• Title/Summary/Keyword: primary closure

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A Retrospective Clinical Study of Skin Cancer: A Single Institution's Experience on 370 Cases (11년간 경험한 피부의 악성종양에 대한 임상적 고찰)

  • Lee, Tae Sung;Pyon, Jai Kyong;Mun, Goo Hyun;Bang, Sa Ik;Oh, Kap Sung;Lim, So Young
    • Archives of Plastic Surgery
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    • v.35 no.3
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    • pp.261-266
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    • 2008
  • Purpose: The incidence of skin cancer is increasing throughout the world including Asian countries such as Korea. Still there are only limited reports of the clinical features of skin cancer in Korea, especially in the fields of plastic surgery. This study is to demonstrate the recent clinical trends of skin cancer and the treatment of skin cancer in Korea by analyzing a single institution's experience. Methods: During a 11-year period, 370 patients visited our department for the excision of skin cancer. Data of the patients such as histopathologic diagnosis, primary site of the tumor, age and sex of the patient, operative methods were reviewed retrospectively. Results: We had 370 patients, 215 men and 155 women. The ages ranged from 10 to 95 years with a mean of 58.8 years. A total of 143 patients were diagnosed as basal cell carcinoma, while 100 were malignant melanoma, 80 were squamous cell carcinoma, 17 were dermatofibrosarcoma protuberans, and 30 were other miscellaneous skin cancers. Local flaps were the most frequently used reconstructive method after wide excision of the cancer, which was followed by primary closure, split-thickness skin graft, free flap and full-thickness skin graft. Conclusion: There was a gradual increase in the incidence of skin cancer after the year 2000. Basal cell carcinoma had the highest incidence which frequently involved the sun-exposed regions in the old ages. Malignant melanoma showed a relatively high incidence compared with other previous studies in Korea. The extremities were the most frequent location for malignant melanoma. Clinical features of other various skin cancers were also reported in this study. The reconstructive method highly depends on the primary site of the cancer, while local flaps were the mostly used operative technique.

IDIOPATHIC MESIAL MOVEMENT OF IMPACTED MAXILLARY CANINE (미맹출 견치의 특발성 근심 이동)

  • Choi, Ami;Song, Je Seon;Lee, Jae Ho;Choi, Hyung Jun;Choi, Byung Jai;Kim, Sung Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.1
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    • pp.41-47
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    • 2013
  • Maxillary canines are the most commonly impacted or ectopically erupted teeth. If we find the abnormality of maxillary canines early, we can manage it reasonably and systematically. If we cannot see the spontaneous normalization at the periodic recall, primary canine extraction will be the next treatment choice. However, if the primary canine is extracted too early, the extraction socket will be filled with hard bone and then the eruption pathway can be locked. So it is more beneficial to extract the primary canine at the period about 6 months before the normal canine eruption time. The next treatment plan can be surgical and orthodontic approaches before the root apical closure of the impacted canine. Sometimes, surgical extraction and further prosthetic procedure can be needed for a severely malposed impacted canine or badly resorpted incisor. This is the case of the idiopathic mesial movement of impacted maxillary canines.

Differences in Panicle Structure and Spikelet Degeneration in Two Different Types of Rice Cultivars; Milyang 23 and Koshihikari (벼 품종 밀양 23호와 고시히카리의 수형태와 영화 퇴화 차이)

  • 강시용
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.42 no.6
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    • pp.833-840
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    • 1997
  • Differentiation and degeneration of spikelets in paddy rice has been studied in high yielding Indica$\times$Japonica hybrid cultivar, Milyang 23 and a Japonica type cultivar, Koshihikari. Germinated seeds planted in 5000$^{-1}$ a pots filled with submerged soil and cultured under natural conditions. The young panicles of main stem were continuously dissected and observered by Cryo-SEM from the panicle initiation stage, and investigated about formation position of the differentiation and degeneration spikelet within a panicle of 7 days after heading. The degeneration of spikelet appeared simultaneously throughout panicle just after closure of spikelet by the palea and lemma. Differentiated and degenerated spikelets per panicle were about 240, 80 for Milyang 23 and 87, 6 for Koshihikari, respectively. The spikelets degeneration in Milyang 23 was mainly on the secondary and tertiary branch which were developed from primary branch of middle-basal panicle node and hardly not the spikelets of primary branch, and degeneration rate of secondary and tertiary rachis branch and spikelets for Milyang 23 were 2.5 times greater than those of Koshihikari. The proper relation equation between total differentiation or normal spikelets number per panicle(Y) and each rachis branch number were different between cultivars, Le., Y=5.5X$_1$+3.0X$_2$ for Koshihikari as previously proposed, but those of Milyang 23, Y=5.7X$_1$+3.5X$_2$+2.8X$_3$ for total differentiation spikelets and Y=5.6X$_1$+3.2X$_2$+2.4X$_3$ for normally developed spikelets, where X$_1$, X$_2$, X$_3$ are number of primary, secondary, tertiary rachis branch, respectively.

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Information Types and Display Methods according to the Relation between Frequency of Exposure and Degree of Cognition (노출빈도와 인지도 관계에 따른 정보의 유형과 표현기법)

  • Han, Ji-Ae;You, Si-Cheon
    • Journal of Digital Convergence
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    • v.10 no.10
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    • pp.497-504
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    • 2012
  • Information types and display methods according to the relation between frequency of exposure and degree of cognition was suggested by this study as a way to enhance effective communication by information in aspect of user cognition. First of all, we ascertained the relation between frequency of exposure and degree of cognition by literature research for cognitive psychology and cognitive engineering psychology, results are as follows based in it. First, we suggested information types and attributes for visualization as 'Framework' which helps designers understand cognitive demands of users. Specifically, there are 4 types(STM, STA, LTM, LTA) of information according to the relation between frequency of exposure and degree of cognition, cognitive characteristics for each types and 'attributes matrix for visualization' which is consisted of 14 attributes of high -quality information and resorted by the types. Second, we suggested a guideline for display methods according to depth of information in the design process of information contents. For display methods of STM, STA information as primary information, we suggested "Attribution theory of Distinctiveness", "Advance Organizer", "Progress Closure", "Affordance", for display methods of LTM information as multidimensional information, we suggested "Modularity", "Consistency", "Mimicry", "Mnemonic Device". We had found from this study that there are distinction of status for attributes of information visualization according to information types or depth, and various display methods by them.

Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw

  • Kang, Mong-Hun;Lee, Dong-Keon;Kim, Chang-Woo;Song, In-Seok;Jun, Sang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.5
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    • pp.225-231
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    • 2018
  • Objectives: The purpose of this study was to investigate the demographic and clinical characteristics of patients with medication-related osteonecrosis of the jaw (MRONJ) and to elucidate factors affecting recurrence in surgical treatment. Materials and Methods: A total of 51 patients who were diagnosed with MRONJ were analyzed according to demographic and clinical features and treatment results through a retrospective chart review from 2013 to 2017 in the Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul in Korea. Results: Alendronate composed the majority of medication doses (55.6%), followed by ibandronate (20.0%), risedronate (15.6%), and zoledronate (6.7%). Forty patients (88.9%) were given oral medication, and five patients (11.1%) were intravenously treated, and the mean duration of medication use was $61.1{\pm}42.9$ months. A total of 10 patients (22.2%) had a drug holiday before MRONJ-induced dental treatment lasting an average of $6.8{\pm}7.0$ months. MRONJ occurred 2.7 times more in the mandible, with 41 cases (73.2%) occurring in the mandible and 15 cases (26.8%) occurring in the maxilla, and the prevalence of affected posterior parts (premolar-molar) was six times greater than that of the anterior parts (incisor-canine) (48 cases vs 8 cases, 85.7% vs 14.3%). The most common dental cause of MRONJ was tooth extraction (69.6%). Regarding recurrence, there was no statistical difference in recurrence rate according to either site or stage. However, recurrence occurred in 4 out of 34 cases (11.8%) in the primary closure group and 9 out of 20 cases (45.0%) in the secondary healing group, and there was a statistical difference with respect to closure technique. Conclusion: The identified risk factors in patients taking bone resorption inhibitors can aid dental clinicians in ensuring prevention and proper treatment of MRONJ.

Use of a Postoperative Hepatic Arterial Embolization in Patients with Postoperative Bleeding due to Severe Hepatic Injuries (외상성 대량 간 손상 환자에서 수술 후 간 동맥 색전술의 유용성)

  • Cha, Soo Hyun;Jung, Yong Sik;Won, Jae Hwan;Kim, Wook Whan;Wang, Hee Jung;Kim, Myung Wook;Lee, Kug Jong
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.59-66
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    • 2006
  • Purpose: Acute liver failure after massive partial hepatectomy is critical condition with high mortality. To prevent postoperative liver failure from being induced by a massive partial hepatectomy, many doctors do a minimal resection on the single lobe of the liver that might cause postoperative bleeding from the remaining ruptured parenchyma. The objective of this study was to assess clinical experience with postoperative hepatic arterial embolization to control bleeding from the remaining ruptured liver during the postoperative period. Methods: This retrospective 4-year study was conducted from May 2002 to April 2006 and included consecutive patients who had sustained massive hepatic injuries and who had undergone a laparotomy, followed by postoperative hepatic arterial angiographic embolization to control bleeding. Data on the injury characteristics, the operative treatment and embolization, and the amount of transfused packed red cells (PRBC) were gathered and analyzed. In addition, data on the overall complications and survival rate were collected and analyzed. Results: Every case showed severe liver injury, higher liver injury scaling grade IV. Only ten cases involved a ruptured bilateral liver lobe. A lobectomy was done in 6 cases, a left lobectomy was done in 3 cases, and a primary suture closure of the liver was done in 2 cases. Suture closure was also done on the remaining ruptured liver parenchyma in cases of lobectomies. The postoperative hepatic arterial embolizations were done by using the super-selection technique. There were some cases of arterio-venous malformations and anomalous vessel branches. The average amount of transfused PRBC during 24 hours after embolization was $2.36{\pm}1.75$, which statistically significantly lower than that before embolization. Among the 11 cases, 9 patients survived, and 2 died. There was no specific complications induced by the embolization. Conclusion: In cases of postoperative bleeding in severe hepatic injury, if there is still a large amount of bleeding, postoperative hepatic arterial embolization might be a good therapeutic option.

Postoperative Left Ventricular Dynsfunction in Adult PDA (성인 동맥관 개존증 수술 후 좌심실 기능 저하의 위험 인자 분석)

  • 윤태진
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.785-791
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    • 2000
  • Left ventricular dysfuction is common in immediate postoperative periods after surgical correction of heart diseases with chronic left ventricular volume overload. We speculated postoperative changes of left ventricular volume and unction in patients with patent ductus osus(PDA) who had underwent surgical repair at ages older than 16 years. Factors influencing postoperative left ventricular volume and function were also analyzed. Material and Method: From August 1989 to August 1999 thirty-siz adult patients with PDA 28 females and 8 males. were enrolled in this study. Their age ranged from 16 years to 57 years(mean :32 years). Types of surgical repair were division with primary closure in 22, division with patch closure in 6, internal obliteration using cardiopulmonary bypass in 4 and ligation in 4. Aortic clamping was combined during surgical repair in 22(61%) and cardiopulmonary bypass was used in 8(22%) Two-dimensional echocardiography studies were performed in 34(94%) preoperatively and in 25(66%) immediate postoperatively to assess postoperative changes of left ventricular internal dimensions. left ventricular volume and ejection fraction. Duration of postoperative follow-up ranged from 1 month to 99 months (mean:22 months) and 10 patients underwent 16 echocardiographic evaluation during this period Result : Preoperative and postoperative left ventricular systolic dimensions(LVIDs) were 42$\pm$8.0mm and 42$\pm$8.3mm left ventricular diastolic dimensions(LVIDd) were 64$\pm$10.0mm and 56$\pm$7.4mm left ventricular end systolic volumes(LVESV) were 62$\pm$19cc (z=1.87$\pm$0.06) and 59$\pm$24cc(z=1.78$\pm$0.08) left ventricular end diastolic volumes(LVEDL) were 169$\pm$40cc(z-1.17$\pm$0.1) and 112$\pm$29cc(z=0.85$\pm$0.1) and ejection fractions(EF) were 66$\pm$6.7% and 48$\pm$12.6% respectively. There were statistically significant differences between preoperative and postoperative values in LVDIDd(p=0.001) LVEDV(p=0.001) and EF(p=0.0001) while no significant difference is LVIDs and LVESV. Postoperative depression of ejcection fraction was significantly related with z-score of preoperative LVESV and LVEDV by univariateanalysis while LVEDV only was significant risk factor for postoperative LV dysfunction by multiple regressioin analysis ($\Delta$LVEF=-13.3-4.62$\times$LVEDV(z), p=0.001) During the follow-up periods ejection fractions become normalized in all except one patients. Conclusion ; Left ventricular function is usually deteriorated after the surgical correction of PDA in adult age and preoperative LVEDV is a major determinant of postoperative LV function.

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Basic Rules of Incision in Periodontal Flap Preparation (임상가를 위한 특집 3 - 치주판막 절개의 기본원리)

  • Shin, Seung-Il
    • The Journal of the Korean dental association
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    • v.50 no.8
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    • pp.474-481
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    • 2012
  • The periodontal flap surgery is the most widely utilized surgical procedure to reduce the pocket depth and to access the subgingival root surfaces for scaling and root planing. The diagnosis of the periodontal lesion and the objective of the surgery will dictate the type of flap procedure which will be utilized to obtain the best result. The incisions, type of flap and the selection of suturing design must be planned and executed to fit the problem. Periodontal flaps are designed to preserve gingival integrity and to gain access to root surfaces for residual calculus removal and to thoroughly remove granulation tissue so bone defects can be visualized and treated. Gentle and efficient procedures result in optimum healing and minimal postoperative pain. When flaps need to be repositioned apically or less often, coronally, then the flaps must sit passively at the appropriate level before suturing. To ensure this, buccal and lingual flaps need to be elevated beyond the mucogingival junction so the elasticity of the mucosa allows for flap mobility. Sometimes it may be necessary to extend the flap elevation apically with a split incision approach to minimize the effect of the less elastic periosteum. Vertical incisions can aid in flap positioning by allow ing the clinician to suture the flap at a different level to the adjacent untreated gingiva. In osseous periodontal surgery, flaps are apically positioned to minimize postoperative pocket depth. In regenerative periodontal surgery including implant surgery, soft tissue cove rage of bony defects, graft materials, membranes, and bio logic agents is important so sulcular incisions and light suturing techniques are crucial.

A Study on the Theoretical Frameworks and the Implementation Effects of the Fishery Closures as Multi-strategical Measures of Fisheries Management (어업관리 휴어제의 이론체계와 도입 타당성 및 기대효과에 관한 연구)

  • Lee Sang-Go
    • The Journal of Fisheries Business Administration
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    • v.37 no.2 s.71
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    • pp.33-59
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    • 2006
  • This study describes approaches to fisheries management that restrict access by fishers to an area in some way. When fishery closure is established as a technical conservation measure it is a form of input control as a Korea fisheries management system. There are many compelling reasons why a fisheries manager should seriously consider closed areas and/or time restrictions, either as a complement to other measures or as the primary facet of the Korean fisheries management strategy. Fishery closures have been shown to be effective in many fisheries and are an important tool in the management armoury. In many respects justifications for their use and the process of implementation are likely to be relatively straightforward compared to permanent area closures. From a Korean fisheries management perspective, the benefits that flow from fishery closures are usually less easy to predict than for other management measures. Moreover, even if one accepts that implementation of fisherg clossures will provide higher production levels in adjacent fished areas, the potential benefits may often be in danger of being largely dissipated. If, for example, the fishery remains open access, the increased production is likely to attract new entrants into the fishery, thereby driving it back towards bioeconomic equilibrium. From a Korean wider fisheries conservation perspective, however, fishery closures have important and clearly defensible roles to play and some form of zoning arrangement will often effectively serve conservation values. Given the increasing trend towards the establishment of national networks of fisherg closures, it seems likely that fisheries managers throughout the world will need to ensure that they are familiar with the issues surrounding these approaches. The importance of being explicit about the goals for fishery closures in Korea have been continually emphasised throughout this study. There may, of course, be multiple justifications for the measure, in which case it is important to try and specify them in order of priority.

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Reconstruction of Hypopharynx and Cervical Esophagus : Choice of Flap (하인두 및 경부식도 결손의 재건 : 재건술의 선택)

  • Choi Eun-Chang;Lee Sei-Young;Chung Tae-Young;Kim Se-Heon;Kim Young-Ho;Ryu Dae-Hyun;Kim Choong-Bae
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.26-32
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    • 2000
  • Background and Objectives: Various flaps are using for reconstruction of hypopharyngeal and esophageal defect. However, complication and indication of each flap are not fully analyzed. Patient and Methods: Records of 52 hypopharyngeal cancer patients who had surgical treatment and 13 other head and neck cancer patients who underwent hypopharyngeal and/or esophageal reconstruction with flap were retrospectively analyzed. Eighty three percent(54 cases) of patients needed reconstruction other than primary pharyngeal closure. Five split thickness skin graft, 1 pectoralis major myocutaneous flap, 20 forearm free flap, 13 jejunal free flap, 15 gastric pull up were used. Result: Flap failure was noted in 2 cases who had subsequent gastric transposition. Wound dehiscence and fistula were most common problem of forearm free flap. Most fistulas were developed in patients with conduit type reconstruction of forearm flap while there wasn't any fistula in patient with patch type reconstruction. Stenosis of lower anastomosis was the frequent problem of jejunal transfer. Gastric pull-up has frequent com-plication of stomal stenosis. All but three patients had reached oral feeding postoperatively. Conclusion: Based on this study, forearm flap is effective in partial hypopharyngeal defect while jejunum is the choice for circumferential defect. Gastric pull-up is for combined esophageal defect.

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