• Archives of Plastic Surgery
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• 제45권2호
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• pp.158-164
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• 2018

Background During breast augmentation, the transaxillary approach provides the advantage of allowing the mammary prosthesis to be placed through incisions that are remote from the breast itself, thereby reducing the visibility of postoperative scars. For patients experiencing capsular contracture who do not want additional scars, the previous transaxillary scar can be used for site change and implant exchange. Methods This study analyzed 17 patients (34 breasts) with submuscular breast implants with grade III-IV capsular contracture who received treatment from 2010 to 2015. The mean age of the patients was 29 years (range, 20-38 years). The inclusion criterion was a pinch test of more than 3 cm at the upper pole of the breast. Previous axillary scars were used to expose the pectoralis fascia, and submuscular breast implants were removed carefully. The dissection underneath the pectoralis fascia was performed with endoscopic assistance, using electrocautery under direct visualization. Results The mean follow-up period was 14 months (range, 6-24 months). The entire dissection plane was changed from the submuscular plane to the subfascial plane. Round textured gel implants were used, with a mean implant size of 220 mL (range, 160-300 mL). Two patients developed grade II capsular contracture. There were no cases of malposition or asymmetry. Three patients complained of minor implant palpability. None of the patients required additional surgery. Conclusions Endoscopic subfascial conversion may be an effective technique for treating capsular contracture and avoiding scarring of the breast in selected patients.

• Journal of Chest Surgery
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• 제36권8호
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• pp.610-613
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• 2003

협착성 심낭염을 앓던 68세 남자 환자가 심낭절제술을 받았다. 심낭은 하모닉 스칼펠로 절제되었다. 하모닉 스칼펠은 에너지의 적은 전달과 조직으로의 전기 에너지 전달이 거의 없다는 점이 전지소작과는 다르다. 전기소작은 전류의 전달을 통하여 작동하기 때문에, 종종 정상적인 심장 리듬을 방해한다. 이는 전류의 전달이 없기 때문에, 수술 중 그리고 수술 후에 의미 있는 심박동의 이상이 감소됨을 확인할 수 있다. 이러한 새로운 도구는 근육 자극이 없고, 적은 열을 발산하며, 연기가 없어서 수술장 시야가 방해받지 않으며, 쉽게 지혈이 가능한 장점이 있다. 본 교실은 하모닉 스칼펠을 이용하여 심낭절제술을 시행한 환자를 경험하였기에, 간략한 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제35권6호
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• pp.495-499
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• 2002

Plummer-Vinson(Paterson-Kelly) 증후군은 임상적으로 상부식도 혹은 하인두의 막양구조(web)와 이로 인한 연하곤란, 철분결핍성 빈혈, 그리고 구강점막의 위축성 변화를 동반하는 질환으로, 식도암을 유발하는 전암성 병변으로, 일반적으로 경구 철분 투여만으로 증상을 호전시키거나 내시경을 이용한 풍선확장술이나 전기소작술 치료가 주로 시행되고 있다. 본 병원에서는 63 세 여자환자에게서 나타난 상부식도의 협착을 유발한 병변에 대하여 공장 이식편을 이용한 유리이식술 치료한 후, 병리조직학적인 검사에서 상피내암종으로 진행한 Plummer-Vinson 증후군으로 판명되었기에 이를 보고하고자 한다.

• 대한수의학회지
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• 제59권3호
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• pp.119-122
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• 2019

The goals of this study were, first, to evaluate the feasibility of inducing gastric perforation with 99% alcohol injection after electrocautery (EA-method), and, second, to observe "enhanced peritoneal stripe sign (EPSS)" and other lesions upon induction of gastric perforation. Six clinically normal beagle dogs were prepared for gastric perforation using endoscopy. After gastric perforation, EPSS and other lesions on ultrasonography were observed eventually (at 0 h, 3 h, day 1, day 2, day 3, day 4, day 5, and day 6). We graded the EPSS depending on its width and number. EPSS was observed until day 4 of the examination in all the 6 dogs. The grades of EPSS were the highest at 3 h and declined gradually. Peritoneal effusion was observed in all dogs at 3 h and on day 1. Regional bright mesenteric fat was confirmed in all dogs on days 3 and 4. In conclusion, gastric perforation can be induced by EA-method. EPSS and peritoneal effusion appear at a very early stage, and regional bright mesenteric fat was identified on days 3 and 4 in almost all dogs with gastric perforation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권1호
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• pp.13-20
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• 2022

The lifetime incidence of epistaxis in dental and maxillofacial practice has been reported to be as high as 60% and can be caused by dental implant placement, Le Fort I osteotomy, intranasal supernumerary tooth, odontogenic tumors, blood disorders and maxillofacial trauma. Most epistaxis cases are minor and easily managed with direct compression on the nares for 10 minutes. For more significant or recurrent epistaxis, other techniques might include electrocautery, anterior or posterior nasal packing, or Foley catheter balloon. For patients with refractory epistaxis, cauterization of the sphenopalatine artery under endonasal endoscopy or embolization of the internal maxillary artery should be performed. Epistaxis control is required in patients diagnosed with inherited or acquired bleeding disorders or with drug-induced coagulopathies during dental procedures. In these cases, hemostatic system adjustment and hemostasis achieved by local and adjunctive methods are required. Dentists and maxillofacial surgeons must be aware that the nasal cavity is a potential source of perioperative hemorrhage. Depending on the invasiveness of the dental intervention, preoperative involvement of the hematologist and cardiologist is usually necessary to reverse anticoagulation or to cease anticoagulant therapy.

• 대한화상학회지
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• 제22권2호
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• pp.34-37
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• 2019

Fires in operating rooms rarely occur. However, this type of disaster can complicate almost any surgical procedure. Fuel, heat and oxygen are related with fire outbreak. When ignition sources such as alcohol-based surgical preparation solutions are present, the risk of an operating room fire increases, and burns are more severe in such conditions. Many manufacturers recommend waiting at least three minutes after application to allow complete drying for reduce fire risk. There are a few studies regarding flame burns in the operation room, although most of these studies are related to preoperative skin preparation. However, alcohol containing solutions can be used occasionally for cleansing of the operation field after the surgery, therefore, the surgical team should pay attention to surgical fires, even if they have completed the operation successfully. We present our case of a post-operative flame burn and introduce some precautions that will reduce the risk of alcohol burns.

• Journal of Trauma and Injury
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• 제30권2호
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• pp.33-40
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• 2017

Purpose: The role for minimally invasive surgery in chest trauma is vague, one that recently is more frequently performed, and one attractive option to be considered. Thoracoscopic surgery may improve morbidity, mortality, hasten recovery and shorten hospital stay. Methods: A total of 31 patients underwent video assisted thoracoscopic surgery for the treatment of blunt and penetrating chest trauma from June 9th, 2013 to March 21st, 2016 in Jeju, South Korea. Results: Twenty-three patients were males and eight patients were females. Their ages ranged from 23 to 81 years. The cause of injury was due to traffic accident in 17 patients, fall down in 5 patients, bicycle accident in 2 patients, battery in 2 patients, crushing injury in 2 patients, and slip down, kicked by horse, and stab wound in one patient each. Video assisted thoracoscopic exploration was performed in the 18 patients with flail chest or greater than 3 displaced ribs. The thoracoscopic procedures done were hematoma evacuation in 13 patients, partial rib fragment excision in 9 patients, lung suture in 5 patients, bleeding control (ligation or electrocautery) in 3 patients with massive hemothorax, diaphragmatic repair in two patients, wedge resection in two patients and decortication in 1 patient. There was only one patient with conversion to open thoracotomy. Conclusion: There is a broad range of procedures that can be done by thoracoscopic surgery and a painful thoracotomy incision can be avoided. Thoracoscopic surgery can be done safely and swiftly in the trauma patient.

• Clinical and Experimental Reproductive Medicine
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• 제18권2호
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• pp.209-214
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• 1991

Endosalpingiosis is defined as the ectopic location of tubal epithelium. The term is purely descriptive and does not necessarily imply either the direct origin from tubal mucosa or the similarity of function. This study was performed to evaluate the clinical and pathologic characteristics of endosalpingiosis in the patients with endosalpingiosis proven by pathologic investigation. The medical histories and pathologic reports of 22 endosalpingiosis patients who received the laparotomy at Seoul National University Hospital from August, 1982 to December, 1990 were reviewed. The results were as follows: 1. Age distribution was from 26 to 46 years with the mean age of 34.0 years. 2. Twelve(54.6%) patients were nulligravida and the chief complaint of these patients was infertility(45.5%). 3. Six (27.3%) patients had the previous laparoscopic tubal sterilization by electrocautery or ring application. 4. Four (18.2%) patients had previous history of tubal pregnancy. 5. The most prevalent location of endosalpingiosis was the proximal segment of the salpinx, and the length of the proximal stump from the lesion was less than 1cm in 16(72.7%) patients.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.687-691
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• 2008

Purpose: An inverted nipple presents both cosmetic and functional problems. It is a source of repeated irritation and inflammation, and interferes with nursing. In addition, its abnormal appearance may cause psychological distress. With consideration of its underlying pathophysiologic components and severity, a number of techniques have been introduced for correction of this anomaly. The diversity of techniques indicates the lack of a good, sustainable, and durable solution for this quite common problem. We report our method as an alternative solution for correcting of the inverted nipple. Methods: From August 2003 to November 2007, 273 nipples in 147 patients were treated. 126 patients had bilateral inverted nipples. Patient age at the operation ranged from 21 to 63 years(mean age, 34 years). All nipples were congenital anomaly. 45 nipples were graded as grade I, 179 nipples as II, and 49 nipples as III. In the our study, we made some modification to the classic purse-string suture: (1) twice purse-string suture: (2) excision of diamond-shaped skin at the nipple neck: (3) buried suture of the breast parenchyma at the nipple base: (4) some timely release of retraction using Bovie's electrocautery dissection at inner surface of the nipple neck. Results: The operation time averaged 15 minutes. The mean follow-up period ranged from 3 to 48 months, with an average of 8.4 months. There were no complications associated with the surgery, such as infection, hematoma, permanent sensory disturbance, or total nipple necrosis except temporary sensory loss in 9 cases, partial nipple necrosis in 7 cases, and recurred inversion in 15 cases. All patients except recurred inversion were satisfied with their results. Conclusion: We believe that our modified purse-string suture is a reliable, simple, safe, and effective method for correcting the inverted nipple.

• Archives of Plastic Surgery
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• 제34권3호
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• pp.358-364
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• 2007

Purpose: A life-threatening hemorrhage resulting from a severe facial fracture is rare, but it needs a prompt and aggressive treatment. Especially, a massive oronasal bleeding combined with midfacial fracture which may result from the rupture of the internal maxillary artery. With the recent advances in the radiologic intervention, its use has increased for managing these life threatening case. We reviewed its usefulness with our experiences and literatures. Methods: A retrospective review was performed to determine the usefulness of the transcatheter arterial embolization in patients with panfacial trauma. If the vital signs were unstable, cardiopulmonary resuscitation was performed. Oronasal bleeding was controlled with nasal packing and electrocautery. All injured regions were studied by radiologic study including CT. Even after primary management, if the oronasal bleeding was persistent, radiologic intervention was performed 10 patients were treated with transcatheter arterial embolization and the bleeding focus controlled by embolization with polyvinyl alcohol and gelfoam. Results: After the intervention, the vital signs became stable and there were no complications from embolization in the follow-up for 6 months. Also patients could recover through appropriate operations. Conclusion: Transcatheter arterial embolization for maxillofacial injury has many advantages for both, the doctor and the patient. First, less pain is induced than a compression device or an operation, which is another way to treat oronasal bleeding. Second, it does not need general anesthesia. And through a single procedure not only we can know the accurate bleeding point, but we can also bleeding by embolization.