• Advances in pediatric surgery
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• v.14 no.2
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• pp.117-124
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• 2008

Children who underwent reparative operations for esophageal atresia (EA) with or without tracheoesophageal fistula (TEF), are confronted with many gastrointestinal or respiratory problems, especially during the early years of life. We reviewed the medical records of 50 patients who underwent repairs of EA with or without TEF at the Division of Pediatric Surgery, Samsung Medical Center, from December 1994 to December 2005. Current status of children was accessed by telephone-interview, but only 27 of them were accessible. Of 50 patients, 3 patients (6 %) were type A, 45 patients (90 %) were type C, and 2 patients (4 %) were type E. The mean interval between primary operation and interview was 5.5 years. The incidences of growth retardation (<10 percentile of height/weight) were 39 % and 21 % during the first 5 years after repairs, respectively. The incidences of dysphagia or gastroesophageal reflux and recurrent respiratory infections were 33 % and 39 %, respectively. However, these problems were likely to improve as the children grew. The incidences of growth retardations (<10 percentile of height/weight) were 11 % and 11 % for the children more than five years postoperative. The incidences of dysphagia or gastroesophageal reflux and recurrent respiratory infections were 22 % and 22 %, respectively. Children with EA with or without TEF are faced with many obstacles. Close observation and adequate treatment for delayed postoperative complications are necessary to improve the quality of life for these children.

• Tuberculosis and Respiratory Diseases
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• v.48 no.4
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• pp.543-549
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• 2000

The incidence of deep neck infection has been reduced by modern antibiotic therapy. Life-threatening deep neck infection of odontogenic or upper airway origin may extend to the thorax. Early diagnosis, administration of the potent antibiotics, and complete debridement and drainage are essential to improve the chances for survival in these very ill patients. We report two cases of deep neck infection which were complicated by thoracic infection such as mediastinitis, pericarditis, and empyema as a result of descending infection.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.35-39
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• 2011

Objectives The high sensitivity of ultrasound and thyroglobulin determination for follow-up of differentiated thyroid cancer allows early detection of nonpalpable recurrences. Intraoperative localization of these small foci in previously dissected necks is a surgical challenge. We assessed the safety and effectiveness of ultrasound-guided tattooing (US-tattoo) with a charcoal suspension for localizing nonpalpable cervical recurrences after thyroidectomy for thyroid cancer. Subjects and Methods Between March 2009 and December 2010, we retrospectively reviewed 19 patients who underwent US-tattoo with injection of a charcoal suspension for recurrent thyroid papillary cancer on central neck compartment after thyroidectomy. All patients underwent the surgical dissection after US-tattoo. The complications and effectiveness of US-tattoo were evaluated. Results The technical success rate of US-tattoo for suspicious lesions was 100%. There was no complication with regard to US-tattoo. During surgery, all but one tattooed lesions were detected by surgeons. On final pathologic reports, all recurrence lesions but two cases were successfully removed. Conclusion Preoperative US-tattoo is a safe and effective method for successful reoperation of central neck compartment recurrences after thyroidectomy.

• Korean Journal of Bronchoesophagology
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• v.5 no.1
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• pp.7-13
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• 1999

Background and Objective： The tuberculous lymphadenitis of neck is one of the most common extra-pulmonary tuberculosis in Korea. Although the incidence of pulmonary tuberculo-sis has decreased recently, that of cervical tuberculous lymphadenitis has not decreased. In spite of great efforts and diversity of study, the exact criterias of diagnosis and optimal therapeutic methods of cervical tuberculous lymphadenitis have been the subject of much debate and still remain unclear. So we intend to enucleate clinical manifestations and suggest the optimal therapeutic manners. Material : The 483 cases, diagnosed as cervical tuberculous lymphadenitis by fine needle aspiration biopsy during the past 10 years from Jan. 1987 to Dec. 1996 Method : Retrospective study Results 1) The overall rate of tuberculous cervical lymphadenitis was 23.4% of neck mass. 2) Incidence ratio of male to female was 1：2.7 3) The frequent location of tuberculous lymphadenitis was posterior cervical area, supraclavicular area, jugular chain in order. 4) The response rate of medical treatment in tuberculous cervical lymphadenitis was 84.9%. 5) The duration of medical treatment in remissioned group was 18.6 months in average. 6) Surgical intervention was needed in 15.1%. 7) The duration of post operative medical treatment was 18.4 months in average. Conclusion : Tuberculous cervical lymphadenitis is prevalent in women, age of 20-40 years and mainly involve posterior cervical area. Fine needle aspiration biopsy is a very useful method for early detection of cervical tuberculous lymphadenitis. After diagnosis is made, anti-tuberculosis medication is recommended for more than 18 months. Unless the size of neck mass is decreases inspite of the thorough anti-tuberculosis medication for more than 1 month or if complication like as abscess or fistula occurs, surgery is needed with post operative medical treatment for more than 12 months.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.223-231
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• 2003

Purpose: Achilles tendon rupture has become more common in the recent years. As suture with foreign material has been blamed for impaired healing, better results should be expected from the use of autogenous material such as plantaris tendon. We have evaluated the surgical results of end-to-end anastomosis using the plantaris tendon as suture material. Materials and Methods: Between Jan 1997 and Jan 2002, the 60 patients were included this study during one year follow-up. We performed the operations with end-to-end suture technique using modified Lynn's method. The plantaris tendon has been used as a autogenous suture material and can be utilized in the end-to-end anastomosis of ruptured Achilles tendon with modifed Bunnel suture technique. We used a clinical scoring system reported by Leppilahti to evaluate the results. Results: The overall results were excellent in thirty eight(63.3%), good in sixteen(26.6%), fair in five(8.3%) cases, and poor in only one (1.6%) case. Fifty four cases(90%) had the score more than good. We had no deep infection, rerupture, deep vein thrombosis, and skin necrosis as major complication. In just 2 cases, although there were superficial skin infection, the wounds did not proceed necrosis due to using antibiotics. Conclusion: End-to-end anastomosis using the plantaris tendon as suture material was good treatment option that had low infection rate and no foreign body reaction because of using autogenous material, and therefore we can get rapid healing of ruptured tendon due to early ragne of motion and accerlerated rehabilitation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.1
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• pp.40-45
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• 2007

Objective. The objective of this international comparative study was to investigate the clinical features and outcome of the treatment of infratemporal fossa abscess (IFA). Study design. This retrospective study was conducted at the Deptartment of Oral and Maxillofacial Surgery of Hallym University and "Iuliu Hatieganu" University of Medicine and Pharmacy. Ten-year records of patients were reviewed in Romania and six-year records were reviewed in Korea. The collected data was then analyzed. Results. A total of 36 cases were found to be IFA (12 males and 24 females: average age; $36.3{\pm}15.5$ yrs: 34 cases from Romania and 2 cases from Korea). The annual frequency of IFA in Romanian and Korean hospitals was 3.40 and 0.33 respectively (P<0.001). The etiology was septic anesthesia (33.3%), infection occurring after extraction (30.6%), periapical lesion (13.9%), impacted third molar (8.3%), post-extraction alveolitis (5.6%), and unknown (8.3%). A successful outcome was seen in 27 patients (75.0%) after initial treatment. The main complication after initial treatment was restricted movement of the mouth (9 cases). Conclusion. The etiology of IFA was various and minimal swelling hampered early diagnosis. To prevent IFA, preoperative painting with antiseptic agent must be stressed and proper drainage proved important to relieve pain and to prevent further complications.

• Archives of Craniofacial Surgery
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• v.15 no.2
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• pp.47-52
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• 2014

Background: Management of positional plagiocephaly by wearing a cranial molding helmet has become a matter of growing medical interest. Some research studies reported that starting helmet therapy early (age 5 to 6 months) is important and leads to a significantly better outcome in a shorter treatment time. The aim of the present study was to evaluate the effectiveness of cranial remodeling treatment with wearing helmet for older infants (${\geq}18$ months). Methods: We conducted a retrospective study of 27 infants with positional plagiocephaly without synostosis, who were started from 2008 to 2012. Every child underwent a computerized tomography (CT) before starting helmet therapy to exclude synostosis of the cranial sutures and had CT performed once again after satisfactory completion of therapy. Anthropometric measurements were taken on using spreading calipers in every child. The treatment effect was compared using cranial vault asymmetry (CVA) and the cranial vault asymmetry index (CVAI), which were obtained from diagonal measurements before and after therapy. Results: The discrepancy of CVA and CVAI of all the patients significantly decreased after cranial molding helmet treatment in older infants (${\geq}18$ months) 7.6 mm from 15.6 mm to 8 mm and 4.51% from 9.42% to 4.91%. Six patients had confirmed successful outcome, and all subjects were good compliance patients. The treatment lasted an average of 16.4 months, was well tolerated, and had no complication. Additionally, the rate of the successful treatment (final CVA ${\leq}5mm$) significantly decreased when the wearing time per was shorter. Conclusion: This study showed that treatment by cranial remodeling orthosis was effective if the patient could wear the helmet longer and treatment duration was somewhat longer than in younger patients, well tolerated in older infants and had no morbidity. This therapeutic option is available and indicated in these older infants before other cranial remodeling surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.5
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• pp.383-389
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• 2002

This is a retrospective study on emergency patients with active oral bleeding. The study was based on a series of 135 patients treated as emergency patients at Wonju Christian Hospital, from Jan. 1, 1997, to Dec. 31, 2001. The postoperative bleeding was the most frequent cause of active oral bleeding in emergency room and bleeding from trauma and medically compromised (bleeding disorders) patients were next in order of frequency. In the injury of maxillofacial vessels, peak incidence was occurred in the inferior alveolar vessel (42.9%), followed by the submucosal vessel of lip & cheek, the superior alveolar vessel, and sublingual vessels. The most common disease of bleeding disorders was vascular wall alteration (infection, etc), followed by liver disease, thrombocytopenic purpura, anti-coagulation drugs in order. In the characteristics of dental diseases on bleeding disorders, periodontal disease and alveolar osteitis (osteomyelitis) were more common. The hemostasis was most obtained by use of wound suture, simple pressure dressing, drainage for infection control and primary interdental wiring of fracture. In the complication group, the infrequent incidence was showed in vomiting, hypovolemic shock, syncope, recurred bleeding & aspiration pneumonia. In the uncontrolled oral bleeding, the injured vessels were suspected as skull base & ethmoidal vessels. In this study, authors found that the close cooperation between the dentistry (Oral and maxillofacial surgery) and the medicine (emergency & internal medicine) was the most important for early proper control of active oral bleeding. And then post-operative wound closure, drainage for infection control and previous systemic evaluation of bleeding disorders were critical for the prevention of postoperative bleeding in the local dental clinic.

• Child Health Nursing Research
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• v.2 no.2
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• pp.35-44
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• 1996

The purpose of this study was to examine the knowledge and attitude of breast feeding and to explore the predictive variables for the intention of breast feeding of mothers. One hundred and thirty-five mothers who delivered at the D University hospital during the period of May to June in 1996 comprised the sample. Data were collected by questionnaire methods before discharge at the hospital. Data were analyzed using percent, 1-test, and logistic regression. The results were as follows : 1. During their pregnancy, majority of mothers (74.8%) got the breast feeding information. Information sources were book (34.5%), family and relatives(32.4%), mass media(24.3%), and professionals such as nurses and doctors (8.8% ). The frequently reported sources of most encouragement for breast feeding were mother in law(20.7%) and baby's father (11.1% ). 2. The mean score of the items of Knowledge and Attitude toward Breast Feeding Scale were 42.56 (SD=5.47) and 39.07(SD=5.15) , representing positive attitude toward breast feeding. The correlation between knowledge and attitude score was significant(r 〓.54, p<.001). Knowledge of breast feeding were significantly different between breast feeding intention group (including partial breast feeding) and artificial feeding intention group(t=2.79, p<.01) 3. Logistic regression analysis revealed that feeding method in the hospital, delivery type, knowledge toward breast feeding, disease related to pregnancy, complication related to delivery, and educational level of mother were predictives of the intention of breast feeding. 4. The most frequently rated reasons for the plan for mixed feeding were concern about insufficient milk (37.9%) and work(27.6%), The major reasons for plan for artificial milk feeding were having premature baby(25.9%) and maternal health problems including infection(14.8% ) and drug use due to chronic illness (14.8%). From the result of the study, it is recommended to develop supportive nursing intervention strategy to promote breast-feeding intention and practice. The intervention could be more effective to begin early in pregnancy and include teaching for breast feeding skills as well as information provision for positive attitude formation.

• Tuberculosis and Respiratory Diseases
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• v.77 no.3
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• pp.141-144
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• 2014

Invasive pulmonary aspergillosis (IPA) is rarely reported in patients who have normal immune function. Recently, IPA risk was reported in nonimmunocompromised hosts, such as patients with chronic obstructive pulmonary disease and critically ill patients in intensive care units. Moreover, influenza infection is also believed to be associated with IPA among immunocompetent patients. However, most reports on IPA with influenza A infection, including pandemic influenza H1N1, and IPA associated with influenza B infection were scarcely reported. Here, we report probable IPA with a fatal clinical course in an immunocompetent patient with influenza B infection. We demonstrate IPA as a possible complication in immunocompetent patients with influenza B infection. Early clinical suspicion of IPA and timely antifungal therapy are required for better outcomes in such cases.