• Journal of Chest Surgery
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• v.22 no.5
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• pp.851-856
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• 1989

Initial successful treatment of postpneumonectomy empyema depends to a large extent on adequate dependent drainage of the empyema sac and the use of antibiotics. But definite control of the infected space remains a disturbing and controversial area in the field of thoracic surgery. A 55-year-old man had a right pneumonectomy for tuberculosis with the development of postoperative thoracic empyema and in October 1973. Postoperatively, an empyema developed and the condition was managed with closed drainage and an open window thoracostomy. He was transferred to our institution in October 1988, and underwent thoracoplasty for the obliteration of the empyema space, resulting in a remaining space. The remaining space after thoracoplasty was obliterated by myoplasty using a rotation flap of splitted pectoralis major muscle three months later. He was discharged with uneventful course 12 days after operation, and continues to do well 3 months following operation. Our experience shows that thoracoplasty and myoplasty offer an effective alternative method of management of post-pneumonectomy empyema.

• Journal of Chest Surgery
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• v.30 no.9
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• pp.936-940
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• 1997

Pulmonary aspergilloma is potentially a life threatening disease resulting from the colonization of lung cavities by Aspergillus fumigatus. A case is reported: a 43-year-old man with symtomatic cavitary aspergilloma presenting with severe productive coughing, hemopt sis, occasional fever, and chilling. On preoperative plain chest radiograph and CT scan, we could find a rounded irregular opacity in a large pulmonary cavity. He received 2 separate operations for therapeutic need. At the first opertion, we performed cavernostomy and thoracoplasty because of severe pleural adhesions, tearing of cavity wall, and high risk of respiratory insufficiency. At the second operation, we performed myoplasty and omentoplasty for closure of remaining air space and complete wrapping of the BPF site. All symptoms of dyspnea and hemoptysis have since resolved. We believed that in the high risk patients who have severe respiratory symptoms, such as in aspergilloma and open cavity with a risk of respiratory insufficiency, cavernostomy followed by myoplasty or omentoplasty should be recommended.

• Journal of the Korean Society for Precision Engineering
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• v.22 no.11 s.176
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• pp.30-37
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• 2005

• Archives of Plastic Surgery
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• v.40 no.1
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• pp.62-65
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• 2013

The philtrum plays a key role in the appearance of the upper lip and nostril sill. Therefore, construction of the philtrum is crucial for attaining a natural appearance of the upper lip. We used a flipping myoplasty of the orbicularis oris muscle on a patient with a flat philtrum in order to effectively reconstruct the philtral dimple and column. A 35-year-old female presented to our department with the complaint of a flat upper lip. A superficial layer of the orbicularis oris muscle on the median aspect of the upper lip was vertically incised and elevated to a thickness of 2 mm. Both sides of the elevated muscle flap were then folded to the lateral sides so that the border could be sutured onto the outer portion of the orbicularis oris muscle. The patient was observed for one year postoperatively. Her philtrum deepened by 1.25 mm, with the central angle of her Cupid's bow improving from a preoperative measurement of $146^{\circ}$ to $128^{\circ}$ postoperatively. In a patient with an indistinct philtrum, a flipping orbicularis oris myoplasty was performed to attain a definite philtral column and a philtral dimple. Natural upper lip movement was maintained, and an aesthetically and functionally satisfactory reconstruction was achieved.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.2
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• pp.143-149
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• 2020

Objectives: Long-term facial paralysis results in degeneration of the distal nerve segment and atrophy of the supplied muscles. Options for these patients include free muscle transfer, temporalis myoplasty, and botulinum toxin injections for smile reanimation. In this study we aimed to evaluate the subjective and objective outcomes of these procedures. Materials and Methods: In our study, we retrospectively analyzed smile symmetry in patients with facial palsy (n=8) who underwent facial reanimation procedures. Results: Subjective analysis showed high satisfaction in seven out of eight patients. Objective analysis showed statistically significant improvement postoperatively in both vertical and horizontal smile symmetry at rest and during maximum smile (P<0.001). Conclusion: Choosing the ideal procedure for the patients is the most critical aspect for facial reanimation. Though free muscle transfer is considered gold standard procedure, temporalis myoplasty also gives satisfactory results. Residual synkinesis which can lead to disturbing aesthetic deformity can be effectively treated with botulinum toxin.

• Journal of Chest Surgery
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• v.13 no.1
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• pp.26-33
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• 1980

The incidence of the empyema thoracis has been drastically reduced with the advent of antimicrobial drugs. Empyema thoracis is however still dealt with one of major problems in thoracic surgery because of difficulties in the management of associated bronchopleural fistula. During the period of January 1975 to June 1979, 145 patients of empyema thoracis were treated in the Department of Thoracic Surgery, Busan National University Hospital. This reports dealed especially with the incidence, etiology and management of chronic empyema thoracis with B.P.F. and estimated the results of intercostal myoplasty. The results: 1 ] Among 145 empyema thoracis patients, 33 patients [22.7%] had bronchopleural fistula. 2] Male predominated in general with the ratio of 4:1 and in empyema thoracis with B.P.F. male predominance was further more prominent with the ratio of 10:1. Peak incidence of chronic empyema thoracis lay on 3rd and 4th decade. 3] The most common causation of empyema thoracis was pneumonia [77.3%] in children and tuberculosis [48.8%] in adult. 4] The most common causative organism of empyema thoracis was staphylococcus aureus [52.5%]. 5] Among 40 cases of resection for pulmonary tuberculosis, 4 cases developed empyema thoracis with B.P.F. [10%], and resection for another underlying pathology was 2.1%. 6] In contrast to good prognosis of acute empyema thoracis, chronic empyema thoracis with B.P.F. was improved only 66.6% of cases. 81.5% of chronic empyema without B.P.F. were cured completely. 7] Intercostal myoplasty were performed in 21 cases of empyema thoracis with B.P.F. and of which 15 cases showed that fistula were closed. 8] The over all mortality rate in empyema thoracis was 8.7%. The mortality rate of chronic empyema thoracis with and without B.P.F. was 15.2% and 5.3% respectively.

• Archives of Plastic Surgery
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• v.48 no.5
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• pp.528-533
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• 2021

Bladder acontractility affects several thousand patients in the United States, but the available therapies are limited. Latissimus dorsi detrusor myoplasty (LDDM) is a therapeutic option that allows patients with bladder acontractility to void voluntarily. Our goal was to conduct a systematic review of the literature to determine whether LDDM is a better option than clean intermittent catheterization (CIC) (standard treatment) in patients with bladder acontractility. On January 17, 2020, we conducted a systematic review of the PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov databases, without time frame limitations, to identify articles on the use of LDDM for bladder acontractility. Of 75 potential articles, 4 fulfilled the eligibility criteria. The use of LDDM to treat patients with bladder acontractility was reported in four case series by the same group in Europe. Fifty-eight patients were included, and no comparison groups were included. The most common cause of bladder acontractility was spinal cord injury (n=36). The mean (±standard deviation) operative time was 536 (±22) minutes, postoperative length of hospital stay ranged from 10 to 13 days, and follow-up ranged from 9 to 68 months. Most patients had complete response, were able to void voluntarily, and had post-void residual volume less than 100 mL. Although promising outcomes have been obtained, evidence is still weak regarding whether LDDM is better than CIC to avoid impairment of the urinary tract among patients with bladder acontractility. Further prospective studies with control groups are necessary.

• Journal of Chest Surgery
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• v.24 no.11
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• pp.1107-1114
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• 1991

We have experienced fourteen patients of esophageal perforation at the department of thoracic and cardiovascular surgery, Chonbuk National University Hospital during the period from mar. 1980 to Oct. 1990. The ratio between male and female patients was 5 : 9, and their age ranged from 22 years to 69 years. The causes of th eesophageal perforation were iatrogenic in 6 cases, foreign body 5 cases, diverticulitis 2 cases, and postpneumonectomy 1 case. The locations were cervical esophagus in 2 cases, upper thoracic in 2 cases, mid-thoracic 4 cases, and lower thoracic 6 cases. The underlying diseases associated with perforation were lye stricture, diverticulum, achalasia, and postpneumonectomy empyema. The treatments were supportive in 6 cases and combined with surgical measures in 8 cases. surgical measurs were as follows : incision and drainage in 2 cases, esophagectomy with esophagogastrostomy 3 cases, esophagocardiomyotomy with partial fundoplication in 1 case, simple closure with myoplasty and thoracoplasty 1 case, and empyema drainage and gastrostomy 1 case. There was no mortality.

• Journal of Chest Surgery
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• v.24 no.6
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• pp.555-559
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• 1991

Post-pneumonectomy empyema thoracis is an uncommon, but very serious problem. Early diagnosis & adequate drainage followed by thoracoplasty and or myoplasty are very important principles for the management of the empyema thoracis & will enable patient to recover from the toxic effects. During the period of January, 1985 to December, 1990, 13 patients with post-pneumonectomy empyema thoracis were treated in the department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine. There were 10 males % 3 females ranging from 31 years to 79 years of age. The occurrence ratio of left to right side was 8: 5. The underlying pathologic lesions of empyema thoracis were pulmonary tuberculosis[7], lung ca. [2] pneumothorax[2], lung abscess[1] pneumonia[1]. We treatment procedure for post-pneumonectomy empyema thoracis were open window thoracostomy in 10 cases, Clagett procedures in 2 cases, one thoracoplasty, and two cases of Clagett procedures followed by open window thoracostomy in one cases.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.747-752
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• 1984

Bronchopleural fistula is the communication between a bronchus or bronchiole and the pleural space, clinically bronchopleural fistula is usually combined with infection. But pneumothorax is the communication between a peripheral air space such as a ruptured bleb, and the pleural space. The author studies on the 62 bronchopleural fistula patients who were admitted to P.N.U.H. from 1974 to October, 1984 according to causative mechanism which was postresectional origin, non resectional surgical origin and spontaneous origin, and its underlying diseases. The following results were obtained. 1.The causes of BPF: 5.16% was spontaneous origin, 30.6% was postresectional origin, 17.7% was other surgical origin. 2.The causes of BPF after resectional operation: 42.1% was tuberculosis, 21.1% was tumor resectional case. 3.The proper operational method for BPF was thoracoplasty with myoplasty. 4.The average operation for BPF was 2.7 times.