• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.15 no.1
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• pp.75-83
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• 1985

Bitewing and periapical radiographic techniques are used in clinical and epidemiological studies to assess crestal alveolar bone levels. The purpose of the present study investigated relationships between these techniques by assessing alveolar crest location at the same site. Bitewing and periapical radiographs were available from posterior quadrants of 120 subjects. The distance from cemento-enamel junction to the alveolar crest (CEJ -CR) was measured for each proximal surface from the distal of the cuspid to the distal of the second molar. Data were arranged according to the proximal surface examined, and bitewing and periapical measurements were compared using paired tests. The obtained results were as follows; 1. In maxilla, a significant t ratio with a P value of 0.05 or less was reached for 78% and in mandible reached for 39%. 2. Pearson correlations were calculated 32 surfaces (89%) had values below 0.70 and so, data obtained by these techniques can not be used interchangeably on an individual or group basis. 3. In situations where the periapical measure was greater than the bitewing, it ranged up to 20.7% greater with a mean 9.8%. Where the bitewing was greater than periapical, it ranged up to 51. 9% greater, with a mean 18.2%. 4. The percentage difference was greater in maxillary posterior areas than in mandibular molar, premolar areas. A lower prevalence of significant differences was attributed to relatively more simple root and favorable radiographic conditions in mandibular molar and premolar areas. 5. The anatomical limitations imposed on periapical radiographic technique, most often result in somewhat foreshortened radiographic images. This situation would tend to be accentuated by the anatomical restrictions of the hard palate. 6. Consequently, since the significant differences frequently exist between measurements obtained from bitewing and periapical techniques, it is important to define which technique is used.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.20-27
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• 1998

Among many kinds of introduced free flaps, scapular freeflap is one of the most popularly using modalities in fasciocutaneous defect coverage with minimal donor defect and easier procedure and constant vascular patterns of the donor. Many surgeons who had experience of this flap pointed out deficit of the reliable sensation of the transplanted flap is the main shortcoming of the scapular free flap. If we can subjugate that point, scapular free flap is the most excellent procedure in such a cases as heel pad reconstruction and hand reconstruction which are relatively important to have skin with protective sensation. Author performed anatomical literature review, 10 cadaveric dissections and 12 clinical dissections. In surgical anatomical aspect, the upper six dorsal rami of the thoracic nerves have medial branches which pierce Longissimus thoracis and Multifidus muscle with small cutaneous twigs which pierce Latissimus dorsi and Trapezius muscle. Among that cutaneous twigs, several twigs distribute to the skin of the back from midline to lateral aspect which territory is identical to scapular free flap. We analysed clinical experiences of that sensory bearing scapular free flap surgical anatomy and one year follow-up studies with several results. 1) Two to three cutaneous twigs which pierced from the Trapezius muscle over the scapular free flap region. 2) Each twigs has two to four nerve fascicles with small artery. 3) The nerve distributed to the ordinary scapular free flap and large enough size and pedicle length to neurorrhapy with various recipient site nerves. 4) The inconvenience of this procedure is the vascular pedicle and nerve pedicle have opposite directions, vascular pedicle of that comes from lateral direction from subscapular vessels, but nerve pedicle comes from medial direction from trapezius muscle. Author can found constant cutaneous nerve branches which come from piercing the Trapezius. This nerves are helpful for protective sensation in transplanted scapular free flap. We can't had enough follow-up and evaluation of the nerve function of this procedure, we need continuous research works to application of this procedure. The in conveniences come from directional differences of pedicle can solve with longer harvest neural pedicle and change direction of the neural pedicle.

• Journal of Trauma and Injury
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• v.32 no.1
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• pp.40-46
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• 2019

Purpose: We perform an analysis of infection risk factors for fracture patients and confirm that the risk factors reported in previous studies increase the risk of actual infection among fractured patients. In addition, injury severity score (ISS) which is used as an evaluation tool for morbidity of trauma patients, confirms whether there is a relationship with infection after orthopedic fracture surgery. Methods: We retrospectively reviewed 1,818 patients who underwent fixation surgery at orthopedic trauma team, focused trauma center from January 1, 2015 to December 31, 2017. Thirty-five patients were infected after fracture surgery. We analyzed age, sex, open fracture criteria based on Gustilo-Aderson classification 3b, anatomical location (upper extremity or lower extremity) of fracture, diabetes, smoking, ISS. Results: Of 1,818 patients, 35 (1.9%) were diagnosed with postoperative infection. Of the 35 infected patients, nine (25.7%) were female and five (14.0%) were upper extremity fractures. Three (8.6%) were diagnosed with diabetes and eight (22.8%) were smokers. Thirteen (37.1%) had ISS less than nine points and six (17.1%) had ISS 15 points or more. Of 1,818 patients, 80 had open fractures. Surgical site infection were diagnosed in 12 (15.0%) of 80. And nine of 12 were checked with Gustilo-Aderson classification 3b or more. Linear logistic regression analysis was performed using statistical analysis program Stata 15 (Stata Corporation, College Station, TX, USA). In addition, independent variables were logistic regression analyzed individually after Propensity scores matching. In all statistical analyzes, only open fracture was identified as a risk factor. Conclusions: The risk factors for infection in fracture patients were found to be significantly influenced by open fracture rather than the underlying disease or anatomical feature of the patient. In the case of ISS, it is considered that there is a limitation. It is necessary to develop a new scoring system that can appropriately approach the morbidity of fracture trauma patients.

• Journal of the Korea Society of Computer and Information
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• v.26 no.3
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• pp.19-28
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• 2021

Esophagogastroduodenoscopy is a method commonly used for early diagnosis of upper gastrointestinal lesions. However, 10-20 percent of the gastric lesions are reported to be missed, due to human error. And countries including the US, the UK, and Japan, the World Endoscopy Organization (WEO) suggested guidelines about essential gastrointestinal parts to take pictures of so that all gastric lesions are observed. In this paper, we propose deep learning techniques for classification of anatomical sites, aiming for the system that informs practitioners whether they successfully did the gastroscopy without blind spots. The proposed model uses pre-processing modules and data augmentation techniques suitable for gastroscopy images. Not only does the experiment result with a maximum F1 score of 99.6%, but it also shows a error rate of less than 4% based on the actual data. Given the performance results, we found the model to be explainable with the potential to be utilized in the clinical area.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.532-536
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• 2009

Bypass surgery is performed for insuring continuity of a blood supply that is restricted due to obstruction of the native blood supply. Two types of surgery are commonly carried out: one is anatomic bypass and the other is extraanatomic bypass. Especially, extraanatomic bypass surgery is performed in patients who are a high risk for performing anatomical bypass surgery. The risk factors for anatomical bypass surgery are old age, infection, previous surgery and trauma. A 96-year-old patient underwent extraanatomic bypass surgery from the right femoral artery to the left femoral artery due to total occlusion of the left iliac artery, and 7 years after that operation, a pseudoaneurysm abruptly and spontaneously appeared from the bypass suture site without any predisposing factor. The lesion was revealed to be an organizing thrombus.

• Archives of Reconstructive Microsurgery
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• v.21 no.2
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• pp.86-91
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• 2012

Purpose: Mass can compress around tissue and cause deviation of normal anatomical structures. Often, mass grows toward neurovascular pedicle and encircles depending on the nature of mature mass. Neglecting neurovascular involvement of the mass is a serious problem not to be overlooked. Authors have performed microscopic approach regarding mass involving the neurovascular pedicle in the hand. Materials and Methods: From January 2007 through February 2012, retrospective analysis for nine cases of mass involving neurovascular pedicles was done. Patients were evaluated preoperatively by ultrasonography or MRI and checked intraoperative finding. Masses were evaluated by site, preoperative evaluation, involved neurovascular pedicle, histopathologic diagnosis, complication, and recurrence. Results: The site of mass involving neurovascular pedicles was 4 cases on the wrist, 2 cases on the palm, 2 cases on the finger, 1 case on the hand dorsum. Involved neurovascular pedicles were 3 radial arteries and nerves, 3 proper digital arteries and nerves, 1 radial artery, 1 superficial branch of radial nerve, 1 common digital artery and nerve. The histopathologic diagnosis of mass were 3 ganglions, 2 giant cell tumors, 2 epidermal cysts, 1 fibroma, and 1 benign spindle tumor. There were 2 cases of recurrence and secondary excisions were performed. Conclusion: Neurovascular pedicle injury can lead to serious complication like sensory and motor disorders, distal part ischemia, and so on. In case of mass suspected neurovascular invasion, accurate preoperative evaluation such as ultrasonography or MRI is necessary. To prevent any neurovascular related complication during mass excision, delicate surgical technique using a microscope becomes essential.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.248-255
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• 2013

Reconstruction techniques of orofacial defects caused by wide excision of the intraoral malignant lesions are various. Although radial forearm free flap is a common donor site on reconstruction of soft tissue defect, anterolateral thigh (ALT) free flap also has an established site in orofacial soft tissue reconstruction as the favored donor flap with recent progress of the microsurgical technique. A 59-year-old female complained of hyperplastic mass on the right retromolar and buccal cheek, which was diagnosed as a squamous cell carcinoma (SCC) by an incisional biopsy. Before the operation, we planned a wide excision of the SCC lesion, supraomohyoid neck dissection, reconstruction with radial forearm free flap (RFFF), and split thickness skin graft. We accidentally found an arterial variation of the forearm area during elevation of RFFF, and changed the plan of reconstruction operation to reconstruction with ALT free flap. Operative sites was healed well during the post-operative period, and we referred to the department of radiation oncology for post-operative radiotherapy.

• Archives of Reconstructive Microsurgery
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• v.21 no.1
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• pp.56-60
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• 2012

Purpose: Thumb reconstruction plays most important role in hand injuries because total loss of a thumb constitutes about 40% disability in the hand. The reconstruction can be accomplished by pollicization, free toe-to-thumb transfer, wrap around procedure and lengthening extraction. However, we sometimes need consecutive or double free flaps in the reconstruction of mutilating hand injuries. Methods: We reconstructed a mutilating hand injury in a 54-years old man. Because of severe crushing injury of right thumb and index fingers, we reconstructed a thumb with pollicization using nearly amputated middle finger. Although it survived completely, the adjacent soft tissues which had been covered by fillet flap from the space past was necrosed on 1 month. We debrided the necrotic tissues and covered it with anteromedial thigh perforator free flap consecutively because he had an anatomical variation in branches of lateral femoral circumflex artery. Results: He had an uneventful postoperative course without any complication such as infection, dehiscence and flap necrosis. Three months later, he had undergone tenolysis and defatting procedure of flap site. He recovered the some amount of grip function and was happy with the result. Conclusion: In severe hand trauma including thumb amputation, thumb reconstruction using pollicization and perforator free flap could be an alternative option. It provides minimal donor site morbidity and an acceptable functional result.

• Korean Journal of Clinical Pharmacy
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• v.26 no.4
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• pp.324-329
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• 2016

Background: With the development of information and communication technology, there is a growing number of people looking for health information on the internet. This pilot study was performed to analyze the pattern of pharmacist consultation on the internet portal site. Methods: Questions and answers posted on the portal site "Naver Jisik-iN" from March 1st to 31th in 2016 were collected. Medications asked were categorized into prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others. Medications were subcategorized into 14 according to the anatomical therapeutic chemical classification system. Questions were divided into 10 categories based on Hepler's drug-related problems. Results: Of the 955 cases, females accounted for 59.5% and inquirers from 11 to 40 years old, 89.4%. The number of prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others were 428 (44.8%), 328 (34.3%), 31 (3.3%), 2 (0.2%), 122 (12.8%), and 44 (4.6%), respectively. Questions for drugs acting on alimentary tract and metabolism took up 27.4% followed by those on nervous system, 13.6% and anti-infectives for systemic use, 12.2%. Pharmacist consultation regarding drug information, drug interaction, and adverse reaction occupied 47.9%, 15.2%, and 12.3%, respectively. Conclusion: Health counseling through online is predicted to increase steadily, so pharmacists should broaden their boundaries beyond off-line pharmacies to meet social needs.

• Archives of Plastic Surgery
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• v.38 no.3
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• pp.235-240
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• 2011

Purpose: Management of pressure sores has been improved, along with development of musculocutaneous flaps and perforator flaps. Nowadays, the treatment of pressure sore with perforator flaps has shown several advantages, including minimal donor site morbidity, relatively versatile flap design not only in primary cases but also in recurred cases and minimized anatomical rearrangement of regional muscle position. In this study, we report our clinical experience of gluteal perforator flap used in the treatment of a greater trochanteric pressure sore. Methods: A clinical study was performed on 7 patients who underwent total 10 operations. 1 superior gluteal artery perforator flap and 9 inferior gluteal artery perforator flaps were used to reconstruct the defect, followed by the mean observation duration of 22 months. Results: There were no total flap loss. We treated 2 cases of partial flap loss with debridement and primary repair. 2 recurred cases were successfully treated using the same method. Donor sites were all primarily repaired. Conclusion: The gluteal perforator flap could be considered as a safe and favorable alternative in the treatment of soft tissue defects in the greater trochanteric area. The advantages of the flap include low donor site morbidity and the possibility of versatile flap design not only in primary cases but also in recurred cases.