• Archives of Plastic Surgery
• /
• 제37권6호
• /
• pp.763-768
• /
• 2010

Purpose: Reconstruction of soft tissue defect using tissue expander can provide better flap which is more similar to surrounding tissue in color, skin texture and hair compared to other methods. Many pediatric patients need reconstruction of soft tissue defect because of giant congenital nevi, congenital or acquired malformations and burn scars. Reconstruction using tissue expander is adequate to minimize dysmorphism in these patients. We intended to assess outcomes of using tissue expander in pediatric patients by retrospective study. Methods: Total cases were 168 of pediatric patients who received soft tissue reconstruction using tissue expander by the same surgeon from February, 1982 to May, 2009. All patients who received soft tissue reconstruction were under 10 years old. Mean age was 4.3 years old, the youngest 13 months, the oldest 8 years. Eightynine cases were male and 79 cases were female. Most common cause was giant hairy nevi (67 cases, 39.9%), secondary cause was burn scar/scar contracture (61 cases, 36.3%). Trunk (38 cases, 22.6%) was most common anatomical location. Results: Soft tissue defects were successfully covered using tissue expander in 149 cases (88.7%) without major complications. There was infection on 8 cases (4.7%) and we treated by adequate antibiotics in these cases. There were tissue expander folding or valve displacement on 5 cases (3%). Conclusion: Usage of tissue expander is useful on pediatric patients because tissue expansion is rapid on children and there are less secondary contractures on operation site than full thickness skin graft. Because of psychological stress due to tissue expander, operation should be performed before school age.

• Journal of Trauma and Injury
• /
• 제21권2호
• /
• pp.128-135
• /
• 2008

Purpose: As the care of surgical patients becomes increasingly complex and catheter-based techniques are more frequently applied, the pattern of iatrogenic vascular injuries may be increasing. Major vascular injuries can jeopardize a patient's life or limb survival. The purpose of this study was to examine the current etiology and prognosis for iatrogenic vascular injuries. Methods: We reviewed medical records of 29 cases of iatrogenic vascular injury that were treated Seoul National University Bundang Hospital between October 2003 and October 2008. We studied clinical variables including demographics, cause of injury, clinical presentations, management and prognosis. Results: The mean age was 60.8 years (range: 25-86), and the male to female ratio was 1.9 : 1. The causes of injuries were operation related complication in 18 cases (62.1%), endovascular intervention and diagnostic angiography in 11 cases (37.9%). The types of vascular injury were partial severance in 14 cases, pseudoaneurysm in 8, arteriovenous fistula (AVF) in 3, thrombosis in 2, complete severance in 2. Especially, device related complication including percutaneous closing device were occurred in 9 and the others came from inadvertent physician's procedure. Primary repair were done in 12 cases, end-to-end anastomosis in 5, interposition graft in 4, ligation in 2, patch angioplasty in 1, peudoaneurysm excision and arteriorrhaphy in 1, hematoma evacuation in 1, and endovascular repair in 3. There were 2 cases of mortality, one of them due to hemorrhagic shock and the other due to septic shock. Conclusion: Proper selection of treatment modalities should be important to have better outcome according to the type of injury as well as anatomical location. Each physician should be familiar to new device as well as patient's topographical feature. Immediate referral to vascular specialist is also essential to reduce morbidity.

• Journal of Korean Neurosurgical Society
• /
• 제41권6호
• /
• pp.391-396
• /
• 2007

Objective : This study was performed to review the clinical characteristics and operative results of brain abscess in order to define the therapeutic strategy for this disease. Methods : We reviewed the medical records and radiology images of brain abscess patients treated in our hospital during the last 16 years. A total of 35 cases included 23 males and 12 females, with the mean age of 48 years old. We excluded cases of postoperative, post traumatic, and fungal abscess. All patient underwent at least one surgical treatment such as stereotactic aspiration or craniotomy with excision. Results : Twenty seven [77.1%] patients presented with symptoms of increased intracranial pressure. The frontal lobe was the most common anatomical place, and streptococcal species were the most frequently encountered pathogens. The chronic pulmonary diseases and chronic otitis media are common underlying condition. Eighteen patients underwent stereotactic aspiration and 17 patients had excision of their abscess as an initial treatment. Seven patients had a repeated surgery, 6 of them had been treated with aspiration initially. At discharge, 60.0% patients showed a favorable outcome. Conclusion : The stereotactic drainage would be more suitable for the brain abscess located in deep and eloquent area. A large, solitary, and well-encapsulated lesion of superficial location could be best treated with complete excision, and this procedure was more definite because it is associated with less repeated surgery and showed more favorable outcome compared to aspiration surgery.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
• /
• 제61권11호
• /
• pp.588-592
• /
• 2018

Background and Objectives The incidence of facial bone fracture is increasing. The zygomatic bone, due to its anatomical prominence, is the second most common site of all facial bone fractures. In this study, we present the clinical experiences of zygomatic arch fracture in a tertiary hospital and introduce the Gillies approach for reduction and its outcome results. Subjects and Method We collected data from retrospective chart reviews of patients who underwent surgeries from 2010 to 2017 for zygomatic arch fractures at Chungbuk National University Hospital. Data were analyzed according to age, gender, cause of trauma, location of trauma, and clinical symptoms including trismus. All surgery was performed under general anesthesia and via the use of Gillies approach. The result of surgery was evaluated by postoperative facial computed tomography. Results Sixteen patients underwent surgery for zygomatic arch fracture. The patients had the average age of 41.3 years, a male predominance of 15:1 and physical assault as the most common cause of trauma. The time lag between injury and surgical reduction was 5.5 days. The surgical outcomes were assessed 'good' in 14 cases and 'moderate' in one case. Patients who had trismus preoperatively were resolved of it in all cases after operation. Postoperative complications were absent. Conclusion The Gillies approach proved to be a relatively easy, safe, and reliable method, and its surgical outcomes was satisfactory in our experiences.

• 셀메드
• /
• 제9권3호
• /
• pp.3.1-3.7
• /
• 2019

Recent researches on adipocytes in human and mice model have reported that the adipocytes are not only the fat depots but having role in maintenance of physiology and metabolism through adipokines released by them in accordance to their anatomical location. Ayurveda scholars too have mentioned different tissues like Vasa (inter muscular fat), Meda (visceral fat) and Majja (bone marrow) which are predominantly rich in adipocytes similar to adipose tissues, with a different sites, functions, compositions and pathological outcomes. The metabolic effect of Meda and Majja Dhatu on other tissues like muscle (Mamsa Dhatu), bone (Asthi Dhatu) and reproductive tissue (Shukra Dhatu) shows their functional interdependence. The detailed description of therapeutic indications of Vasa and Majja under Snehakarma (oleation therapy) illustrates that clinical physiology of these tissues have been elaborated rather than general physiology. This article is an attempt to comprehend the physiological aspect of Vasa, Meda and Majja retrospectively on the basis of their therapeutic indication for the management of variety of disorders, in the form of Sneha through different therapeutic procedures. An effort has been also taken to distinguish Vasa, Meda, Majja based on the functional peculiarities of adipocytes present in different sites of body like omentum, muscle and bone marrow. Critical observation of explanations of Vasa, Meda and Majja in Ayurveda compendia and advanced research in field of adipocytes reflected that Ayurveda scholars had deep insights regarding the various dimensions of adipocytes, most of which are in consistent with the advanced physiology and biomolecular studies of adipocytes.

• 대한심미치과학회지
• /
• 제27권2호
• /
• pp.97-104
• /
• 2018

하악 전치부는 다른 구강 내 영역에 비해 높은 임플란트 성공률과 더 나은 접근성을 갖고 있다. 비록 부적절한 드릴링으로 인한 설측 피질골 천공 가능성과 설동맥 손상으로 인한 출혈 가능성이 있더라도 다른 부위와 비교했을 때 주요 해부학적 구조물이 적기 때문에 상대적으로 안전하다. 또한 상악 전치부와 비교했을 때 환자들이 심미적으로 덜 민감한 부위이다. 그러나 좁은 협설측 치조골 폭 때문에 이상적인 임플란트 식립 위치로의 식립은 상악 전치부만큼 어렵다. 이러한 하악 전치부에서 일체형 임플란트는 매우 유용한 치료방법이다. 하악 전치의 해부학적 치근형태와 얇은 치조골을 고려할 때, 임상적으로 3mm보다 큰 직경의 임플란트 식립은 어렵다. 본 증례는 하악 전치부 무치악 부위에서 일체형 임플란트의 식립과 즉시 부하를 동반하여 심미적인 보철물을 구현한 경우이다.

• 고신대학교 의과대학 학술지
• /
• 제33권3호
• /
• pp.358-368
• /
• 2018

Objectives: To identify the relationship between surgical success rate and preoperative nasal mucosal thickness around the lacrimal sac fossa, as measured using computed tomography. Methods: We reviewed 33 eyes from 27 patients who underwent endoscopic dacryocystorhinostomy after diagnosis of primary nasolacrimal duct obstruction and who were followed-up with for at least six months between 2011 and 2014. We measured preoperative nasal mucosal thickness around the bony lacrimal sac fossa using computed tomography and analyzed patient measurements after classifying them into three groups: the successfully operated group, the failed operation group, and the non-operated group. Results: Surgery failed in six of the 33 eyes because of a granuloma at the osteotomy site and synechial formation of the nasal mucosa. The failed-surgery group showed a clinically significantly greater decrease in nasal mucosal thickness at the rearward lacrimal sac fossa compared with the successful-surgery group. However, nasal mucosal thickness of fellow eyes (i.e., non-operated eyes) was not significantly different between the two groups, and the location of the uncinate process did not appear to influence mucosal thickness. In the failed group, posteriorly located mucosal thickness of operated eye fossa was thinner than that of the non-operated eyes, but not significantly so. Conclusions: Our results from this quantitative anatomical study suggest that nasal mucosal thickness is a predictor of endoscopic dacryocystorhinostomy results.

• Imaging Science in Dentistry
• /
• 제51권2호
• /
• pp.167-174
• /
• 2021

Purpose: Sex determination can be done by morphological analysis of different parts of the body. The mastoid region, with its anatomical location at the skull base, is ideal for sex identification. Statistical shape analysis provides a simultaneous comparison of geometric information on different shapes in terms of size and shape features. This study aimed to investigate the geometric morphometry of the inter-mastoid triangle as a tool for sex determination in the Iranian population. Materials and Methods: The coordinates of 5 landmarks on the mastoid process on the 80 cone-beam computed tomographic images(from individuals aged 17-70 years, 52.5% female) were registered and digitalized. The Cartesian x-y coordinates were acquired for all landmarks, and the shape information was extracted from the principal component scores of generalized Procrustes fit. The t-test was used to compare centroid size. Cross-validated discriminant analysis was used for sex determination. The significance level for all tests was set at 0.05. Results: There was a significant difference in the mastoid size and shape between males and females(P<0.05). The first 2 components of the Procrustes shape coordinates explained 91.3% of the shape variation between the sexes. The accuracy of the discriminant model for sex determination was 88.8%. Conclusion: The application of morphometric geometric techniques will significantly impact forensic studies by providing a comprehensive analysis of differences in biological forms. The results demonstrated that statistical shape analysis can be used as a powerful tool for sex determination based on a morphometric analysis of the inter-mastoid triangle.

• Korean Journal of Acupuncture
• /
• 제39권3호
• /
• pp.84-90
• /
• 2022

Objectives : Acupoints are divided into three categories: classical acupoints, extra-acupoints, and Ashi points. The aim of this study was to understand the meaning and features of Ashi points. Methods : We examined the original meaning of Ashi points from the classical medical texts, including the Beijiqianjinyaofang, the Essential Prescriptions Worth a Thousand Gold for Emergencies, and the Huangdi Neijing, the Yellow Emperor's Canon of Internal Medicine. Results : First, the Ashi method is to locate the points for the acupuncture and moxibustion based on the patients' reactions mainly manifested by sensations of comfort and pain, which can help identify not only Ashi points but also classical and extra-acupoints. Thus, Ashi points may or may not match to classical or extra-acupoints, and we propose that Ashi points should not be classified mutually exclusive to classical or extra-acupoints. Second, there are several similarities between Ashi points and myofascial trigger points. They are located by palpation and have no fixed anatomical positions. Patients experience painful but pleasant feeling when Ashi and myofascial trigger points are pressed, and stimulation of these points have treatment effects. Conclusions : We suggest that Ashi method be used to identify the acupoints based on how patients react when these points are pressed. Ashi points may or may not correspond to classical or extra-acupoints, and share traits with myofascial trigger points.

• Journal of Oral Medicine and Pain
• /
• 제47권3호
• /
• pp.148-151
• /
• 2022

Obstructive sialadenitis, one of the diseases that most frequently causes swelling and pain in the salivary glands, is mainly caused by structural obstructions. Sialolithiasis is the most frequent cause of the disease, and other causes include calculus formation, duct strictures, foreign bodies, and anatomical variations. Although there is a possibility that facial fillers directly block the salivary ducts, no cases of obstructive sialadenitis associated with them have been reported yet. We report the case of a 34-year-old female patient who complained of recurrent swelling and pain in the left buccal mucosa. She had undergone facial filler injection procedures on her facial area for cosmetic purposes several years before. Based on the findings of magnetic resonance imaging (MRI) and MR sialography, she was diagnosed with obstructive sialadenitis due to facial fillers. Through this case, we should remember to obtain a thorough history including filler treatments in the case of parotid gland swelling. We also suggest proper utilization of advanced imaging such as MRI in evaluating the location of facial fillers.