• Journal of Chest Surgery
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• v.36 no.6
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• pp.439-443
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• 2003

A lower laryngeal and upper tracheal stenosis that is of idiopathic origin is occasionally seen. It is called an idiopathic tracheal stenosis. These circumferential fibrous stenosis is rare and they are most often located in the subglottic larynx and extend to varying distances predominantly in young women. Because of the unknown nature of the disease process and uncertainty about its future progression, patients were approached conservatively. Recently, surgical resection and reconstruction have been increasingly performed, as favorable results were obtained. Three female patients with dyspnea were admitted. For two patients, they were diagnosed this conditions as bronchial asthma by mistake. All patients were performed computed tomography and bronchoscopy. For two patients with subglottic stenosis, subglottic resection was performed by cervical collar incision, and for the other one patient with distal tracheal stenosis, tracheal resection was performed by right posterolateral thoracotomy. A diagnosis of idipathic tracheal stenosis was confirmed by postoperatively pathologic finding. For one case, because of anastomosis site infection and restenosis, a whole tracheal exposure was performed by cervical collar incision and median sternotomy. And reoperation was peformed successfully.

• Journal of Trauma and Injury
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• v.30 no.2
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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.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.409-413
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• 2013

Background Buried non-incisional double-eyelid blepharoplasty is a popular aesthetic procedure. Although various modified continuous suture techniques have been used to create a more natural appearance and to reduce downtime, complications such as loosening of the double fold, asymmetry, and foreign body reactions have been observed. Methods This study included 250 patients who underwent double-eyelid blepharoplasty between March 1997 and November 2012 using a modified single-knot continuous buried non-incisional technique. With 4 stab incisions in the upper eyelids, one of two needles loaded with double-armed 7-0 nylon was passed in one direction alternately through the dermis and the conjunctiva, while the other needle was passed subconjunctivally in the opposite direction. Both ends of the sutures were knotted within a lateral stab incision of the upper eyelids and were buried in the orbicularis oculi muscle. Results Most patients displayed satisfactory aesthetic results, and no significant complications occurred. There was no obvious regression of the double fold; however, 3 patients required reoperation to correct loosening of the fold on one side during the follow-up period. One patient presented with the suture knot subcutaneously, and the knot was removed in the clinic. Conclusions The modified single-knot continuous buried non-incisional technique is a simple and less time-consuming method for a durable double fold and provides satisfactory aesthetic results.

• Journal of Veterinary Clinics
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• v.15 no.2
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• pp.472-475
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• 1998

A female Green iguana (Iguana iguana) was brought to the small animal clinic in Hannover Veterinary school because of anorexia and convulsion. Two months ago, the owner bought two iguanas, one female and one male and had to take a female to the one of local small animal clinic because she, born in 19931 didn't eat well and showed the tremor of the legs. The veterinarian suspected it to have a calcium deficiency and gave an injection of calcium and vitamin D3. But still during the last two months, the female iguana did only eat some lettuce while the other male ate lettuce, fruits and commercial cat-food ($Whiskas^{\circledR}$, Effem, Verden). It was not possible to evaluate the rations of these different "food-components". They are kept in the terrarium with water container. By palpation of the abdomen, hard thing like stone was palpated in the mid-region. The blood test wasn't carried out because of the difficulties of getting blood and because of her bad condition. It was firmly diagnosed as cystic calculus through radiography. Since the animal is in shock state already, the prognosis after surgery was bad. It was assumed to be too late to expect its surviving with the surgery carried out or without it. Cystotomy was performed in the cranial ventral paramedian incision in order to preserve the large ventral abdominal vein in the linen alba region. After two stay sutures ("holding suture" ) with 5-0 polyglactin 910 ($Vicryl^{\circledR}, Ethicon$) on the bladder, cystotomy was carried out and the stone inside was removed. Then, the bladder was closed in one-layer sutures. The abdomen was closed in simple interrupted suture with same material after the instillation of 10 ml saline solution into the abdominal cavity. The cystic calculus was in a size of $5.8{\times} 5.O{\times} 3.5 cm$. The analysis of the stone was carried out in two ways which are the infrared spectroscopy of the stone and quick analysis by $Merckognost^{\circledR}$(Diagnostica Merck, Merck). In the result of the infrared spectroscopy, the stone wee composed of 10% ammonium urate and 90% dihydrated uric acid. This iguana wasn't able to survive.n't able to survive.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.755-760
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• 2011

Purpose: Correction of cleft lip nose deformity (CLND) in adulthood is different from one in childhood. Usually correction of CLND is final surgery for adult patient who has cleft lip, so many things have to be considered for correction. Of course, it is different from common rhinoplasty, either. The adult patients can be corrected by complete rhinoplasty with various techniques. To recognize how rhinoplasty techniques was used for correction of CLND, authors analyzed detailed techniques which were selected in the adult patients for 10 years and reviewed comprehensive operation. Methods: A retrospective review was conducted involving 64 patients with CLND who underwent surgery and aged after 14 years at operation between 2001 and 2010. Detailed techniques were investigated by medical record review and classified according to incision, septoplasty, osteotomies, correction of vault, tip plasty and etc. Results: Except one, all patients were performed open rhinoplasty. 49 patients were performed septoplasty. 33 patients were performed complete rhinoplasty with osteotomies. Hump nose correction was performed for 10 patients. Dorsal augmentation was performed for 8 patients. And all patients were performed tip plasty. Tip plasty using suture technique was performed for 58 patients and graft was performed for 48 patients. Conclusion: Correction of CLND in adult is one of the most challenging and varied operation of plastic surgery. In this study, the majority of patients were performed complicated and delicated procedures. It seems to be because patient's demand level has been elevated and rhinoplasty procedures have been advanced. This study may help to planning of CLND correction.

• Journal of Korean Neurosurgical Society
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• v.48 no.3
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• pp.244-250
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• 2010

Objective : Adequate management of increased intracranial pressure (ICP) is critical in patients with traumatic brain injury (TBI), and decompressive craniectomy is widely used to treat refractory increased ICP. The authors reviewed and analyzed complications following decompressive craniectomy for the management of TBI. Methods : A total of 89 consecutive patients who underwent decompressive craniectomy for TBI between February 2004 and February 2009 were reviewed retrospectively. Incidence rates of complications secondary to decompressive craniectomy were determined, and analyses were performed to identify clinical factors associated with the development of complications and the poor outcome. Results : Complications secondary to decompressive craniectomy occurred in 48 of the 89 (53.9%) patients. Furthermore, these complications occurred in a sequential fashion at specific times after surgical intervention; cerebral contusion expansion ($2.2{\pm}1.2$ days), newly appearing subdural or epidural hematoma contralateral to the craniectomy defect ($1.5{\pm}0.9$ days), epilepsy ($2.7{\pm}1.5$ days), cerebrospinal fluid leakage through the scalp incision ($7.0{\pm}4.2$ days), and external cerebral herniation ($5.5{\pm}3.3$ days). Subdural effusion ($10.8{\pm}5.2$ days) and postoperative infection ($9.8{\pm}3.1$ days) developed between one and four weeks postoperatively. Trephined and post-traumatic hydrocephalus syndromes developed after one month postoperatively (at $79.5{\pm}23.6$ and $49.2{\pm}14.1$ days, respectively). Conclusion : A poor GCS score ($\leq$ 8) and an age of $\geq$ 65 were found to be related to the occurrence of one of the above-mentioned complications. These results should help neurosurgeons anticipate these complications, to adopt management strategies that reduce the risks of complications, and to improve clinical outcomes.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.4
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• pp.381-390
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• 1991

The purpose of this study was to select the absorbable suture material with the lowest level of foreign body reaction in the extraoral field. The absorbable sutures tested were polyglactin 910(Vicryl), polyglycolic acid(Dexon), and chromic gut. Black silk served as to control suture. Eighteen domestic rabbits served as the animal model for testing purposes. After shaving the fur, A six centimeter incision was made in the hind quarter of all eighteen animals. Each wound was then closed wit two Vicryl, two Dexon, and two chromic gut sutures. All wounds were closed in the same manner. A similar wound was made on the oppsite side and closed with black silk suture. Three rabbits were then sacrificed on postoperative day one, three, seven fourteen, twenty-one, and twenty-eight. The surgical sites were then examined histologically. 1. On days one, three, and seven all suture materials as a similar severe level of inflammatory response. On the fourteenth day the inflammatory reaction of Vicryl was minimal, chromic gut was moderate, and Dexon was severe, Black silk control groups demosnstrated the most severe levels of inflammation of all sutures tested from day fourteen to twenty-eight. 2. On the fourteenth day all absorbable suture materials demonstrated similar minimal levels of resorption. At twenty-eight days Vicryl demonstrated a greater amount of resorption than Dexon or cromic gut suture. There was no resorption noted in the black silk control groups through day twenty-eight. 3. Due to its decreased level of inflammatory response in the animal model, Vicryl might be expected to as a decreased level of response in humans. It is felt that Vicryl is preferred to Dexon or chromic gut for extraoral suturing.

• Journal of Gastric Cancer
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• v.10 no.4
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• pp.206-211
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• 2010

Purpose: Most surgeons administer prophylactic antibiotics for 3 to 5 days postoperatively. However, the Center for Disease Control (CDC) guideline recommends antibiotic therapy for 24 hours or less in clean/uncontaminated surgery. Thus, we prospectively studied the use of short term prophylactic antibiotic therapy after gastric cancer surgery. Materials and Methods: A total of 103 patients who underwent gastric cancer surgery between October 2007 and June 2008 were prospectively enrolled in a short term prophylactic antibiotics program. One gram of cefoxitin was administered 30 minutes before the incision, and one additional gram was administered intraoperatively for cases with an operation time over 3 hours. Postoperatively, one gram was administered 3 times, every 8 hours. Patients were checked routinely for fever. All cases received open surgery, and the surgical wounds were dressed and checked for Surgical Site Infection (SSI) daily. Results: Of the 103 patients, 15 were dropped based on exclusion criteria (severe organ dysfunction, combined resection of the colon, etc). The remaining 88 patients were included in the short-term program of prophylactic antibiotic use. Of these patients, SSIs were detected in 8 (9.1%) and fever after 2 postoperative days was detected in 11 (12.5%). The incidence of SSIs increased with patient age, and postoperative fever correlated with operation time. Conclusions: Short term prophylactic antibiotic usage is feasible in patients who undergo gastric cancer surgery, and where there are no grave comorbidities or combined resection.

• Advances in pediatric surgery
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• v.3 no.1
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• pp.47-53
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• 1997

Accidental ingestion of caustic substance is one of the common problems among children around the world. Acid intake accounts for a mere 5% of all reported cases of corrosive ingestion in the West. Because of the esophageal sparing effect of acid, clinically significant esophageal involvement after acid ingestion occurs in only 6 to 20 percent of the instances. Despite effort of prevention, 7% to 15% of children sustaining caustic esophageal burns develop esophageal strictures. If balloon dilatation or bougie dilatation fails to resolve the esophageal strictures, successful outcome following replacement by colon or stomach has been reported in children. But the complications and morbidity following these operations are still relatively high. Seven patients with corrosive-acid induced esophageal strictures who were operated upon at the Department of Pediatric Surgery, Seoul National University Children's Hospital from 1991 to 1995 were reviewed. Primary resection and anastomosis was performed in all of 7 patients. The stricture involved short segments of the esophagus at the level of the lower cervical and the upper thoracic vertebra. The operations were approached through a left cervical incision or a left thoracotomy. In one patient, operative repair of anastomotic leakage was done, and three patients required re-resection of anastomotic strictures postoperatively, and one patient required a third operation(reversed gastric tube) due to an anastomotic stricture. The other anastomotic leaks, strictures or pulmonary complications were resolved with conservative treatment. In conclusion, primary resection and anastomosis of the esophagus was performed successfully on the 6 of 7 children with acid induced corrosive esophageal strictures. This approach is physiologic, especially in children who should have a long life expectancy, and recommended for the treatment of short-segment acid induced corrosive esophageal strictures.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.6
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• pp.1261-1266
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• 2009

The wrinkle is a typical sign showing aging. These days lots of people want to have a young and healthy appearance and many medical doctors are studying about wrinkle cure. In fact a young face without wrinkle looks more healthy and energetic. Therefore the wrinkle cure is important at the point of medical view. This research is an investigation of several studies about wrinkle cure using acupuncture needle. We have to consider the problem of the whole body which is related 12 meridians and meridian muscles as well as topical skin and tissues. There are three parts affecting wrinkle formation and cure. The first is a meridian and meridian muscle, the second is a local muscle and fascia on the head and neck, the third is a local skin structure. There are three kinds of method to cure the wrinkle locally. The first one is the perpendicular treatment of acupuncture, called the microneedle therapy, the process of this method is that lots of microneedles stab in the skin to dermis. The second one is the transverse treatment of acupuncture. The process of this method is that an acupuncture needle inserts just under the wrinkle skin. The third one is the incision treatment of acupuncture, called subcision, the process of this method is to cut the fibrous band which connect from the facial muscle to SMS(superficial musculoaponeurotic system) using cuttable needle. The hematoma after treatment let a collagen increase.