• Archives of Plastic Surgery
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• v.49 no.3
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• pp.369-372
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• 2022

Reduction mammaplasty is the gold standard treatment for gigantomastia. We report one female patient with juvenile gigantomastia associated with severe pulmonary hypertension where her pulmonary pressure decreased significantly after the surgery, improving her quality of life. A 22-year-old female patient with gigantomastia since 10 years old, tricuspid regurgitation, and pulmonary thromboembolism antecedent was admitted to the emergency department. Her oxygen saturation was 89%. Acute heart failure management was initiated. An echocardiogram reported left ventricle ejection fraction (LVEF) of 70% with severe right heart dilation, contractile dysfunction, and arterial pulmonary pressure (PASP) of 110 mm Hg. A multidisciplinary team considered gigantomastia could generate a restrictive pattern, so a Thorek reduction mammoplasty with Wise pattern was performed. Presurgical measurements were: sternal notch to nipple-areola complex, right 59 cm, left 56 cm. Three days after surgery, the patient could breathe without oxygen support. In the outpatient follow-up, patient referred reduction of her respiratory symptoms and marked improvement in her quality of life. Six months after surgery, a control echocardiogram showed a LVEF of 62% and PASP of 85 mm Hg. Pulmonary hypertension may be present in patients with gigantomastia. Reduction mammoplasty may be a feasible alternative to improve the cardiac signs and symptoms in patients with medical refractory management.

• Korean Journal of Head & Neck Oncology
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• v.39 no.1
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• pp.33-36
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• 2023

Malignant lymphoma rarely occurs in the larynx and hypopharynx. Few cases of malignant lymphoma in the larynx were reported in Korea. However, malignant lymphoma in the hypopharynx had been not reported in Korea. A 68-year-old woman came to the outpatient clinic with a foreign body sensation in her throat. A round, smooth margin, bright pink-colored mass was confirmed by the laryngoscopy. The patient took neck computer tomography. A small bulging of mucosa was observed, but there was no peripheral infiltration or abnormally enlarged lymph nodes. We did excision using CO2 LASER. She was finally diagnosed with mucosa-associated lymphoid tissue lymphoma (MALT lymphoma). After diagnosis, several image studies confirmed that there was no metastatic lesion. She got only radiotherapy after that and kept a complete response state for over 2 years.

• Korean Journal of Head & Neck Oncology
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• v.40 no.1
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• pp.15-17
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• 2024

Clear cell carcinoma is a rare variant of salivary gland carcinoma, and its occurrence in the tongue base is even rarer. We present a case of a 55-year-old female patient with clear cell carcinoma of the tongue base. The patient initially presented with a 3-month history of palpable tongue mass, leading to her visit to the otolaryngology outpatient clinic. The patient underwent a complete resection of the tumor under general anesthesia. Postoperative follow-up imaging studies showed no evidence of recurrence. This case report highlights the diagnostic and management challenges associated with clear cell carcinoma of tongue base and demonstrates that a high index of suspicion is required to diagnose clear cell caricnoma, given its rarity and overlapping features with other clear cell neoplasms.

• Clinical and Molecular Hepatology
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• v.24 no.4
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• pp.402-408
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• 2018

Background/Aims: With improvements in the survival of liver transplantation (LT) recipients, the focus is shifting to patient quality of life (QOL), and employment is an important factor in aiding the social reintegration of LT patients. This study aims to evaluate the current employment status of liver graft recipients and various factors that may hinder reemployment. Methods: Fifty patients above age 18 who underwent either living or deceased donor LT at a single center from March 2009 to July 2016 were interviewed during their visit to the outpatient clinic. The internally developed questionnaire consisted of 10 items. The Karnofsky Performance Scale and EQ-5D were used to evaluate patient function and QOL. Results: A total of 25 (50%) patients returned to work after transplantation (the working group), and 21 (84%) patients in the working group returned to work within the first year after transplantation. In the non-working group (n=25), 17 (68%) answered that their health was the reason for unemployment. Fatigue and weakness were the most frequent symptoms. Conclusions: The data shows that as many as 50% of total patients returned to work after receiving LT. Fatigue and weakness were the most common complaints of the unemployed group, and resolving the causes of these symptoms may help to increase the employment rate.

• Archives of Craniofacial Surgery
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• v.24 no.1
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• pp.37-40
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• 2023

Penetrating wounds to the face are cosmetically devastating and can be life-threatening. If the foreign body causing the penetrating wound is a piece of wood, small remnants might be left behind after the initial treatment. A 33-year-old male patient presented to the emergency center after a piece of lumber pierced his face as a passenger in a traffic accident. The patient's vital signs were stable, and emergency surgery was performed to remove the foreign body and repair the soft tissue. No noteworthy complications were seen after open reduction and internal fixation of the facial bone fractures. Seven months after the accident, the patient underwent scar revision along with full-thickness skin grafting for post-traumatic scars. After the surgery, pus-like discharge which was not previously present was observed, and the graft did not take well. A residual foreign body, which was the cause of graft failure, was found on computed tomography and the remaining foreign body was removed through revision surgery. The patient is receiving outpatient follow-up without any complications 6 months after surgery. This case demonstrates the importance of performing a careful evaluation to avoid missing a residual foreign body, especially if it is of wooden nature.

• Journal of Korean Dental Science
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• v.16 no.1
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• pp.63-73
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• 2023

Purpose: Hyperdontia is a developmental disorder of the oral cavity. Mesiodens refers to the hyperdontia located between the maxillary central incisors. During the surgical procedure, the anesthetic method for pain control should be considered along with factors related to the surgery itself. The purpose of this study was to evaluate the effect of the impacted position of the mesiodens on the selection of sedation method and to suggest incisive foramen as a brief reference. Materials and Methods: This study included 126 patients who were scheduled for extraction of mesiodens. The selection criteria included patients with one palatally impacted inverted mesiodens accessible from the palatal gingival margin, and those with good cooperation potential in order to control for clinical information. Using cone beam computed tomography, vertical, horizontal, and palatal positional factors were measured, and the anesthetic method was determined by two examiners. The patients were grouped into vertical and horizontal groups based on the position of the incisive foramen. Data were statistically analyzed using the Mann-Whitney test, the chi-square test, and logistic regression analysis. Result: All positional factors differed between the outpatient and inpatient anesthetic groups. The vertical minimum distance from the alveolar ridge to the mesiodens (Va) and the minimum distance from the palatal surface to the crown tip of the mesiodens (Tc) were factors affecting the choice of anesthetic method. The distribution of the vertical and horizontal positional groups differed between the outpatient and inpatient anesthetic groups. Conclusion: The incisive foramen can be used as a brief reference to determine the appropriate anesthetic method. Referral for inpatient anesthesia may be a priority if they are in the V₂H₂ group with Va ≥5 mm, and Tc ≥6 mm, and outpatient sedation may be considered if they are in the V₁H₁ group with Va ≤1.5 mm, and Tc ≤2.5 mm.

• Journal of Korean Foot and Ankle Society
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• v.21 no.1
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• pp.12-16
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• 2017

Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.

• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.151-155
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• 2018

Purpose: Toe ulcers have been implicated as a causative factor in diabetic foot amputation. The aim of this study was to evaluate the outcomes of percutaneous needle flexor tenotomies of diabetic claw toes with ulcers or pending ulcers. Materials and Methods: The authors undertook a retrospective chart review between January 2014 and June 2016 to identify those patients who underwent a percutaneous needle flexor tenotomy for diabetic claw toe deformities. We evaluated 54 toes in 42 patients. Twenty-four patients were female and the mean age at the time of operation was 57 years. The mean follow-up time was 11 months. Thirty-four patients (46 toes) had tip toe ulcers or pending ulcers and 8 patients (8 toes) had dorsal pending ulcers. All patients had palpable pulses and good capillary refill. Results: Forty-three of 46 tip toe ulcers (93.5%) healed without significant complications and 8 dorsal ulcers showed no specific changes within 5 weeks. There were no recurrent ulcers at final follow-up. Four patients developed transfer lesion of the adjacent toe and needed subsequent tenotomy. Conclusion: Percutaneous needle tenotomy in an outpatient clinic was an effective and safe method for treating toe ulcers in neuropathic patients to offload the tip of the toe so that ulcer healing could occur.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.352-357
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• 1986

Congenital cystic adenomatoid malformation [CCAM] of the lung is a rare but often fatal congenital lung bud anomaly that causes acute respiratory distress in the newborn infants. In those who survive infancy and early childhood, its clinical manifestations are not unusual to detect. Recently we experienced two children with CCAM; one with coughing and high fever, another without any symptom On case I, the patient was a 9 year-old female, and was suffered from coughing and high fever since 15 days before. Medical treatment was failed and then, exploratory thoracotomy was performed under the impression of loculated empyema. Finally, a right lower lobectomy was done with a satisfactory postoperative course. On case II, the patient was a 12 year-old female, and admitted for evaluation of known large pulmonary cyst which was checked at the outpatient clinic. Preoperative evaluations gave no more informations, so obliteration of cysts was performed with open biopsy. Two patients with CCAM are described in Korean Univ. Medical Center.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.87-90
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• 2016

Cough, the most common symptom, encountered in the outpatient clinic can be caused by various underlying diseases. It defines as chronic cough that the duration of cough is more than 8 weeks with a normal chest X-ray findings. The cause of cough can be found out for more than 90% through the appropriate diagnostic approach and Upper airway cough syndrome, Asthma and Gastroesophageal reflex disease are the most common causes of disease to non-smokers. Chronic cough can be due to not one reason but various reasons and achieve good results by a systematic approach to diagnosis and a concrete treatment on the basis of the sufficient understanding of the underlying disease.