• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.1-8
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• 2000

Purpose: This study was undertaken to evaluate the clinical features and complication such as esophageal stricture in children with corrosive esophagitis. Methods: We retrospectively reviewed medical records of 31 children who accidentally ingested corrosive materials and visited to emergency room of Chonnam National University Hospital from Jan. 1992 to Dec. 1999. Twenty-one children were examined by upper gastrointestinal (UGI) endoscopy to evaluate location and severity of caustic injury. Results: 1) Among 31 patients, there were 20 males and 11 females and the ratio of male to female was 2:1. Average age at diagnosis was 2.3 years (12 months to 9.8 years). Twenty-seven (87.1%) patients were accidentally ingested vinegar. 2) Initial presenting symptoms were dysphagia (54.8%), vomiting (48.3%), chemical burn on lips and skin (45.2%), excessive salivation (45.2%), coughing and respiratory grunting (32.3%) and aspiration pneumonia (9.8%). 3) UGI endoscopic examination showed caustic injury in 17 children: grade I in 8, grade II in 7 and grade III in 2. The region of caustic injury was proximal esophagus in 5, distal esophagus in 3, entire esophagus in 9 and stomach in 6. 4) Corrosive esophageal strictures developed in 6 children (19.4%) and gastric outlet stricture in 1 (3.2%). All of them showed grade II or III caustic injury on endoscopic examination. Conclusion: The development of esophageal stricture was related to the severity of the caustic injury. Early UGI endoscopic examination in caustic ingestion seems to be useful for prediction of development of caustic stricture.

• Journal of radiological science and technology
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• v.33 no.1
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• pp.25-29
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• 2010

To evaluate the usefulness of newly designed percutaneous bone biopsy needle for pumpkin's specimen collection. We manufactured three types of biopsy needle with different internal processing which were made of 10 mm-diameter acrylic material. We made the conventional type (Ct) similar to the clinical type then compared the test group. The type a (Ta) made 1 cm-length internal processing from the distal, type b (Tb) made taper, and type c (Tc) made internal processing like spiral configuration. We performed 20 times biopsy to get an 10 mm length specimen from pumpkin's surface and evaluated the success rate of the biopsy, length of the specimen, and determine internal processing type of the most suitable biopsy needle (ANOVA test). Success rates of Ct, Ta, Tb, and Tc were 55%, 80%, 90%, and 100%, respectively. The lengths of the specimen of Ct, Ta, Tb, and Tc were $5.6{\pm}1.1\;mm$, $5.9{\pm}0.87\;mm$, $3.9{\pm}0.77\;mm$, and $9.4{\pm}0.54\;mm$, respectively. All groups were statistically significant (p < 0.05) except the group between Ct and Ta (p = 0.28). Newly designed bone biopsy needle seems to be useful for obtaining enough specimen. Tc may be more effective than other types.

• The korean journal of orthodontics
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• v.40 no.6
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• pp.398-410
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• 2010

Objective: The purpose of this study was to investigate the changes in dentofacial morphology of non-orthodontically treated female patients with TMJ disk displacement. Methods: The sample consisted of 25 Korean female patients with bilateral TMJ disk displacement who visited the Department of Orthodontics, Seoul National University Dental Hospital from 1996 to 2006. Disk displacements were diagnosed using the magnetic resonance imaging (MRI) of both TMJs. Baseline (T1) and follow-up (T2) lateral cephalograms were analyzed. The mean age of samples at T1 was $18.1{\pm}3.5$ years (range 14.2 - 25.8 years) and at T2, $21.1{\pm}3.5$ years (range 16.2 - 28.0 years). The mean observation period was $3.0{\pm}1.9$ years. Descriptive statistics for each variable were calculated at baseline (T1) and follow-up (T2) stages, and during the observation period (T2-T1). Results: Skeletal changes were found in 64% of the non-orthodontically treated female patients with TMJ disk displacement during the observation period. The L1 to Mandibular plane distance (mm) increased significantly by 0.8 mm (p < 0.01). But there were no significant differences in the other dental relationship variables (overjet, overbite, U1 to palatal plane) during the observation period. Most patients with skeletal changes showed a backward rotation of the mandible. The ratio of the rotation was a decrease of SNB by $0.43^{\circ}$ for every $1^{\circ}$ increase of FMA (Spearman rho = -0.660, P < 0.01). A few patients showed a distal shift of the mandible without rotation or significant changes in the vertical dimension. Conclusions: During observation periods without orthodontic treatment, non-growing patients with TMJ disk displacement showed dentoskeletal changes, mainly backward rotation of the mandible.

• The korean journal of orthodontics
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• v.29 no.2 s.73
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• pp.183-195
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• 1999

Growth and development evaluation of patients with growth potential is of great importance for orthodontic treatment planning. Timing of orthodontic intervention greatly depends on one's developmental status, thus if there is a difference in skeletal maturation among malocclusion types different treatment timing should be applied. The objective of this study was to evaluate and compare skeletal maturation among different malocclusion types. The samples used in this study was 38 Class I, 36 Class II and 33 ClassIII females aging from 8 to 10 years. Handwrist X-rays were taken with 6 month interval till 12-13 years of age. The results were as follows. 1. There was no skeletal maturity difference among different malocclusion types. 2. The hamular process of hamate was observed at $9.16{\pm}0.72$ years, pisiform bone at $9.13{\pm}0.71$ years and the ulnar sesamoid at $10.34{\pm}0.84$ years. 3. The timing of epiphyseal capping on the third finger was $10.96{\pm}0.80$ years for distal phalanx and $11.27{\pm}0.87$ years for middle phalanx, $11.12{\pm}0.85$ years for proximal phalanx of the first finger, $11.21{\pm}0.82$ years for radius and $11.62{\pm}0.85$ years for middle phalanx of the fifth finger. 4. The appearance of pisiform bone showed high correlation with appearance of hamular process of hamate(r=0.91) and ulnar sesamoid bone appearance showed high correlation with advanced ossification of hamular process(r=0.86). Timing of epiphyseal capping among different parts showed high correlation(r=0.80-0.90). 5. The shape of middle phalanx of the fifth finger showed the highest variability ($20.6\%$).

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.373-384
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• 2003

The purpose of this study was to evaluate the eruption pattern of a cyst-associated mandibular premolar after marsupialization of a dentigerous cyst in children. The result from the twenty two pairs of normalized panoramic radiographs of twenty two patients who underwent neither extraction nor orthodontic traction of the cyst-associated mandibular after marsupialization were as follows. 1. The eruption speed of a cyst-associated premolar was 3.5 times faster than that of the normal contra-lateral premolar(p<0.05). The angulation change of test group was an average of $2.7^{\circ}$ per month. 2. In the change of the level of root formation, the group which had a little root maturity tended to be faster in the eruption speed(p>0.05) and the R1/4 group had a great change in the angulation change(p>0.05). 3. In the change to be with the cusp position index, the eruption speeds were increased to the 30% deviation groups. But, the eruption speed was decreased above that(p>0.05). 4. Group with cyst diminishment rate of more than $80mm^2$ per month showed the fastest eruption speed of all(p<0.05). 5. The mesial angulated teeth in the test group were decreased more rapidly than the distal angulated teeth in the eruption speed(p>0.05). But, increased in the angulation change(p<0.05). 6. There was a tendency of faster tooth eruption with less deviation of tooth axis. Group with tooth axis deviation of less than $15^{\circ}$ showed the fastest angulation change of all(p<0.05). 7. The eruption speed and the angulation change rapidly decreased during the first 6 months following marsupialization. Based on the results of this study, a cyst-associated mandibular premolar erupted more rapidly after marsupializaton. We thought so that it's prognosis was good if the tooth had a little root maturity, a little devitation and cyst lesion healed faster. We recommend that if there is enough space for eruption, orthodontic traction and surgical treatment of the cyst-associated tooth should be postponed 6 months after marsupialization.

• Journal of Veterinary Clinics
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• v.26 no.4
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• pp.353-358
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• 2009

Unilateral ureteronephrectomy was performed in a dog presented with unilateral hydroureter and hydronephrosis. On laparotomy, severe adhesion of the dorsomedial border of the affected kidney to the abdominal aorta longitudinally and caudal pole of the kidney firmly to the ipsilateral ovary were observed. Since it was not possible to ligate the renal artery and vein separately due to severe adhesion tissue, two mass ligations were applied in the medial border of kidney, and the adhesion tissue was transected distal to each ligature. Then, blunt and sharp dissections were performed to isolate dorsomedial border of the kidney from the abdominal aorta, but they brought out unexpected hemorrhage caused by incision of renal artery and it has been suspected that two mass ligations could not include renal artery, which was adhered to dorsomedial border of the kidney. The hemorrhage was controlled by double ligations and electrocautery. In this case report, we recommend that if isolation of renal vessels is impossible due to strict adhesion of kidney to adjacent tissue, the mass ligation could be chosen to isolate and exteriorize the kidney and placed carefully not only at medial border of the kidney, where the renal vessels come into the kidney anatomically but also additional border of the kidney where adhesion tissues are formed.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.787-792
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• 2004

Even though there well developments in various treatment techniques for acute limb ischemia, this disease is both life threatening and limb threatening. We investigated early and mid-term results of operation for acute limb ischemia with symptoms, the combined diseases, location of occlusion, complication in our patients. Material and Method: A retrospective review was conducted in 54 patients (43 men, 11 women, mean age 67.2 years) presenting with acute limb ischemia due to arterial thrombosis or embolism between Jan. 1996 and Dec. 2003, initially underwent thromboembolectomy. Result: In 33 patients (61.1%) the timeinterval from the onset of symptom to admission was within 24 hours. Causes of acute limb ischemia were embolic occlusion (27.8%), native arterial thrombosis (66.7%), and bypass graft thrombosis (5.6%). The distribution of arterial occlusion location was at 8 aortoiliac (14.8%) and 43 distal to femoral (79.6%) and brachial (5.6%). Clinical categories were grade I in 64.8%, IIa in 24.1%, IIb in 7.4%, and III in 3.7%, All the patients were received embolectomy. Underlying diseases were heart disease (72.2%), hypertension (33.3%), cerebrovascular accident (16.7%) and diabetes (18.5%). History of smoking was noted in 96,3% of the cases. Mortality rate was 5.6％ and overall amputation rate was 9.3% (5/54). The 1-year limb salvage rate was 93.62%. Postoperative complications were 1 wound infection, 1 G1 bleeding, 3 acute renal failure, and 1 compartment syndromes. The functional outcomes of the salvaged limb according to the recommended scale for gauging changes in clinical status, revised version in 1997 were +3 in 68.5%, +2 in 9.3%, +1 in 7.4%, -1 in 5.6%, -2 in 3.7%, and -3 in 5.6%. Conclusion: This study revealed 5.6% mortality and the amputation rate was 9.3%. We have retrospectively shown good results from early diagnosis & early operation. To improve outcome, early diagnosis and understand the underlying diseases, prompt treatment and operation would be appreciated.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.966-972
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• 1997

Between June 1994 to August 1996, 13 patients underwent emergency coronary artery bypass operations. There were 3 males and 10 females and ages ranged from 56 to 80 years with the mean of 65.5 years. The indications for emergency operations were cardiogenic shock in 12 cases and intractable polymorphic VT(ve'ntricular tachycardia) in 1 case. The causes of cardiogenic shock were acute evolving infarction in 6 cases, PTCA failure in 4 cases, acute myocardial infarction in 1 case, and post-AMI VSR(ventricular septal rupture) in 1 case. Pive out of 13 patients could go to operating room within 2 hours. However, the operations were delayed from 3 to 10 hours in 8 patients due to non-medical causes. In 12 patients, 37 distal anastomoses were constructed with only 3 LITA's(left internal thoracic arteries) and 34 saphenous veins. In a patient with post-AMI VSR, VSR repair was added. In a patient with intractable VT and critical sten sis limited to left main coronary artery, left main coronary angioplasty was performed. Pive patients died after operation with the operative mortality of 38.5%. Three patients died in the operating room due to LV pump failure, one patient died due to intractable ventricular tachycardia on postoperative second day, and one patient died on postoperative 7th day due to multi-organ failure with complications of mediastinal bleeding, low cardiac output syndrome, ARF, and lower extremity ischemia due to IABP. In 8 survived patients, 3 major complications (mediastinitis, PMI, UGI bleeding) developed but eventually recovered. We think that the aggressive approach to critically ill patients will salvage some of such patients and the most important factor for patient salvage is early surgical intervention before irreversible damage occurs.

• Journal of Gastric Cancer
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• v.8 no.1
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• pp.27-34
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• 2008

Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.779-784
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• 2002

Recently, the number of coronary artery bypass surgery(CABG) is increasing according to the increasing incidence of coronary artery disease. However, CABG is not a definite corrective surgery; therefore, in some patients, redo-CABG may be required. We retrospectively reviewed our redo-CABG experiences to help future redo-CABG. Material and Method: From January 1991 to April 2001, 14 cases of redo-CABG were performed in Yonsei Cardiovascular Center(M:F＝12:2) and mean age was 61,7 $\pm$ 7.1(47-72) years. Mean time from 1st. CABG to redo-CABG was 121.9 $\pm$ 50.5(6.1-179.6) months. Thirteen cases were conventional on-pump CABG and one case was off-pump CABG. In two patients, mitral valve re-replacement and mitral valve repair were performed each. All redo-CABG were performed through mid-sternotomy. During redo-CABG, left internal mammary artery and saphenous vein grafts were used in 6 patients, left internal mammary artery and left radial artery grafts were used in 2 patients, left internal mammary artery and gastroepiploic artery were used in one patient and only greater saphenous veins were used in 5 cases(In one case, cephalic vein was also used). The number of mean distal anastomosis was 2.1 $\pm$ 0.9(1-4). Result: There were no operative death and no perioperative myocardial infarctions and cerebrovascular accidents or other heart related complications. Mean follow up duration was 40.1 $\pm$ 38.6(1.1-118.5) months. During follow up period, angina was re-developed in one patient 13 months after operation. Two patients died of end-stage renal failure 14.8 months and 116.3 months after redo-CABG, respectively. During follow up period, coronary angiography was performed in 3 patients, and all grafts were patent. At last follow up, mean Canadian class was 1.3. Kaplan-Meier survival at 9 years was 90.0 $\pm$ 9.5% and event free survival at 9 years was 71.4 $\pm$ 6.9%. Conclusion: After redo-CABG, all patients improved their angina symptom and daily activity. And long-term survival after redo-CABG was excellent. Therefore, if patients have indications for redo-CABG, thenredo-CABG must be strongly recommended and performed.