• Archives of Plastic Surgery
• /
• 제32권2호
• /
• pp.245-249
• /
• 2005

Various surgical procedures have been described for treating osmidrosis axillare. Elimination of the apocrine glands is prime goal. Optimal operative procedure is characterized as follows: minimal axillary scar(which has cosmetic merits), less complications such as hematoma and seroma, short and less painful recuperating period, minimal damage to the skin and low recurrence rate. Three types of incision technique in subdermal shaving method have beeb commoly used. First, single incision method has an advantage of minimal scarring but more recurrence due to incomplete removal of apocrine glands may occur. Second, double incision technique(Bipedicled flap) has advantages of complete excision, low recurrence rate and relatively minimal scarring, but it could cause frequent necrosis of skin and folding of skin flap. Skoog's method is the third method, which makes four flaps by offset cruciate incisions. It is a better technique in aspect of complete excision of apocrine glands and low recurrence rate but has disadvantages such as development of hypertrophic scar or scar contracture in the line that lies perpendicular to natural axillary skin crease. We used a modified procedure which has shorter length in vertical and transverse incision compared with the classic Skoog's method. We dissected further subcutaneous tissue through the diamond-shaped incision and utilize wide operation field that provide adequate excision of subdermal tissue and proper hemostasis. Between 1999 and 2004, we operated 160 osmidrosis axillare in 80 patients in this technique. Most patients obtained satisfactory result with very low complications. Hematoma or seroma 3.1% Infection 0.6% Partial wound disruption 10% Recurrence 1.2%. Modified Skoog's method for treating osmidrosis axillae could be a optimal technique providing wide operation field for adequate excision of apocrine glands and proper hemostasis and leaving relatively inconspicuous scar and low incidence of scar contracture.

• Archives of Plastic Surgery
• /
• 제37권2호
• /
• pp.169-174
• /
• 2010

Purpose: Reduction mammaplasty is a procedure with a relatively high patient satisfaction rate, however, associated scarring around the areola can be a serious problem. This study proposes a new modification of the breast reduction procedure by means of an inframammary incision alone. Methods: The breast is marked out preoperatively with standing position. Under the general anesthesia, an inframammary incision of approximately 7 - 8 cm is done. The subcutaneous plane is made in the lower pole of the breast, then the subglandular plane is entered and a sharp dissection is made up to 2 cm below the areola. The breast is mobilized from the chest wall and a cone-shaped parenchyme is removed in en-block except from the retroareolar central part. The remaining both pillars are gathered together with absorbable sutures and the base of the gland is narrowed to project the breast forward. The wound is closed in a layered fashion and taping of the breast mound is applied to redistribute the breast skin. Results: 21 patients (36 breasts) underwent this procedure from December 2004 to December 2009. Average follow up was 9 months (ranged from 6 months to 12 months). No major complication occurred. Most patients were pleased with the breast size, shape, and scars. However, 2 patients complained their hypertrophic scars which were corrected by revision. Conclusion: This technique is a simple approach to mild to moderate breast reduction through an inframammary incision alone. And, this technique provides an option with minimal complications and invisible scarring, which is especially important in the young patient group.

• 대한지리학회지
• /
• 제42권3호
• /
• pp.388-404
• /
• 2007

강원도의 내린천, 연곡천, 골지천, 오십천을 대상으로 영동 및 영서 하천의 하안단구 발달 과정을 지구조적인 측면에서 분석하였다. 하안단구 분포 패턴과 하천 하각 속도를 분석, 검토한 결과, 4개 하천 중 오십천 상류의 하안단구 4면, 5면, 6면에서는 태백산맥을 축으로 한 지반 융기의 영향이 뚜렷이 확인되었다. 태백산맥 분수계가 융기축이라면 영서하천 상류부 폭 $30\sim40km$ 구간이 융기대에 해당된다. 융기대 내부에 위치하는 내린천의 중 상류와 골지천 유역 전체는 하천 전 구간에서 융기작용이 활발하여, 상 하류 간의 융기량에 따른 하상비고 차이는 나타나지 않는다. 하안단구 2면$\sim$1면 사이와 1면$\sim$현재까지의 하각 속도는 두 시기의 기후 조건 차이로, 각각 $0.13\sim0.22m/ka,\;0.17\sim0.27m/ka$로 다르게 나타났다. 하안단구 1면 형성 이후부터 현재까지 영서 하천에 비해 영동 하천의 하각 속도가 다소 높다. 이는 하천 대부분 구간이 융기대에 포함되는 영서 하천에 비하여, 영동 하천은 하구가 최종적인 침식기준면인 해수면이므로 하각작용이 보다 활발했기 때문이다.

• 대한지리학회지
• /
• 제49권1호
• /
• pp.1-17
• /
• 2014

본 연구는 태백산맥 남부에 위치한 울진 광천, 평해 남대천, 영덕 오십천을 대상으로 하안단구 지형 특성,분포, 형성시기, 하각률을 분석하여, 지반융기와 기반암 특성에 의한 하안단구 형성과정을 추정하였다. 울진 광천 상류부의 구조 및 기후단구 1면은 하상비고 9~12m, 형성 시기는 MIS 2, 하각률은 0.40m/ka로 분석되었으며, 영덕 오십천 상류부의 구조 및 기후단구 1면은 하상비고 7~10m, 형성 시기는 MIS 3, 하각률은 0.10m/ka로 계산되었다. 이러한 결과는 울진 광천 유역이 영덕 오십천 유역에 비해 상대적으로 지반 융기율이 클 가능성을 의미한다. 울진 광천의 하류부는 영덕 오십천과 달리 해면변동단구가 확인되지 않는데, 울진 광천은 큰 융기율과 풍화 침식에 강한 기반암으로 인해 하곡에서 지형의 잔존 가능성이 낮은 것으로 보인다. 한편, 연구 대상 하천의 구조 및 기후단구는 가장 낮은 단의 형성시기가 다르고, 간빙기 내 기온 저하기와 아간빙기에 형성된 단구면도 확인되었다. 따라서 기존 기후단구 모델에 따른 하안단구 편년 방법에 대해 재고할 필요가 있다.

• Archives of Plastic Surgery
• /
• 제36권6호
• /
• pp.727-734
• /
• 2009

Purpose: The Inaba's procedure, the treatment of osmidrosis axillae, has the advantages of low recurrent rate and easy to learn, yet it produces early postoperative discomfort and scar formation by tie - over dressing. The authors modified the Inaba's procedure by using delayed suture of the incision wound and omitting tie - over dressing. The comparative study of Inaba's procedure and its modification was performed to confirm the advantages of modified procedure. Methods: The study contains the retrospective analysis of the medical records of 296 patients with osmidrosis who were treated using the Inaba's procedure from December, 1996 to February, 2007. The study also contains the prospective analysis of 20 patients, from March, 2007 to July, 2008, who were treated by the modified Inaba's procedure with delayed suture of the incision wound and gentle pressure dressing instead of tie - over dressing. The operative results of two groups were compared and verified by Mann - Whitney U test(SPSS 12.0). Results: The incidence of complications was 14.5% in the Inaba's procedure, whereas 6.2% in the modified Inaba's procedure. Both procedures have the same basic surgical procedure in terms of the location of incision site and subdermal shaving of the sweat glands, and therefore similar good results were obtained in the aspect of postoperative axillary odor, recurrent rate and postoperative condition of axillary hair. Certainly, the modified Inaba's procedure had better outcome in each element of PSS(Patient Scar Self-Rating Scale), compared to the Inaba's procedure. In addition, the modified Inaba's procedure showed a statistical significance in dressing - related pain reduction and overall satisfaction. Conclusion: The modified Inaba's procedure had advantages of decreased early postoperative complications such as hematoma, discomfort and pain caused by tie - over dressing, and decreased scar formation. However, the drawback was delayed suture of the incision wound after 48 hours.

• Journal of Minimally Invasive Surgery
• /
• 제21권4호
• /
• pp.148-153
• /
• 2018

Purpose: Single incision laparoscopic appendectomy (SILA) is a widely used surgical procedure for treatment of appendicitis with better cosmesis. However, many surgeons generally tend to choose conventional multiport laparoscopic appendectomy regarding with complicated appendicitis. The aim of this study is to demonstrate the safety and feasibility of SILA for treatment of complicated appendicitis by comparison with 3-ports conventional laparoscopic appendectomy (CLA). Methods: Retrospective chart review of patients diagnosed appendicitis at single hospital during January 2015 to May 2017 collected 500 patients. Among 134 patients with complicated appendicitis, we compared outcomes for 29 patients who got SILA and 105 patients who got CLA. Results: 179 and 321 patients were treated by SILA and CLA, respectively. 134 (26.8%) patients were treated for complicated appendicitis, 29 patients by SILA and 105 patients by CLA, respectively. There was no case converted to open or added additional trocar in both groups. There were no differences in demographics with regard to age, sex, body mass index (BMI), and American society of anesthesiologists (ASA) scores. There was no difference in mean operating time ($58.97{\pm}18.53$ (SILA) vs. $57.57{\pm}21.48$ (CLA), p=0.751). The drain insertion rate (6.9% vs 37.1%, p=0.001) and the length of hospital stay ($2.76{\pm}1.41$ vs. $3.97{\pm}2.97$, p=0.035) were lower in SILA group with significance. There was no significant difference in the rate of surgical site infection (6.9% vs. 6.7%, p=1.000). Conclusion: This study demonstrates that SILA is a feasible and safe procedure for treatment of complicated appendicitis.

• 대한지리학회지
• /
• 제44권4호
• /
• pp.447-462
• /
• 2009

본 연구는 태백산맥의 남쪽 말단부에 위치하며 유역 분지의 대부분이 퇴적암으로 구성된 고현천을 대상으로, 하안단구 지형 분류 및 퇴적물 분석을 통해 하안단구의 분포 특성과 형성 과정을 고찰하였다. 고현천 하곡에는 1면$\sim$3면의 하안단구가 발달해 있으며, 충적층의 퇴적 상태와 암석 하상의 존재로 판단할 때, 침식단구일 가능성이 높다. 고현천 하안단구 1면의 형성시기는 약 37,000년 전으로 MIS(Marine Oxygen Isotope Stage) 3시기에 해당하며, 하안단구 2면은 약 113,000년 전으로 MIS 5시기에 해당된다. 따라서 고현천의 하안단구는 상대적으로 온난한, 빙기 내의 아간빙기 또는 간빙기 내의 냉량기에 형성된 것으로 추정된다. 고현천 하안단구 1면의 하각률은 0.054m/ka, 2면의 하각률은 0.115m/ka로 계산되었는데, 이는 낮은 지반 융기율과 부족한 유량으로 인해 우리나라의 다른 하천보다 낮은 하각률을 나타내는 것으로 판단된다.

• Journal of Chest Surgery
• /
• 제55권1호
• /
• pp.44-48
• /
• 2022

Background: Although classical multi-port video-assisted thoracic surgery has been widely performed, single-incision thoracoscopic surgery (SITS) is a popular surgical technique for the treatment of primary spontaneous pneumothorax (PSP). However, the inconvenient alignment of instruments and the limited field of view occasionally make surgeons convert from SITS to multi-port surgery or extend the incision. This study aimed to present an easy and safe SITS technique for PSP using a spinal needle. Methods: In total, 139 patients underwent SITS between May 2011 and December 2017. We used a spinal needle to hook the bulla or bleb, and wedge resection was performed through a small incision. Patients' medical records were reviewed retrospectively, and a telephone survey was conducted to investigate the recurrence rate. Results: The mean age of the 139 patients was 23.62±9.60 years. The mean operative time was 36.69±14.64 minutes, and multi-port conversion was not performed. The mean postoperative hospital stay was 3.00±0.78 days, and the mean indwelling chest tube duration was 1.97±0.77 days. No complications were observed. In the mean follow-up period of 86.75±23.20 months, recurrence of pneumothorax was found in 3 patients. Conclusion: We suggest that SITS for PSP with the aid of a spinal needle to replace a grasper is a safe and easy technique that only requires a small incision.

• Journal of Chest Surgery
• /
• 제55권6호
• /
• pp.462-469
• /
• 2022

Background: Carotid endarterectomy (CEA) is used to treat carotid stenosis, which is associated with cerebral infarction and may result in neurologic deficits such as stroke, transient ischemic attack (TIA), and local nerve injury. To decrease surgery-related complications and improve patient satisfaction with esthetic outcomes, efforts have been made to minimize incision size instead of using a standard longitudinal incision. Methods: We performed a retrospective analysis of 151 cases of CEA, of which 110 used conventional incisions and 41 used high mini-skin incisions (HMIs), from March 2015 to December 2021 at a single institution. Short-term (30-day) postoperative results were evaluated for rates of mortality, stroke, TIA, and cranial/cervical nerve injuries. Risk factors for nerve injury were also assessed. Results: The HMI group showed significantly (p<0.01) shorter operative and clamp times than the conventional group. The HMI group also had significantly shorter incision lengths (5.3±0.9 cm) than the conventional group (11.5±2.8 cm). The rates of stroke, TIA, and death at 30 days were not significantly different between the 2 groups. There was no significant difference in the rate of cranial and cervical nerve injuries, and all injuries were transient. A high lesion level (odds ratio [OR], 9.56; 95% confidence interval [CI], 3.21-28.42; p<0.01) and the clamp time (OR, 1.07; 95% CI, 1.03-1.12; p<0.01) were found to be risk factors for nerve injuries. Conclusion: Use of the HMI in CEA for carotid stenosis was advantageous for its shorter operative time, shorter internal carotid artery clamp time, reduced neurologic complications, and improved esthetics.

• Clinical Endoscopy
• /
• 제55권5호
• /
• pp.615-625
• /
• 2022

Background/Aims: Mucosal incision-assisted biopsy (MIAB) for tissue acquisition (TA) from subepithelial lesions (SELs) is emerging as an alternative to endoscopic ultrasound (EUS)-guided TA. Only a limited number of studies compared the diagnostic utility of MIAB and EUS for upper gastrointestinal (GI) SELs; therefore, we conducted this systematic review and meta-analysis. Methods: A comprehensive literature search from January 2020 to January 2022 was performed to compare the diagnostic accuracy and safety of MIAB and EUS-guided TA for upper GI SELs. Results: Seven studies were included in this meta-analysis. The pooled technical success rate (risk ratio [RR], 0.96; 95% confidence interval [CI], 0.89-1.04) and procedural time (mean difference=-4.53 seconds; 95% CI, -22.38 to 13.31] were comparable between both the groups. The overall chance of obtaining a positive diagnostic yield was lower with EUS than with MIAB for all lesions (RR, 0.83; 95% CI, 0.71-0.98) but comparable when using a fine-needle biopsy needle (RR, 0.93; 95% CI, 0.83-1.04). The positive diagnostic yield of MIAB was higher for lesions <20 mm (RR, 0.75; 95% CI, 0.63-0.89). Six studies reported no adverse events. Conclusions: MIAB can be considered an effective alternative to EUS-guided TA for upper GI SELs without an increased risk of adverse events.