• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.6
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• pp.266-272
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• 2014

Purpose: This study was conducted in order to investigate the therapeutic effect of closed reduction according to a classification in patients with nasal bone fracture. Methods: The study was conducted retrospectively on 186 patients with a mean age of 38 years (range: 7 to 80 years). All patients were diagnosed by clinical and radiologic examination, and then classified according to Hwang's classification by computed tomography. The patients were further classified by their age, gender, causes of fracture, operation timing after fracture, concurrent facial bone fracture, and complications. All patients underwent the same reduction and treatment protocol and were then followed up regularly for at least three months. Results: The cause of the fracture was slip down, and the highest prevalence was shown in the 20s. The mean operation timing after fracture was 4.1 days (range: 1 to 14 days), and it tended to be longer in the case of defected septal bone or more severe fracture. The most common concurrent facial bone fracture was orbital blow-out fracture, and zygomaticomaxillary complex and maxillary fracture occured frequently. The largest number of complications occurred in class III and IIBs patients, and the main complication was postoperative pain. Conclusion: Results of nasal bone closed reduction on the 186 patients showed that serious complications rarely occurred. Closed reduction is generally an effective treatment for nasal bone fracture. However, in the case of severe concurrent septal bone fracture or comminuted fracture with depression, open reduction should be considered. Further study with a larger number of patients and further classification is required.

• Journal of Gastric Cancer
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• v.11 no.1
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• pp.46-54
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• 2011

Purpose: There are few studies that have focused on the predictors of recurrence after gastrectomy for gastric carcinoma. This study analyzed the patients who died of recurrent gastric carcinoma and we attempted to clarify the clinicopathologic factors that are associated with the timing of recurrence. Materials and Methods: From June 1992 to March 2009, 1,795 patients underwent curative gastric resection at the Department of Surgery, Hanyang University College of Medicine. Among them, 428 patients died and 311 of these patients who died of recurrent gastric carcinoma were enrolled in this study. The clinicopathologic findings were compared between the 72 patients who died within one year after curative gastrectomy (the early recurrence group) and the 92 patients who died 3 years after curative gastrectomy (the late recurrence group). Results: Compared with the late recurrence group, the early recurrence group showed an older age, a more advanced stage, a poorly differentiated type of cancer and a significantly higher tendency to have lymphatic invasion, vascular invasion and perineural invasion.Especially in the gastric cancer patients with a more advanced stage (stage III and IV), the early recurrence group was characterized by a significantly higher preoperative serum carcino embryonic antigen level, perineural invasion and a relatively small number of dissected lymph nodes. Conclusions: The clinicopathologic characteristics of recurrent gastric cancer are significantly different according to the stage of disease, and even in the same stage. For the early detection of recurrence after curative surgery, it is important to recognize the clinicopathological factors that foretell a high risk of recurrence. It is mandatory to make an individualized surveillance schedule according to the clinicopathologic factors.

• Journal of Gastric Cancer
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• v.21 no.1
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• pp.30-37
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• 2021

Purpose: While the amylase concentration of the drainage fluid (dAmy) has been reported to be a predictor of postoperative pancreas-related complications (PPRC), the optimal timing for its measurement has not been fully investigated. Materials and Methods: The clinicopathological data of 387 patients who underwent elective gastrectomy for gastric cancer were reviewed. Laboratory data, including dAmy on postoperative days 1 (dAmy1) and 3 (dAmy3), and serum C-reactive protein (sCRP) concentrations on postoperative days 1 (sCRP1) and 3 (sCRP3) were compared between patients with PPRC and without PPRC. Results: Nineteen of the 387 patients (4.9%) developed PPRC. The optimal cutoff values of dAmy1, dAmy3, sCRP1, and sCRP3 were 1514 IU/L, 761 IU/L, 8.32 mg/dL, and 15.15 mg/dL, respectively. The area under the curve of dAmy1 was greater than that of dAmy3 (0.915 vs. 0.826), and that of sCRP3 was greater than that of sCRP1 (0.820 vs. 0.659). In the multivariate analysis, dAmy1 (P<0.001) and sCRP3 (P=0.004) were significant predictors of PPRC, while dAmy3 (P=0.069) and sCRP1 (P=0.831) were not. Thirteen (41.9%) of 31 patients with both dAmy1 ≥1,545 IU/L and sCRP3 ≥15.15 mg/dL had PPRC ≥Clavien-Dindo II. In contrast, among 260 patients with both dAmy1 <1,545 IU/L and sCRP3 <15.15 mg/dL, none developed PPRC. Conclusions: dAmy1 was more useful than dAmy3 in predicting PPRC. The combination of dAmy1 and sCRP3 may be a useful criterion for the removal of drains on postoperative day 3.

• Journal of Chest Surgery
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• v.49 no.2
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• pp.115-118
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• 2016

Williams syndrome (WS) is a developmental disorder characterized by vascular abnormalities such as thickening of the vascular media layer in medium- and large-sized arteries. Supravalvular aortic stenosis (SVAS) and peripheral pulmonary artery stenosis (PPAS) are common vascular abnormalities in WS. The natural course of SVAS and PPAS is variable, and the timing of surgery or intervention is determined according to the progression of vascular stenosis. In our patient, SVAS and PPAS showed rapid concurrent progression within two weeks after birth. We report the early manifestation of SVAS and PPAS in the neonatal period and describe the surgical treatment for stenosis relief.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.77-86
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• 2009

Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.1
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• pp.39-40
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• 2009

Maxillary sinusitis is an infectious disease which can arise from odontogenic etiology and a maxillary osteomyelitis can spread into the sinus and consequently develop maxillary sinusitis. In this case report, a mid eighty's lady was diagnosed as BRONJ with maxillary sinusitis as a complication. The patient was managed successfully in collaboration with a endocrinologist. Through serial follow-up of serum CTX, we could decide the timing of surgical intervention.

• Journal of Chest Surgery
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• v.53 no.4
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• pp.178-183
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• 2020

During esophagectomy and esophagogastrostomy, the prediction of anastomotic leakage relies on the operating surgeon's tactile or visual diagnosis. Therefore, anastomotic leaks are relatively unpredictable, and new intraoperative evaluation methods or tools are essential. A fluorescence imaging system enables visualization over a wide region of interest, and provides intuitive information on perfusion intraoperatively. Surgeons can choose the best anastomotic site of the gastric tube based on fluorescence images in real time during surgery. This technology provides better surgical outcomes when used with an optimal injection dose and timing of indocyanine green.

• Journal of Chest Surgery
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• v.45 no.4
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• pp.213-224
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• 2012

Tetralogy of Fallot (TOF) is an index lesion for all paediatric and congenital heart surgeons. In designing an appropriate operation for children with TOF, the predicted postoperative physiology must be taken into account, both for the short and long term. A favourable balance between pulmonary stenosis (PS) and pulmonary insufficiency (PI) may be critical for preservation of biventricular function. A unified repair strategy to limit both residual PS and PI is presented, along with supportive experimental evidence. A strategy for dealing with coronary anomalies and some comments regarding best timing of operation are also included.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.6
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• pp.428-434
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• 2020

Orbital floor blowout fractures can result in a variety of signs and symptoms depending on the severity of the bone defect. Large defects often result in enophthalmos and restriction of ocular movement; yet the timing of surgery can be delayed up to two weeks with good functional outcomes. In contrast, an orbital trapdoor defect with entrapment of the inferior rectus muscle usually elicits pain with marked restriction of the upward gaze and activation of the oculocardiac reflex without significant dystopia or enophthalmos. When autonomic cardiac derangement is diagnosed along with an orbital floor fracture, it has been suggested that the fracture should be treated immediately. Otherwise, it will result in continued hemodynamic instability and muscular injury and may require a second surgery. This article reports the management of an unusual presentation of a trapdoor blowout orbital floor fracture surgery with oculocardiac response in an adult, with emphasis on its pathophysiology, management, and differential diagnosis.

• Archives of Craniofacial Surgery
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• v.21 no.2
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• pp.119-122
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• 2020

Stevens-Johnson syndrome (SJS) is a rare disease in which extensive toxic epidermolysis occurs after medication. Skin and mucous membranes are involved in about 90% of SJS cases, and webbing of mouth corners (microstomia) may occur when they are affected. Few reports have been issued on microstomia in SJS, and no consensus has been reached regarding treatment methods, timings, or results. We encountered a case of microstomia following SJS after ofloxacin medication in a 22-year-old woman treated by commissuroplasty using a lozenge-shaped excision. We present an appropriate correction method and surgical timing for microstomia following SJS.