• Journal of Chest Surgery
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• 제44권5호
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• pp.338-342
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• 2011

Background: The axillary artery is frequently used for cardiopulmonary bypass, especially in acute aortic dissection. We have cannulated the axillary artery using a side graft or by directly using Seldinger's technique. The purpose of this study was to assess the technical problems and complications of both cannulation techniques. Materials and Methods: From January 2003 to December 2009, 53 patients underwent operations using the axillary artery for arterial cannulation. The axillary artery was cannulated with a side graft in 35 patients (side graft group) and directly using Seldinger's technique in 18 patients (direct group). Results: The results were compared between two groups, focusing on cannulation-related morbidities including neurologic morbidity. Arterial damage or dissection of the axillary artery occurred in 1 (2.9%) patient in the side graft group and in 1 (5.6%) patient in the direct group. Malperfusion and insufficient flow did not occur in either group. There were no postoperative complications related to axillary cannulation, such as brachial plexus injury, compartment syndrome, or local wound infection, in either group. Conclusion: Technical problems and complications of the axillary arterial cannulation in both techniques were rare. Direct arterial cannulation using Seldinger's technique was done safely and more simply than the previous technique. It was concluded that both axillary arterial cannulation techniques are acceptable and it remains the surgeon's preference which technique should be used.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.414-420
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• 2019

Background Congenital muscular torticollis (CMT) is characterized by persistent head tilt toward the affected side. No consensus exists regarding the cause of this disorder. In this study, we analyzed various clinical factors in patients with CMT who were treated with surgical release. This analysis enabled us to identify potential causative factors of CMT and to establish a basis for surgical interventions. Methods In total, 584 patients who underwent surgical intervention for CMT from October 2007 to December 2016 were included in this study. Their demographic characteristics, birthrelated factors, and clinical features were analyzed. Results Data from 525 patients were analyzed in this study after exclusion of those with insufficient information. Before birth, 31 patients (5.9%) were diagnosed with oligohydramnios, and 87 (16.6%) had a breech presentation. Seven (1.3%) cases of clavicle fracture and two (0.4%) cases of cephalohematoma were noted at birth. Before surgery, 397 patients (75.6%) underwent physiotherapy and 128 patients (24.4%) did not. The duration of physiotherapy ranged from 1 to 50 months (average, 6 months). Conclusions Our study shows that 16.6% of the CMT patients presented in the breech position, which is a much higher rate than that observed in the general population (3%-4%). We hypothesize that being in the breech position as a fetus appears to exert a significant influence on shortening and fibrosis of the sternocleidomastoid muscle.

• 대한치과보철학회지
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• 제62권2호
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• pp.131-139
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• 2024

무치악 환자에서 임플란트를 이용한 보철치료는 임플란트 고정성 보철, 임플란트 융합 국소 의치, 하이브리드 보철물, 임플란트 유지 및 지지 피개의치 등의 다양한 방법이 있다. 본 증례에서는 중등도 이상의 만성 치주염에 이환 되어 전악 발치가 필요한 환자에서 computer guided surgery를 이용하여 계획된 위치에 임플란트를 식립하였다. 상악은 불량한 골질로 초기고정력이 충분하지 않아 지연 부하를 시행하였고 골 유착 기간 동안 임시 의치를 사용하였다. 하악은 안정적인 초기 고정을 얻어 즉시 부하를 이용하여 환자의 불편감을 감소시켰다. 임플란트 일차 안정은 즉시 부하를 얻기 위해 가장 중요한 요소로 여겨지기 때문에 수술 전 반드시 임상적, 방사선학적 평가를 통해 잔존 치조골 양 및 골질을 파악해야 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권2호
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• pp.136-141
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• 2013

After the Iraq war, the Korean government established an Iraq Peace and Reconstruction Division, 'Zaytun'. Zaytun division has been dispatched in northern Iraq, since August 3, 2004. As one of our missions, 'Zaytun Hospital' was built to support the demand for the insufficient medical facilities and supplies in Iraq, which was opened on November 27, 2004. Zaytun Hospital, equipped with modern operation room and general ward, has been composed of 12 clinical departments. Although we had many problems, such as difficulty of communication with Iraqis, connection with medical facilities of Iraq and risk of terrorism, we overcame these difficulties and were able to achieve our missions successfully. I wish that our special experience in Iraq are will be the guideline to other oral and maxillofacial surgeons, who want to help those individual in unfortunate areas such as Iraq.

• 대한족부족관절학회지
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• 제18권1호
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• pp.8-13
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• 2014

Amputation of diabetic foot ulcer and infection is a critical modality for saving a patient's life from life threatening infections or ischemic limbs. However, it can cause serious handicaps or complications, such as lifetime shortening and re-amputation of the other limb. The minimal amputation is the main goal of amputation in diabetic patients. However, insufficient amputation can have a harmful effect on patients. The decision of amputation is very difficult and should be made using multidisciplinary approaches. All aspects of the patient's situation, including vascular status, degree of infection, and medical conditions should be considered. The foot surgeon should keep in mind the notion that proper amputation can lead to a new life for diabetic foot patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.83-85
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• 2000

The purpose of this study is to evaluate the effect of $HTR^{TM}$ (hard tissue replacement, Bioplant Inc, U.S.A) polymer on short-term healing as a grafting material for alveolar ridge augmentation. A 48-year-old female presented insufficient bone height and width for the placement of implants. $HTR^{TM}$ polymer was used for ridge augmentation. Bone biopsy was harvested 8 months after the ridge augmentation procedure. $HTR^{TM}$ polymer displayed rapid bone regeneration and mature lamellar and trabecular bone redevelopment. Clinical and histologic observation from the treatment of the patient presented suggest that $HTR^{TM}$ polymer seems to be a appropriate material for alveolar ridge augmentation.

• Journal of Korean Dental Science
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• 제3권1호
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• pp.11-16
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• 2010

Objective : This prospective study sought to verify the stability of three types of short implants measuring 7mm or less. Materials and methods : Implants measuring 7mm or less were placed in patients at multicenter dental clinics in Korea, China, Taiwan, and Singapore. Initial stability, intraoperative and postoperative complications, crestal bone loss, and survival rate of the implant were prospectively evaluated. Results : The primary stability of a 6-mm implant was lower than that of a 7-mm implant. The marginal bone loss of short implants measuring less than 7mm was minimal. Complications such as wound dehiscence, implant mobility, and peri-implant mucositis developed, and these were associated with initial implant failure. The short-term survival rate of 6-mm implant was 93.7%, and that of 7-mm implant, 96.6%. Conclusion : Short implant for the mandible with insufficient height for the residual ridge can be selectively used. Poor primary stability and wound dehiscence can cause osseointegration failure and alveolar bone loss.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.281-284
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• 2010

Purpose: Pseudohypoparathyroidism is a hereditary disorder characterized by symptoms and signs of hypoparathyroidism, typically in association with distinctive skeletal and developmental defects. Hypoparathyroidism is caused by a insufficient end-organ response to PTH (parathyroid hormone). Hypoparathyroidism consists of four types in which the most common form, pseudohypoparathyroidism-Ia, accompany with Albright's hereditary osteodystrophy. We experienced a case of a woman who had been suffering from calcified mass on left foot, diagnosed Albright's hereditary osteodystrophy. Methods: We present a case of a 24-year-old Korean female who visited plastic surgery department with a painful mass on dorsum of the left foot. On the physical exam, bony hard and painful mass, fixed to dermis, was noted. Plain X-ray films demonstrate suspicious calcification on subcutaneous tissue of dorsum of the left foot. The patient was diagnosed pseudohypoparathyroidism 2 years ago at the plastic surgery department. At the visiting time, the laboratory results were within normal range even though the patient actually had a disease. The reason is because the patient has been treated with Vit.D, calcium replacement therapy and thyroid hormone therapy. Moreover, the patient has been treated with anticonvulsant agents due to epilepsy. On the brain computer tomography (CT), calcification was noted on the basal ganglia and dentate nucleus. So we decided the total excision of entire mass from the left foot. Results: We excised main mass with numerous pinhead sized masses which were scattered around the main mass. The $6.0{\times}4.0{\times}0.5\;cm$ sized main mass was bony hard, and its surface was flat and margin was irregular. The permanent biopsy was confirmed that the main mass and all the scattered tiny masses were heterotopic calcification. The patient did not suffer from the pain after the mass excision. The wound has been healed without any problem. Conclusions: Heterotrophic calcification is often accompanied with pseudohypoparathyroidism, but such a huge one is uncommon. We report a case of pseudohypoparathyroidism with heterotrophic calcification developed in dorsum of left foot who was diagnosed by excisional biopsy.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.574-580
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• 2008

Purpose: Philtral deformity is a stigma of secondary cleft lip nose. It occurs from the false arrangement of orbicularis oris muscle and the scar of previous operation. Various methods have been used to correct this deformity. We successfully corrected philtral deformity using overlapping of orbicularis oris muscle flap. Methods: From November 2000 to August 2007, we performed 39 cases of correction of philtral deformity in secondary cleft lip nose with overlapping of orbicularis oris muscle flap. Their age ranged from 5 to 53 years old. Existing scar tissue of previous operation was deepithelialized and preserved as scar flap. Lateral orbicularis oris muscle flap was elevated, advanced and overlapped upon medial muscle flap after dissection of orbicularis oris muscle of both sides. Reconstruction of philtral column was made from overlapping area by fixation of end part of lateral muscle flap to the point between philtral dimple and column. The degree of muscle flap advancement was decided by correction state of lateral muscle bulging. Correction of nostril floor depression or whistle deformity was also performed with preserved scar flap, if necessary. Results: Realignments of orbicularis oris muscle were possible in the majority of the patients and final results of philtral reconstruction were satisfactory mostly. Correction of nostril floor depression and whistle deformity was also achieved. Additional correction was performed later to 4 patients in whom insufficient reconstruction was noted. No significant complication was observed. Conclusion: More natural and symmetric philtrum was acquired with overlapping of orbicularis oris muscle flap. To the authors' knowledge, it is an easy and effective method for correction of philtral deformity through anatomical rearrangement of distorted orbicularis oris muscle with relatively simple procedure.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.299-305
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• 2009

Purpose: Recently, the incidence of malignant melanoma has been steadily increasing. Malignant melanoma is already known to have poorer prognosis than other primary skin cancers. Despite the poor prognosis, it is relatively less known to the public so that a number of patients visit hospital carrying advanced stage tumor. Yet, extensive study about malignant melanoma is currently insufficient, and specific guidelines and statistical figures in Korea are almost inexistent. Therefore, authors reviewed patients with malignant melanoma who have visited our hospital for last 14 years. Methods: Between January 1994 and January 2008, 62 patients were diagnosed with malignant melanoma at our hospital. A retrospective study was performed with data from patients' charts and biopsy results. Annual incidence, mean age of onset, gender, tumor location, tumor thickness, pathologic ulceration, clinicopathologic subtype, and clinical AJCC stage were evaluated. Analysis of factors associated with survival were performed using the Cox proportional hazard model. Kaplan - Meier method was used to generate survival curves. Results: Clinicopathologic features of 62 patients (32 male, 30 female) with average age of 57 years were evaluated. Most lesions were found in lower limb, and the most common subtype was acral lentiginous melanoma. We could also find that age, tumor thickness, and clinical stage were the only significant prognostic factors. Conclusion: Clinicopathologic features of malignant melanoma were analyzed in this study, but the result is not ready to be generalized because the number of cases is too small. Further study must be performed to report clinical guidelines for prognosis and treatment for malignant melanoma patients in Korea.