• Journal of Chest Surgery
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• v.26 no.6
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• pp.463-469
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• 1993

From May 1986 to May 1992, 72 patients were diagnosed and operated for primary lung cancer, among them 65 patients were clinically evaluated at the department of Thoracic & Cardiovascular Surgery, Masan Koryo General Hospital. 1. There were 52 males 13 females[M:F=4:1], and 5th, 6th decade of life[72%] was peak incidence. 2. The preoperative diagnosis and its positive rate were sputum cytology 35%, bronchoscopy 47%, pleural effusion cytology 80%, and pleural biopsy 50%. 3. The classification histologic types were squamous cell cancer 71%, adenocarcinoma 17%, undifferentiated cell carcinoma 4.6%, and staging classification were Stage I 31%, Stage II 22%, Stage IIIa 26%, and Stage IIIb 20%. 4. The operative methods were lobectomy 52%, pneumonectomy 36%, and open biopsy 12%, and operability was 89%, resectability was 88%. 5. The postoperative complications developed 13 patients[22%], and operative mortality was 5%. 6. The overall actuarial survival rate was 1year 70%, 2year 42%, 3year 32%, 4year 26%, and 5year 22%, according to Stage 5year survival rate was Stage I 37%, Stage II 22%, Stage IIIa 3year 12%, Stage IIIb 2year 23%. And according to operative method lobectomy 23%, pneumonectomy 19%.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.5
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• pp.435-439
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• 2011

Ameloblastoma is an aggressive benign odontogenic epithelial tumour that may arise from the enamel organ, remnants of dental lamina, or the lining of an odontogenic cyst. It is usually categorized into solid or multicystic, unicystic, and peripheral types. Treatment ofameloblastomas include conservative methods such as marsupialisation, enucleation, and curettage; and radical treatments such as marginal or segmental resection. Radical treatments have resulted in lower recurrence rates; however, may also encounter esthetic, functional, and reconstructive problems. Unicystic ameloblastoma has been considered less aggressive and a lower recurrence tendency. Thus, many authors have recommended conservative treatment in cases of unicystic ameloblastoma. An 11 year-old boy presented with displaced second and third molars by luminal unicystic ameloblastoma in the mandible. Cyst enucleation, curettage, and third molar extraction were done. No signs of recurrence or esthetic problems such as facial asymmetry were seen radiologically and clinically, up to 8 years 2 months postoperatively.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.131-133
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• 2009

Intrathoracic goiters consist of two types: the primary and secondary type. Primary intrathoracic goiters are very rare. We report here on a case that was resected with using the thoracoscopic assist technique. The transthoracic or transsternal approach is necessary for primary goiters to remove them completely without complications.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.532-536
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• 2009

Bypass surgery is performed for insuring continuity of a blood supply that is restricted due to obstruction of the native blood supply. Two types of surgery are commonly carried out: one is anatomic bypass and the other is extraanatomic bypass. Especially, extraanatomic bypass surgery is performed in patients who are a high risk for performing anatomical bypass surgery. The risk factors for anatomical bypass surgery are old age, infection, previous surgery and trauma. A 96-year-old patient underwent extraanatomic bypass surgery from the right femoral artery to the left femoral artery due to total occlusion of the left iliac artery, and 7 years after that operation, a pseudoaneurysm abruptly and spontaneously appeared from the bypass suture site without any predisposing factor. The lesion was revealed to be an organizing thrombus.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.121-130
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• 2004

The purpose of this study was the long-term clinical and radiological evaluation of conservatively treated condylar fractures in children. This study was therefore undertaken to analyze the long-term effects of treating condylar fractures in children with conservative therapy in order to resolve the controversial question of whether complete remodeling occurs in this age or, if not, whether it is more likely to be associated with certain types of fracture or with other factors. This study was based on a series of 11 consecutive children and adolescents, aged between 3 and 15 years, with fractures of the condylar process who had been treated with conservative therapy at the Department of Oral & Maxillofacial surgery, Inha University Hospital, Inchon, Korea. All patients underwent a clinical investigation with special emphasis on Temporomandibular joint function and facial asymmetry. The patients also underwent a radiologic investigation, focusing on fracture remodeling and symmetry of mandible. It consists of panoramic radiograph, PA & lateral cephalogram and 3-D CT. No patient described impaired temporomandibular joint(TMJ) function or pain on the affected side. 2 of 8 (25%) unilateral and 1 bilateral fractures show slight facial asymmetry. Despite apparently excellent recovery of function, there were marked remodeling changes evident on the CT scan. Such changes are not usually evident on panoramic radiograph. Radiologic investigation showed incomplete remodelling(54.5%) and asymmetry of the mandible (27.3%) in some patients. Conservative treatment of condyle fracture in children results in satisfactory long-term outcome of jaw function despite a relative high frequency of radiologically noted aberrations.

• Archives of Plastic Surgery
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• v.42 no.6
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• pp.741-745
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• 2015

Background Microvascular complications after free-flap breast reconstructions are potentially devastating problems that can increase patient morbidity and lead to flap loss. To date, no comprehensive study has examined the rates of salvage and the methods of microvascular revision in breast reconstruction. We reviewed the treatment of microvascular complications of free-flap breast reconstruction procedures over a seven-year period. Methods A retrospective review of all patients who underwent microvascular breast reconstruction at our institution between April 2006 and December 2013 was conducted. Based on their surgical records, all patients who required emergency re-exploration were identified, the rate of flap salvage was determined, the factors associated with flap salvage were evaluated, and the causes and methods of revision were reviewed. Results During the review period, 605 breast reconstruction procedures with a free lower abdominal flap were performed. Seventeen of these flaps were compromised by microvascular complications, and three flaps were lost. The overall salvage rate was 82.35%. No significant differences between the salvaged group and the failed group were observed with regard to age, BMI, axillary dissection, number of anastomotic arteries and veins, recipient vessel types, or use of the superficial inferior epigastric vein in the revision operation. Successful salvage of the flap was associated with a shorter time period between recognizing the signs of flap compromise and the take-back operation. Conclusions The salvage rate of compromised lower abdominal flaps was high enough to warrant attempting re-exploration. Immediate intervention after the onset of flap compromise signs is as important as vigilant postoperative monitoring.

• Archives of Reconstructive Microsurgery
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• v.17 no.1
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• pp.19-27
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• 2008

Purpose: Microvascular reconstructive surgery has become an integral part of the treatment of head and neck cancer patients. This review of 121 free flaps for head and neck cancer patients performed over the last 11 years was done to evaluate circulatory crisis, salvage, and secondary reconstruction and to investigate which factors may contribute to these rates. Method: Nine emergent explorations among 121 head and neck reconstruction with free flaps were reviewed to analyze detection of vascular crisis, the time interval from detection of circulatory crisis to exploration, operation procedures and results, and secondary reconstructions. Emergent exploration was done with our protocol. Result: Nine free flaps exhibited signs of vascular problems between 1 day and 6 days postoperatively. The emergent exploration rate of this series was 7.4% (9/121). The salvage rate was 55.6% (5/9), giving an overall flap viability of 96.7% (117/121). In our study, preoperative radiation therapy, positive smoking history, alcohol consumption history, combined disease such as diabetes mellitus and hypertension, recipient vessels and types of vascular anastomosis were not related to the causes of circulatory crisis. The mean time interval between the onset of clinical recognition of impaired flap perfusion and re-exploration of the salvaged 5 flaps was 3.2 hours, that of failed 4 flaps was 11.25 hours. Conclusion: Despite high overall success rate, relatively low salvage rate may be attributed to late detection of circulatory crisis and in long time interval between detection and exploration. We conclude that early detection of circulatory crisis and expeditious re-exploration are a matter of great importance for the success of salvage operation.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.127-133
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• 2008

Purpose: The purpose of this study is to evaluate the remodeling process of the various skin substitutes in 4th and 6th weeks following the transplantation when transplanted onto nude mice. Methods: Three types of artificial skin substitutes, such as PLGA scaffold with keratinocyte sheets(group 1), acellular human dermis($Surederm^{(TM)}$) and keratinocyte sheet(group 2), bioengineered skin($Neoderm^{(TM)}$)(group 3), were applied to the wound on nude mice. All mice were killed in 2, 4 weeks and/or 6 weeks after grafting and tissue samples were harvested from the back of mice. The changes in wound size, degree of angiogenesis, formation of basement membrane and epidermis, density of collagen fibers and neural restoration were examined. Results: There was no significant changes in wound size among the three groups. However, the size of wound decreased in the non-substituted group due to contracture. Degree of angiogenesis and systhesis of collagen or neurofilaments were mostly increased in bioengineered skin($Neoderm^{(TM)}$)(group 3), followed by acellular human dermis($Surederm^{(TM)}$) and keratinocyte sheet(group 2), PLGA scaffold with keratinocyte sheets (group 1). However, group 3 and group 2 showed similar thickness of basement membrane and epidermis. Conclusion: We found that degree of angiogenesis, formation of basement membrane and skin appendages, density of collagen fibers and neurofilaments can be the categories to evaluate the success of artificial skin substitution in early stages.

• The Journal of Advanced Prosthodontics
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• v.7 no.2
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• pp.129-137
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• 2015

PURPOSE. Squamous cell carcinoma (SCC) of the tongue has a relatively high incidence of all oral cancers. Some studies have reported a relationship between intraoral dental prosthesis and SCC of the tongue; however, this relationship remains controversial. The purpose of this study was to investigate the relationship between SCC of the tongue and the positional aspects of dental prosthesis using a retrospective analysis. MATERIALS AND METHODS. A total of 439 patients with SCC of the tongue were diagnosed and treated in the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. Patients were treated over a 12.5-year period ranging from January 1, 2001 to June 30, 2013. Statistical analysis was performed to examine potential differences between the groups. RESULTS. The number of patients with a crown and/or a bridge (134, 63.5%) was significantly different than the number of patients without a prosthesis (77, 36.5%). Even after accounting for different types of prostheses such as crowns, bridges, and dentures, no significant differences were observed between the position of the prosthesis and the location of the SCC of the tongue, with significance defined as a P-value less than .05 by the Pearson-Chi square test. CONCLUSION. Patients with crowns and/or bridges exhibited more frequent SCC of the tongue compared with patients without these prosthesis. These data support the hypothesis that mechanical trauma and galvanic phenomena play a role in the etiology of SCC of the tongue.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.403-405
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• 2007

Purpose: Malignant degeneration of fibrous dysplasia is an uncommon recognized complication of this disease. Especially, degeneration of fibrous dysplasia to malignant fibrous histiocytoma(MFH) in facial bone is rare and the publications had been limited. The purpose of this report is to share our experience. Methods: A 46-year-old patient with facial fibrous dysplasia visited our clinic for recent facial tingling and swelling. Malignant degeneration of fibrous dysplasia was suspected. Results: Total excision of the mass and adjacent facial bone was performed. Defect was immediately reconstructed with bone graft and bone cement. At a month follow up, metastasis was detected at ipsilateral parotid gland. Superficial parotidectomy and neck dissection was performed. The patient is currently taking chemotherapy. Conclusion: Because of the uncommon presentation of this entity, clinical course of treatment was dependent on other histological types of malignant degeneration. We report this case to share our experience.