• Imaging Science in Dentistry
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• v.53 no.2
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• pp.137-144
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• 2023

Purpose: This study aimed to evaluate the anatomic circle around the impacted lower third molar to show, document, and correlate essential findings that should be included in the routine radiographic assessment protocol as clinically meaningful factors in overall case evaluation and treatment planning. Materials and Methods: Cone-beam computed tomographic images of impacted lower third molars were selected according to specific inclusion criteria. Impacted teeth were classified according to their position before assessment. The adjacent second molars were assessed for distal caries, distal bone loss, and root resorption. The fourth finding was the presence of a retromolar canal distal to the impaction. Communication with the dentist responsible for each case was done to determine whether these findings were detected or undetected by them before communication. Results: Statistically significant correlations were found between impaction position, distal bone loss, and detected distal caries associated with the adjacent second molar. The greatest percentage of undetected findings was found in the evaluation of distal bone status, followed by missed detection of the retromolar canal. Conclusion: The radiographic assessment protocol for impacted third molars should consider a step-by-step evaluation for second molars, and clinicians should be aware of the high prevalence of second molar affection in horizontal and mesioangular impactions. They also should search for the retromolar canal due to its associated clinical considerations.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.145-150
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• 2014

Purpose: To assess the accuracy and role of single-contrast computed tomography (CT) in the management of anterior abdominal stab wound (AASW). Methods: During 8-years period, single-contrast CT was performed in 21 hemodynamically stable AASW patients (age range, 22-64 years; median age, 45 years), including 19 men and 2 women. CT scans were evaluated by one trauma surgeon and one senior resident to determine the depth of injury(peritoneal violation or not), and abnormal findings of intraperitoneal cavity associated with stab injury. We retrospectively reviewed medical records regarding operative findings. Results: Nine patients underwent abdominal surgery and 12 patients nonoperative management. In the abdominal surgery group, abnormal CT findings included peritoneal violation in 14 patients and abnormal intraperitoneal cavity findings in 5 patients. There was no statistical significant difference regarding abnormal CT findings between abdominal surgery group and nonoperative management group. Among the nine abdominal surgery patients, therapeutic laparotomy was performed on 4 patients. The positive predictive value (PPV) and negative predictive value (NPV) of peritoneal violation to predictive therapeutic laparotomy were 28.6% and 100%, respectively. In addition, the PPV and NPV of abnormal intraperitoneal cavity CT findings to predict therapeutic laparotomy were 40.0% and 87.5%, respectively. There was no statistical significant difference regarding the abnormal CT findings between therapeutic laparotomy group and non therapeutic laparotomy group. Conclusion: CT is a good adjunctive method to evaluate hemodynamicaly stable AASW patients. If peritoneal violation is not seen on CT scan, conservative treatment on local wound may be safely performed without additional abdominal surgery. However, further study is warranted to evaluate the exact role of CT in the diagnostic workup of AASW patients.

• Advances in pediatric surgery
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• v.8 no.1
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• pp.16-22
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• 2002

Between March 1999 and January 2000, 82 boys with the diagnosis of inguinal hernias (12 bilateral and 70 unilateral hernias), underwent Ultrasound (US) examination of both sides of the groin, a total of 164 inguinal imaging prior to surgery. The patients ages ranged from 3 days to 12 years with a mean of 32.6 months. Ninty four examinations were on the clinically symptomatic side and 70 were on the asymptomatic side. The US criteria for the diagnosis of an inguinal hernia were as follows: 1) visceral hernia, the presence of bowel loops, or omentum in the inguinal canal, 2) communicating hydrocele, the presence of fluid in the processus vaginalis, 3) widening of patent processus vaginalis at the level of internal inguinal ring. The width of patent processus vaginalis at the level of internal inguinal ring over 4 mm is considered an occult hernia. Among the 94 symptomatic groins, US findings showed 31 (33%) visceral hernias, 18 (19%) communicating hydroceles, and 38 (41%) widening of the internal inguinal ring, and 7 (7%) groins without abnormalities. In 70 asymptomatic groins, there were 4 (6%) visceral hernias, 5 (7%) communicating hydroceles, 11 (16%) widening of the internal inguinal ring, and 50 (70%) groins without abnormalities. Among the 70 asymptomatic groins there were US abnormalities in 20 (28%). One hundred and seven groins with positive US findings were surgically explored. Among 107 operated sites, the operative findings were compatible with the US diagnosis in 104, a sensitivity for US of 97.2%. In patients with US findings of widening of internal inguinal ring (>4 mm), there was patent processus vaginalis in 36 out of 38 symptomatic groins and 10 of 11 asymptomatic groins. The sensitivity of US to the operative findings in widening of internal inguinal ring was 93.8%. For visceral hernia and communicating hydrocele, the sensitivity of positive US findings was 100%. Ultrasonography for inguinal hernias appears to be a rapid, reliable, and noninvasive screening diagnostic tool with high positive specificity. Therefore, we recommend the use of US as a routine diagnostic tool in pediatric patients with inguinal hernias and hydroceles.

• Journal of Internet of Things and Convergence
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• v.3 no.2
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• pp.21-32
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• 2017

This study is a descriptive investigation for understanding factors influencing the length of stay in the postanesthesia care unit of elderly patients. Retrospective investigation was conducted on 300 patients aged 65 or older among those who had received an operation under general anesthesia and treated in postanesthesia care unit of hospital C located in Gyeonggi-do, from January 1 to December 31, 2014. The patients' average postanesthesia care unit stay was found to be 48.4 minutes and the 30-59 minute section accounted for the highest part with 58.0%. The postanesthesia care unit stay time according to intra-operative factors showed significant differences depending upon muscle relaxants, transfusion, ABGA, body temperature and total hours under anesthesia. Concerning the post anesthesia care unit stay length according to post-operative factors, significant differences were observed depending upon complications, PCA device, and circulatory drug use. In order to find out factors influencing the post anesthesia care unit stay length, the multiple regression analysis was conducted. As a result, the circulatory drug use and intra-operative lower body temperature were found to have an effect on the post anesthesia care unit stay length with the total explanatory power of 13%. Based on these findings above, it is deemed helpful to carefully monitor factors related to the post anesthesia care unit stay length and provide swift response accordingly for shorter post anesthesia care unit stay time of elderly general anesthesia patients.

• Journal of Veterinary Clinics
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• v.35 no.4
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• pp.126-129
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• 2018

This study was performed to describe the outcome of pars plana retinopexy with perfluoro-n-octane (PFO)-silicone oil (SiO) exchange in dogs with rhegmatogenous retinal detachment in Seoul National University Veterinary Medical Teaching Hospital (SNU VMTH) from 2014 to 2017. Nine eyes of 8 dogs were included in this study. Medical records including signalment, history, duration from onset of blindness to surgical intervention, pre-operative findings, duration from surgery to regaining vision, and post-operative complications were evaluated. No eyes were visual before surgery. Duration from onset of blindness to surgical intervention was 2-30 days (median 8 days); duration from surgery to regain vision was 1-14 days (median 6 days); follow-up time was 15-1088 days (median 69 days). Post-operative complications were divided as temporary vs permanent conditions. Temporary complications were corneal ulcer, uveitis, retinal haemorrhage, glaucoma, subconjunctival leakage of SiO, and vitreal haemorrhage. Permanent complications were anterior chamber migration of SiO, retinal degeneration, corneal degeneration, re-detachment, and cataract. Six of 9 eyes regained functional vision, five of which remained visual throughout the follow-up time while the other one lost vision after 3 months because of uveitic glaucoma. In conclusion, pars plana retinopexy with PFO-SiO exchange provided fair outcome in 66.7% cases described in this study.

• Korean Journal of Head & Neck Oncology
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• v.22 no.1
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• pp.29-32
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• 2006

Background: The location of parotid gland tumors can influence the duration and the difficulty of the operation. If the information about tumor location was available preoperatively, it would allow accurate operative planning and counseling of patients in terms of the length of the operation and the potential morbidity. Methods: This study was based on a retrospective review of 100 patients with parotid gland tumors underwent parotidectomy from January 2000 to October 2005 at Yong-Dong Severance Hospital. Based on computed tomographic(CT) scan findings, 4 landmarks such as facial nerve(FN) line, Utrecht(U) line, Conn's are(CA), and retromandibular vein (RV) were drawn on the scans in same plane. The location of tumors were determined by the landmarks and confirmed by the operative findings. The accuracy of each landmarks was evaluated. To find out the accuracies according to tumor size, the tumors were divided into 2 groups; less than 2 cm and larger than 2 cm in diameter. Results: U line was the most accurate(94%), sensitive(89.3%) and specific(97.7%) in predicting tumor location of the parotid gland. However, in small tumors less than 2cm, FN line (p=0.022) and RV criteria (p=0.028) were more reliable in accuracy. Conclusion: CA, FN line, U line, and RV are all useful landmarks in preoperative prediction for the location of parotid gland tumors. However, U line was the most accurate, but we must consider that proper landmark should be used in prediction according to the size of tumor because the accuracy of landmark may change.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.118-124
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• 1984

Congenital Cystic Adenomatiod Malformation (C.C.A.M.) is rare, but one of the most common congenital pulmonary anomalies that cause acute respiratory distress in the newborn infants. It is characterized and differentiated from the diffuse pulmonary cystic disease pathologically, i.e. adenomatoid appearance due to marked proliferation of the terminal respiratory components. An 2/12 year old male patient was suffered from respiratory distress and cyanosis on crying since birth, but no specific therapy was given. With progression of symptoms, he came to Korea University Hospital for further evaluation and then transfered to Dept. of Chest Surgery for operative correction under the impression of Congenital Obstructive Emphysema suggested by a pediatrician. On gestational and family history, there was nothing to be concerned such as congenital anomaly. Physical examinations showed; moderate nourishment and development (Wt. 5.5kg), cyanosis on crying, both intercostal and lower sternal retraction on inspiration, Lt. chest building with tympany, Rt. shifting of cardiac dullness, decreased breathing sound with expiratory wheezing on entire Lt. lung field, decreased breathing sound on Rt. upper lung filed, and tachycardia. The remainders were nonspecific. Laboratory findings were normal except WBC $14000/mm^3$ (lymphocyte 70%), Hgb 9.8m%, Hct 28%, negative Mantaux test, and sinus tachycardia and counter-clockwise rotation on EKG. Preoperative simple Chest PA revealed marked hyperlucent entire Lt. lung, herniation of Lt. upper lobe to Rt., collapsed Rt. upper lobe, tracheal deviation and mediastinal shifting to Rt., and no pleural reaction. At operation, after Lt. posterolateral thoracotomy, 4th rib was resected. Operative findings were severe emphysematous changes limited to both lingular segmentectomy was done. The resected specimen showed slight solidity, measuring $8{\times}4.5{\times}2cm$ in size, and small multiple cystic spaces filled with air. Microscopically, entire tissue structures were glandular in appearance, cyst were lined by ciliated columnar epithelium, and occasional cartilages were noted around the cystic spaces. Bronchial elements were dilated but normal pattern on histologically. The patient had a good postoperative courses clinically and radiologically, and discharged on POD 10th without event. The authors report a case of Cogenital Cystic Adenomatoid Malformation (C.C.A.M.)

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.13-18
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• 2009

Purpose: To report the clinical results of patients treated for a rupture of the distal tendon of biceps brachii Materials and Methods: Between February 1987 and March 2004, we treated 16 patients with a rupture of the distal tendon of biceps brachii. 9 of 16 patients underwent surgical treatment. All cases were male, median age was 26.3(range, 16-48) years. The mean interval between injury and surgery was 4.7 days (range, 1~36 days). Operative correction was performed anatomically, using the two-incision technique(3 cases) or one-incision technique(6 cases). Clinical outcomes were evaluated one year after operation by assessing the review about the physical examination finding and radiologic findings with surgical findings, range of motion, muscle strength, subjective satisfaction, activity and return to previous occupation. and via telephone interview in cases of conservative treatment. Results: In cases of surgical treatment, 85.8%, 86.3% of flexion-extension and supination-pronation motion than healthy side were measured respectively. 75% of flexion power than healthy side was measured. Eight of nine(89%) were very satisfied. Eightl of nine returned to original job. In cases of conservative treatment, 65% of flexion power than pre-injury state was reported. Four of seven were satisfied, two were dissatisfied, one was very dissatisfied. Three of seven returned to original job. Conclusion: Early anatomic reconstruction can restore more strength and endurance for supination and flexion range and power. Conservative management may be considered for partial injuries, but operative repair must be considered in complete rupture, athletes, patient with high activity.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.90-97
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• 1982

Two hundred one patients of ventricular septal defect, which were operated at Seoul National University Hospital, were analysed on clinical background during the period from January, 1975 to December, 1980. The results were as follows: 1. Of the 201 patients, 118 patients were male [58.7%] and 83 patients were female [41.3%]. Their age ranged from 15 months to 40 years, and the mean age was 8.7 years. 40% of the patients were between 4 and 8 years. 2. The most common symptoms showed frequent U RI and exertional dyspnea. 3. On Kirklin`s anatomical classification, type I constituted 26.9%, type II 58.2%, type III 12.4%, and type IV 1.0%. We showed marked increased incidence of type I VSD as compared to Caucasians* 4. 46 cases were associated with other congenital cardiac diseases. They were PDA [13 cases], AI[11 ], ASD[6], PS[10], MI[4], and Double aortic arch [1]. 5. In 128 patients, who had complete hemodynamic data and were not associated with other congenital cardiac diseases, an attempt was made to correlate the EKG findings with the hemodynamic data, and defect size with the hemodynamic data. The children had variable distribution of PA syst. pr. and Rp/Rs. But most of adults had $R_P$/$R_S$of 0.15 or less. As $P_P$/$P_S$increased, the rate of operative complication increased also. 6. When a normal EKG pattern was present, $Q_P$/$Q_S$and $R_P$/$R_S$and $P_P$/$P_S$were relatively low. When EKG findings were LVH pattern, there was diastolic volume overload to left ventricle. As RVH, there was systolic pressure overload to right ventricle. And as BVH, there was mixed pattern of diastolic volume overload to left ventricle and systolic pressure overload to right ventricle. 7. Among patients in defect was less than 1 $cm^2$ per $M^2$ of BSA, $Q_P$/$Q_S$was less than 2:1, and $R_P$/$R_S$less than 0.25, and PAsyst. pr. less than 50 mmHg, and $P_P$/$P_S$was less than 0.5. But patients with the defect greater than 1 $cm^2$ per $M^2$ of BSA had no correlationship between $Q_P$/$Q_S$, $R_P$/$R_S$, PAsyst. pr. and defect size in each other. Most of patients with the defect greater than 2 $cm^2$/$M^2$ BSA, $R_P$/$R_S$was greater than 0.5. 8. Operative mortality rate was 9.5% [19 cases] among 201 patients. And complication rate including mortality rate was 22.9% [46 cases].

• Journal of Chest Surgery
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• v.43 no.4
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• pp.399-403
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• 2010

Background: Video-Assisted Thoracic Surgery can be performed with the lung collapsed. During the procedure, pleural adhesion may result in lung injury, bleeding, and thoracotomy conversion. Identifying the presence of pleural adhesion before surgery can make it easy to plan trocar introduction and perform the procedure. Material and Method: Between June 2009 and November 2009, we performed ultrasound in 24 patients to detect pleural adhesion before surgery and compared the results with the operative findings. We primarily examined the lateral chest, where the trocar would be inserted, and, occasionally, the anterior or posterior chest. Result: Patient diseases were: 6 hyperhidroses, 8 interstitial lung diseases, 5 lung cancers, 2 mediastinal tumors, 1 peripheral pulmonary embolism, 1 metastatic lung cancer, and 1 sarcoidosis. Of the 22 patients who did not have pleural adhesions on ultrasound, four revealed mild adhesions not related to the trocar insertion sites. However, ultrasound showed pleural adhesions in two patients, consistent with the operative findings. There was no air leak or thoracotomy conversion related with trocar insertion. Conclusion: Ultrasound requires only a few minutes to detect the presence of the pleural adhesion and was very useful in identifying the pleural adhesion before VATS.