• 대한두개안면성형외과학회지
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• 제20권4호
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• pp.219-222
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• 2019

The purpose of this study is to discuss several approaches to addressing naso-orbito-ethmoidal (NOE) fracture. Orbital fracture, especially infraorbital fracture, can be treated through the transconjunctival approach easily. However, in more severe cases, for example, fracture extending to the medial orbital wall or zygomatico-frontal suture line, only transconjunctival incision is insufficient to secure good surgical field. And, it also has risk of tearing the conjunctiva, which could injure the lacrimal duct. Also, in most complex types of facial fracture such as NOE fracture or panfacial fracture, destruction of the structure often occurs, for example, trap-door deformity; a fracture of orbital floor where the inferiorly displaced blowout facture recoils to its original position, or vertical folding deformity; fractured fragments are displaced under the other fragments, causing multiple-packed layers of bone.

• Medical Lasers
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• 제10권1호
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• pp.52-54
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• 2021

There is growing interest in minimizing postoperative scarring after a thyroidectomy. Among the many treatment types, laser therapy, especially picosecond-domain laser therapy, is accepted as a standard method. In the present case, a patient with a pigmented, contracted scar was treated using the combination of a picosecond laser and ablative fractional (AF) CO₂ laser. After 15 sessions of 1,064-nm picosecond with micro lens array (MLA) and AF CO₂ laser application, the patient showed significant improvement in their pigmented lesions and scar contracture with no noticeable side effects for 16 months. These results suggest that a combination of picosecond laser with MLA and AF CO₂ laser can treat pigmented, contracted scars safely and effectively.

• Clinics in Shoulder and Elbow
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• 제25권2호
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• pp.121-128
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• 2022

Background: To determine the reasons and factors that contribute to the cancellations of shoulder surgeries at a tertiary referral center and to analyze the characteristics of these patients. Methods: Patients scheduled for shoulder surgery from June 2017 to July 2019 were allocated to a surgery group (n=224) or a cancellation group (n=96). These groups were compared with respect to patient characteristics, types of surgery, distance from patient's home to the hospital, traveling time to the hospital, and waiting period before surgery. Reasons for cancellation and responses were acquired using a telephone interview and were subsequently analyzed. Results: The cancellation group was older, had a less frequent history of trauma, and had a lower proportion of patients undergoing arthroscopic rotator cuff repair than the surgery group (p=0.009, p=0.014, and p=0.017, respectively). In addition, mean distance from the patients' homes to the hospital and preoperative waiting time were both longer in the cancellation group (p=0.001 and p<0.01, respectively). The most common reason given for cancellation was another medical condition (28.1%). Conclusions: Older age, need for arthroscopic rotator cuff repair surgery, longer distance from the patient's home to the hospital, and longer waiting period significantly increased the chance of cancellation. The main reason for canceling surgery was a concurrent medical condition. Therefore, identification of other medical conditions in advance is an important consideration when surgeons recommend shoulder surgery to patients. Surgeons should also consider patient's age, type of surgery, distance from the hospital, and waiting time when assessing the possibility of surgery cancellation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권5호
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• pp.500-504
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• 2008

Angiomyoma is the vascular type of leiomyoma that the tumor cells are originated from vascular smooth muscle cells. It's frequently found in the subcutaneous tissues of the lower extremities. Such case of an angiomyoma within the oral cavity is rarely found. From a series of 7748 smooth muscle tumors of all types, only 0.06% were found in the oral cavity. This is a rare case of a young woman appeared with oral angiomyoma located in the left mandibular posterior region with plain radiograph, CT and histologic review.

• Journal of Gastric Cancer
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• 제24권3호
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• pp.267-279
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• 2024

Purpose: The optimal treatment for gastroesophageal junction adenocarcinoma (GEJA) remains controversial. We evaluated the treatment patterns and outcomes of patients with locally advanced GEJA according to the histological type. Materials and Methods: We conducted a single-institution retrospective cohort study of patients with locally advanced GEJA who underwent curative-intent surgical resection between 2010 and 2020. Perioperative therapies as well as clinicopathologic, surgical, and survival data were collected. The results of endoscopy and histopathological examinations were assessed for Siewert and Lauren classifications. Results: Among the 58 patients included in this study, 44 (76%) were clinical stage III, and all received neoadjuvant therapy (72% chemoradiation, 41% chemotherapy, 14% both chemoradiation and chemotherapy). Tumor locations were evenly distributed by Siewert Classification (33% Siewert-I, 40% Siewert-II, and 28% Siewert-III). Esophagogastrectomy (EG) was performed for 47 (81%) patients and total gastrectomy (TG) for 11 (19%) patients. All TG patients received D2 lymphadenectomy compared to 10 (21%) EG patients. Histopathological examination showed the presence of 64% intestinal-type and 36% diffuse-type histology. The frequencies of diffuse-type histology were similar among Siewert groups (37% Siewert-I, 36% Siewert-II, and 33% Siewert-III). Regardless of Siewert type and compared to intestinal-type, diffuse histology was associated with increased intraabdominal recurrence rates (P=0.03) and decreased overall survival (hazard ratio, 2.33; P=0.02). With a median follow-up of 31.2 months, 29 (50%) patients had a recurrence, and the median overall survival was 50.5 months. Conclusions: Present in equal proportions among Siewert types of esophageal and gastric cancer, a diffuse-type histology was associated with high intraabdominal recurrence rates and poor survival. Histopathological evaluation should be considered in addition to anatomic location in the determination of multimodal GEJA treatment strategies.

• 대한의용생체공학회:의공학회지
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• 제41권4호
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• pp.154-164
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• 2020

Various simulator systems for surgery training have been developed and recently become more widely utilized with technology advancement and change in medical education adopting actively simulation-based training. The authors have developed tissue-instrument interaction modeling and graphical simulation algorithms for an arthroscopic surgery training simulator system. In this paper, we propose algorithms for basic surgical techniques, such as cutting, shaving, drilling, grasping, suturing and knot tying for rotator cuff surgery. The proposed method constructs a virtual 3-dimensional model from actual patient data and implements a real-time deformation of the surgical object model through interaction between ten types of arthroscopic surgical tools and a surgical object model. The implementation is based on the Simulation Open Framework Architecture (SOFA, Inria Foundation, France) and custom algorithms were implemented as pulg-in codes. Qualitative review of the developed results by physicians showed both feasibility and limitations of the system for actual use in surgery training.

• Archives of Plastic Surgery
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• 제49권2호
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• pp.221-226
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• 2022

With the growing complexity of the U.S. health care system, highly motivated medical directors with strong leadership skills are vital to the success of health care facilities. Presently, there are no articles assessing a plastic surgeon's qualifications for the role of medical director. In addition, there is a paucity of literature comparing the responsibilities of medical directors across various types of health care institutions. Herein, we outline why plastic surgeons have the unique skillset to succeed in this role and highlight the differences between medical director positions across the vast landscape of health care. While the intricacies of this position vary greatly across different landscapes of the health care industry, successful medical directors lead by following a set of universal principles predisposing them for success. Plastic surgeons innately exhibit a subset of particular traits deeming them suitable candidates for the medical director position. While transitioning from the role of a surgeon to that of a medical director does require some show of adaptation, plastic surgeons are ultimately highly likely to find intrinsic benefit from serving as a medical director.

• Journal of Gastric Cancer
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• 제6권4호
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• pp.270-276
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• 2006

목적 : Borrmann 제4형 위암은 일반적으로 다른 형의 위암에 비해 예후가 나쁜 것으로 알려져 있다. 이에 본 연구에서는 Borrmann 제4형 위암의 임상병리학적 특성 및 예후를 다른 형의 위암과 비교 분석하고, Borrmann 제4형 위암의 예후 인자로서의 의의를 알아보고자 한다. 대상 및 방법: 1995년 1월부터 2004년 12월까지 삼성서울병원에서 수술 받은 4,416명의 진행 위암 환자 중 Borrmann형 분류 및 생존여부의 추적이 가능하였던 4,389명의 환자를 대상으로 임상적 특징, TNM 병기 및 생존율을 후향적으로 분석하였다. 결과: Borrmann 제4형 위암은 다른 형의 위암에 비해 위벽침윤도, 림프절 전이, 원격 전이 모두 진행된 상태인 경우가 많았고, 근치적 절제술 비율이 낮았다. 5년 생존율은 Borrmann 제4형이 20.7%로 다른 형의 5년 생존율 53.7%에 비해 유의하게 낮았으며, 동일 병기에서도 낮은 생존율을 보이고 있었다. 단변량 및 다변량 분석에서 위벽침윤도, 림프절전이, 원격전이, 치유도 그리고 Borrmann 제4형이 위암의 독립적인 예후 인자였다. 결론: Borrmann 제4형 위암은 다른 형의 위암과 비교시 임상병리학적으로 구분되는 특성을 지니고 있으며 진행된 상태에서 진단되는 경우가 많았다. 동일 병기에서도 Borrmann 제4형 위암은 다른 형에 비해 낮은 생존율을 보이고 있어 이를 고려한 예후 판단과 보다 적극적인 치료가 필요하다.

• Journal of Korean Neurosurgical Society
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• 제47권6호
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• pp.446-453
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• 2010

Objective : The purpose of this study was to analyze the biomechanical effects of three different constrained types of an artificial disc on the implanted and adjacent segments in the lumbar spine using a finite element model (FEM). Methods : The created intact model was validated by comparing the flexion-extension response without pre-load with the corresponding results obtained from the published experimental studies. The validated intact lumbar model was tested after implantation of three artificial discs at L4-5. Each implanted model was subjected to a combination of 400 N follower load and 5 Nm of flexion/extension moments. ABAQUS$^{TM}$ version 6.5 (ABAQUS Inc., Providence, RI, USA) and FEMAP version 8.20 (Electronic Data Systems Corp., Plano, TX, USA) were used for meshing and analysis of geometry of the intact and implanted models. Results : Under the flexion load, the intersegmental rotation angles of all the implanted models were similar to that of the intact model, but under the extension load, the values were greater than that of the intact model. The facet contact loads of three implanted models were greater than the loads observed with the intact model. Conclusion : Under the flexion load, three types of the implanted model at the L4-5 level showed the intersegmental rotation angle similar to the one measured with the intact model. Under the extension load, all of the artificial disc implanted models demonstrated an increased extension rotational angle at the operated level (L4-5), resulting in an increase under the facet contact load when compared with the adjacent segments. The increased facet load may lead to facet degeneration.

• Archives of Plastic Surgery
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• 제37권6호
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• pp.758-762
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• 2010

Purpose: It is difficult to provide accurate diagnosis and proper treatment for vascular anomalies, because vascular anomalies have a wide spectrum of lesion with various symptoms. Furthermore, vascular anomalies often require the services of a wide range of specialists. So, many patients have been discouraged by the lack of expertise and treatment options available to them. In this study, we aimed to describe the scope of the Vascular Malformation clinic (VAM clinic), a multidisciplinary clinic for hemangioma and vascular malformation patients and investigate of diagnostic accuracy of VAM clinic. Methods: 68 patients have included in a retrospective, medical record review study in the VAM clinic from may 2002 to august 2009. Data included the types of diagnoses of patients seen in the clinic, locations of lesions, comparison of accuracy of diagnoses at other clinic and initial diagnoses at VAM clinic and types of recommended treatments. Results: Initial diagnosis at VAM clinic showed 94.2% accuracy, while diagnosis at other clinic only showed 12.5% accuracy. Head and neck is most frequently occurred lesions in patients of VAM clinic. And VAM clinic is able to provide various and proper treatments to patients. Conclusion: Hemangiomas and vascular malformations can present with various medical problems. VAM clinic, the multidisciplinary clinic provided accurate diagnoses and proper treatments to patients.