• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권4호
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• pp.329-332
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• 2007

This study compared and evaluated the variation of patients' symptoms depending on whether or not antibiotics had been used in the recovery period after the orthognathic surgery. 28 patients, with no particular medical history, were divided into two groups on the basis of whether antibiotics had been applied after the orthognathic surgery. All patients had been operated on maxilla and mandible simultaneously and were investigated with any symptom changes within the postoperative 4 days. Among the symptoms that could follow after the orthognathic surgery, 6 symptoms were checked every 24 hours on 5 points basis. Phases of each symptom improvements were checked and analyzed by ANOVA statistical method. Aspects of symptom changes according to application of antibiotics showed no statistical significance. Symptoms, except for swelling, showed continuous improvements after the surgery. Swelling increased until postoperative $2^{nd}\;day$, and then started to decrease. This study shows that post-surgical use of antibiotics has no significance provided that post-surgical infection had not occurred.

• Journal of Chest Surgery
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• 제16권1호
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• pp.97-101
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• 1983

The steadily increasing number of operations performed on the heart has given rise to occasional complications involving the nervous system, and this has been interested to cardiac surgeons and neurologists. This survey has been carried out on all Gases submitted to open heart surgery at Seoul National University Hospital during 1982 to determine which operative features were associated with the occurrence of neurological damage. 514 subjects were studied and neurological damage was noted in twenty-five patients [4.9%]. Eight of these 25 patients died in the postoperative period, but neurological damage contributed to the fatal outcome in six cases. Remaining seventeen patients were discharged without problems except one Cortical blindness and one hemiplegic patients who were survived without other problems . A number of features were found to be related to the development of neurological damage, which were age, duration of perfusion, nature of operation, cardiac rhythm and presence of the thrombi or calcification and hypothermic arrest. But many unknown etiological factors are remained out of our sight. A significant increase in the incidence of neurological damage was shown in older age group [13.3% in over 40 year of age], and also the duration of the bypass was associated with subsequent neurological injury especially more than 120 minutes [11.6%]. The presence of atrial fibrillation with intracardiac thrombi or calcification was also a contributing factor to developing neurological complication [16.7%]. These factors were regarded to influence the postoperative neurological complications and more effective method for prevention of these neurologic complication should be studied.

• Journal of Chest Surgery
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• 제16권1호
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• pp.18-29
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• 1983

Thirty-two patients with a cyanotic cardiac malformations having more complex intracardiac defects than ones in a tetralogy of Fallot underwent complete intracardiac repairs in a-full-year period from July 1981 to June 1982. Twenty-two patients [68.8%] died within 30 days after surgery: Transposition of the great arteries, seven of 10 patients; Double-outlet right ventricle, four of 6 patients; Tricuspid atresia, four of 6 patients; Single ventricle, all of 4 patients; Pulmonary atresia, two of 3 patients; Double-outlet left ventricle, none of 2 patients; and Truncus arteriosus, one of a single patient. All deaths occurred with a low cardiac output syndrome or a failed off-bypass, and they were almost always accompanied with other grave postoperative complications. The complex intracardiac anatomy itself was one of the risk factors by making a complete intracardiac repair of the defects difficult in a small heart. The reconstruction of the right ventricular outflow carried a difficulty in balancing an adequate relief of the obstruction with an avoidance of making too much pulmonary valvular insufficiency as well. On the other hand, the presence of an elevated pulmonary arterial pressure and a high pulmonary vascular resistance was also the factors affecting the postoperative surviv als. The importance of detailed knowledge of intracardiac anatomy and hemodynamics from the careful preoperative evaluation of the patient was discussed along with the necessity of technical refinement of the correction.

• Journal of Chest Surgery
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• 제17권4호
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• pp.819-828
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• 1984

Between September 1973 and December 1983, 61 patients with carcinoma of the esophagus were treated surgically at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Among 61 patients, male patients were 51 cases, female 10 cases and the age ranged from 21 years old to 72 years old with the average of 54.6 years old. Min symptoms of esophageal cancer were dysphagia (91.5%), weight loss (40.4%), pain(27.6%), and the average symptom duration was 3.85 months. The anatomical locations of esophageal cancer in preoperative esophagogram revealed 41.7% in middle 1/3, 8.3% in esophagograstic junction or cardia. Among 61 cases, 9 cases were managed by feeding gastrostomy due to inoperability, 8 cases by exploratory thoracotomy or lapatotomy only without curative or palliative resection, and 44 cases by curative or palliative resection with reconstruction. Among 52 cases of exploration, 44 cases were managed with curative or palliative resection of cancer and the resectability revealed 84.6% in operated cases. Among palliative or curative resected group, the esophagogastrostomy was performed in 40 cases (90.9%), esophagojejunostomy in 3 cases(6.8%), esophagectomy only in 1 case(2.3%). Postoperative complications were noticed in 12 cases, such as anastomotic leakage in 7 cases(15.6%), empyema in 2 cases (4.4%), respiratory failure in 2 cases (4.4%), anastomotic stricture in 1 case (2.2%). among 7 postoperative anastomotic leakage, 2 patients died as a result of that complication and the operative mortality revealed 4.3%. During follow-up work, the mean survival period was 19.3 months in patients who discharged hospital alive, and the 2 year survival rate was 34.6%.

• Journal of Chest Surgery
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• 제7권2호
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• pp.139-144
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• 1974

Clinical observations were made on 513 cases of pulmonary resection for tuberculosis, those were treated at the Department of Thoracic Surgery in National Medical Center from January 1964 to December 1973. 1. The ratio of male to female cases of operation was 2.8:1 in male predominence and age from 21 to 30 occurred 74.3% of the total cases. 2. The extent of disease showed 59.3% moderately advanced, 38.4% far advanced and 2.3% minimal cases. Duration of chemotherapy before surgery was more than one year in 92.7% and only 7.3% was treated less than one year. Preoperative sputum examination for AFB was persistent negative in 8.6,% of cases. 3. Different operative procedures were performed in 513 cases, lobectomy in 230, pneumonectomy and Pleuropneumonectomy in 172, segmentectomy in 63, lobectomy and supplemental segmentectomy with conventional thoracoplasty in 32 cases. 4. The postoperative complications occurred in 67 cases [13.0%]. Of these complications, bleeding in 4.6% , dead space problem in 2.5% and empyema with or without bronchopleural fistula occurred in 2.3% of cases. 5. Overall mortality within 5 months postoperative period was 1.5,0/0 and the most common causes of death were due to shock and empyema with bronchopleural fistula. 6. In all our 867 cases of report I and II, complications occurred in 13.9% and mortality rate was 1.8%.

• 정신신체의학
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• 제7권1호
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• pp.3-9
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• 1999

외모의 이상은 환자에게 정신적 손상 및 사회생활적응에 문제를 일으킬 수 있으므로 성형외과의사의 역할은 단순한 외형의 교정에 그치는 것이 아니라 그 환자의 삶의 질(quality of life)을 높이는 차원에서 환자의 정신적, 정서적 손상을 동시에 교정하여 사회생활에 보다 잘 적응하도록 하는 것이다. 성형수술 받는 환자는 다른 수술 받는 환자에 비해서 수술결과에 대한 기대수준이 높으므로, 의사는 수술 전에 충분한 설명을 해 주어야 하며 수술 후에도 의사 환자 관계를 계속 잘 유지하는 것이 필요하다. 수술결과에 불만족 하는 경우 다른 성형외과의사의 의견(second opinion)을 들어보고, 그래도 불만족 하는 경우 정신과의사의 자문을 받는 것이 순서이다.

• Journal of Chest Surgery
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• 제28권4호
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• pp.355-359
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• 1995

A clinical analysis was performed on 48 cases with mitral stenosis who received open mitral commissurotomy from December 1983 to June 1991 at the Department of Thoracic & Cardiovascular Surgery, Chungnam National University Hospital. Fifteen patients were men and 33 were women. the mean age was 35.6 years with the range of 16 to 61 years. The distribution of preoperative NYHA Functional Classes was as follows; class II, 25 patients; class III, 20 patients; class IV, 3 patients. Three patients had cerebral emboli preoperatively, all of whom were in atrial fibrillation. The preoperative electrocardiographic studies revealed that 32 patients had sinus rhythms and 16 had atrial fibrillations. Twenty-six patients had open mitral commissurotomy alone and 22 patients had additional cardiac procedures. Intraoperatively, there were 6 cases of left atrial thrombosis. There was no perioperative death but early postoperative complications were found in 3 cases. The patients were followed up from 2 to 99 months[mean 33.7 months . There was one case of late unexplained sudden death. There was a case of late postoperative cerebral infarction, 5 cases of mitral restenosis and 3 cases of congestive heart failure and/or arrhythmia. Mitral valve replacements were required in 3 patients.But, it is evident that open mitral commissurotomy has many advantages beyond mitral valve replacement concerning the results of the mitral valve replacement underwent during the same period at the Department of Thoracic & Cardiovascular Surgery, Chungnam National University Hospital.

• Advances in pediatric surgery
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• 제1권1호
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• pp.59-62
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• 1995

Meconium peritonitis is defined as an aseptic, chemical or foreign-body peritonitis caused by spill of meconium in the abdominal cavity related to the prenatal perforation of the intestine. Perforation is usually caused by obstruction from meconium ileus, intestinal atresia, stenosis, volvulus, internal hernia, congenital peritoneal bands, intussusception, or gastroschisis. Less commonly, no evidence of distal obstruction exists. Here, we present two cases of generalized meconium peritonitis of antenatal diagnosis. The first case, detected at 8 months of gestational age, had a perforation of the proximal blind pouch of jejunal atresia, associated with respiratory distress due to severe abdominal distension. This case was successfully treated with resection and anastomosis and brief period of postoperative ventilatory support. The second case had a distal ileal perforation with thick meconium in the terminal ileum. In this case, there was no dilatation of ileum proximal to the perforation site. Resection and anastomosis was performed and postoperative course was uneventful.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.45-48
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• 2020

In neurosurgical cases, problems related to wound healing can vary from simple wound dehiscence to multilayer defects. This study demonstrates an effective method to prevent persistent cerebrospinal fluid (CSF) leakage using reinforcing acellular dermal matrix in neurosurgical patients with wound dehiscence. A 52-year-old woman was admitted for management of recurrent glioblastoma. After tumor removal surgery, the patient experienced sustained CSF leakage from the wound despite reparative attempts. The plastic surgery team performed wound repair procedure after remnant tumor removal by the neurosurgery team. Acellular dermal matrix was applied over the mesh plate to prevent CSF leakage and the postoperative status of the patient was evaluated. No sign of CSF leakage was found in the immediate postoperative period. After 3 years, there were no complications including CSF leakage, wound dehiscence, and infection. We hereby propose this method as a feasible therapeutic alternative for preventing CSF leakage in patients experiencing wound problem after neurosurgical procedures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권3호
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• pp.226-231
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• 2001

Modified surgical technique for transposition of the inferior alveolar nerve followed by immediate placement of endosseous implants in mandibles with moderate to severe atrophy are presented. Five transpositions of the inferior alveolar nerve together with the installation of 10 implants were performed in four patients. The mean postoperative follow-up time was 17 months, with a range of 8 to 20 months. All implants with functioning pontics remained stable, with no mobility or symptoms of pain and infection during the follow-up period. Neurosensory evaluation was performed using the two-point discrimination test. Two patients had objective neurosensory dysfunction at postoperative, but all the nerve function were reported as normal by the patients 4 months postoperatively.