• Asian Spine Journal
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• v.12 no.6
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• pp.1060-1068
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• 2018

Study Design: Retrospective study. Purpose: Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature: Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods: we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results: The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2-L3 before and after surgery, respectively. The corresponding figures at L3-L4, L4-L5, and L5-S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions: we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.555-562
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• 1996

A competent velopharyngeal sphincter is essential for intelligible speech. If the velopharyngeal incompetence exist, the seal will not be complete during speech, with a resultant hypernasal speech quality. The patient with velopharyngeal incompetence(VPI) may develope other compensatory speech problems. There are many approaches available to correct velopharyngeal incompetence, which include speech therapy, push back palatorrhaphy, pharyngeal wall implants and pharyngoplasty. This is cases report of velopharyngeal incompetence, which were successfully treated by superiorly based pharyngeal flap, covered with splitted hinge flap of nasal lining mucosa of the soft palate, named modified Hogan method. The advantages of this method are precision in the approximation of the flap due to pentagonal shaped flap design, good blood supply due to omission of the midsagittal incision on nasal lining mucosa, and simplicity than Hogan method.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.51-55
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• 2009

Purpose: Excessive apocrine gland secretion and bacterial decomposition cause axillary osmidrosis, which results in physical discomforts and social problems of patients. Many surgical procedures have been introduced such as skin excision and simple closure, local flap, skin graft, subcutaneous shaving and liposuction method, but the result was not satisfactory to patients and several complications, such as symptom recurrence, hematoma, seroma, delayed wound healing, skin flap necrosis and scarring remain as problems. Methods: For the purpose of reducing these problems, we employed combination treatment of liposuction and rasping method. From January 2006 to February 2008, Total 54 patients were treated with this procedure for bilateral axillary osmidrosis. Results: Follow - up evaluation period was from 2 months to 12 months, and the results were satisfactory. In our method, the length of skin incision is less than 1 cm, so the resultant scar is negligible. Apocrine glands in subcutaneous tissue were mostly removed by liposuction apparatus and remained other glands in subdermal area were mostly removed by rasping. The recurrence rate and postoperative complication were minimal. Conclusion: Our method is very simple, short operation time and excellent results without specific complication.

• Archives of Plastic Surgery
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• v.42 no.3
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• pp.361-362
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• 2015

• Journal of Chest Surgery
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• v.15 no.4
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• pp.428-431
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• 1982

A vascular complication caused by lumbar disc surgery is not infrequent till recently after the first report by Linton & White in 1945. In October 1980, we experienced one case of arteriovenous fistula following lumbar disc surgery in the department of thoracic surgery, CAFGH. The A-V fistula was situated between left common iliac artery and vein, which was confirmed by angiography easily. The A-V fistula was corrected surgically by Taylor`s method successfully without complication.

• Archives of Plastic Surgery
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• v.45 no.1
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• pp.96-97
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• 2018

• Archives of Craniofacial Surgery
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• v.19 no.2
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• pp.102-107
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• 2018

Background: Nasal fracture and orbital blowout fracture often occur concurrently in cases of midface blunt trauma. Generally, these multiple fractures treatment is surgery, and typically, the nasal bone and orbit are operated on separately. However, we have found that utilizing a transconjunctival approach in patients with concurrent nasal bone fracture and orbital blowout fracture is a useful method. Methods: The participants in the present study included 33 patients who visited the Plastic Surgery outpatient department between March 2014 and March 2017 and underwent surgery for nasal fracture and orbital blowout fracture. We assessed patients' and doctors' satisfaction with surgical outcomes after indirect open reduction via a transconjunctival approach for the treatment of nasal bone fracture with associated orbital blowout fracture. Results: According to the satisfaction scores, both patients and doctors were satisfied with transconjunctival approach. Conclusion: We presented here that our method enables simultaneous operation of nasal fracture accompanied by orbital blowout fracture, rather than treating the two fractures separately, and it allows precise reduction of the nasal fracture by direct visualization of the fracture site without any additional incisions or difficult surgical techniques. Also, by preventing the use of excessive force during reduction, this method can minimize damage to the nasal mucosa, thereby reducing the incidence of nasal bleeding.

• Archives of Plastic Surgery
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• v.49 no.1
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• pp.34-38
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• 2022

The deep inferior epigastric perforator (DIEP) flap has been widely used for autologous breast reconstruction after mastectomy. In the conventional surgical method, a long incision is needed at the anterior fascia of the rectus abdominis muscle to obtain sufficient pedicle length; this may increase the risk of incisional hernia. To shorten the incision, several trials have investigated the use of endoscopic/robotic devices for pedicle harvest; however, making multiple additional incisions for port insertion and operating in the intraperitoneal field were inevitable. Here, we describe the first case, in which a DIEP free flap was successfully made using the da Vinci SP model. Our findings can help surgeons perform operations in smaller fields with a single port in the extraperitoneal space. Moreover, this method is expected to lead to fewer donor-related complications and faster healing.

• Korean Journal of Cleft Lip And Palate
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• v.6 no.2
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• pp.91-105
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• 2003

There are significant limitations in the precision of mandibular distraction in setting a desired occlusal and facial esthetic outcome. The purpose of this study is to present the simulation method for the distraction osteogenesis treatment planning. 3-D surgery simulation software programs V-works and V-Surgery(Cybermed, Seoul, Korea) were used from the 3D CT data in addition to the conventional data facial photography, panorama and cephalogram, dental cast model. We have utilized already for the various surgical procedures to get information preoperatively for the maxillofacial surgery like cancer localization and reconstructive surgery, orthognathic surgery and implant surgery in the department of Oral and Maxillofacial surgery, Seoul National University Hospital. On the software, bone cutting can be done at any place and any direction. Separated bone segment can be mobilized in all 3 dimensional direction. After the 3D simulation on the software program, mock surgery on the RP model can be performed. This planning method was applied to two hemifacial microsomia patients. With this protocol, we could simulate the movement of bony segment after maxillofacial distraction osteogenesis

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.1
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• pp.82-88
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• 2005

Treatment methods of mandibular condylar fracture were conservative and surgical method. Surgical method of mandibular high condylar fracture was very difficult because approach and internal fixation of small size fracture fragment were difficult. So there is a tendency to select conservative method over surgical method for guiding a stable occlusion and avoiding TMJ disorder and growth disturbance, minimizing pain and deviation during function. But, in case of mandibular high condylar fracture patient who has no biting teeth on posterior teeth area, guiding a stable occlusion and conservative functional treatment were very difficult. In this case, patient was 62years old male. He had fracture of mandibular symphysis, right mandibular body, left mandibular high condyle. We treated the patient for mandibular symphysis and right mandibular body fracture area with surgical method. But left mandibular high condylar fracture area was difficult to treat with surgical method. So we selected a conservative functional method on left mandibular high condylar fracture area. We intended recovery of vertical dimension and stable occlusion with implantation of immediate provisional implant on maxillar and mandibular posterior teeth area, and temporary crown. And then patient did mandibular functional movement and his mandibular function was recoverd.