• Archives of Plastic Surgery
• /
• v.34 no.5
• /
• pp.653-655
• /
• 2007

Purpose: The umbilicus is an important aesthetic component of the abdomen. Its absence is both cosmetically and psychologically distressing to the patient. Umbilical reconstruction should always be aimed at creating an umbilicus of sufficient depth and good morphology with less scarring. The C-V flap developed for nipple reconstruction was used in an inverted fashion in case of umbilical reconstruction. The aim of this article is to report our experience of scarred umbilical reconstruction using inverted C-V flap. Methods: A 22-year-old woman presented with contracted scar tissue in the umbilical region because she had undergone surgical correction of an umbilical hernia at 5 year of age. Pedicle of the inverted C-V flap was based cephalically. For enhancing depth of the umbilicus, three anchoring sutures to linea alba were done at both lateral and caudal aspects of the umbilical tube. Primary closures were done at donor sites of the V flaps and bolster sutures were done in the caudal direction of the inverted umbilical tube. Results: The patient was satisfied with the appearance of umbilicus. Major complications such as dehiscence, infection, and delayed healing did not occur. Conclusion: The inverted C-V flap is easy and simple technique, and it can produce a satisfactory reconstruction of umbilical structure.

• Archives of Plastic Surgery
• /
• v.34 no.5
• /
• pp.667-670
• /
• 2007

Purpose: Among the materials for cranioplasty, autogenous bone is ideal because it is less susceptible to infection and has lower rates of subsequent exposure. However, the procedure is technically demanding to perform and requires a donor site. Disadvantages further exist when the defect is large and there are attendant limitations in donor site. The authors present their experience with reconstruction of large skull defect using right-angled zigzag osteotomized outer table of autogenous calvarial bone, overcoming the limitation in donor site. Methods: From 2000 to 2006, 9 patients were retrospectively reviewed, who had undergone reconstruction with right angled zigzag osteotomized outer table of autogenous calvarial bone. Results: Aesthetically satisfactory skull shape was achieved. Major complications of infection, hematoma, plate exposure, and donor site complications of dural tear with bleeding, cerebrospinal fluid leak, and meningitis were not seen. One patient had delayed wound healing and was successfully managed conservatively. Conclusion: Autogenous bone is the material of choice for cranioplasty, especially in complicated cases. Right angled zigzag osteotomy is a useful method in reconstruction of large skull defects with less donor site morbidity.

• Restorative Dentistry and Endodontics
• /
• v.39 no.2
• /
• pp.79-88
• /
• 2014

Appropriate use of local hemostatic agent is one of the important factors on the prognosis of endodontic microsurgery. However, most investigations to date focus on the hemostatic efficacy of the agents, whereas their biologic characteristics have not received enough attention. The purpose of this paper was to review the biologic response of local hemostatic agents, and to provide clinical guidelines on their use during endodontic microsurgery. Electronic database (PUBMED) was screened to search related studies from 1980 to 2013, and 8 clinical studies and 18 animal studies were identified. Among the materials used in these studies, most widely-investigated and used materials, epinephrine, ferric sulfate (FS) and calcium sulfate (CS), were thoroughly discussed. Influence of these materials on local tissue and systemic condition, such as inflammatory and foreign body reaction, local ischemia, dyspigmentation, delayed or enhanced bone and soft tissue healing, and potential cardiovascular complications were assessed. Additionally, biological property of their carrier materials, cotton pellet and absorbable collagen, were also discussed. Clinicians should be aware of the biologic properties of local hemostatic agents and their carrier materials, and should pay attention to the potential complications when using them in endodontic microsurgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.38 no.1
• /
• pp.50-54
• /
• 2012

According to Luhr's classification, a fracture in the mandible with a width of less than 15-20 mm is considered to be an atrophic mandibular fracture and its incidence is very rare. Because of the reduced cross-sectional area and smaller contact area of the fractured ends as well as the poorly vascularized bony structure and delayed bone healing, an atrophic mandibular fracture is a great challenge for oral and maxillofacial surgeons. Surgeons tend to perform closed reduction, because open reduction is considered a non-life-saving surgery among elderly patients. Thus, most of them have limited experience in surgical management. According to recent reports, open reduction yields a good result, and the Association for Osteosynthesis (AO) group has recommended open reduction. This is a case report of our two experiences of open reduction and rigid fixation of atrophic mandibular fractures by the AO principle. Articles were also reviewed here.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.8 no.1
• /
• pp.55-63
• /
• 1981

The purpose of this study is to observe the effect of formocresol and glutaraldehyde to tooth germs and periapical tissues after perforation of interradicular portion of pulpal floor and application of physiological saline solution in control groups, formocresol and glutaraldehyde in experimental groups. The following results were obtained 1. In control groups, normal healing processes were seen, and, on the sixteenth day, the epithelization of injured areas was completed. Inflammatory reactions were limited to the injured surface, and the underlying alveolar bone were normal and successive tooth germs were normal. 2. In both formocresol groups and glutaraldehyde groups, tissue reactions were identical. Inflammatory reactions were slightly compared with control groups, but the surface epithelizations were delayed compared with control group. 3. In both formocresol and glutaraldehyde groups, necrosis was seen in superficial tissue of bone marrow, and, at 24th day, center area of bone marrow on the successive tooth germs were losed and replaced with connective tissue, and superficial soft tissue of the injured area was connected with soft tissue on the successive tooth germ. In remaining alveolar bone, osteoclastic reaction was remarkable. 4. In both formocresol and glutaraldehyde groups, there is no injury to the successive tooth germs. 5. In both formocresol and glutaraldehyde groups, periodontal membrane was normal, but the partial resorption of cementum and dentin near the injured area were seen.

• Korean Journal of Head & Neck Oncology
• /
• v.11 no.2
• /
• pp.167-172
• /
• 1995

Pharyngocutaneous fistula(PCF) is one of the complications following total laryngectomy in laryngeal and hypopharyngeal cancer. Fistula lead to delayed wound healing, more serious complications such as carotid blow-out, prolonged hospitalization, significant patient morbidity and occasional mortality. Identification of patients at high risk for fistula formation, appropriate preventive measures, and appropriate management are the head and neck surgeon's responsibility. So we analyzed the clinical data of pharyngocutaneous fistula which was developed after total laryngectomy. Following results were obtained: 1) Occurrence of PCF increases with salvage surgery compared to curative surgery. 2) Early detection and effective management of PCF are the key factors to decreasing the hospitalization period. 3) Constructing a pharyngostoma seems to be an ideal method of preventing dangerous complications and ultimately closing the fistula. 4) Simultaneous reconstruction is necessary in the high risk group.

• Journal of Korean Foot and Ankle Society
• /
• v.12 no.1
• /
• pp.59-65
• /
• 2008

Purpose: To evaluate the results of anterolateral thigh perforator free flap for reconstruction of foot and ankle in old diabetic patients. Materials and Methods: Fifteen diabetic foot ulcer patients over the age of 55 were operated with anterolateral thigh perforator free flap. Hematological, hemodynamic, diabetic, bacteriologic and radiologic tests were checked with examination of blood vessel state in both the donor site and the recipient site. After surgery, serial check-up was performed at 6 week, 6 month, and 1 year postoperatively on the survival of transplantation tissue, condition of foot, and condition of walking. Results: There are one case of transplantation failure and four cases of partial tissue-necrosis. Delayed wound-healing was observed both recipient and donor tissue sites. At the final follow up, three cases of small ulcer were found at junction of flap and recipient tissue in plantar area. Fourteen out of fifteen patients could walk without any brace or walking aids. Conclusion: Reconstruction of foot and ankle region in old diabetic patients with the anterolateral thigh perforator free flap is a useful method which can prevent the amputation of foot and ankle.

• Journal of Korean Foot and Ankle Society
• /
• v.12 no.1
• /
• pp.86-92
• /
• 2008

Purpose: To evaluate the safety and prognostic factors of intramedullary nailing of distal tibia fractures in terms of function and symptoms of the ankle joint. Materials and Methods: We retrospectively analyzed 22 distal tibial fractures with intramedullary nailing. The mean duration of follow-up was 43 months. We reviewed medical records to describe each case. We measured radiographic parameters such as fracture configuration, arthritic change of the ankle joint and status of reduction. We also assessed clinical results by AOFAS ankle hind foot scoring system, degree of pain by VAS and range of motion to find out prognostic factors for functional result of the ankle joint. Results: Bone healing was obtained in all cases without any wound complications. Mean AOFAS ankle score was 94. There were 4 cases with mild (VAS<3/10) ankle pain and 2 cases with mild limitation of ankle motion. The comminution of fracture had a significant relationship with delayed angular deformity of ankle joint (p=0.032). There was no other significant parameter affecting ankle joint function except the location of nail-end. Conclusion: Intramedullary nailing in distal tibia fracture is a safe and effective procedure. But further study may need to evaluate the relationship between the position of nail-end and the function of ankle joint.

• Journal of Korean Foot and Ankle Society
• /
• v.12 no.2
• /
• pp.128-134
• /
• 2008

Purpose: We evaluated the complications and failures after total ankle arthroplasty during at least 2 years short term follow up. Materials and Methods: There were 45 cases of 42 patients of HINTEGRA$^{{R}}$ (Newdeal SA, Lyon, France) model from November 2004 to August 2006. Follow up averaged at least 2 year. We evaluated the complications and analyzed the cause of the failures. Results: There were totally 15 cases of complication, 5 cases of medial impingement syndrome, 3 cases of varus malposition, 2 cases of delayed healing of wounds, and each one case of deep peroneal nerve problem, medial malleolus fracture, post-operative deep infection, gouty arthritis pain, and Achilles tendinitis. Conclusion: Total ankle arthroplasty had higher complication rate than any other joint arthroplasty, so we need a more meticulous preoperative and peri-operative care.

• Tuberculosis and Respiratory Diseases
• /
• v.38 no.3
• /
• pp.304-308
• /
• 1991

Corticosteroid has been extensively used for the treatment of many medical diseases caused by immune and inflammatory response. And recently it becomes the first choice of treatment for bronchial asthma in a point of it's anti-inflammatory effects. However, this therapy has been associated with many well-known complications including truncal obesity, diabetes mellitus, excerbation of hypertension, delayed wound healing, easy bruisy, atropy of proximal muscles, psychotic symptoms, and/or osteoporosis. We report a case of patient with bronchial asthma who developed an uncommon side reaction, intractable hiccup persisting longer than 48 hours after treatment with oral corticosteroid.