• Journal of Chest Surgery
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• v.30 no.7
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• pp.724-728
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• 1997

We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms r vealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardiopulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.3051-3056
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• 2015

Background: Skin self-examination (SSE) may facilitate early diagnosis of melanoma at a potentially curable stage. Little data are available concerning the SSE frequency and knowledge about the symptoms of melanoma in non-patient populations. The aim of our study was to assess the performance of skin self-examination, recognition of potential melanoma symptoms as well as behavior related to sun exposure among web users in Poland. Materials and Methods: A cross-sectional study was conducted among readers of a scientific portal. Invited respondents were asked to complete an online questionnaire. Finally, statistical analysis was conducted on 4,919 surveys towards potential clinical signs of melanoma and SSE performance. Results: Approximately 60% of respondents had ever performed SSE in their life. Only 18.4 % declared performance on a regular, monthly, basis. Factors promoting this activity were established to be bigger place of residence, higher education and sensitive skin phototype, higher level of knowledge concerning melanoma, safe tanning rules and, especially, past surgical excision of naevi. Declared longer use of tanning beds was linked to understanding better the importance of clinical features of melanoma. Awareness of hazardous behavior during sunbathing is associated with the attempts to change them. Conclusions: Regular SSE is not a common practice, whilst the knowledge about the clinical features of melanoma is varied. Therefore, constant pressure should be put on promotion of regular skin self-examination and teaching its proper techniques, including familiarity with the ABCD (asymmetry; border; color; diameter) rule and its extension of "EFG" (elevated, firm, progressive growth) criteria.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.39-47
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• 2014

Purpose: Peri-implantitis, a clinical term describing the inflammatory process that affects the soft and hard tissues around an osseointegrated implant, may lead to peri-implant pocket formation and loss of supporting bone. However, this imprecise definition has resulted in a wide variation of the reported prevalence; ${\geq}10%$ of implants and 20% of patients over a 5- to 10-year period after implantation has been reported. The individual reporting of bone loss, bleeding on probing, pocket probing depth and inconsistent recording of results has led to this variation in the prevalence. Thus, a specific definition of peri-implantitis is needed. This paper describes the vast variation existing in the definition of peri-implantitis and suggests a logical way to record the degree and prevalence of the condition. The evaluation of bone loss must be made within the concept of natural physiological bony remodelling according to the initial peri-implant hard and soft tissue damage and actual definitive load of the implant. Therefore, the reason for bone loss must be determined as either a result of the individual osseous remodelling process or a response to infection. Methods: The most current Papers and Consensus of Opinion describing peri-implantitis are presented to illustrate the dilemma that periodontologists and implant surgeons are faced with when diagnosing the degree of the disease process and the necessary treatment regime that will be required. Results: The treatment of peri-implantitis should be determined by its severity. A case of advanced peri-implantitis is at risk of extreme implant exposure that results in a loss of soft tissue morphology and keratinized gingival tissue. Conclusions: Loss of bone at the implant surface may lead to loss of bone at any adjacent natural teeth or implants. Thus, if early detection of peri-implantitis has not occurred and the disease process progresses to advanced peri-implantitis, the compromised hard and soft tissues will require extensive, skill-sensitive regenerative procedures, including implantotomy, established periodontal regenerative techniques and alternative osteotomy sites.

• Journal of Gastric Cancer
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• v.14 no.4
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• pp.252-258
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• 2014

Purpose: The macroscopic diagnosis of tumor invasion through the serosa during surgery is not always distinct in patients with gastric cancer. The prognostic impact of the difference between macroscopic findings and pathological diagnosis of serosal invasion is not fully elucidated and needs to be re-evaluated. Materials and Methods: A total of 370 patients with locally advanced pT2 to pT4a gastric cancer who underwent curative surgery were enrolled in this study. Among them, 155 patients with pT3 were divided into three groups according to the intraoperative macroscopic diagnosis of serosal invasion, as follows: serosa exposure (SE)(-) (no invasion, 72 patients), SE(${\pm}$) (ambiguous, 47 patients), and SE(+) (definite invasion, 36 patients), and the clinicopathological features, surgical outcomes, and disease-free survival (DFS) were analyzed. Results: A comparison of the 5-year DFS between pT3_SE(-) and pT2 groups and between pT3_SE(+) and pT4a groups revealed that the differences were not statistically significant. In addition, in a subgroup analysis of pT3 patients, the 5-year DFS was 75.1% in SE(-), 68.5% in SE(${\pm}$), and 39.4% in SE(+) patients (P<0.05). In a multivariate analysis to evaluate risk factors for tumor recurrence, macroscopic diagnosis (hazard ratio [HR], SE(-) : SE(${\pm}$) : SE(+)=1 : 1.01 : 2.45, P=0.019) and lymph node metastasis (HR, N0 : N1 : N2 : N3=1 : 1.45 : 2.20 : 9.82, P<0.001) were independent risk factors for recurrence. Conclusions: Gross inspection of serosal invasion by the surgeon had a strong impact on tumor recurrence in gastric cancer patients. Consequently, the gross appearance of serosal invasion should be considered as a factor for predicting patients' prognosis.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.16 no.3
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• pp.193-201
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• 2006

This study was performed to investigate employee exposures to waste anesthetic gases, such as enflurane and sevoflurane in operating rooms of general surgical, children's and dental clinics of a large hospital located in Seoul and to analyze factors affecting the concentrations of waste anesthetic gases. The results of the study are summarized below. 1. Based on results of personal and area samples for airborne enflurane, all of the employees investigated in this study were exposed to airborne enflurane concentrations below the ACGIH-threshold limit value (TLV) of 75 ppm. 2. However, based on results of personal samples for sevoflurane, employees of two (2) out of eleven (11) operating rooms were exposed to sevoflurane concentrations in excess of the NIOSH recommended exposure limit (REL) of 2 ppm. A similar trend was found in the area samples. 3. To investigate the source of sevoflurane emissions, airborne sevoflurane concentrations were measured on an anesthesia machine, a drug cabinet and a desk. It was indicated that the geometric means were 0.93 ppm, 0.83 ppm and 0.72 ppm, respectively. 4. Factors affecting waste anesthetic gas concentrations were the age of anesthesia machine, the volume of operating room and the extent of ventilation (p<0.05). 5. It is recommended that the use of anesthesia equipments be properly controlled, the operating room be well ventilated, and the airborne concentrations of anesthetic gases be continuously monitored.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.153-159
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• 1991

The use of the autogenous free fat is a well-known procedure to fill in superficial depressions resulting from the traumatic or congenital defects. The major donor site for this procedure was the abdominal subcutaneous fat or buttocks. In 1977, Egyedi was the first to report the use of the buccal fat pad as a pedicled graft. The buccal fat pad is a structure usually considered to be a nuisance when encountered in intraoral procedures such as facial bone osteotomies, elevation of buccal falp, or procedures on Stensen's duct. In these operations, appearance of the buccal fat pad complicates surgical exposure. The buccal fat pad is a lobulated convex mass of fatty tissue covered by a very delicate membrane, and is described as having a body from which four processes extend. These projection serve as a filling material between the various muscular structures in the area. Recently malar depression was augmented with the pedicled buccal fat pad in 3 cases, and it was used for the reconstruction of the nasolabial fold in one case.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.4
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• pp.704-709
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• 2006

Ectopic eruption should be understood as a change in the course of the normal eruption path of a dental bud at any moment in its origin. Transposition is a unique and extreme form of ectopic eruption. The treatment for ectopic eruption and transposition is various from simple observation to surgical exposure and orthodontic traction, according to direction of erupting tooth degree of developing root apex and eruption space etc. Autotransplantation is transplantation of tooth from one area of the mouth to another in the same individual or is moving a eruption tooth into extraction socket or surgically prepared socket, and autotransplantation is considered as a treatment of choice for the ectopic eruption when orthodontic traction is unable or when tooth movement is limited. These cases which were treated with autotransplantation of maxillary lateral incisor and maxillary canine were reported, and good esthetic and functional result were induced.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.2
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• pp.329-334
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• 2007

The infection of primary teeth occurs by caries or trauma. But, if it is not treated on time, the complication may occur such as enamel hypoplasia, discoloration, impaction, displacement and dilaceration of permanent successors. The periapical lesion on primary tooth could displace the permanent successors in any direction. Treatment options of displaced tooth are observation after extracting the primary teeth, surgical exposure orthodontic traction, transplantation and extraction. In these cases, displacement of permanent central incisor caused by the periapical lesion of primary teeth was observed. The spontaneous eruption after extraction of primary teeth was expected considering degree of displacement, development of root and direction of eruption. This case report shows spontaneous eruption of displaced permanent tooth germ was achieved with periodic examination after extraction of primary teeth.

• Archives of Plastic Surgery
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• v.44 no.2
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• pp.124-135
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• 2017

Background In cases of total knee arthroplasty (TKA) threatened by potential hardware exposure, flap-based reconstruction is indicated to provide durable coverage. Historically, muscle flaps were favored as they provide vascular tissue to an infected wound bed. However, data comparing the performance of muscle versus fasciocutaneous flaps are limited and reflect a lack of consensus regarding the optimal management of these wounds. The aim of this study was to compare the outcomes of muscle versus fasciocutaneous flaps following the salvage of compromised TKA. Methods A systematic search and meta-analysis were performed to identify patients with TKA who underwent either pedicled muscle or fasciocutaneous flap coverage of periprosthetic knee defects. Studies evaluating implant/limb salvage rates, ambulatory function, complications, and donor-site morbidity were included in the comparative analysis. Results A total of 18 articles, corresponding to 172 flaps (119 muscle flaps and 53 fasciocutaneous flaps) were reviewed. Rates of implant salvage (88.8% vs. 90.1%, P=0.05) and limb salvage (89.8% vs. 100%, P=0.14) were comparable in each cohort. While overall complication rates were similar (47.3% vs. 44%, P=0.78), the rates of persistent infection (16.4% vs. 0%, P=0.14) and recurrent infection (9.1% vs. 4%, P=0.94) tended to be higher in the muscle flap cohort. Notably, functional outcomes and ambulation rates were sparingly reported. Conclusions Rates of limb and prosthetic salvage were comparable following muscle or fasciocutaneous flap coverage of compromised TKA. The functional morbidity associated with muscle flap harvest, however, may support the use of fasciocutaneous flaps for coverage of these defects, particularly in young patients and/or high-performance athletes.

• Archives of Reconstructive Microsurgery
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• v.6 no.1
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• pp.87-95
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• 1997

Traumatic injury to the hand often leads to soft tissue defects with exposed tendons, bones, or joints. Though many new flap have been introduced, the choice of flap that would be best for the patient depends on such factors as the site, size, and degree of wounds. Additionally the selected surgical method should be yielded cosmetic and functional superiority by the one-staged reconstruction. In our experience, small to medium sized soft tissue defect with bone and tendon exposure of hand can be resurfaced with an arterialized venous free flap from the volar aspect of distal forearm. Wide and deep defects of the hand can be covered with a sensory cutaneous free flap such as the medial plantar free flap, dorsalis pedis free flap, and radial forearm free flap. Specialized flap such as wrap-around flap, toe-to-finger transfer, onychocutaneous free flap can be used for the recontruction of defect on the thumb and finger. Based on the above considerations and our clinical experience of 60 free flap cases of the hand, the various methods for the proper repair of soft tissue defects of the hand are described. And we obtained satisfactory functional and cosmetic results with 95% success rate of free flap.