• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.2
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• pp.100-106
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• 2013

There are many challenges for reconstruction after intraoral tumor resection. Especially, palatomaxillary reconstruction has two primary goals: closure of the oronasal communication and re-creation of proper myomucosal function. Prosthodontic treatment using obturator and several surgical procedures are selected depending on the size and site of the defect, the difficulty of operative procedure, operation time and donor site problem. Above all, it is considered that radial forearm free flap is the first choice for palatal reconstruction. Our department introduces a novel method using tunnelized-facial artery myomucosal island flap for palatomaxillary defect reconstruction, which can successfully reduce donor-site morbidity, and duration of surgery and hospitalization.

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.1
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• pp.134-138
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• 1999

연구개는 그 주위조직과 더불어 생리적 기능에 있어 음성, 연하, 및 호흡 등에 중요한 역할을 한다. 종양등의 이유로 인한 연구개의 외과적 절제는 그 해부학적 크기와 모양의 영구적인 변화로 인해 여러기능의 상실을 초래한다. 이에 따른 결함은 과도한 비음, 연하중 음식물이나 유동물의 비관으로의 누출 등을 들 수 있다. 연구개와 그 주위조직의 생리적인 기능의 숙지 및 이를 응용한 보철물(Palatopharyngeal Obturator)의 적절한 제작은 이러한 기능적 결함을 수복하는데 이용되어진다. 본 증례에서는 종양으로 인해 연구개를 절제한 환자의 보철적 수복에 있어, 구강내 온도에 따라 그 형상이 변화하는 인상재를 이용하여, 측-후 인두벽의 운동을 기능적으로 인기하는 방법을 이용하였다. 이러한 방법으로 제작된 보철물은 종양으로 인한 연구개의 절제 후 생리적인 기능의 장애를, 올바른 Palatopharyngeal 폐쇠를 유도함으로써 음질의 향상, 연하등의 기능을 회복시키는데 큰 도움이 될 수 있음을 보여준다.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.4
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• pp.161-169
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• 2008

Objectives : This study was carried out to investigate the relationship of pelvic alignment between AP view of the pelvis in standing and supine position. Methods : Sixteen healthy peoples who get $51.59{\pm}4.14$ as average in SF-36 were evaluated by X-ray findings. After measuring innomiate measurement, off centering measurement, sacral ala measurement, illium shadow measurement, the area of obturator foramen, those were analyzed statistically. Results : It was not all to be corresponded to distort pelvic alignment of AP view of the pelvis in standing and in supine. Sometimes it was the opposite result. Conclusions : These results suggest that the diagnosis of pelvic alignment to go through on each position is brought about disagreement with each other.

• Imaging Science in Dentistry
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• v.51 no.2
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• pp.203-208
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• 2021

Ghost cell odontogenic carcinoma (GCOC) is a rare malignant neoplasm characterized by the presence of ghost cells. It is considered to originate from either a calcifying odontogenic cyst(COC) or a dentinogenic ghost cell tumor(DGCT). Its clinical and radiographic characteristics are non-specific, including slow growth, locally aggressive behavior, and eventual metastasis. This case report describes a 43-year-old Thai man with plain radiographs and cone-beam computed tomographic images revealing a unilocular radiolucency with non-corticated borders surrounding an impacted left canine associated with radiopaque foci around the cusp tip. Based on the microscopic findings, the lesion was diagnosed as GCOC. Partial maxillectomy of the right maxilla was performed, and radiotherapy was administered. An obturator was made to support masticatory functions Three years later, the lesion showed complete bone remodeling and no signs of recurrence, and long-term follow-up was done regularly.

• Archives of Plastic Surgery
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• v.49 no.6
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• pp.724-728
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• 2022

Various flaps are used to reconstruct skin and soft tissue defects of the vulva following resection of malignancies. Whenever possible, reconstruction using local flaps is the standard treatment. Here, we describe vulvar defect reconstruction using keystone flaps. Standard keystone flaps are based on randomly located vascular perforators. However, we designed a keystone flap that includes perforators of three named arteries (the anterior labial artery of the external pudendal artery, cutaneous branches of the obturator artery, and posterior labial artery of the internal pudendal artery) and the pudendal nerve, which accompanies the internal pudendal artery. Four patients with squamous cell carcinoma and extramammary Paget's disease of the vulva underwent radical vulvectomy and keystone flaps including perforators of three arteries. Depending on the morphology of the defects, keystone flaps were used with different designs. For elliptical and unilateral vulvar defects, a standard keystone flap was designed, and for defects on both sides of the vulva, a double opposing keystone flap was used. For oval defects, the omega variant keystone flap was designed, and when the morphology of the defect needed rotation of the flap, a rotational keystone flap was designed. All the patients showed good function and sensation, with an acceptable cosmetic appearance.

• Journal of Medicine and Life Science
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• v.20 no.4
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• pp.166-171
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• 2023

Mixed urinary incontinence (UI) is common in women. This study aimed to assess the efficacy of anti-incontinence surgery in female patients with equally severe stress UI (SUI) and urge UI (UUI). All patients had equal severity of SUI and UUI. The postoperative cure rate was categorized into the cure group (CG) and failure group (FG). Postoperative satisfaction was categorized into the satisfaction group (SG) and the dissatisfaction group (DG). Statistical significance was set at P<0.05. Ninety patients (SG, 73.3%; DG, 26.7%; CG, 93.3%; FG, 6.7%) were included in the study. In the univariate analysis, body mass index (BMI), total bladder capacity, and overactive bladder symptom score (OABSS) were significantly different between the SG and DG groups. Peak urinary flow, Valsalva leak point pressure (VLPP), and OABSS were significantly different between the CG and FG groups. In the multivariate analysis, OABSS (P=0.001) and BMI (P=0.032) were independent predictors of postoperative satisfaction. VLPP (P=0.023) was the only independent factor associated with the postoperative cure rate. In equal severity of SUI and UUI, VLPP was found to be the only independent factor associated with postoperative cure rates. Higher VLPP values were associated with higher cure rates. BMI and OABSS were identified as independent predictors of postoperative satisfaction, with lower BMI and OABSS associated with higher postoperative satisfaction.

• Journal of the Korean Society of Radiology
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• v.84 no.6
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• pp.1403-1407
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• 2023

Lymph node metastasis from bladder cancer mainly involves the external/internal iliac and obturator nodes as the primary lymphatic drainage sites of the bladder, and common iliac sites as the secondary drainage. Lymph node involvement above the diaphragm is rare. Metastasis to the head and neck region is associated with poor prognosis and low survival rate. Herein, we report a case of cervical cutaneous and lymph node metastases in a patient with bladder cancer. This is a rare case of advanced urothelial carcinoma presenting as an aggressive inflammatory process with extensive lymph node involvement, without bony or visceral metastasis.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5505-5510
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• 2012

Objective: The aim of this retrospective study is to analyze the clinical and pathological factors related to the prognosis of Chinese patients with stage Ib to IIb cervical cancer. Methods and Results: 13 clinical pathological factors in 255 patients with stage Ib to IIb cervical cancer undergoing radical hysterectomy and systematic lymphadenectomy were analyzed to screen for factors related to prognosis. The cumulative 5-year survival of the 255 patients was 75.7%. The result of the univariate analysis suggested that clinical stage, cell differentiation, depth of cervical stromal invasion, parametrial tissue involvement, and lymph node metastasis were prognostic factors for patients with stage Ib to IIb cervical cancer (P<0.05). Compared with cases with involvement of iliac nodes, obturator nodes, or inguinal lymph nodes, cases with metastasis to the common iliac lymph nodes had a poorer prognosis (P<0.05). Cases with involvement of four or more lymph nodes had a poorer prognosis than those with involvement of three or fewer lymph nodes (P<0.05). Using multivariate Cox proportional hazards model regression analysis, non-squamous histological type, poor differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion were found to be independently related to patients poor prognosis (P<0.05). Conclusion: Non-squamous histological type, poor cell differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion are the independent poor prognostic factors for patients with stage Ib to IIb cervical cancer.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.2
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• pp.77-83
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• 2016

Objectives: To evaluate the effectiveness of regenerative tissue matrix (Alloderm) as an oral layer for difficult anterior palatal fistula closure. Materials and Methods: The authors have tested the feasibility of a novel surgical technique of adding a regenerative tissue matrix (Alloderm) as an oral layer for closure of recalcitrant large anterior palatal fistulae and report the outcome of the first 12 patients in this pilot study. Patients with recurrent large fistula who otherwise would require either a local pedicled flap, free flap, or an obturator were treated with this technique and followed up for at least 6 months to monitor the progress of healing. Results: Of the 12 patients, 8 patients (66.7%) had complete closure of the fistula, and 2 patients (16.7%) showed reduction in size of the fistula to the extent that symptoms were eliminated, for an overall success rate of 83.3% (10/12 patients). Premature graft loss and recurrence of the fistula were noted in 2 patients (16.7%). Conclusion: Alloderm provided an adequate barrier allowing healing to occur unimpeded and allowed closure of the palatal fistula. In our experience, this new technique using regenerative tissue matrix as an adjunct to the oral layer in large anterior palatal fistula has an advantage compared to other more invasive complex procedures and has been shown to provide satisfactory results.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.144-148
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• 2015

Purpose: Immediate identification of vascular injury requiring embolization in patients with pelvic bone fracture isn't an easy task. There have been many trials finding indicators of embolization for patients with pelvic bone fracture. Although Young and Burgess classification is useful in decision making of treatment, it is reported to have little value as indicator of embolization in major trauma patients. The aim of this study is to find out Young and burgess classification on predicting vessel injury by analzyng pelvic radiograph taken from major trauma patients with pelvic bone fracture. Methods: Among major trauma patients with injury severity scores (ISS) higher than 15 who visited our emergency room from January 2011 to June 2014, 200 patients were found with pelvic bone fracture in trauma series and thus pelvic CT angiography was taken. Setting aside patients with exclusion criteria, 153 patients were enrolled in this study for analysis of Young and Burgess classification. Results: The most common mechanism of injury was lateral compression in both groups. There was no statistical significant difference in Young and Burgess classification (p=0.397). The obturator artery was the most commonly injured artery in both groups. Six patients had more than one site of bleeding. Conclusion: Prediction of transcatheter angiographic embolization using Young and Burgess classification in severe trauma patients is difficult and requires additional studies.