• Archives of Plastic Surgery
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• v.34 no.1
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• pp.115-118
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• 2007

Purpose: It is even less common traumatic pseudoaneurysm of the superficial temporal artery and rare with fewer than 200 cases reported in the recent literature. Most common causes of traumatic pseudoaneurysm is sequelae of blunt, penetrating, or iatrogenic surgical trauma. The diagnosis is based on physical findings and can be confirmed by duplex ultrasonogram, computed tomography, and angiography. Surgical resection, percutaneous embolization and conservative treatment have all been used to treat pseudoaneurysm. However recently, non invasive technique like percutaneous thrombin injection under ultrasonographic guidance has been done rather than surgical ligation. In this report, we proposed the several treatment options such as conservative treatment, thrombin injection, and surgical ligation according to the multifarous conditions of pseudoaneurysm, patient, and causes. Methods: We describe two cases of traumatic pseudoaneurysm of superficial temporal artery in which CT angiography was effective in diagnosis and characterization. One is chronic pseudoaneurysm after traffic accident, which is fusiform shape and small size. Since the patient prefered it, we proposed percutaneous thrombin injection first. But we recognize that this method failed, we used surgical ligation according to information of CT angiographic findings. The other is acute pseudoaneurysm after blunt trauma, which is large size accompanying large hematoma. So we proposed compressive dressing and aspiration of hematoma. Results: Two cases were well treated with no recurrence or complication. Conclusion: In conclusion, when selecting a treatment options, followings should be considered: pseudoaneurysm in CT angiography, chronicity, cause, and patient's preference.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.441-448
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• 2019

Background Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy affecting the skin, for which timely diagnosis and aggressive treatment are essential. MCC has most often been reported in Caucasians, and case reports in Asians are rare. This study presents our experiences with the surgical treatment and radiotherapy of MCC in Asian patients. Methods We retrospectively reviewed the records of seven MCC patients between 2000 and 2018 from a single institution, and analyzed patient characteristics, tumor characteristics, surgical treatment, sentinel lymph node evaluation, reconstruction, adjuvant radiation therapy, and prognosis. Results Eight MCC lesions occurred in seven patients, most commonly in the head and neck region. All patients underwent surgical excision with reconstruction. The final surgical margin was 1.0 cm in most cases, and reconstruction was most commonly performed with a splitthickness skin graft. Five patients received adjuvant radiotherapy, and two patients received sentinel lymph node biopsy. During the follow-up period, three patients remained well, two died from other causes, one experienced recurrence, and one was lost to follow-up. Conclusions We treated seven Asian MCC patients and our series confirmed that MCC is a very dangerous cancer in Asians as well. Based on our experiences, thorough surgical excision of MCC with histopathological clearance should be considered, with sentinel lymph node evaluation if necessary, followed by appropriate reconstruction and careful postoperative observation. Adjuvant radiation therapy is also recommended for all Asian MCC patients. The results of this case series may provide guidance for the treatment of Asian MCC patients in the future.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.178-185
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• 2015

Purpose: The purpose of this study was to conduct a comparative assessment on the satisfaction level for the two interfaces of surgical guide system (SimPlant and R2GATE), the design and convenience of manufactured surgical guides and the importance of using the surgical guides thereof by means of survey. Materials and Methods: Hereupon, they simulated the implant surgical process by mounting the two manufactured systems of surgical guide on a dental mold, respectively. The study subjects were instructed to complete the questionnaire as to the satisfaction level upon completion of the simulated surgery. This study summarized the data of each question after collecting the completed questionnaires. Then, this study analyzed the summarized data by utilizing statistical program SPSS 20.0 (IBM). Results: R2GATE had a higher value of the satisfaction level on the design and convenience of manufactures surgical guides. R2GATE group ($7.33{\pm}1.26$) was found to have a higher value in terms of the overall satisfaction level compared to SimPlant group ($6.67{\pm}1.26$) (${\alpha}$ = 0.05). Conclusion: The user satisfaction level on the surgical guide manufactured for R2GATE system was to such an extent as it can be widely used in clinical environment. Moreover, the surgical guide manufactured as R2GATE system can guide both the length and direction of a drill simultaneously. As a result, it is highly recommended for those beginners who do not have a lot of experience in implant placement.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.1
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• pp.67-71
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• 2001

A cyst that develops in children's jaw occasionally disturbs the eruption of the succedaneous teeth. These teeth, however, usually have the potential of eruption. So, if the obstacles to eruption are eliminated, it is possible that the teeth erupt spontaneously to their normal position. In those cases, it usually requires the management of the cyst and the eruption guidance of the displaced teeth. Many surgical procedures have been described for the elimination of cysts. When the cyst is large and displaces the permanent teeth, marsupializaion is a surgical technique that may be preferred to enucleation in treatment of cysts. In marsupializaion, if the opening is maintained properly, it may be possible to manage the cyst and guide the displaced teeth into the normal position. In these cases, the cysts were managed with marsupialization in concomittent application of acrylic obturators, and as a result the displaced permanent teeth were guided into normal position. Even though the etiologic factors of the two cases are different, the treatment was the same. And both cases show that the potential for heal ing is remarkable with spontaneous relocation of displaced tooth, provided the opening is maintained during the eruption of the permanent tooth.

• Korean Journal of Head & Neck Oncology
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• v.36 no.1
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• pp.1-8
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• 2020

It is well established that cancer patients are more susceptible to infection because of the immunosuppressive status caused by both disease itself and anticancer treatment, including surgery and chemoradiation. Head and neck cancer (HNC) patients are generally at high-risk for coronavirus disease 2019 (COVID-19) infection and serious adverse outcomes. Although there is an urgent need for guidance in the delivery of safe, quality oncologic care, no international consented recommendation addressed the management of HNC patients in COVID-19 due to limited data. In this review, we summarized the consideration for head and neck oncologic care in the context of the COVID-19 pandemic, based on the data and the very recent recommendations from the Korean Cancer Association and National Cancer Center. COVID-19 should be taken into consideration in the comprehensive management of HNC patients, and multidisciplinary evaluation of multilevel surgical-risks, discussion of optimized strategy, and shared-decision-making with the patient are needed to maximize both the safety from infectious pandemic and outcome of surgical and oncologic care.

• The Korean Journal of Pain
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• v.29 no.2
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• pp.129-135
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• 2016

Although discal cysts are a rare cause of low back pain and radiculopathy. Currently, surgical excision is usually the first-line treatment for discal cysts. However, alternative treatment methods have been suggested, as in some cases symptoms have improved with interventional therapies. A 27-year-old man presented with an acute onset of severe pain, and was found to have a discal cyst after an open discectomy. The patient underwent cyst aspiration and steroid injection through the facet joint under C-arm guidance. After the procedure, the patient's pain improved to NRS 0-1. On outpatient physical examination 1 week, and 1 and 3 months later, no abnormal neurological symptoms were present, and pain did not persist; thus, follow-up observation was terminated. When a discal cyst is diagnosed, it is more appropriate to consider interventional management instead of surgery as a first-line treatment, while planning for surgical resection if the symptoms do not improve or accompanying neurologic deficits progress.

• Journal of Chest Surgery
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• v.53 no.4
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• pp.233-241
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• 2020

Vagal damage and subsequent pyloric denervation inevitably occur during esophagectomy, potentially leading to delayed gastric emptying (DGE). The choice of an optimal pyloric procedure to overcome DGE is important, as such procedures can lead to prolonged surgery, shortening of the conduit, disruption of the blood supply, and gastric dumping/bile reflux. This study investigated various pyloric methods and analyzed comparative studies in order to determine the optimal pyloric procedure. Surgical procedures for the pylorus include pyloromyotomy, pyloroplasty, or digital fracture. Botulinum toxin injection, endoscopic balloon dilatation, and erythromycin are non-surgical procedures. The scope, technique, and effects of these procedures are changing due to advances in minimally invasive surgery and postoperative interventions. Some comparative studies have shown that pyloric procedures are helpful for DGE, while others have argued that it is difficult to reach an objective conclusion because of the variety of definitions of DGE and evaluation methods. In conclusion, recent advances in interventional technology and minimally invasive surgery have led to questions regarding the practice of pyloric procedures. However, many clinicians still perform them and they are at least somewhat effective. To provide guidance on the optimal pyloric procedure, DGE should first be defined clearly, and a large-scale study with an objective evaluation method will then be required.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.645-657
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• 2022

Purpose To evaluate and compare the diagnostic outcomes of ultrasonography (US)-guided fine needle aspiration (FNA) and core needle biopsy (CNB) performed on the same thyroid nodule using a surgical specimen for direct comparison. Materials and Methods We included 89 thyroid nodules from 88 patients from February 2015 to January 2016. The inclusion criterion was thyroid nodules measuring ≥ 20 mm (mean size: 40.0 ± 15.3 mm). Immediately after surgical resection, FNA and subsequent CNB were performed on the surgical specimen under US guidance. FNA and CNB cytopathologic results on the specimen were compared with the surgical diagnosis. Results Among the 89 nodules, 30 were malignant and 59 were benign. Significantly higher inconclusive rates were seen in FNA for malignant than benign nodules (80.0% vs. 39.0%, p < 0.001). For CNB, conclusive and inconclusive rates did not differ between benign and malignant nodules (p = 0.796). Higher inconclusive rates were seen for FNA among cancers regardless of US features, and in the subgroup of size ≥ 40 mm (62.5% vs. 22.9%, p = 0.028). Eleven cancers were diagnosed with CNB (36.7%, 11/30), while none was diagnosed using FNA. Conclusion In this experimental study using surgical specimens, CNB showed a potential to provide improved diagnostic sensitivity for thyroid cancer, especially when a conclusive diagnosis is limited with FNA.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.77-84
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• 2010

Purpose: The nasal bones are the most common fracture sites of the facial bones, and a careful reduction may still result in secondary deformities, such as saddle nose, deviated nose, hump nose etc, requiring secondary cosmetic rhinoplasty. Therefore, this study examined the clinical characteristics of nasal bone fractures to propose guidelines for patient selection and surgical procedures to achieve more satisfactory results and to prevent secondary deformities with simultaneous augmentation rhinoplasty and bony reduction. Methods: The study was based on 26 out of 149 nasal bone fracture patients who underwent simultaneous augmentation rhinoplasty with bony reduction between May 2008 and April 2009. Retrospective analysis was performed according to the clinical data, surgical techniques and postoperative results. Results: Of the 26 patients, there were 15 males and 11 females. The incidence according to the Stranc's classification revealed that 62% of patients were injured by a frontal impact and 38% by a lateral impact. Frontal impact plane I (50%) was the most frequent type. At the follow up, 18 (81.2%) out of 22 patients were satisfied with their postoperative outcome, and the remaining 4 patients were fair. No one was dissatisfied. However, 5 cases in 3 patients (23%) had some complications; minimal implant deviation in 2 cases, minor irregularity on the nasal dorsum in 2 cases and palpable implant movement under palpation in 1 case. None of these cases required surgical correction. Conclusion: With the proper guidance, simultaneous augmentation rhinoplasty with bony reduction can prevent secondary deformities and satisfy the cosmetic outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.5
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• pp.406-413
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• 2004

Progress in medical science and cell biology has resulted in the transplantation of human cells and tissues from on human into another, facilitating reproduction and the restoration of form and function, as well as enhancing the quality of life. For more than 40 years, society has recognized the medical and humanitarian value of donation and transplanting organs and tissues. The standard operating procedures of hard tissues reflect the collective expertise and conscientious efforts of tissue bank professionals to provide a foundation for the guidance of tissue banking activities. Procurement of allograft tissues from surgical bone donors is a part of tissue banking. During the past decades the use of bone allografts has become widely accepted for the filling of skelectal defects in a variety of surgical procedures. In particular in the field of orthopaedic and oral and maxillofacial surgery the demand for allografts obtained from either living or post-mortem donors has increased. Hospital-based tissue banks mainly retrieve allografts from living donors undergoing primary total hip replacement for osteoarthritis or hemi arthroplasty for hip fractures and orthgnatic surgery such as angle reduction. Although bone banks have existed for many years, the elements of organized and maintaining a hospital bone bank have not been well documented. The experience with a tissue bank at Korea Tissue Bank(KTB) between 2001 and 2004 provides a model of procurement, storage, processing, sterilization and documentation associated with such a facility. The following report describes the standard operating procedures of hard tissues such as femoral head obtained from living donors.