• Journal of Chest Surgery
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• v.35 no.4
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• pp.303-306
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• 2002

Patients with severe Ebstein's anomaly showing in the neonatal period, represent progressive cardiac enlargement with pulmonary hypoplasia and functional pulmonary atresia with patent ductus alteriosus-dependent pulmonary circulation. Biventricular repair in these patients had been mostly unsuccessful except for Starnes' procedure that converts the anatomy to single ventricle physiology for Fontan procedure. A 4-days old male was admitted with the diagnosis of severe Ebstein's anomaly with anatomic pulmonary atresia and severe cardiac enlargement. He successfully underwent biventricular repair with vertical plication method of atrialized right ventricle, tricupid annuloplasty, transannular right ventricular outflow tract reconstrulltion, atrial septal defect patch closure with fenestration, and right atrial reduction angioplasty Postoperatively, cardiothoracic ratio was significantly reduced and mild tricuspid regurgitation was remnant in echocardiography. The patient is currently 10 months old and is fully active without restrictions.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.87-91
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• 2009

The surgical management of complete transposition of the great arteries, ventricular septal defect, and pulmonary stenosis still remain a significant challenge. The Rastelli (REV procedure) remains the most widely applied procedure for surgical repair of these lesions. Although the Rastelli procedure can be performed with good early results, the intermediate- and long-term results have been less than satisfactory because of deterioration of the hemodynamic performance of the LVOT or RVOT. We performed a modified Nikaidoh procedure as an alternative surgical procedure in a 19-month-old boy weighing 10.4 kg with this anomaly. Aortic translocation with biventricular outflow tract reconstruction resulted in a more "normal" anatomic repair and postoperative echocardiography showed straight, direct, and unobstructed ventricular outflow.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.367-376
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• 1997

The 234 patients who received treatment of midfacial fractures at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital from Jan. 1, 1992 to Dec. 31, 1996 were analyzed clinicostastically. Results obtained were as follows ; Male predominated over females by a ratio of 5.3 to 1. The frequently developing age groups were first 3rd (25%), 4th (21%) and the 2nd (18%) decade on succession. The peakest month was the August (16%), and May (11%), September (9%), October (9%). When it comes to the reasons for in-patients, traffic accident was predominant to 38%. In the 234 cases of midfacial fractures, zygomaticomaxillary complex fracture was the most by 37%. The most common with injury show that facial laceration marked by 49%, neurologic injury 24%, and mandibular fracture 20% each by each. About the time from injury onset to operation, 55% of cases were less than a week while the others (45%) more than a week. 3 plates were used for operation : 2 for zygoma or maxilla fracture and 3 for zygomatiomaxillary complex fracture. especially 4 for Le Fort I fracture, 5.5 for Le Fort I, II ; I, III ; II, III fracture, 7 for Le Fort I,II,III fracture were used. 20 patients (8%) appealed their complication and the most common was reported as infection. Above results suggest that early diagnosis and treatment of fracture site, systemic condition and associated injuries are necessary, and coorperative treatment with medical department should be performed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.48-58
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• 2001

After performing mandibular setback surgery, we found some changes in patterns and organs of speech. This investigation was undertaken to investigate the aspect and degree of speech patterns according to the amount of surgical setback in mandibular prognathic patients. Thirteen patients with skeletal Class III malocclusion were studied preoperative and postoperative over 6 months. They had undergone the mandible setback operation via bilateral sagittal split ramus osteotomy(BSSRO). We split the patients into two groups. Group 1 included patients whose degree of mandibular setback was 6mm or less, and Group 2 above 6mm. Control group was two adults wish normal speech patterns. A phonetician performed narrow phonetic transcriptions of tape-recorded words and sentences produced by each of the patients and the acoustic characteristics of the plosives, fricatives, and flaps were analyzed with a phonetic computer program (Computerized Speech Lab(CSL) Model 4300B(USA)). The results are as follows: 1. Generally, Patients showed longer closure duration of plosives, shorter VOT(voice onset time) and higher ratio of closure duration against VOT. 2. Patients showed more frequent diffuse distribution than the control group in frication noise energy of fricatives. 3. In fricatives, frequency of compact from were higher in group 1 than in group 2. 4. Generally, a short duration of closure for /ㄹ/ was not realized in the patient's flaps. Instead, it was realized as fricatives, sonorant with a vowel-like formant structure, or trill type consonant. 5. Abnormality of the patient's articulation was reduced, but adaptation of their articulation after surgery was not perfect and the degree of adaptation was different according to the degree of surgical setback.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.330-333
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• 2009

Alveolar bone resorption after extraction impairs the necessary bone volume and complicates the case for implant surgery and aesthetic implant prosthesis. Immediate implant surgery after extraction decreases the number of surgical procedures and the duration of treatment, while allowing minimum alveolar bone resorption and preserving the residual bone volume. Although immediate implant holds many advantages such as preservation of hard and soft tissue around the extraction socket, greater implant survival rate and higher patient satisfaction, various complications and high failure rate are discouraging factors for the clinicians. In this case report, severe alveolar bone resorption with soft tissue changes were predicted after the extraction of prolonged retained deciduous incisors and impacted maxillary canines and thus decided on immediate implant procedure. Immediate implant surgery after extraction was carried out with minimal bone reduction and tapered wide-neck implant to establish initial stability. Simultaneous bone graft was done by filling the defect area with iliac cancellous bone with additional onlay-type bone graft and absorbable membrane on the labial bone for upper lip support. A stable and esthetic result was obtained with shortened treatment period.

• Journal of the Korean Arthroscopy Society
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• v.3 no.1
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• pp.54-61
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• 1999

The current treatment of extensive meniscal injuries has resulted in numerous investigations and clinical trials to restore normal meniscal functions. A cryopreserved meniscal allograft transplantation is one of the successful methods available to restore the meniscus. All the procedures of 26 cases were performed in an minimal open fashion, though initial four cases were done with the aid of arthroscope. In all of the grafts, we used a bone bridge which was attached to meniscus for better stability and healing. Anterior cruciate ligament reconstructions were also performed simultaneously with the meniscal procedures. We attempted to minimize articular cartilage by employing so called the "Key-hole technique" for the medial meniscus transplantation. First, the meniscal cartilage bone bridge was shaped into a cylinder and a bone tunnel was made just beside the medial border of the anterior criciate ligament insertion of the recipient knee joint, and the bone bridge of the meniscal cartilage was push to press-fit. The inserted meniscal cartilage was sutured by the usually employed technique under arthroscopic control. The lateral meniscus was shaped different to the medial meniscus in that the bone bridge was semicylindrical and the bone trough was made beside the lateral border of the anterior criciate ligament insertion of the recipient knee joint. The meniscus was put into the bone trough and the leading suture was extracted anterior to the tibia and tied the knot. The inserted meniscus was sutured in the same manner as the medial meniscus transplantation. By the above described method, the authors were able to minimize the articular cartilage invasion and transplant the meniscus with relative accuracy.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.4
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• pp.151-156
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• 2001

The reported incidence of osteosarcoma of the foot varies between 0.2-2% of all osteosarcoma. Low grade osteosarcoma of the long bone represents only 1.9% of all osteosarcoma. A 38-year-old female had suffered painful mass in the proximal phalanx of the second toe for 1 year. Radiographic finding showed enlarged osteloytic mass which had penetrated thin cortex of the second toe and apparent increased uptake in bone scan was seen. Mass resection with autogenous bone graft using rib was performed. Histologically, the tumor was compatible with "low grade osteosarcoma". Second stage wide resection was performed. Because low grade osteosarcoma located in the proximal phalanx of the second toe is very rare, we report this unusual case with review of literature.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.225-229
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• 2004

Purpose: Some patients develop gastroesophageal reflux disease (GERD) after a gastrectomy for stomach cancer. Therefore, we conducted this research to gain an understanding of esophageal acidity and motility change. Materials and Methods: From July 2002 to March 2004, the cases of 15 randomized patients with stomach cancer who underwent a radical subtotal gastrectomy (RSG) with Billroth I(B-I) reconstruction (n=12) or a radical total gastrectomy (RTG) with Roux-en-Y (R-Y) gastroenterostomy (n=3) were analyzed. We investigated the clinical values of the ambulatory 24-hour pH monitoring and esophageal manometry in these patients, just before discharge from the hospital after an operation. Results: GERD was present in three patients ($20\%$). Compared with two reconstructive procedures, 3 of the 12 patients in the RSG with B-I group had GERD; however, none of RTG with R-Y group had GERD. Compared with pathologic stage, 2 of 9 patients in stage I, 1 of 2 patients in stage II, none of 3 patients in stage III, and none of 1 patient in stage IV had GERD. Esophageal manometry was performed in 10 patients. Nonspecific esophageal motility disorder (NEMD) was present in 7 patients. Conclusion: Some patients had GERD as a complication following a gastrectomy for stomach cancer. We suspect that the postoperative esophageal symptom is due to not only bile reflux but also gastroesophageal acid reflux. Therefore, careful observation is recommended for the detection of GERD.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.21-26
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• 2006

Considering the skeletal class III malocclusion that complains of mandibular prognathism, there have been some studies of the mandibular change for comparing the changes of pre operative with post operative state. Nowadays it is common to do the orthognathic 2-jaw surgery for the correction of the maxillary deficiency, the post operative stability and the esthetics. We compare and analyze the changes of soft tissue around the nose and the lip with the changes in the direction and the amount of maxilla. Patients who were diagnosed as maxillofacial deformity and received orthognathic surgery of both jaws at Yongdong Severance hospital from 2001 through 2003 were included in this study. Their lateral cephalograms were analyzed, and the post operative change of hard tissue and soft tissue were studied. Upon analyzing the preoperative cephalograms and 6 month post operative cephalograms, there were significant in the vertical change of Labialis superius(Ls) and Stomion(Stm) in soft tissue in relation to the vertical change of skeletal landmarks (Anterior Nasal Spine, Subspinale, Prosthion, Incision Superious). In addition, there were no significance in horizontal movement of the skeletal landmarks among groups. In terms of hard tissue landmarks, group 3(maxillary posterior impaction and advancement surgery group) showed significantly greater change in the vertical movement of Anterior Nasal Spine(ANS), Subspinale(A), Prosthion(Pr), and Incision Superious(Is) compared with other groups. In terms of soft tissue change, group 3 showed more significant change in the vertical movement of Ls and Stm. This study calculated the changes of the skeletal and soft tissue landmarks in order to act as a guide in planning and performing the surgery and as a reference in predicting the postoperative change of facial appearance.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.263-269
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• 2001

Median cleft of the lower lip and/or mandible is a rare congenital anomaly, first mentioned by Couronne in 1819. Monroe(1966), Fujino(1970), Ranta(1984) and Oostrom(1996) conducted comprehensive reviews and list cases in literature. Median cleft varies greatly, from a simple vermilion notch to a complete cleft of the lip involving the tongue, the chin, the mandible, the supporting structures of the median of the neck, and the manubrium sterni. The associated anomalies include ankyloglossia, cleft tongue, neck contraction, heart lesion, absence of hyoid bone, and so on. The etiology of median cleft is unknown. Various possibilities, such as failure of mesodermal penetration into the midline, failure of fusion of mandibular processes, external factors apart from the embryogenic pattern such as pressure, position in utero, circulatory failure caused placental adhesion, diseases in pregnancy, and so on, have been discussed. A 8-year-old girl was referred to the Dept. of Oral & Maxillofacial Surgery, Kyungpook National University Hospital and had been aware of the fact that at birth "she had something wrong with her mouth." Shortly after birth she had been examined by a plastic surgeon and at that time surgical procedure had been performed to release the tongue from the lower jaw and lip at local hospital. On admission, she had a slight notching of lower lip and two fibrous frenum ran from the lip along the ventral surface of the tongue, diastema between her mandibular central incisors, and slightly constricted bifid mandible associated independent movement of the two halves of mandible. The patient had autogenous iliac bone graft to reconstruct the mandibular midline defect. The postoperative result was uneventful. In future, the correction of the soft tissue deformities such as notching of the lower lip and partial ankyloglossia will be required for the esthetic and functional improvement.