• Knee surgery & related research
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• 제30권4호
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• pp.319-325
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• 2018

Purpose: Body mass index (BMI) is often used to predict surgical difficulty in patients receiving total knee arthroplasty (TKA); however, BMI neglects variation in the central versus peripheral distribution of adipose tissue. We sought to examine whether anthropometric factors, rather than BMI alone, may serve as a more effective indication of surgical difficulty in TKA. Materials and Methods: We prospectively enrolled 67 patients undergoing primary TKA. Correlation coefficients were used to evaluate the associations of tourniquet time, a surrogate of surgical difficulty, with BMI, pre- and intraoperative anthropometric measurements, and radiographic knee alignment. Similarly, Knee Injury and Osteoarthritis Outcome Score (KOOS) was compared to BMI. Results: Tourniquet time was significantly associated with preoperative inferior knee circumference (p=0.025) and ankle circumference (p=0.003) as well as the intraoperative depth of incision at the quadriceps (p=0.014). BMI was not significantly associated with tourniquet time or any of the radiographic parameters or KOOS scores. Conclusions: Inferior knee circumference, ankle circumference, and depth of incision at the quadriceps (measures of peripheral obesity) are likely better predictors of surgical difficulty than BMI. Further study of alternative surgical indicators should investigate patients that may be deterred from TKA for high BMI, despite relatively low peripheral obesity.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권3호
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• pp.206-210
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• 2007

This study observed the frequency of post-surgical infection according to post-surgical application of antibiotics in order to evaluate the benefits of the use of antibiotics after the orthognathic surgery. 349 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The mean(SD) age of the 349 patients was 22.7(${\pm}4.25$) with a male-female ratio of 168:181. 226 patients received only 1.0g of a third-generation cephalosporin(Cefpiramide) intravenously 30 minutes prior to the surgery. Likewise, 123 patients received 1.0g of Cefpiramide 30 minutes prior to the surgery and twice daily longer than the third day after surgery. The mean(SD) duration of administration was 4.75(${\pm}0.89$) day. The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. However, 14 patients of 226 patients received antibiotics only prior to the surgery developed postoperative infection, 2 patients of 123 patients received antibiotics longer than postoperative 3 days developed postoperative infection. Postoperative infection frequency showed no significant difference between the two groups(p=0.094). Also, bi-maxillary operation and mandibular operation alone, showed no significant difference in the frequency of post-surgical infection when antibiotics had been continuously used after the surgery. From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.

• Journal of Chest Surgery
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• 제56권3호
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• pp.206-212
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• 2023

Background: Delayed sternal closure (DSC) is a useful option for patients with intractable bleeding and hemodynamic instability due to prolonged cardiopulmonary bypass and a preoperative bleeding tendency. Vacuum-assisted closure (VAC) has been widely used for sternal wound problems, but only rarely for DSC, and its efficacy for mediastinal drainage immediately after cardiac surgery has not been well established. Therefore, we evaluated the usefulness of DSC using VAC in adult cardiac surgery. Methods: We analyzed 33 patients who underwent DSC using VAC from January 2017 to July 2022. After packing sterile gauze around the heart surface and great vessels, VAC was applied directly without sternal self-retaining retractors and mediastinal drain tubes. Results: Twenty-one patients (63.6%) underwent emergency surgery for conditions including type A acute aortic dissection (n=13), and 8 patients (24.2%) received postoperative extracorporeal membrane oxygenation support. Intractable bleeding (n=25) was the most common reason for an open sternum. The median duration of open sternum was 2 days (interquartile range [25th-75th pertentiles], 2-3.25 days) and 9 patients underwent VAC application more than once. The overall in-hospital mortality rate was 27.3%. Superficial wound problems occurred in 10 patients (30.3%), and there were no deep sternal wound infections. Conclusion: For patients with an open sternum, VAC alone, which is effective for mediastinal drainage and cardiac decompression, had an acceptable superficial wound infection rate and no deep sternal wound infections. In adult cardiac surgery, DSC using VAC may be useful in patients with intractable bleeding or unstable hemodynamics with myocardial edema.

• Journal of Periodontal and Implant Science
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• 제29권3호
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• pp.519-540
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• 1999

The purpose of this study is to compare the healing aspects of the use of ePTFE membrane alone versus combination treatment of ePTFE membrane and bone grafts on class II furcation defects. Seventeen defects were applied ePTFE membrane alone on mxillary molar buccal class II furcation defects as Group I, seventeen defects were applied ePTFE membrane and bone grafts on maxillary molar buccal class II furcation defects as Group II, twenty-three defects were applied ePTFE membrane alone on mandibular molar buccal class II furcation defects as Group III, twenty defects were applied ePTFE membrane and bone grafts on mandibular molar buccal class II furcation defects as Group IV . Measurements were made to determine clinical attachment level, probing depth, gingival depth, SBI, mobility at baseline, 3, 6, 12 months postoperatively. Additional measurements were made to determine membrane exposure level at surgery, 1, 2, 6 weeks postoperatively. And then healing patterns and postoperative complications were evaluated. The result as follows : There were statistically significant differences in probing depth reduction, clinical attachment gain, mobility reduction at values of 3, 6, 12 months postoperatively compared to values of baseline(p<0.05), whereas no significant differences in SBI and gingival recession. In group II, membrane exposure level was increased at 1, 2, 6 weeks postoperatively compared to value of baseline(p<0.05). There were statistically significant differences in changes of probing depth at 3, 6, 12 months postoperatively in combination groups of ePTFE membrane and bone graft compared to groups of ePTFE membrane alone(p<0.05). The vast majority of cases fall into typical healing and delayed healing response when membranes were removed in all groups. Pain and swelling were common postoperative complications. In conclusion, this study was showed more effective healing aspects in combination treatment of ePTFE membrane and bone graft than ePTFE membrane alone and on mandibular molar class II furcation defects than maxillary molar.

• 대한두경부종양학회지
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• 제6권2호
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• pp.108-113
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• 1990

Thirty nine cases of nasopharyngeal malignant tumor from 1981 to 1989 in Korea univeristy hospital were reviewed retrospectively. The results were as follows; 1) The most common initial symptom was neck mass(41.0%), and cranial nerve involvement was found in 6 cases. Lateral wall of the nasopharynx including $Rosenm\"{u}ller's$ fossa was the frequent predelection site(68.4%). 2) Histopathologically, squamous cell carcinoma was the most common and stage IV were 71.8%. 3) Thirty four cases were treated by radiation therapy alone and 5 cases were treated by combined modality(radiation therapy+chemotherapy). Overall 5 year survival rate was 28.2%(squamous cell carcinoma; 23.5%, undifferentiated carcinoma; 35.7%).

• 대한두경부종양학회지
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• 제16권1호
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• pp.83-86
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• 2000

Thyroglossal duct cyst is common midline mass, which is related to hyoid bone and may show signs of inflammation. Carcinoma arising in the thyroglossal duct cyst is rare, occuring in less than 1% of thyroglossal duct cyst. Papillary adenocarcinoma is the most common histologic type(75-85%). The initial treatement of choice is wide excision of the tumor bearing tissue(Sistrunk procedure), resection of associated lymph node alone is enough when they are small and isolated, but a modified neck dissection must be done if regional involvement is more extensive. Its prognosis is excellent(the incidence of regional lymph node metastasis is 7% compare to 89% for papillary cancer of thyroid gland proper).

• Journal of Chest Surgery
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• 제26권9호
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• pp.686-695
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• 1993

A total of eighty one patients with resected stage II and IIIA non-small cell lung cancer treated with postoperative adjuvant radiation therapy between Jan. 1971 and Dec. 1990 were retrospectively analysed to evaluate whether postoperative radiation therapy improves survival. Patterns of failure and prognostic factors were also analysed. The 5 year overall and disease free survival rate were 40.5%, 43.4% and median survival 30 months. The 5 year actuarial survival rates by stage II and IIIA were 53.9% and 36.2%. Loco-regional failure rate was 14.7% and distant metastasis rate was 33.3% and both 4%. Statistically significant prognostic factor affecting survival was presence of mediastinal lymph node metastasis[N2]. This retrospective study suggests that postoperative radiation therapy in resected stage II and IIIA non-small cell lung cancer can reduce loco-regional recurrence and may improve survival rate as compared with other studies which were treated by surgery alone.

• Clinics in Shoulder and Elbow
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• 제6권1호
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• pp.67-71
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• 2003

The shoulder is the most common site in the body for calcific deposition. Calcific tendinitis is one of the common lesions of the painful shoulder. The surpaspinatus tendon is the most frequently affected location, next the infraspinatus and relatively rare the subscapularis tendon. We report upon a case of calcific tendinitis of subscapularis tendon alone, which developed in a 61-year-old female after minor trauma and was treated successfully with surgical excision.

• Journal of Chest Surgery
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• 제6권1호
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• pp.95-100
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• 1973

This is a report on a total of four cases of esophageal perforation due to fish bone in the Department of Thoracic Surgery, Hanyang University Hospital. The perforated portions of esophagus were upper third of esophagus, that is, cervical esophalgus principally. The complications after esophageal perforation were acute mediastinitis with mediastinal emphysema in 2 cases, acute mediastinitis with both pyothorax in one case and cervical subcutaneous abscess alone in one case. Collar mediastinostomy was required to control disturbance of cardiopulmonary function as emergency procedure. Gastrostomy was of worthy for the various purposes, that` is, for feeding, absolute rest of the esophagus, and for prevention against continuous infection from esophageal leakage. After the gastrostomy. 3 cases were healed by spontaneous closure of esophageal perforation between one to four weeks. One case expired from severe septic shock due to acute diffuse mediastinitis and both pyothorax.

• Journal of Chest Surgery
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• 제22권2호
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• pp.265-271
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• 1989

Sixteen patients with esophageal diverticulum operated on between July 1979 and September 1988 at the Department of Thoracic Surgery of National University Hospital have been studied. There were 2 cases of the pharyngoesophageal diverticula, 12 cases of the midesophageal diverticula, and 2 cases of the epiphrenic diverticula. Twelve cases of midesophageal diverticula consisted of 9 cases of pulsion type and 3 cases of traction type. There were 13 women and three men, whose ages ranged from 25 to 65 years with an average age of 45.5 years. Diverticulectomy alone in three cases, diverticulopexy with myotomy in two cases, and diverticulectomy with myotomy in 11 cases were performed. There were no deaths or morbidity and all patients have achieved marked improvement of their symptoms except four patients who had a concomitant hypopharyngeal carcinoma, had a postoperative recurrence in epiphrenic diverticulum, and had two cases of postoperative transient regurgitation which subsided spontaneously one and one and half year later.