy techniques have been described, each associated with unique surgical challenges, complications and recurrence rates. We describe a common ground surgical approach to Dupuytren's disease; 3-dimensional fasciectomy (3DF). 3DF aims to address the potential contributors to the high recurrence rate of Dupuytren's disease and unite current limited fasciectomy practice that varies considerably between surgeons. Methods We describe the 3DF principles; raising thin skin flaps (addressing dermal involvement), excising diseased palmar fascia with a 3-5 mm clearance margin (treating highly locally recurrent conditions) and excising the vertical septae of Legueu and Juvara (providing deep clearance, hence addressing all potentially involved pathological tissue). The surgical outcomes between traditional limited fasciectomy (LF) and 3DF are compared. Results From the 786 operations included (n=585), postoperative recurrence rates were significantly lower for the 3DF group (2/145, 1.4%) than the LF group (72/641, 11.2%) (P= 0.001), and the time to recurrence was significantly longer ($5.0{\pm}0years$ vs. $4.0{\pm}0.2years$; P<0.0001). With recurrence excluded, there were no differences between the postoperative complication rates for 3DF (5/145, 3.5%) and LF (41/641, 6.4%) (P=0.4). Conclusions Our results suggest that 3DF leads to lower recurrence rates and a longer disease-free period for patients, without increasing complications. 3DF provides a safe, efficacious, common ground surgical approach in the treatment of Dupuytren's flexion deformity.

• Journal of Korean Neurosurgical Society
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• v.42 no.3
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• pp.179-183
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• 2007

Objective : Posterior arthrodesis in atlantoaxial instability has been performed using various posterior C1-2 wiring techniques. Recently, transarticular screw fixation (TASF) technique was introduced to achieve significant immediate stability of the C1-2 joint complex. The purpose of this study is to assess the clinical outcomes associated with posterior C1-2 TASF for the patient of atlantoaxial instability. Methods : We retrospectively reviewed data obtained from 17 patients who underwent C1-2 TASF and supplemented Posterior wiring technique (PWT) with graft between 1994 and 2005. There were 8 men and 9 women with a mean age of 43.5 years (range, 12-65 years). An average follow-up was 26 months (range, 15-108 months). Results : Successful fusions were achieved in 16 of 17 (94%). The pain was improved markedly (3 patients) or resolved completely (14 patients). There was no case of neurological deterioration, hypoglossal nerve injury, or vertebral artery injury. Progression of spinal deformity, screw pullout or breakage, and neurological or vascular complications did not occur. Conclusion : The C1-2 TASF with supplemental wiring provided a high fusion rate. Our result demonstrates that C1-2 TASF supplemented by PWT is a safe and effective procedure for atlantoaxial instability. Preoperative evaluation and planning is mandatory for optimal safety.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.53.1-53.6
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• 2019

Background: The nasal bone is the most protruding bony structure of the facial bones. Nasal bone fracture is the most common facial bone fracture. The high rate of incidence of nasal bone fracture emphasizes the need for systematical investigation of epidemiology, surgical techniques, and complications after surgery. The objective of this study is to investigate the current trends in the treatment of nasal bone fractures and the effectiveness of closed reduction depending on the severity of the nasal bone fracture. Patients and methods: A total of 179 patients with a nasal bone fracture from 2009 to 2017 were enrolled. Their clinical examination, patient's records, and radiographic images of nasal bone fractures were evaluated. Results: Patients ranged from children to elderly. There were 156 (87.2%) males and 23 (12.8%) females. Traffic accident (36.9%) was the most common cause of nasal fracture. Orbit fracture (44 patients, 24.6%) was the most common fracture associated with a nasal bone fracture. Complications after surgery included postoperative deformity in 20 (11.2%) patients, nasal obstruction in 11 (6.1%) patients, and olfactory disturbances in 2 (1.1%) patients and patients with more severe nasal bone fractures had higher rates of these complications. Conclusion: Closed reduction could be performed successfully within 2 weeks after injury.

• Clinics in Shoulder and Elbow
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• v.18 no.3
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• pp.128-132
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• 2015

Background: We described a surgical method for osteosynthesis and reported the resultant strength after application of a PHILOS plate through the anterolateral approach for the treatment of fractures of the distal humerus. Methods: Between February 2010 and March 2012, open reduction and internal fixation operations with the PHILOS plate for treatment of fracture of the distal humerus were performed on a total of nine patients (five men, four women). The mean age was 40.8 years (range, 24-50 years), and the average follow-up period was 9.1 months (range, 6-15 months). Clinical evaluations were performed 6 months after the operation. Clinical assessment included determination of the range of motion of the elbow, the Mayo and Oxford elbow scores, and any postoperative complications. Results: Fracture union was noted in all patients, with an average period of 12.4 weeks. The average Mayo elbow and Oxford elbow scores were 87.2 (of a total of 100) and 43.3 (of a total of 48), respectively. For the postoperative range of motion of the elbow, all patients showed complete recovery to the preoperative range of motion. No other conditions, such as neurolepsis, plate breakage, or rotational deformity, were observed. Conclusions: Open reduction and internal fixation of distal humerus fractures with a PHILOS plating system via anterolateral approach can be effective. A high rate of union with good outcomes can be assumed.

• Archives of Plastic Surgery
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• v.35 no.6
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• pp.739-742
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• 2008

Purpose: Breast augmentation is one of the common procedures in plastic surgery today. The shape, size and insertion plane of the implant is decided preoperatively by physical examination of the breast. Pectus excavatum is one of the most common anomalies of chest wall, characterized by a depression of the anterior chest wall. For patients with a mild type of pectus excavatum, the main purpose of the treatment is aesthetic rather than functional improvement. Two most surgical treatment options for skeletal deformity are the Ravitch technique and minimally invasive Nuss repair. Other options for soft tissue repair are implant insertion and autologous soft tissue augmentation. We performed a surgical operation with Nuss procedures and breast augmentation for a patient with mild pectus excavatum and hypoplastic breast. Methods: A 32 year-old female was presented with hypoplastic breast. Preoperative chest CT was performed, showing pectus excavatum. After Nuss procedure, we inserted saline implant(275 cc textured round breast implant, moderate profile) submuscularly to restore adequately projected breast. Results: Patient's postoperative course was uneventful without any complication. After 6 months of follow-up period, the patient had an excellent result, with high patient satisfaction and no complications. Conclusion: For patients with a mild type of pectus excavatum, who do not have cardiopulmonary symptoms and requires for aesthetic improvement, this simple approach with Nuss procedure and breast augmentation achieves excellent aesthetic correction with low complication rate and high patient satisfaction.

• Journal of Veterinary Clinics
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• v.34 no.4
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• pp.287-290
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• 2017

A 6-month-old, 4.1 kg female Dachshund dog presented with intermittent non-weight bearing lameness of the right thoracic limb. Radiographs revealed caudolateral luxation of the right radial head and a shortened right ulna compared to the contralateral limb. Bone lengthening by distraction of the ulna using the Ilizarov technique was performed following ulnar osteotomy. The rate of distraction was 1.5 mm per day, adjusted a total of 3 times daily for a total distraction distance of 10 mm. The Ilizarov fixator was removed four weeks after surgery. The patient showed knuckling due to radial nerve injury that occurred during limb-lengthening. Corrective osteotomy was performed using a plate and pin for the luxation and deformity of the right radial head. The luxation of the radial head was successfully reduced following surgery. However, the knuckling persisted after surgery. Rehabilitation for radial nerve injury was performed using heat therapy, massage, a passive range of motion exercises, water treadmill exercises, neuromuscular electrical stimulation, leash-walking, and acupuncture. 15 months after surgery, the patient showed satisfactory weight-bearing ambulation without recurrence of lameness. The use of the Ilizarov technique is a good surgical option for the treatment of a patient with congenital elbow luxation.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.319-323
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• 2008

Edward's syndrome is a genetic disorder of 18th chromosomal trisomy. Main clinical features of this syndrome include systemic conditions, such as mental retardation, growth retardation, dyspnea, congenital heart disease, and orthopedic disorders, such as flexion deformity and rocker-bottom feet. The characteristics of fetal abnormality are hydramnios, small placenta, common umbilical artery. Infants with Edward's syndrome have very low survival rate. Almost half of them die during fetal stage. Fifty percent of them survive 2 months, and 5 to 10 percent of them survive about 1 year. A 3-year and 7 month old girl visited our dental hospital for the treatment of dental caries. Considering her systemic disease, low body weight, medical history of cardiac surgery, and difficulty in airway management, dental procedure was performed under general anesthesia. We report this case with review of literatures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.7.1-7.7
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• 2015

Background: Osteoradionecrosis is a delayed complication from radiation therapy which causes chronic pain, infection and constant deformity after necrosis. Most of the osteoradionecrosis occurs spontaneously or after the primary oncologic surgery, dental extraction or by trauma of prosthesis. The treatment of osteoradionecrosis relies on both conservative measures and surgical measures. The fibular osteocutaneous free flap has become more popular choice for reconstruction of maxillofacial defects as a treatment of osteoradionecrosis. Methods: We presented our experiences from 7 patients with osteoradionecrosis who have had reconstruction surgery with fibular osteocutaneous free flap at National Cancer Center during the recent 5 years. We performed segmental mandibular resection with fibular osteocutaneous free flap for all 7 patients of advanced osteoradionecrosis who were not controlled by conservative treatment such as wound irrigation, debridement, and antibiotics. Results: A wide range of techniques were available for the reconstruction of composite defects resulted from the treatment of advanced mandibular osteoradionecrosis. Significant improvement was noted in relieving pain and treating trismus after the surgery however difficulty in swallowing and xerostomia showed less improvement. Conclusions: We concluded that fibular osteocutaneous free flap can be performed safely in patients with osteoradionecrosis and yields positive outcomes with significantly increased success rate. The fibular osteocutaneous free flap was our preferred choice for the mandibular reconstruction due to its versatility and predictability.

• Journal of Korean Neurosurgical Society
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• v.37 no.2
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• pp.116-123
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• 2005

Objective: Percutaneous kyphoplasty using a balloon-catheter is an widely accepted method which achieves the restoration of vertebral height and the correction of kyphotic deformity with little complication in osteoporotic vertebral compression fractures. The authors assess the results of 59 patients who underwent kyphoplasty, and analyze the factors that could affect the prognosis. Methods: From December 2001 to May 2003, fifty-nine patients underwent kyphoplasty. The patients included 49 women and 10 men aged 52-85 years. Average t-score on bone marrow density was -3.58. About 7cc of polymethylmethacrylate(PMMA) was injected into the fractured vertebral body using $Kyphon^{(R)}$ under local anesthesia. The vertical height of all fractured vertebrae was measured both before and after surgery. Outcome data were obtained by comparing pre- and post-operative VAS score and by assessing postoperative satisfaction, drug dependency and activity. Various clinical factors were analyzed to assess the relationship with the outcome. Results: The VAS score improved significantly, and the mean percentage of restored vertebral height was 53%. The mean improvement in kyphosis was $3.6^{\circ}$. Eighty-nine percent of the patients gained excellent or good results. Any of the clinical factors including the interval between fracture and operation, the degree of height loss, the degree of the vertebral height restoration or the correction rate of kyphosis did not affect the clinical results. Conclusion: Kyphoplasty is associated with a statistically significant improvement in pain and function with little complication. The clinical results are not affected by any clinical parameters. Further follow-up study is needed to determine whether the restoration affects the long-term clinical results.

• Ocean and Polar Research
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• v.32 no.4
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• pp.369-377
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• 2010

To characterize ecotoxicological responses to a natural estrogen, $17{\beta}$-estradiol, we evaluated the life-history of the parental ($F_0$) and first generation ($F_1$) of the harpacticoid copepod, Tigriopus japonicus sensu lato. We evaluated the survival of nauplii and copepodites, the number of days until the emergence of copepodites and adult males, the sex ratio, brooding success, and the first brooding day of adult females. No significant differences in the survival rate were noted in response to treatments with different concentrations of $17{\beta}$-estradiol. However, $17{\beta}$-estradiol induced developmental delay and skewed the sex ratio toward males. Copepod development was delayed significantly in the 0.1 and $1\;{\mu}g\;l^{-1}$ $17{\beta}$-estradiol treatment groups relative to the control group, with a more pronounced delay in the $F_1$ group. Body length and biomass were significantly smaller in the $17{\beta}$-estradiol treated groups than in the controls. The male emergence of T. japonicus s.l. was very high in the 10 and $30\;{\mu}g\;l^{-1}$ $17{\beta}$-estradiol treatment group. Furthermore, exposure to $17{\beta}$-estradiol resulted in morphological deformities such as shrinking and swelling of the urosome, twisted setae of the caudal rami, setal loss of swimming legs, abnormal segmentation of antennules, and dwarfism.