• Journal of Chest Surgery
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• v.52 no.6
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• pp.385-391
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• 2019

Background: Preoperative autologous blood donation (PABD) is a conservation strategy for reducing allogenic blood transfusion (ABT) during minimally invasive cardiac surgery (MICS). We aimed to evaluate the effects of PABD on the frequency of ABT and clinical outcomes in patients undergoing MICS. Methods: We enrolled 113 patients (47.8±13.1 years, 50 men) undergoing MICS without preoperative anemia (hemoglobin >11 g/dL) between 2014 and 2017. Of these patients, 69 (the PABD group) donated autologous blood preoperatively and were compared to the non-PABD group (n=44). We analyzed the frequency of perioperative ABT and clinical outcomes. Results: Baseline characteristics did not significantly differ between groups, although preoperative hemoglobin levels were lower in the PABD group. All operations were performed using a minimally invasive approach. Patients' surgical profiles were similar. There were no cases of mortality or significant differences in early postoperative outcomes. During the early postoperative period, hemoglobin levels were higher in the PABD group. No significant difference was found in the frequency of ABT. Conclusion: Although the PABD group had higher postoperative hemoglobin levels, there was no clear clinical benefit in the early postoperative period, despite a great deal of effort and additional cost. Additional PABD in the setting of strict policies for blood conservation was ineffective in reducing ABT for young and relatively healthy patients who underwent MICS.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.1
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• pp.20-31
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• 1995

The need to assess preoperative psychological characteristics of orthognathic surgery patients has recently been recognized. Fifty six patients were involved in this study, they were investigated in the preoperative psychosocial aspects. Korean Version Eysenk Personality Questionaire and Korean Version Tennessee Self-Concept Scale were used for psychological test. The results were as follows : 1. There was no significant difference of sex and age in the personality dimension, the selfconcept scale, and the preoperative tests(P>0.05). 2. 37% of subjects showed phonetic problem, 60% masticatory problem and 56% social problem for facial deformity. The first choice was the face in the order of correction for mastication, phonation and face. And 83% of the subjects forecasted the change in their face after surgical correction, The answer was generally vague. 64% of the subjects expected their personality to become more lively as a result of their operation. 3. Total positive self score and personal self score were less improved in the groups with high scores of toughmindness and neuroticism(P<0.05), degree of suffering was increased in the group with high scores of neuroticism(P<0.05). 4. Degree of subjective deformity, self-consciousness, and degree of dissimilarity were more improved in the group of intraversion, there was a significant correlation with degree of dissimilarity in the group with high score of toughmindness(r=-.64, P<0.05). 5. There was a significant correlation with the forecast of change in the groups with high score in extraversion(r=.59, P<0.01) and with low score in neuroticism(r=-.39, P<0.05).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.46.1-46.9
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• 2019

Background: Oral squamous cell carcinoma (OSCC) constitutes a group of tumors that exhibit heterogeneous biology, histopathology, and clinical behaviors. Case presentation: A 73-year-old male had a whitish leukoplakia-like lesion around inflamed peri-implant area (#42, #43, and #44), and this lesion had transformed to OSCC within 3 years. He underwent mass resection, selective neck dissection, and reconstructive surgery. To detect any carcinogenesis progression, we examined the removed tumor tissue as well as the patient's preoperative and postoperative sera to identify causative oncogenic proteins using immunoprecipitation high-performance liquid chromatography (IP-HPLC). Conclusions: The protein expression levels of p53, E-cadherin, β-catenin, MMP-10, HER2, NRAS, Met, HER2, and ERb were significantly lower in the serum collected on postoperative day 10 than in the preoperative serum, and if these proteins are consistently not elevated in the serum 3 months after surgery compared with the preoperative serum, these proteins can be potential oncogenic proteins. However, we also found that the serum extracted 3 months after the operation had elevated levels of oncogenic proteins compared with that of the preoperative and 10-day postoperative serum indicating the possibility of tumor recurrence. At postoperative follow-up period, ipsilateral neck metastasis and second primary lesion were found and additional surgery was performed to the patient. IP-HPLC using the patient's serum shows the possibility of oncogenic protein detection. However, follow-up IP-HPLC data is needed to find out patient-specific prognostic factors.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.74-80
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• 2005

Purpose: A retrospective review of the radiographs of the proximal metatarsal osteotomy and distal soft tissue procedure for hallux valgus, evaluating the correction of the tibial sesamoid, was undertaken. We evaluated the correlation between the reduction of the tibial sesamoid and the clinical outcomes. Materials and Methods: 17 patients (23 cases) with moderate to severe hallux valgus deformity underwent the proximal metatarsal osteotomy and distal soft tissue procedure. The preoperative and last follow-up radiographs were reviewed according to the tibial sesamoid grade classification recommended by the Research Committee of the American Orthopedic Foot and Ankle Society (AOFAS). We divided them into two groups according to the reduction of the tibial sesamoid. We anaylyzed the clinical outcomes in each group according to Mayo Clinic Forefoot Scoring System (FFSS). Results: In all of the patients, the preoperative tibial sesamoid position were grade 2 or greater. At the last follow-up, 52% (n=12) were grade 1 or less (Group I) and 48% (n=11) were grade 2 or greater (Group II). In group I, the forefoot score was improved from preoperative mean value of 32.0 points to final follow-up value of 66.3 points. In group II, the forefoot score was improved from preoperative mean value of 31.7 points to final follow-up value of 65.9 points. There was no statistical significance between postoperative, average scores in group I and II (p>0.05). Conclusion: The position of the tibial sesamoid was corrected insufficiently in almost half of all cases. In view of clinical outcomes, there was no significant difference between the corrected group and the other group.

• Archives of Craniofacial Surgery
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• v.14 no.1
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• pp.11-15
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• 2013

Background: In cleft lip patients, the necessity of a thorough preoperative analysis of facial deformities before reconstruction is unquestioned. The surgical plan of cleft lip patient is based on the information gained from our preoperative anthropometric evaluation. A variety of commercially available three-dimensional (3D) surface imaging systems are currently introduced to us in plastic surgery for these use. However, few studies have been published on the soft tissue morphology of unrepaired cleft infants described by these 3D surface imaging systems. Methods: The purpose of this study is to determine the accuracy of facial anthropometric measurements obtained through digital 3D photogrammetry and to compare with direct anthropometry for measurement in unilateral cleft lip patients. We compared our patients with three measurements of dimension made on both sides: heminasal width, labial height, and transverse lip length. Results: The preoperative measurements were not significantly different in both side of labial height and left side of heminasal width. Statistically significant differences were found on both side of transverse lip length and right side of heminasal width. Although the half of preoperative measurements were significantly different, trends of results showed average results were comparable. Conclusion: This is the first study in Korea to simultaneously compare digital 3D photogrammetry with traditional direct anthropometry in unilateral cleft lip patients. We desire this study could contribute the methodological choice of the many researchers for proper surgical planning in cleft lip reconstruction field.

• Journal of Yeungnam Medical Science
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• v.21 no.2
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• pp.242-250
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• 2004

In general, the skeletal class III has the characteristics of mandibular overgrowth with a normal maxillary growth or maxillary undergrowth with a normal mandibular growth And clinical and radiographic evaluations of the patient are needed. However, the treatment plan is not dependent on these evaluations alone, because patient's general condition and hope for aesthetics varies. The aim of this report is to consider the treatment of a medically compromised patient with an anterior open bite and skeletal class III, which showed a severe mandibular overgrowth. In 2003, a 17-year-old boy with epilepsy, mental retardation presented at our clinic complaining of concave profile. A clinical examination showed severe mandibular prognathism with an anterior open bite. The radiographic examination revealed a short cranial base, a moderate maxillary overgrowth, severe mandibular overgrowth and skeletal open bite tendency. In 2004, he was verified to have no potential of growth by hand-and-wrist radiographs and an endocrine examination. He completed the preoperative orthodontic treatment and orthognathic surgery (sagittal split ramus osteotomy, genioplasty). He was evaluated on the first visit, the preoperative period and the postoperative period with a clinical and radiographic examination. At the first visit, the patient showed moderate overgrowth of the maxilla, severe overgrowth of the mandible, and a subsequential skeletal open bite. After the preoperative orthodontic treatment (preoperative period), the patient showed the same skeletal problem as before and a decompensated dentition for orthognathic surgery. After orthognathic surgery, his profile had improved, but he had still a skeletal openbite tendency because the maxillary orthognathic surgery was not performed. Severe mandibular prognathism with a maxillary overgrowth and anterior open bite should be treated by bimaxillary orthognathic surgery. However, one-jaw orthognathic surgery on the remaining the skeletal open bite tendency was performed for his medical problem and facial esthetics. This subsequential open bite should be resolved with a postoperative orthodontic treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3703-3708
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• 2015

Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with colorectal, lung, gastric cancer, pancreatic and metastatic renal cell carcinoma. We here evaluated whether preoperative NLR is an independent prognostic factor for non-metastatic renal cell carcinoma (RCC). Materials and Methods: Data from 327 patients who underwent curative or palliative nephrectomy were evaluated retrospectively. In preoperative blood routine examination, neutrophils and lymphocytes were obtained. The predictive value of NLR for non-metastatic RCC was analyzed. Results: The NLR of 327 patients was $2.72{\pm}2.25$. NLR <1.7 and NLR ${\geq}1.7$ were classified as low and high NLR groups, respectively. Chi-square test showed that the preoperative NLR was significantly correlated with the tumor size (P=0.025), but not with the histological subtype (P=0.095)and the pT stage (P=0.283). Overall survival (OS) and disease-free survival (DFS) were assessed using the Kaplan-Meier method. Effects of NLR on OS (P=0.007) and DFS (P=0.011) were significant. To evaluate the independent prognostic significance of NLR, multivariate COX regression models were applied and identified increased NLR as an independent prognostic factor for OS (P=0.015), and DFS (P=0.019). Conclusions: Regarding patient survival, an increased NLR represented an independent risk factor, which might reflect a higher risk for severe cardiovascular and other comorbidities. An elevated blood NLR may be a biomarker of poor OS and DFS in patients with non-metastatic RCC.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1775-1781
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• 2014

Background: To assess the long term clinical outcome of preoperative radiotherapy with or without chemotherapy followed by limb sparing surgery in patients with non-metastatic soft tissue sarcomas (STS) of the extremities. Materials and Methods: Sixty patients with locally advanced STS were retrospectively analyzed. The median tumor diameter was 12 cm. All patients were treated with preoperative radiotherapy delivered with two different fractionation schedules (35Gy/10fr or 46-50Gy/23-25fr). Neoadjuvant chemotherapy was added to 44 patients with large and/or high grade tumors. Surgery was performed 2-6 weeks after radiotherapy. Chemotherapy was completed up to 6 courses after surgery in patients who had good responses. Results: Median follow-up time was 67 months (8-268 months). All of the patients had limb sparing surgery. The 5-year local control (LC), disease free (DFS) and overall survival (OSS) rates for all of the patients were 81%, 48.1% and 68.3% respectively. 5-year LC, DFS and cause specific survival (CSS) were 81.7%, 47%, 69.8%, and 80%, 60%, 60% in the chemoradiotherapy and radiotherapy groups, respectively. On univariate analysis, patients who were treated with hypofractionation experienced significantly superior LC, DFS and CSS rates with similar rates of late toxicity when compared with patients who were treated with conventional fractionation and statistical significance was retained on multivariate analysis. Conclusions: Treatment results are consistent with the literature. As neoadjuvant chemoradiotherapy provides effective LC and CSS with acceptable morbidity, it should be preferred for patients with large and borderline resectable STS.

• Clinics in Shoulder and Elbow
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• v.18 no.3
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• pp.138-143
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• 2015

Background: To evaluate the effect of preoperative fatty degeneration of deltoid and teres minor muscles on the clinical outcome in patient with reverse total shoulder arthroplasty (RTSA). Methods: Nineteen patients with RTSA were enrolled. The mean follow-up period was 16.1 months. The fatty degeneration of three distinct parts in each deltoid and the teres minor muscle was measured using a preoperative magnetic resonance imaging. Postoperatively, the muscle strengths for forward elevation (FE), abduction (Abd), and external rotation (ER) were measured using a myometer at the last follow-up. The parameters for clinical outcome were Constant Score (CS) and Korean Shoulder Score (KSS). Results: The number of cases was 10 in group 1 and 9 in group 2. The strength of FE and Abd were significantly higher in group 1 (p<0.001 and p<0.001, respectively), and the strength of ER was not different significantly between two groups (p=0.065). For the clinical outcome, both CS and KSS were higher in group 1 (p=0.002 and p=0.002, respectively). The number of patients in group A was 11, and group B was 8. Although there was not a significant difference in terms of FE and Abd between group A and B (p=0.091, p=0.238), ER was significantly higher in group A (p=0.012). We did not find a significant difference in the clinical scores (CS, p=0.177 and KSS, p=0.238). Conclusions: These findings suggest the importance of a preoperative evaluation of the fatty degeneration of deltoid and teres minor muscles for predicting postoperative strength and clinical outcome.

• Journal of Chest Surgery
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• v.26 no.2
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• pp.141-147
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• 1993

A total of 40 patients having a diagnosis of atherosclerotic coronary arterial disease were analysed on the operative outcomes according to variables as follows: 1) preoperative risk factors such as age, sex, CCS (Canadian Cardiovascular Society) functional class, type of angina, number of diseased vessel, presence of left main coronary artery stenosis, previous history of habitual smoking and presence of other medical diseases (diabetes mellitus, essential hypertension), 2) preoperative management such as intravenous infusion of nitroglycerine, preoperative IABP (intra-aortic balloon pump) support and whether the operation was scheduled as emergency or not, 3) intraoperative variables such as infusion method and composition of cardioplegic solutions, number of distal anastomosis, use of internal mammary artery, total cardiopulmonary bypass time and total cross clamp time. Complications included operative death in 12.5％, perioperative myocardial infarction in 25.0％ and perioperative arrhythmia in 17.5％. Nineteen perioperative variables were analyzed to identify risk factors for these end points. For operative death, presence of left main coronary artery stenosis (p = 0.056) and cardiopulmonary bypass time (p = 0.029) were significant in the univariate analysis, but presence of left main coronary artery lesion (p = 0.011, $\chi$$^2$= 6.45) and abscence of preoperative of IABP support (p = 0.069, $\chi$$^2$ = 3.30) were independent predictor in multivariate analysis (stepwise linear logistic regression).