• Archives of Craniofacial Surgery
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• v.9 no.2
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• pp.81-84
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• 2008

Purpose: The goals of cranioplasty are to protect the brain from trauma and restore normal cranial contour with as few complication as possible. In patient who suffered from cranial defect, the most satisfactory form of cranioplasty may be archived with autogenous bone grafts. We report on the treatment of large frontal bone defect using pericranial flap and split-rib graft. Methods: A 29-year-old male was referred to our department. He was involved in an automobile accident resulting in large frontal bone and sinus defect and skull basal defect. The reconstruction was undertaken using galeal frontalis myofascial flap and split-rib cranioplasty using bicoronal incision. Results: The postoperative course was successful. For 9 months follow up period, there was no complication about hematoma, infection, CSF leakage and washboard deformity. He was pleased with the results even when absolute symmetry was not achieved. Conclusion: We experienced large frontal bone and sinus defect and skull basal defect patient and successfully treated with split-rib graft and galeal frontalis myofascial flap.

• Advances in pediatric surgery
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• v.4 no.1
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• pp.48-54
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• 1998

A total of 335 pediatric inguinal hernias were analyzed at the Department of General Surgery, St. Benedict Hospital, for last 10 years (1986 to 1995). Male patients were predominant(2.25 : 1), and 78.2 % were under 2 years of age. Right side was 1.63 times more frequent than the left. Among the 19 cases of incarcerated hernias, 84 % could be safely reduced preoperatively. Twelve cases(3.6 %) were repaired by the Bassini procedure and 21 cases(6.3 %) by internal ring repair. The majority (90.1 %) however did not require a posterior wall reconstruction. Bilaterality was found in 25 cases(7.5 %), and in 8 cases(2.4 %) subsequent contralateral hernia developed after primary ipsilateral repair. Postoperative complication occurred in 15 cases(4.5 %); scrotal seroma and/or hematoma(3%), wound infection(0.6 %), and pneumonia(0.9 %). In order to reduce the incidents of complications, children with inguinal hernias should be treated by a pediatric surgeon.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.4
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• pp.227-232
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• 2014

The indication for submandibular intubation is the requirement for intraoperative maxillomandibular fixation (MMF) in the presence of injuries that preclude nasotracheal intubation. Thus, We reported 2 cased of endotracheal intubations via submandibular approach that is applicable in patients with skull base fractures for a reliable general anesthesia. Endotracheal intubation via submandibular approach was applied during general anesthetic procedures for open reduction in three patients with Le Fort II, III or nasoorbitoethmoid (NOE) fractures. No complications due to submandibular intubation, such as infection, postoperative scarring, nerve injury, hematoma, bleeding, or orocutaneous fistula, were observed following submandibular intubation. Endotracheal intubation via submandibular approach is effective in patients with skull base fractures. In our method, the tube connector is removed in orotracheal intubation in order to avoiding the tube removal or displacement. The advantages of this method are very simple, safe, and to provide the good operation field.

• Advances in pediatric surgery
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• v.17 no.1
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• pp.58-64
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• 2011

Minimally invasive techniques for pediatric inguinal hernia repair have been evolving in recent years. We applied the laparoscopic method to repair pediatric inguinal hernia using the techniques of sac transection and intra-corporeal ligation. Between November 2008 and August 2010, 67 pediatric patients (47 boys and 20 girls) with inguinal hernias were included in this study. Postoperative activities, pain, and complication were checked prospectively at regular follow-up. One patient presented with clinically bilateral hernia, and three patients had metachronous hernias. Thirty-two cases out of 63 patients with unilateral hernias had a patent processus vaginalis on the contralateral side. Mean operation time was $35{\pm}11.4$ minutes for unilateral hernias and $43{\pm}11$ minutes for bilateral hernias. There were no intra-operative complications. One patient had a small hematoma on the groin postoperatively, which subsided spontaneously in a week. Recurrence and metachronous hernia were not found at follow up. In summary, laparoscopic inguinal repair in children is safe, easy to perform and has an additional advantage of contralateral exploration. Further studies should include long term follow-up.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.51-55
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• 2009

Purpose: Excessive apocrine gland secretion and bacterial decomposition cause axillary osmidrosis, which results in physical discomforts and social problems of patients. Many surgical procedures have been introduced such as skin excision and simple closure, local flap, skin graft, subcutaneous shaving and liposuction method, but the result was not satisfactory to patients and several complications, such as symptom recurrence, hematoma, seroma, delayed wound healing, skin flap necrosis and scarring remain as problems. Methods: For the purpose of reducing these problems, we employed combination treatment of liposuction and rasping method. From January 2006 to February 2008, Total 54 patients were treated with this procedure for bilateral axillary osmidrosis. Results: Follow - up evaluation period was from 2 months to 12 months, and the results were satisfactory. In our method, the length of skin incision is less than 1 cm, so the resultant scar is negligible. Apocrine glands in subcutaneous tissue were mostly removed by liposuction apparatus and remained other glands in subdermal area were mostly removed by rasping. The recurrence rate and postoperative complication were minimal. Conclusion: Our method is very simple, short operation time and excellent results without specific complication.

• Health Policy and Management
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• v.15 no.4
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• pp.26-45
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• 2005

The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.157-162
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• 2010

Purpose: Free flap reconstruction in the pediatric population is difficult. However, microsurgery has had remarkable success rates in children. The aim of study is to present our clinical experience using free flap for reconstruction of soft tissue defects in children and to describe long-term follow-up results. Methods: Between June 2002 and July 2010, 30 cases of pediatric reconstruction were performed with free flap. The authors analyzed several items, such as the kind of flap, associated complications, and growth problems. Results: Among the 30 cases, 21 cases were due to traffic accidents, 5 to cancer, and 4 to falls and other soft tissue defects. The lower leg and foot were the most common sites of the lesion. In the free flap operations we have done, 20 cases involved an anterolateral thigh perforator free flap, 6 a superficial circumflex iliac perforator free flap, and 4 an upper medial thigh perforator free flap. In early postoperative complications, partial necrosis was seen in 2 cases, infection in 1 case, and the hematoma in 1 case. A satisfactory success rate and functional results were achieved. Conclusion: Free flap reconstruction in children allows satisfactory function with no significant effect on growth. Free flaps are regarded as the primary choice for selective pediatric reconstructive cases.

• Korean Journal of Head & Neck Oncology
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• v.2 no.1
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• pp.33-39
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• 1986

This is a clinical analysis of 24 cases of parotid gland tumor who were treated in the department of Surgery, Chonnam National University Medical School during the past 10years from January, 1976 to December, 1985. According to this analysis of total 24 cases, we concluded as follows; 1) 21 cases were benign tumors and 3 cases were malignant tumors. As the histopathological findings, benign tumor included 88%and malignant tumor 12%. Majority of benign tumor contained mixed tumor(86.7%), and the malignant tumor contained mucoepidermoid carcinoma (66.7%). 2) The peak age incidence was 40th in benign tumor and 50th in malignant tumor. 3) The chief complaints of patient was a painless mass and the duration of illness was average 5.2 years. 4) The mean size of mass was 4.5cm in diameter. 5) The surgical procedures were performed with excision 6 cases, superficial lobectomy 8 cases, wide excision with partial parotidectomy 4 cases, total parotidectomy 3 cases in benign tumors. In malignant tumors, total parotidectomy 2 cases and wide excision with partial parotidectomy 1 case were performed. 6) Major postoperative complications such as facial nerve palsy 7 cases (temporary ; 5 cases, permanent; 2 cases), Frey syndrome 1 case, seroma 1 case, hematoma 1 case, and wound infection 1 case were developed. The recurrence contained pleomorphic adenoma 1 case and mucoepidermoid carcinoma 1 case.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.2
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• pp.173-180
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• 2007

According to the increase in use of implants in clinical dentistry, new kinds of complications happen. Complications that can happen during implant placement are bleeding, nerve injury, jaw fracture, fenestration of maxillary sinus or nasal cavity, dehiscence, fenestration, injury of adjacent tooth. And complications that can happen after implant operation are infection, bleeding, hematoma, chronic sinusitis, peri-implantitis. Problems that are confronted during implant placement happen by inadequate preoperative treatment plan, inadequate consideration about individual anatomic difference, inadequate operation process and lack of experience of clinician. It is important that clinicians consider possible complications in advance and make a comprehensive treatment plan. We report the patient who was happened ramus fracture during block bone harvesting from ramus of severely atrophic mandible, the patient who came to emergency ward due to postoperative swelling and bleeding and the patient whose implant was migrated to maxillary sinus with a review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.1
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• pp.86-91
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• 2000

Autogenous bone graft is the useful technique for management of various bone defect in oral and maxillofacial surgery. The most common site for bone graft harvest is the anterior iliac crest. There is usually considerable cancellous bone graft available and it can be obtained with minimal morbidity. However, complications noted in iliac crest grafts include prolonged postoperative pain, hematoma and fracture, gluteal muscle weakness. Occasionally, when large amounts of bone graft are needed and previous harvest procedure had used, iliac bone harvest may be not adequate. Like the iliac crest, the greater trochanter has abundant cancellous bone and is readily accessible with acceptable morbidity. The purpose of this study was to assess the availability of cancellous bone graft from the greater trochanter, compare the quantity with that available from the anterior iliac crest, investigate anatomical hazards, and make recommendations for consistent harvest.