• Journal of Chest Surgery
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• 제32권10호
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• pp.966-969
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• 1999

Congenital defects of the sternum are rare development anomalies. They result form the failure of the lateral sternal bars to fuse. This malformation may be associated with other ventral midline fusion defects and ectopia cordis. A complete sternal cleft is the rarest form and less than 10 cases have been reported in the medical literature. Here were report a 3-day-old boy with complete sternal cleft without other malformations, who underwent primary surgical repair. Surgical correction of complete sternal cleft should be performed in neonatal period whether the infant if symptomatic or not because it is usually simple, able to achieve good result and primary repair is usually feasible at this period.

• 대한치과의사협회지
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• 제12권10호
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• pp.747-751
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• 1974

The authors had a case of large periodontal cyst treated by Apicoectomies in 32 year old, Korean female. 1. A large periodontal cyst revealed big size in Maxilla, left side. 2. The authors have treated the periodontal cyst by means of the apicoectomies of the involved left lateral incisor, canine, 1st premolar and 2nd premolar teeth, maxilla. 3. Radiographic examination revealed a large radiolucent lesion 2.7 3.7cm in diameter, in the midline area, with involvement of the lateral incisor, canine, 1st premolar and 2nd premolar teeth, maxilla.

• The Korean Journal of Pain
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• 제27권4호
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• pp.321-325
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• 2014

Background: Epidural blocks are widely used for the management of acute and chronic pain. The technique of loss of resistance is frequently adopted to determine the epidural space. A discontinuity of the ligamentum flavum may increase the risk of failure to identify the epidural space. The purpose of this study was to investigate the anatomic variations of the cervical and high thoracic ligamentum flavum in embalmed cadavers. Methods: Vertebral column specimens of 15 human cadavers were obtained. After vertebral arches were detached from pedicles, the dural sac and epidural connective tissue were removed. The ligamentum flavum from C3 to T6 was directly examined anteriorly. Results: The incidence of midline gaps in the ligamentum flavum was 87%-100% between C3 and T2. The incidence decreased below this level and was the lowest at T4-T5 (8%). Among the levels with a gap, the location of a gap in the caudal third of the ligamentum flavum was more frequent than in the middle or cephalic portion of the ligamentum flavum. Conclusions: The cervical and high thoracic ligamentum flavum frequently has midline intervals with various features, especially in the caudal portion of the intervertebral space. Therefore, the ligamentum flavum is not always reliable as a perceptible barrier to identify the epidural space at these vertebral levels. Additionally, it may be more useful to insert the needle into the cephalic portion of the intervertebral space than in the caudal portion.

• 대한치과보철학회지
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• 제34권2호
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• pp.363-372
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• 1996

A common site of fracture in maxillary complete denture is on the anteroposterior midline that coincides with the notch for relief of the labial frenum. Various approaches to reduce the incidence of this type of fracture have been suggested. The most widely used technique is the reinforcement of acrylic resin denture base with several solid metal forms. But few comparative studies on the efficacy of metal reinforcements have been reported. This study was conducted to compare reinforcing effects of commonly available metal reinforcements, which include wire, metal mesh embedded in the denture base and metal plate affixed to the impression surface of denture base by silicoating technique. This was load on the posterior. The strain gauges were oriented perpendicular to the anteroposterior midline of maxillary polished denture surface at one labial and the four palatal sites Non-renforced denture was used as control. The results were as follows : 1. In the non-reinforced denture group, only tensile strains on the palatal polished surface were observed. The tensile strains decreased in the order of incisive papilla, posterior denture border area, mid palatal area and rugae area. Compressive strain was observed on the labial polished surface. 2. As compared with the non-reinforced denture group, the metal plate or the metal mesh reinforced denture groups showed reduced palatal tensile strains,and the metal mesh reinforcement had a better reinforcing effect than the metal plate. But both reinforced denture groups showed no difference in the amount of compressive strain on the labial polished surface when compared to the non-reinforced denture group. 3. The metal wire positioned just above the labial notch decreased the compressive strain on the labial polished surface. But the presence of metal wires in the palatal polished surface caused increase in tensile strains in the area.

• Advances in pediatric surgery
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• 제5권1호
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• pp.26-32
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• 1999

We analyzed our experience with orchidopexy for undescended testicle performed during recent 10 years in order to evaluate our results and to determine the most effective treatment of undecended testes. Between 1988 and 1997, we treated 420 undescended tested (314 palpable and 106 nonpalpable) in 356 boys. Medical records were reviewed with respect to age at presentation, the surgical approach, testicular location, testicular volume and the final outcome. The average patient age at presentation was 4.1 years with 40.2 % presenting before age 2 years. Of 106 nonpalpable testes, 23 testes were intra-abdominal, 32 were preperitoneal and 51 were absent. During the first 5 years, we performed orchidopexy through 31 inguinal and 13 midline transabdominal incisions for 44 paitents with nonpalpable testes. In the next 5 years, all 47 patients with nonpalpable were treated through inguinal incisions. For the nonpalpable testes, the inguinal approach with or without intraperitoneal extension was successful in defining the location of testes and blind-ending vessels in all patients. Laparoscopy did not help to avoid surgical exploration in all our patients with nonpalpable tests. Of 339 inguinal and midline tranabdominal orchidopexies without spermatic vessels ligations, 324 testes were placed in the scrotum, 4 in the upper scrotum and 3 in the inguinal area. Eight testes underwent atrophy. Of 13 Fowler-Stephens orchidopexies, 7 were placed in the scrotum and 6 became atrophied. Testicular growths were noticed in most patients who underwent orchidopexies and the colume of pexed testes became as large as the contralateral normal testes by the mean duration of 43.3 months postoperatively. In conclusion, orchidopexies were successful in most cases of cryptochidism in terms of testicular position and growth. However, there were more testicular atrophies in cases where spermatic vessels were ligated. In cases of nonpalpable undescended testes, the inguinal approach with or without intraperitoneal extesion would be recommended.

• 한국전문물리치료학회지
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• 제13권2호
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• pp.77-84
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• 2006

Although conservative management of congenital muscular torticollis (CMT) has been well documented, relatively little is known about the response to the treatment. The purposes of this case report were to describe the use of a therapeutic approach based on motor development in physical therapy intervention for an infant with CMT and to report the result of the treatment. The patient was a 20-day-old baby boy with left CMT presenting muscular mass in the left sternocleidomastoid muscle. The angle of the lateral head tilt was 20 degrees. The size of muscular mass was 5.3 mm in ultrasonography. Intervention included ultrasonic therapy, soft tissue massage, passive and active range of motion exercises, motor developmental therapy, and parent instruction. The procedures of motor developmental therapy and changes in the amount of lateral head tilt were documented using photography. The size of the mass was decreased to .3 mm before the 5-month follow-up. The patient also maintained a midline head position in the supine position and a midline head alignment during all functional activities. A therapeutic approach based on motor development is a beneficial method for reducing an asymmetrical head and neck position, and facilitating normal development as a component of physical therapy intervention.

• Journal of Korean Neurosurgical Society
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• 제59권6호
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• pp.628-636
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• 2016

Objective : Chronic subdural hematoma (cSDH) is common condition in neurosurgical field. It is difficult to select the treatment modality between the surgical method and the conservative method when patients have no or mild symptoms. The purpose of this study is to provide a suggestion that the patients could be cured with conservative treatment modality. Methods : We enrolled 16 patients who had received conservative treatment for cSDH without special medications which could affect hematoma resolution such as mannitol, steroids, tranexamic acid and angiotensin converting enzyme inhibitors. The patients were classified according to the Markwalder's Grading Scale. Results : Among these 16 patients, 13 (81.3%) patients showed spontaneously resolved cSDH and 3 (18.7%) patients received surgery due to symptom aggravation and growing hematoma. They were categorized into two groups based on whether they were cured with conservative treatment or not. The first group was the spontaneous resolution group. The second group was the progression-surgery group. The mean hematoma volume in the spontaneous resolution group was 43.1 mL. The mean degree of midline shift in the spontaneous resolution group was 5.3 mm. The mean hematoma volume in the progression-surgery group was 62.0 mL. The mean degree of midline shift in the second group was 6 mm. Conclusion : We suggest that the treatment modality should be determined according to the patient's symptoms and clinical condition and close observation could be performed in patients who do not have any symptoms or in patients who have mild to moderate headache without neurological deterioration.

• Journal of Korean Neurosurgical Society
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• 제61권1호
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• pp.35-41
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• 2018

Objective : Rehemorrhage is the most severe complication of postoperative patients with spontaneous intracerebral hemorrhage. The aim of the present study was to assess independent predictors of rehemorrhage and find the possibility of preventing rehemorrhage in postoperative patients with spontaneous intracerebral hemorrhage (sICH). Methods : Medical records of 263 postoperative patients with sICH from our Hospital were reviewed. The relationships between rehemorrhage and parameters were examined by univariate and multivariate analyses. The parameters include time from onset to surgery, hematologic paremeters, neuroimaging characteristics, level and variability of systolic blood pressure, medical histories, operation duration, and blood loss. In addition, relationship between rehemorrhage and clinical outcome were analyzed by using multivariate analyses. Results : Thirty-five (13.31%) patients experienced rehemorrhage after operation. Multivariate analyses indicated that the following factors were independently associated with rehemorrhage : history of diabetes mellitus (odds ratio [OR], 2.717; 95% confidence interval [CI], 1.005-7.346; p=0.049), and midline shift (for every 1 mm increase, OR, 1.117; 95% CI, 1.029-1.214; p=0.009). Rehemorrhage was an independent risk factor of poor functional outcome (OR, 3.334; 95% CI, 1.094-10.155; p=0.034). Conclusion : Our finding revealed that history of diabetes mellitus and admission midline shift were possibly associated with rehemorrhage in postoperative patients with sICH.

• Journal of Yeungnam Medical Science
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• 제13권1호
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• pp.134-140
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• 1996

1986년부터 1995년까지의 10년간 영남대학교 의과대학 부속병원에서 절제술이나 세침 생검을 시행하여 조직 병리학적으로 확진된 신경아세포종 23례 중 전산화단층촬영을 시행한 16례를 대상으로 후향적으로 분석한 결과 신경아세포종은 소아에서 많이 발생하며, 부신에서 호발하고, 임상적인 주 증상은 만져지는 종괴였다. 전산화단층촬영소견은 과반수 이상에서 작고 고밀도이거나 곡선 모양의 석회화를 보이며, 중앙선을 침범하며, 분엽상의 모양과 분명한 경계를 보이고, 내부에 낭성 변화를 보이며, 불균등한 조영 양상을 보이고, 주위 중요 혈관과 림프절을 침범한 소견을 보였다. 이와 같은 전산화 단층촬영소견들은 소아 복부 종양에서 신경아세포종의 진단과 감별에 도움을 줄것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10509-10512
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• 2015

Objective: To investigate the differential features of CT images in children with neuroblastomas (N) and ganglioneuroblastomas (G). Materials and Methods: Clinical data of 12 children in group G and 15 in group N undergoing CT examination and definitely diagnosed by pathology were retrospectively analyzed. The focal conditions were observed and compared in the two groups, including location, size, boundaries, morphology, enhanced degree and mode, abdominal vascular involvement, presence or absence of spanning the midline, infiltration of peripheral organs, angiography manifestations in tumors or surroundings, presence or absence of calcification and vascular tumor emboli as well as metastases of distal organs and lymph nodes. Results: In group N, the incidence of tumors in the adrenal area was conspicuously higher than in group G (P<0.05), while that of tumors with regular morphology and clear boundaries was significantly lower than in group G (P<0.01); Angiography manifestation rate and incidences of vascular embedding, lymph node metastasis, infiltration and organic metastasis in group N were all markedly higher than in group G (P<0.05). There was no statistical significance between the two groups in terms of focal size, presence or absence of calcification and spanning the midline, and enhanced degree and mode, as well as vascular tumor emboli (P>0.05). Conclusions: Mostly located in adrenal areas and with vascular embedding as a primary manifestation, the neuroblastoma extremely readily metastases to lymph nodes and other organs as well as infiltrating local tissues, with dilation on angiography frequent in or around the tumors. With vascular displacement as a primary manifestation, ganglioneuroblastoma has a regular morphology and clear boundaries.