• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.3
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• pp.167-173
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• 2022

Objectives: The purpose of this study was to estimate the minimal clinically important difference (MCID) of mouth opening (MO) and patient satisfaction in surgically treated oral submucous fibrosis (OSMF) patients. Materials and Methods: The status of MO was collected preoperatively (T0), postoperatively at 3 months (T1), and at a minimum of 6 months postoperatively (T2). MCID was determined through the anchor-based approach with the change difference method, mean change method, and receiver operator characteristic curve (ROC) method. Results: In this study, 35 patients enrolled and completed postoperative follow-up (T2) averaging a duration of 18.1 months. At T1, using the change difference method, MO was 14.89 mm and the ROC curve exhibited a 11.5 gain in MO (sensitivity 81.8% and specificity 100%, area under the curve [AUC] of 0.902) and was classified as MCID as reported by patients. At T2, MCID of MO was 9.75 mm using the change difference method and 11.75 mm by the mean change method. The ROC curve revealed that the MCID of MO at T2 was 10.5 mm with 73.9% sensitivity and 83.3% specificity (AUC of 0.873). The kappa value was 0.91, confirming reliability of the data. Conclusion: This study demonstrated MCID values that indicate the clinical relevance of surgical treatment of OSMF if the minimum possible gain in MO is approximately 10 mm.

• Archives of Plastic Surgery
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• v.49 no.2
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• pp.166-173
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• 2022

The introduction of acellular dermal matrix (ADM) to breast reconstruction has allowed surgeons to reexplore the prepectoral implant placement technique in postmastectomy breast reconstruction. Our institution adopted a novel approach using meshed ADM to lessen the financial burden of increased ADM utilization with the prepectoral breast reconstruction. This is a retrospective, single-center review of two-stage prepectoral breast reconstruction using meshed human-derived ADM for anterior prosthesis coverage. Patient demographics, oncologic data, perioperative characteristics, and complications were examined and reported as means with standard deviations. Cost-saving with the meshed technique was evaluated. Forty-eight patients (72 breasts) with a mean age of 48.5 ± 15.0 years (range 26-70 years) were included in the study. The mean follow-up time was 13.2 ± 4.4 months (range 4.1-25.8 months). Nineteen breasts (24.6%) experienced complications, with seromas being the most common complication (12.5%, n = 9). Expander removal and reoperation occurred at a rate of 8.3 and 9.7%, respectively. The average time to drain removal was 18.8 ± 6.6 days (range 8-32 days). Meshed ADM provided an average cost savings of $6,601 for unilateral and $13,202 for bilateral reconstructions. Our study found that human-derived meshed ADM can be safely used in two-staged prepectoral tissue expander-based breast reconstruction and can result in significant cost savings.

• Journal of Veterinary Clinics
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• v.39 no.4
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• pp.162-167
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• 2022

To determine the prevalence of breed, age, and sex of canine primary glaucoma by comparing previous reports in Korea. We included the medical records of dogs diagnosed with primary glaucoma who visited the veterinary medical teaching hospital of Seoul National University (SNU) from January 2011 to December 2020 and investigated their breed, age, and sex. All the patients underwent a full ophthalmic examination. We analyzed the results using a binary logistic regression analysis based on the Jindo dog, which was close to the mean value of the primary glaucoma incidence rate. Of the 14,587 dogs treated at the veterinary medical teaching hospital of SNU, 107 (0.73%) were diagnosed with primary glaucoma. Glaucoma occurred in 14 breeds, including the American Cocker Spaniel, Shih Tzu, Maltese, Pomeranian, Jindo dog, Mixed Breed, Pekinese, Toy Poodle, Samoyed, Shiba Inu, Miniature Pinscher, Boston Terrier, Labrador retriever, and Yorkshire Terrier. The mean age of onset of primary glaucoma was 7.8 ± 2.3 years. Primary glaucoma was observed in 53 spayed females, 11 females, 38 castrated males, and five males. Regardless of neutralization, the ratio of females to males was 1.5:1. This study showed that primary glaucoma was significantly higher in American Cocker Spaniels and higher in Shih Tzus than other breeds in Korea; they had the highest incidence of primary glaucoma at 7 and 8 years of age, respectively. Therefore, the two breeds should be carefully monitored for the occurrence of primary glaucoma when they approach 7 years of age.

• Archives of Craniofacial Surgery
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• v.24 no.1
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• pp.24-27
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• 2023

Background: Osteomas are benign, slow-growing bone tumors that can be classified as central, peripheral, or extraskeletal. Central osteomas arise from the endosteum, peripheral osteomas from the periosteum, and extraskeletal osteomas within the muscle. Frontal peripheral osteomas are mainly encountered in plastic surgery. In this study, we retrospectively analyzed the clinical data of patients with frontal peripheral osteomas. Methods: We retrospectively reviewed the medical records of patients who visited our hospital with frontal peripheral osteomas between January 2014 and June 2022. We analyzed the following variables: age, sex, tumor type (sessile or pedunculated), single or multiple, size, history of head trauma, operation, and recurrence. Results: A total of 39 patients and 41 osteomas were analyzed, of which 29 osteomas (71%) were sessile and 12 osteomas (29%) were pedunculated. The size of the osteomas ranged from 4 to 30 mm, with an average size of 10 mm. The age of patients ranged from 4 to 78 years with a mean age of 52 years. There were seven men (18%) and 32 women (82%), and the man-to-woman ratio was 1:4.6. Two patients (5%) had multiple masses, with two osteomas in each, while only two patients (5%) had a history of head trauma. Twenty-nine patients (74%) underwent ostectomy by a direct approach, and none of the patients experienced recurrence. Conclusion: The epidemiologic data of our study will help plastic surgeons encounter frontal peripheral osteomas in the field to provide proper management for their patients.

• The Journal of the Society of Stroke on Korean Medicine
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• v.16 no.1
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• pp.89-102
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• 2015

■ Objectives This study aimed to investigate the domestic research trend about Amyotrophic Lateral Sclerosis(ALS) treated with Traditional Korean Medicine(TKM). ■ Methods Searches of two major TKM databases were conducted for articles published up to July 2015. Searching keyword was "Lou Gehrig's disease" OR "amyotrophic lateral sclerosis". Studies dealt TKM for ALS were included. ■ Results 18 studies were met our inclusion criteria(two prospective studies, one retrospective study, one follow-up study, 14 case reports). Complex TKM intervention of herbal medication, acupuncture and pharmacopuncture was the most frequently used treatment. Individually, herbal medication was the most frequent followed by acupuncture. Short-term assessment showed improvement in ALS symptoms but long-term assessment showed progression of disease. Accessory symptoms including depression, anxiety and insomnia were improved in four studies. ■ Conclusion For more definite evidence, larger studies with long-term follow-up period are needed. Moreover, benefits that TKM can provide for ALS patients as a part of multi-disciplinary approach should be studied in depth.

• Journal of Chest Surgery
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• v.56 no.2
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• pp.120-125
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• 2023

Background: Multiple rib fractures are common in blunt chest trauma. Until recently, most surgical rib fixations for multiple rib fractures were performed via open thoracotomy. However, due to the invasive nature of tissue dissection and the resulting large wound, an alternative endoscopic approach has emerged that minimizes the postoperative complications caused by the manipulation of injured tissue and lung during an open thoracotomy. Methods: Our study concentrated on patients with multiple rib fractures who underwent surgical stabilization of rib fractures (SSRF) between June 2018 and May 2020. We found 27 patients who underwent SSRF using video-assisted thoracoscopic surgery. The study design was a retrospective review of the patients' charts and surgical records. Results: No intraoperative events or procedure-related deaths occurred. Implant-related irritation occurred in 4 patients, and 1 death resulted from concomitant trauma. The average hospital stay was 30.2±20.1 days, and ventilators were used for 12 of the 22 patients admitted to the intensive care unit. None of the patients experienced major pulmonary complications such as pneumonia or acute respiratory distress syndrome. Conclusion: Minimally invasive rib stabilization surgery with the assistance of a thoracoscope is expected to become more widely used in patients with multiple rib fractures. This method will also assist patients in a quick recovery.

• Journal of Chest Surgery
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• v.56 no.2
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• pp.128-135
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• 2023

Background: Pneumonia caused by severe acute respiratory syndrome coronavirus 2 can cause acute respiratory distress syndrome, often requiring prolonged mechanical ventilation and eventually tracheostomy. Both procedures occur in isolation units where personal protective equipment is needed. Additionally, the high bleeding risk in patients with extracorporeal membrane oxygenation (ECMO) places a great strain on surgeons. We investigated the clinical characteristics and outcomes of percutaneous dilatational tracheostomy (PDT) in patients with coronavirus disease 2019 (COVID-19) supported by ECMO, and compared the outcomes of patients with and without ECMO. Methods: This retrospective, single-center, observational study included patients with severe COVID-19 who underwent elective PDT (n=29) from April 1, 2020, to October 31, 2021. The patients were divided into ECMO and non-ECMO groups. Data were collected from electronic medical records at Ajou University Hospital in Suwon, Korea. Results: Twenty-nine COVID-19 patients underwent PDT (24 men [82.8%] and 5 women [17.2%]; median age, 61 years; range, 26-87 years; interquartile range, 54-71 years). The mean procedure time was 17±10.07 minutes. No clinically or statistically significant difference in procedure time was noted between the ECMO and non-ECMO groups (16.35±7.34 vs. 18.25±13.32, p=0.661). Overall, 12 patients (41.4%) had minor complications; 10 had mild subdermal bleeding from the skin incision, which was resolved with local gauze packing, and 2 (6.9%) had dislodgement. No healthcare provider infection was reported. Conclusion: Our PDT approach is safe for patients and healthcare providers. With bronchoscopy assistance, PDT can be performed quickly and easily even in isolation units and with acceptable risk, regardless of the hypo-coagulable condition of patients on ECMO.

• The korean journal of orthodontics
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• v.53 no.6
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• pp.365-373
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• 2023

Objective: To investigate the potential correlation between fixed orthodontic retention failure and several patient- and treatment-related factors. Methods: Patients finishing treatment with fixed appliances between 2016 and 2017 were retrospectively included in this study. Those not showing fixed retention failure were considered as control group. Patients with fixed retention failure were considered as the experimental group. Additionally, patients with failure of fixed retainers in the period of June 2019 to March 2021 were prospectively identified and included in the experimental group. The location of the first retention failure, sex, pretreatment dental occlusion, facial characteristics, posttreatment dental occlusion, treatment approach and presence of oral habits were compared between groups before and after treatment separately by using a Fisher exact test and a Mann-Whitney U test. Results: 206 patients with fixed retention failure were included, 169 in the mandibular and 74 in the maxillary jaws. Significant correlations were observed between retention failure in the mandibular jaws and mandibular arch length discrepancy (P = 0.010), post-treatment growth pattern (P = 0.041), nail biting (P < 0.001) and abnormal tongue function (P = 0.002). Retention failure in the maxillary jaws was more frequent in patients with IPR in the mandibular jaws (P = 0.005) and abnormal tongue function (P = 0.021). Conclusions: This study suggests a correlation between fixed retention failure and parafunctional habits, such as nail biting and abnormal tongue function. Prospective studies with larger study populations could further confirm these results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.2
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• pp.86-93
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• 2024

Objectives: Orthognathic surgery is a surgical procedure performed by intraoral approach with established and safe techniques; however, excessive blood loss has been reported in rare cases. In response, investigative efforts to identify methods to reduce the amount of blood loss have been made. Among such methods, the administration of tranexamic acid was reported to reduce the amount of intraoperative blood loss. However, few studies to date have reported the effect of tranexamic acid in orthognathic surgery under hypotensive anesthesia. The present study aimed to investigate the effect of the administration of tranexamic acid on intraoperative blood loss in patients undergoing bimaxillary (maxillary and mandibular) orthognathic surgery under hypotensive anesthesia. Patients and Methods: A total of 156 patients (mean age, 27.0±10.8 years) who underwent bimaxillary orthognathic surgery under hypotensive anesthesia performed by the same surgeon between June 2013 and February 2022 were included in this study. The following data were collected from the medical records of each patient: background factors (age, sex, and body mass index), use of tranexamic acid, surgical procedures, previous medical history, duration of surgery, American Society of Anesthesiology physical status findings before surgery, intraoperative blood loss as a primary outcome, in-out balance, and blood test results. Descriptive statistics were calculated for statistical analysis, and a t-test and the chi-squared test were used for between-group comparisons. Group comparisons were performed after 1:1 propensity score matching to adjust for confounding factors. Statistical significance was set at P<0.05. Results: Comparison between the groups based on the use of tranexamic acid revealed a significant difference in operation time. Propensity score matching analysis revealed that intraoperative blood loss was significantly lower in the tranexamic acid group. Conclusion: The administration of tranexamic acid was effective in reducing intraoperative blood loss in patients undergoing bimaxillary orthognathic surgery under hypotensive anesthesia.

• Korean Journal of Radiology
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• v.24 no.12
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• pp.1241-1248
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• 2023

Objective: To evaluate the role of percutaneous pancreatic stent placement in postoperative pancreaticojejunostomy stenosis (PJS). Materials and Methods: This retrospective single-center study included seven procedures in five patients (four males and one female; median age, 63 years) who underwent percutaneous pancreatic stent placement for postoperative PJS between January 2005 and December 2021. The patients were referred to interventional radiology because of unfavorable anatomy or bowel abnormalities. The pancreatic duct was accessed under ultrasound and/or computed tomography guidance. A stent was placed after balloon dilatation of the PJS. Moreover, plastic stents were placed for the first two procedures, whereas bare-metal stents were used for the remaining five procedures. Technical success was defined as the successful placement of stents for the PJS, meanwhile, clinical success was defined as the normalization of pancreatic enzymes without recurrence of pancreatitis. Results: Pancreatic duct access and stent placement were successfully performed in all patients (technical success rate: 100%). All the procedures initially yielded clinical success. However, recurrence of pancreatitis was observed after two procedures that used plastic stents because of stent migration at 0.3 and 3 months after the procedure. In contrast, no instances of recurrent pancreatitis were noted after metal stent placement for a follow-up duration of 1-36 months. No serious procedure-related adverse events were observed. Conclusion: Percutaneous pancreatic stent placement may be a viable option for patients with postoperative PJS in whom an endoscopic approach is not feasible. Metal stents may be considered over plastic stents for the management of PJS, considering the possible lower stent migration and infeasibility of frequent endoscopic stent exchange due to the altered anatomy.