• Clinics in Shoulder and Elbow
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• v.25 no.2
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• pp.106-111
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• 2022

Background: The use of telemedicine for postoperative visits is increasing, especially in rural areas. Few studies have investigated its use for arthroscopic shoulder patients. This study aims to evaluate patient satisfaction with telemedicine for postoperative clinic visits following arthroscopic shoulder procedures in a rural setting. Methods: Patients were prospectively enrolled using the following exclusion criteria: <18 years, open procedures, and non-compliance follow-up at 6 weeks postoperatively. All patients completed a 13-question satisfaction survey, while telemedicine patients completed an additional, separate seven-question survey. Patients who switched groups completed a four-question prompt to determine the reasons for switching. Differences between groups were evaluated by either Student t-test or Mann-Whitney U-test. Results: The study enrolled 32 patients, with five patients following up by telemedicine and 27 in person. Age and distance from clinic were similar between patients who were assigned to the telemedicine group, completed the telemedicine visit, and opted for in-person visits (all p>0.05). Patient satisfaction did not vary significantly based on care by the surgeon, concerns being addressed, thoroughness of visit, overall clinical assessment at a prior visit, and improvements in pain and physical function (all p>0.05). Among patients who opted out of telemedicine visits, the most common reason was a preference to meet in-person but these patients agreed that telemedicine visits are a good idea. Conclusions: Regardless of type of follow-up, individuals reported similar levels of satisfaction with treatment during the visit and improvements in pain and physical function.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.630-634
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• 2021

To date, there have been no reports of patients showing a Tessier number 7 cleft with unilateral complete cleft lip and palate. Furthermore, no studies have established the sequence, plan, or timing of surgical methods for treating patients presenting the above anomalies simultaneously. We report a case of a Tessier number 7 cleft with unilateral complete cleft lip and palate. Two months after birth, lip adhesion was performed on the unilateral complete cleft lip and total excision was performed on the skin tag. At 4 months of age, Tessier number 7 cleft was corrected. At 6 months of age, surgery involving two small triangular flaps was performed on the unilateral incomplete cleft lip after performing lip adhesion. At 13 months of age, two-flap palatoplasty with a vomer flap was performed on the complete cleft palate. At 6 years of age, open rhinoplasty was performed on the unilateral cleft lip nose deformity. At 9 years of age, bone grafting was performed for the alveolar cleft. At follow-up appointments up to 13 years of age, there were no major complications. Here, we present this patient, surgical procedures and timelines, and show our results demonstrating good postoperative outcomes.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.41-45
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• 2009

Background: Reduced bone height is one of the major problems faced in restoring tooth loss with implants. By the use of short implants, it is possible to reduce complicated and invasive treatment such as bone graft, allowing more simple surgery. But short implants are generally considered to have lower success rates than that of standard implants. Purpose: To assess the results of short Straumann implants by a retrospective study of short Straumann implants with TPS(titanium plasma-sprayed) and SLA(sandblasted, large grit, acid etched) surfaces. Materials and methods: 173 implants in 106 patients who received short Straumann implant surgery(${\le}8\;mm$) in the department of oral and maxillofacial surgery, Kyunghee Dental Hospital, from February 1996 to October 2006 were selected and studied. All of the implants were followed up after prosthetic rehabilitation. The average follow-up period was 34 months with 119 months as the longest follow up period. The average follow-up period after prosthetic rehabilitation was 31 months. 64 females(60.4%) and 42 males(39.6%) participated in the research with the age range of 19 to 85(mean age 47). 20 patients(18.9%) were under 40, 85 patients(80.2%) were over 40 and under 70, and only one patient(0.9%) was over 70 years old. Results: 27 implants(15.6%) had TPS surface while 146 implants(84.4%) had SLA surface. 9 implants(5.2%) were 3.3, 108 implans(62.4%) were 4.1mm and 56 implants(32.4%) were 4.8mm in diameter. 167 implants(96.5%) were 8mm and 6 implants(3.5%) were 6mm in length. There were 24 implants(13.9%) on the maxillas and 149 implants(68.8%) on the mandibles. 119 implants(68.8%) were rehabilitated with FPD(fixed partial denture), 47 implants(27.2%) with single crowns and 4 implants(2.3%) with overdentures. Among the fixed partial dentures, 30 of them were splinted with short implants only. After over an year of follow-up period, 139 implants(96.5%) out of 144 implants showed marginal bone loss of less than 1mm. 3 out of 173 implants failed showing 98.27% survival rate. Conclusions: The use of short Straumann implants(${\le}8mm$) can be a simple and reliable treatment method in minimal residual bone height.

• Clinical and Experimental Pediatrics
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• v.57 no.8
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• pp.363-369
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• 2014

Purpose: This study examines changes in developmental profiles of children with language delay over time and the clinical significance of assessment conducted at age 2-3 years. Methods: We retrospectively reviewed the medical records of 70 children (62 male, 8 female), who had visited the hospital because of delayed language development at 2-3 years, and were reassessed at ages 5-6. Language and cognitive abilities were assessed using multiple scales at the initial and follow-up visits. Results: At the initial test, 62 of the 70 children had mental development index (MDI) below 70 of Bayley Scales of Infant Development Test II. Of the 62 children in the follow-up assessment, 30 children (48.4%) remained within the same cognitive range (full-scale intelligence quotient, FSIQ<70 of Wechsler preschool and primary scale of intelligence), 12 had borderline intellectual functioning (FSIQ, 70-85), 6 improved to average intellectual functioning (FSIQ>85), and 5 had specific language impairment, 9 had autism spectrum disorders. At the initial test, 38 of the 70 children had cognitive developmental quotients (C-DQ) below 70. Of the 38 children in the follow-up assessment, 23 children (60.5%) remained within the same cognitive range (FSIQ<70). The correlation coefficient for MDI and FSIQ was 0.530 (P<0.0001) and that for C-DQ and FSIQ was 0.727 (P<0.0001). There was a strong correlation between C-DQ and FSIQ, and a moderate correlation between MDI and FSIQ. Conclusion: Low MDI scores reflect a specific delay in cognitive abilities, communication skills, or both. The C-DQ, receptive language development quotient, and social maturity quotient also help to distinguish between children with isolated language delay and children with cooccurring cognitive impairment. Moreover, changes in the developmental profile during preschool years are not unusual in children with language delay. Follow-up reassessments prior to the start of school are required for a more accurate diagnosis and intervention.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.40-45
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• 2009

Purpose: End-stage ankle arthritis is frequently combined with ankle-hindfoot deformity or ankle instability and therefore additional surgical procedures are often required when performing total ankle arthroplasty. We report the short term clinical and radiographic results of the total ankle arthroplasty with/without the combined adjunctive surgical procedures. Materials and Methods: The study is based on the 17 ankles (16 patients) of end-stage ankle arthritis that were treated with $HINTEGRA^{(R)}$ Total ankle prosthesis (Newdeal, Lyons, France) total ankle arthroplasty (TAA) from 2004 to 2007 with at least 12 months follow-up. The combined adjunctive procedures as well as the VAS pain score, AOFAS score, radiographic measurements and patient satisfactions were evaluated. Results: Average follow-up period was 29 months (13${\sim}$55 months), and the age was average 62 years (39${\sim}$75 years) old. Among total of 17 ankles, varus deformity and lateral ankle instability were found in 4 cases and 3 cases respectively. Twenty additional procedures such as Achilles triple hemisection (9), calcaneal displacement osteotomy (4) and lateral ankle ligament reconstruction (3) were performed in adjunct to TAA in 13 ankles. VAS pain score improved from preoperative average 8.4 (7${\sim}$10) to 2.0 (0${\sim}$5) and the AOFAS functional score improved from 41.8 points (13${\sim}$71 points) to 90.6 (77${\sim}$100 points) at final follow-up. Ninety-four percent of the patients were satisfied with the surgery. Conclusion: We confirmed that many adjunctive combined surgical procedures are often necessary in addressing the end-stage ankle arthritis (74%) with total ankle arthroplasty. We also achieved quite good clinical and radiographic short term results, although the long term follow-up study with larger number of cases are needed in the future.

• Journal of Korean Neurosurgical Society
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• v.51 no.1
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• pp.8-13
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• 2012

Objective : This is prospective study of clinical outcomes of percutaneous plasma disc coagulation Therapy (PDCT) in patients with herniated lumbar disc disease (HLD) to evaluate the safety and efficacy in its clinical application and usefulness as a reliable alternative to microscopic discectomy. Methods : Forty-six patients were enrolled in this study from April 2006 to June 2010. All patients had one-level HLD. Disc degeneration was graded on routine T2-weighted magnetic resonance Image (MRI) using the Pfirrmann's grading system and all index levels were grade 3 and grade 4. Indications for surgery were radiculopathy caused by disc protrusion with soft consistency. MRI was done at one month after the procedure in all patients to check post-PDCT change. The clinical outcomes were evaluated using Visual Analog Scales (VAS) score and MacNab's criteria. Results : This study was approved by the Institutional Review Board of our institution. The age of the study population ranged from 16 to 59 years with a mean age of 37.2 years. There were 29 males and 17 females in this study. The mean period of clinical follow-up was 21 months. The average preoperative VAS score for radiculopathy was $7.4{\pm}1.4$, while the final follow-up VAS score was $1.4{\pm}0.7$ (p<0.001). In MacNab's criteria, 41 patients (89.1%) had achieved favorable improvement (excellent and good) until later follow-up. There were one patient from infection and two patients who needed to convert to open discectomy. Conclusion : PDCT is a safe and efficient treatment modality in a selective patient with HLD.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1007-1010
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• 2015

Background: The clinical significance of bilateral breast cancer is unclear and its influence on prognosis is controversial. Materials and Methods: Between 2005 and 2009 we identified 110 cases of bilateral breast cancer (BBC) ; 49 patients had synchronous (duration between the occurrence of carcinoma in both breasts was less than 12 months) and 61 had metachronous (duration was more than one year with no ipsilateral local recurrence). We compared the patient characteristics including age, menopausal status, clinical stage, tumor size, histological classification, lymph node status, and hormone receptor and Her-2 status. We also compared the treatment given and overall and disease free survival (DFS) of both groups. Results: Synchronous cases tend to present more aggressively than metachronous cases and age at first presentation adversely affects survival. The 5 year overall survival was 78.7% for metachronous and 60% for synchronous. Patients with positive hormonal status had better five year disease free survival in metachronous compared to synchronous cases, at 76% and 63%, respectively. Age at first presentation >45years had better DFS (65%) compared to those with age ${\leq}45$ years (52%) at 5 years follow up. Conclusions: Patients with synchronous breast cancer may have worse prognosis. Young age and hormone receptor negative were risk factors in our study. Close follow up and early detection of contralateral breast cancer is mandatory.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.6
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• pp.354-359
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• 2012

Objectives: The purpose of this study was to investigate whether the age factor would be related with stability of mandibular setback surgery for patients with mandibular prognathism. Materials and Methods: We compared the relapse patterns of 47 patients divided into three age groups (termed younger, adult, and older). The younger group consisted of patients between 15 and 17 years old; the adult group was made up of patients between 21 and 23 years old, and the older group was made up of patients more than 40 years old. The positional change of B point was evaluated at preoperative, postoperative, and follow-up states. Results: The horizontal relapse ratio was 21.7% in the younger group, 15.3% in the adult group, and 15.7% in the older group. Although relatively higher degrees of relapse were found in the younger group, this increase was not statistically significant. Spearman's correlation analysis was performed to explore other factors contributing to relapse. We subsequently found that the amount of relapse was related to horizontal setback. Conclusion: Although the degree of relapse in younger patients is not significant;y higher compared to other groups. The major contributing factor to relapse after sagittal split ramus osteotomy is amount of setback rather than age when the surgery was performed to patients over than 15 years of age.

• Clinics in Shoulder and Elbow
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• v.18 no.1
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• pp.8-12
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• 2015

Background: The aim of this study was to assess demographics, clinical outcomes, and complications of classic floating elbow in adults. Methods: Six patients with ipsilateral diaphyseal fractures of the humerus, radius, and ulna were reviewed retrospectively. All patients were treated operatively and available for follow-up at a minimum of 1 year after surgery. The average age of the patients was 45.2 years (22-64 years) and the average follow-up period was 37.0 months (14-103 months). They were evaluated with postoperative outcome measures, including a visual analog scale (VAS) for pain, Mayo elbow performance score (MEPS), and American Shoulder and Elbow Surgeons (ASES) shoulder score. Residual complications were also evaluated. Results: Five patients (83.3%) had open fracture, and 4 patients (66.7%) presented with associated nerve injury. All fractures were united within postoperative 4 months, except 1 delayed union. The average VAS pain score, MEPS, and ASES shoulder score at the final follow-up examination was 2.5, 79.8, and 67.5 respectively. Three patients including 2 cases of joint stiffness with incomplete recovery from nerve injury and 1 case of complex regional pain syndrome had poor clinical outcome. Conclusions: Although the classic floating elbow is rare, these injuries potentially have associated problems such as open fracture or nerve injury. The presence of residual neurological symptoms predispose to poorer clinical outcomes.

• Clinical and Experimental Otorhinolaryngology
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• v.11 no.4
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• pp.233-241
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• 2018

Objectives. As endoscopic instrumentation, techniques and knowledges have significantly improved recently, endoscopic ear surgery has become increasingly popular. Transcanal endoscopic ear surgery (TEES) can provide better visualization of hidden areas in the middle ear cavity during congenital cholesteatoma removal. We aimed to describe outcomes for TEES for congenital cholesteatoma in a pediatric population. Methods. Twenty-five children (age, 17 months to 9 years) with congenital cholesteatoma confined to the middle ear underwent TEES by an experienced surgeon; 13 children had been classified as Potsic stage I, seven as stage II, and five as stage III. The mean follow-up period was 24 months. Recurrence of congenital cholesteatoma and surgical complication was observed. Results. Congenital cholesteatoma can be removed successfully via transcanal endoscopic approach in all patients, and no surgical complications occurred; only one patient with a stage II cholesteatoma showed recurrence during the follow-up visit, and the patient underwent revision surgery. The other patients underwent one-stage operations and showed no cholesteatoma recurrence at their last visits. Two patients underwent second-stage ossicular reconstruction. Conclusion. Although the follow-up period and number of patients were limited, pediatric congenital cholesteatoma limited to the middle ear cavity could be safely and effectively removed using TEES.