• Archives of Plastic Surgery
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• v.35 no.2
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• pp.152-158
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• 2008

Purpose: Mandibulotomy approach and mandible sparing approach are most common methods for oropharyngeal cancer surgery. Good surgical view and convenience of flap inset are advantages of mandibulotomy approach but deformity of mandible contour, postoperative malocclusion and radionecrosis are its limitations. To make up for the limitations, mandible sparing method is commonly performed, but limited surgical view and difficulties of flap inset are the weak points of this approach. The purpose of the study is to compare mandibulotomy and mandible sparing approaches in postoperative complications and progression of the treatment in oropharyngeal cancer operation and reconstruction. Methods: Single reconstructive microsurgeon operated for oropharyngeal cancer patients with different surgeons of head and neck department who prefer mandibulotomy and mandible sparing approach respectively, and we compared the frequency of postoperative complication, operation time, duration of hospitalization and recurrence rate between two different surgical approaches. Results: Mandibulotomy approach was used in 18 patients and mandible sparing approach was used in 15 patients. In mandibulotomy approach, there happened one case of teeth injury and one case of necrosis of skin and gingiva, but there happened no malocclusion and radionecrosis. In mandible sparing approach, there were 3 cases of fistula and 2 cases of infection which are significantly higher than mandibulotomy approach. There were no significant differences between early regional recurrence and duration of hospitalization. Conclusion: In this study we compared two different methods for the surgical approach in oropharyngeal cancer surgery. As mandible sparing approach has difficulties of limited surgical view, it can be used for the limited indications of anterior tongue and mouth floor cancer. Mandibulotomy approach has advantages of good surgical view and convenience of flap inset. In this method preservation of gingival tissue, watertight fashion suture, delicate osteotomy and plate fixation to maintain occlusion are the key points for the successful results.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.198-204
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• 1998

Unstable fractures of the proximal humerus continue to be difficult problems for orthopaedic surgeons. The optimum treatment of these fractures has remained a matter of controversy. We analyzed the clinical results of open reduction and plate fixation underwent for patients of unstable fractures of proximal humerus after minimum 12 months follow up. The purpose of this study is to evaluate the efficacy of open reduction and rigid plate fixation. Twenty-two patients were managed with open reduction and plate fixation. Mean follow up duration was 20.6 months(range, 12 to 28 mon.). Because the age of patient as a maker of degree of osteoporosis was considered the key factor in the success of anatomic reconstruction, we divided into two groups according to age. Group A was comprised of 12 cases with younger than 50 yrs of age. Ten cases of older than 50 yrs of age were Group B. According to Neer's classification, five cases(22%) were two part fracture, 12 cases(64%) were three part fracture, and three cases(14%) were four part fracture. We used the Neer rating system for evaluating the results. In Group A, overall scores were 79.1. In Group B, overall scores were 76.8. Overall scores in two part fracture were 85, overall scores in three part fracture 78.4 and overall scores in three part fracture 68.3. We achieved excellent or good results in nine cases(75%) of Group A and seven cases(70%) of Group B. Also, we obtained excellent or good results in all cases of two part fracture, ten cases(71%) of three fracture and one case(33%) of four part fracture. The complications were three metal loosening, one avascular necrosis of humeral head, one severe stiff shoulder, one superficial wound infection and one ectopic ossification. The results were excellent or good in 16 cases(73%) out of 22 cases. In conclusion, rigid fixation and supervised early exercise would be a good option for unstable fracture of the proximal humerus.

• Childhood Kidney Diseases
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• v.18 no.1
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• pp.42-46
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• 2014

Kawasaki disease (KD) is a systemic vasculitis that can affect many organ systems. Renal manifestations include pyuria, hematuria, proteinuria, tubulointerstitial nephritis, acute renal failure, hemolytic uremic syndrome, or renal scarring. Although its precise pathogenesis remains unknown, it is considered an autoimmune disease. In the literature, it has been reported that KD may develop in conjunction with urinary tract infections. However, many of these previous studies did not use imaging methods such as renal sonograms, dimercaptosuccinic acid renal scans, and voiding urethrocystograms. We report a case of an 8-month old male infant with high grade vesicoureteral reflux, who developed incomplete KD after recurrent pyelonephritis. Acute pyelonephritis can be an early manifestation of KD. Such cases require the evaluation of urinary tract anomalies according to the guidelines for the management of urinary tract infections.

• Korean Journal Plant Pathology
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• v.13 no.4
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• pp.215-218
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• 1997

The environmental factors affecting maturity of pseudothecia overwintered in iufected leaves by Mycosphaserella nawae was investigated. The pseudothecia in the overwinteringinfected leaves were matured at the end of April when the average temperature was $14^{\circ}C$ and precipitation was enough. Pseudothecia initiation was preceded by the fungal biomass development in a given host. The maturity of the pseudothecia from the leaves defoliated in early October was earlier and higher than those defoliated in November of the previous year. Pseudothecia development was also positively affected by low temperature. The maturity time, as determined by percentage of matured pseudothecia out of prematured ones, was also 20 days earlier, and the rate of maturity was higher for the leaves overwintered in door, than for those kept in greenhouse. We have providedevidence that the conidia play a significant role in the epidemiology of this pathogen. Many pseudothecia were developed in the leaves infected by artificially inoculated conidia and maturation rate of the pseudothecia was not different from that of the typical symptom by ascospores infection of Mycosphaerella nawae.

• Korean Journal of Veterinary Research
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• v.30 no.4
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• pp.479-485
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• 1990

This study was carried out to observe in vitro effect of praziquantel on the viability and internal organ changes of Heterophyopsis continua with light microscopy. Metacercariae were collected from the perch, Lateolabrax japonicus, by artificial digestion technique and fed to 2-week old chickens. Adult worms were recovered from the small intestines of chickens 8 days after infection. For working solutions, praziquantel was diluted with TC199 medium at the concentration of 0.01, 0.1, 1 and $10{\mu}g/ml$. To each petri dish containing 10ml of solution, 5~10 worms were introduced and incubated at $37^{\circ}C$. Motlity of worms was observed at 5, 15, 30, 60 minutes, 1, 2, 4 and 6 hours after incubation. For light microscopy, worms were fixed in 10% formalin under cover glass pressure and stained with Semichon's acetocarmine. The results were as follows: 1. In $0.01{\mu}g/ml$ praziquantel, the worms had their mobility until 6 hours post treatment. However, worms in over $0.1{\mu}g/ml$ of praziquantel contracted within 5 minutes and immobilized. 2. Intestine of the worm incubated in $0.001{\mu}g/ml$ praziquantel for 5 minutes was dilated and intestinal wall was thickened. 3. In incubated over $0.1{\mu}g/ml$ praziquantel, pharynx of the worm protruded out from oral sucker. 4. The lowest effective lethal concentration of praziquantel on H. continua was $0.1{\mu}g/ml$. The worms exposed to the drug were observed to be immobilized immediately after incubation in solutions of over $0.1{\mu}g/ml$ concentration. All of the worms in early period showed severe contraction and those in late period showed severe dilation.

• Korean Journal of Veterinary Research
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• v.29 no.1
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• pp.27-35
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• 1989

To develop more specific and sensitive diagnostic methods for infectious bovine rhinotracheitis, 7-C-2 monoclonal antibody specific to polypeptides of infectious bovine rhinotracheitis virus (IBRV) was applied in indirect immunofluorescence antibody assay (IFA), indirect immunoperoxidase assay(IPA) and radial immunodiffusion enzyme assay (RIDEA). It was found that IBRV infected in MDBK cells could be detected as early as 8 hours post infection by IFA, and that IFA was more rapid and specific to identify IBRV antigen than IPA. The diagnostic efficacy of RIDEA and SN test was studied with 88 bovine sera. It was evident that RIDEA could eliminate the false positive reaction encountered in serum neutralization(SN) test, being more rapid and sensitive than the latter. Highly significant correlation coefficiency (r=0.76, p<0.01) was evaluated between the titers of sera and the diameters of RIDEA. Tracheal membranes and sera collected from 96 slaughtered cattle with lesions in respiratory organs were examined to detect IBRV antigen and antibody by IFA, RIDEA and SN test. It was presented that positive rates were 32.3% in IFA, 20.8% in RIDEA and 21.9% in SN test, and that coincidence rate between RIDEA and SN test were 100% in positive sera and 98.7% in negative sera. In conclusion, it was assumed that application of monoclonal antibody could improve the diagnostic efficacy of IBR by enhancing sensitivity and specificity of IPA, IFA and RIDEA.

• Pediatric Infection and Vaccine
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• v.3 no.2
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• pp.128-132
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• 1996

Tuberculosis in children is an important disease because of higher incidence and mortality, especially in developing and underdeveloped countries. The objectives of this study were to evaluate the cause of antituberculosis medication in children and to find out the basic data for proper drug regimen. We reviewed the medical records of 198 patients who had been treated with antituberculosis drugs from Jan. 1991 to Dec. 1993 in Anam Hospital of Korea University Medical Center. The results are as following; 1) Of 198 patients, 69 cases(34.8%) had treated due to BCG complications. They were all medicated with INH. The durations of medication were 3 months in 46 patients(66.7%), 4~6 months in 17 patients(5.8%), 7~9 months in 4 patients(5.8%), 10-12 months in 2 patients(2.9%). 2) Of 198 patients, 68 cases(34.3%) had treated due to chemoprophylaxis, 59 patients (29.8% of all cases) had histories of house hold contact. Of 68 cases, 51 patients (86.4%) were medicated with INH only, 8 patients (13.6%) were medicated with INH and RFP. 3) Other causes of antituberculosis medication were tuberculous lymphadenitis(14.1%), pulmonary tuberculosis(10.6%), meningitis, miliary tuberculosis(2.0%), and pleurisy(2.0%). Most common causes of antituberculosis medications in children were complication of BCG vaccination and chemoprophylaxis after household contact. So early detection of adult tuberculosis and development of convenient diagnostic methods and safe vaccine for childhood tuberculosis is necessary.

• Archives of Plastic Surgery
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• v.39 no.1
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• pp.36-41
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• 2012

Background : Poststernotomy mediastinitis is a rare, but life-threatening complication, thus early diagnosis and proper management is essential for poststernotomy mediastinitis. The main treatment for mediastinitis is aggressive debridement. Several options exist for reconstruction of defects after debridement. The efficacy of immediate debridement and reconstruction with a pectoralis major muscle flap designed for the defect immediately after the diagnosis of poststernotomy mediastinitis is demonstrated. Methods : Between September 2009 and June 2011, 6 patients were referred to the Department of Plastic and Reconstructive Surgery and the Department of Thoracic and Cardiovascular Surgery of Ajou University Hospital for poststernotomy mediastinitis. All of the patients underwent extensive debridement and reconstruction with pectoralis major muscle flaps, advanced based on the pedicle of the thoracoacromial artery as soon as possible following diagnosis. A retrospective review of the 6 cases was performed to evaluate infection control, postoperative morbidity, and mortality. Results : All patients had complete wound closures and reduced severity of infections based on the erythrocyte sedimentation rate and C-reactive protein levels and a reduction in poststernal fluid collection on computed tomography an average of 6 days postoperatively. A lack of growth of organisms in the wound culture was demonstrated after 3 weeks. There were no major wound morbidities, such as hematomas, but one minor complication required a skin graft caused by skin flap necrosis. No patient expired after definitive surgery. Conclusions : Immediate debridement and reconstruction using a pectoralis major muscle flap is a safe technique for managing infections associated with poststernotomy mediastinitis, and is associated with minimal morbidity and mortality.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.743-749
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• 2009

Purpose: Many researches about various surgical method for blepharoptosis have already been introduced. But researches for complications after blepharoptosis correction is relatively insufficient. So, this study was performed to recognize common complications that arised depending on the severity of blepharoptosis, levator function and surgical method. Methods: 250 patients who have underwent surgical treatment for blepharoptosis from 1987 to 2006 were employed in this study. Patients were categorized by severity of blepharoptosis, levator function and surgical method that has been used. Complications after blepharoptosis correction were analyzed. Result: Total of 64 patients had occurred complications, the specifics are as following; undercorrection 22, asymmetry 13, overcorrection 12, lagophthalmos 4, abnormal eyelid contour 4, exposure keratitis 3, ectropion 2, inclusion cyst 2, infection 1 and conjunctival prolapse 1. Among above patients, 3 patients had two kinds of complications. 21 patients was underwent secondary surgery due to complication. Conclusion: Evaluating the outcomes of the secondary surgery, the early correction was better than the late correction. The most of the complications were recovered through conservative and surgical treatments. The most of the complications (47 patients) were undercorrection, asymmetry, overcorrection and took 73.4% of the total complications. The more severe the blepharoptosis and the more poor the levator function, the rate of complications were higher. According to the operation methods, most complications were occurred in levator operation, frontalis transfer and OOM flap.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.806-810
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• 2009

Purpose: Gynecomastia is an abnormal increase in the volume of the male breast. Subcutaneous mastectomy was the first surgical treatment for gynecomastia. But because of the complications such as nerve injury and scar formation, subcutaneous mastectomy has been substituted with liposuction. Recently various techniques including ultrasound - assisted liposuction has been used for treatment of gynecomastia. The purpose of this study is to evaluate the results of XPS$^{(R)}$ microresector(Shaver) for treatment of gynecomastia. Methods: 17 patients, 33 breasts of gynecomastia, Simon grade I or II have been treated with XPS$^{(R)}$ microresector(Shaver). The mean age was 24.5. The subcutaneous tissue and glandular tissue were removed with XPS$^{(R)}$ microresector(Shaver). The operation time, the weight of removed tissue and patients' satisfaction score were accessed. Results: The mean operation time was 78.2 minutes. The mean weight of removed tissue was 113.8 g. There was no significant complications such as necrosis, hematoma, infection or scar contracture. Patients' satisfactory score of scar, shape and confidence were 8.4, 8.2 and 8.4 respectively. As the average score was 8.3, almost patients were satisfied with their breasts. Conclusion: The authors have treated 17 patients suffering from gynecomastia with XPS$^{(R)}$ microresector(Shaver). We obtained short operation time, early recovery, minimal operative scar and less complications with XPS$^{(R)}$ microresector(Shaver) for the treatment of gynecomastia, and patients were satisfied with the results of our method. We concluded XPS$^{(R)}$ microresector(Shaver) is an alternative option for the treatment of gynecomastia.