• Archives of Plastic Surgery
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• v.33 no.4
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• pp.525-529
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• 2006

Purpose: Facial nerve injury is a rare but feared complication of face lift. Uncertainty as to the depth and vulnerability of the facial nerve in face lift dissection causes some surgeon, particularly novices, to dissect slowly. Excessively thin flaps can be made because of fear of nerve injury, contributing to skin slough. Methods: From September 1998 to February 2003, the authors operated on 34 aging face patients using classical face-lift. We had analysed about quantity of skin removal and degree of elevated flap. The authors have found quantity of skin removal was 1.5-2.0 cm, degree of elevated flap was 40-45 degree on average. Results: The authors performed preauricular pre-excision face-lift technique on 12 aging face patients from July 2003 to Feburary 2005 based on experienced surgery. This technique reduced fear of dissecting skin flap necrosis and facial nerve injury because of firmly attached pre-auricular skin removed in advance. Conclusions: We easily dissected SMAS without visual field disturbance, nerve damage and reduced operation time and bleeding loss compared to classical face-lift.

• Archives of Plastic Surgery
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• v.44 no.5
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• pp.449-452
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• 2017

The nipple-sharing technique for nipple reconstruction offers excellent tissue matching. The method used for nipple graft harvesting determines the quality of the graft and hence, the success of nipple sharing. Here, we described a guillotine technique wherein the nipple is first transfixed with 2 straight needles to stabilise it. Two No. 11 blades are then inserted in the center and simultaneously swept outwards to amputate the distal portion of the nipple. This technique provides good control, resulting in a very evenly cut base. The recipient bed is deepithelialized thinly, and the nipple graft is inset with interrupted 8-0 nylon sutures under magnification. Being a composite graft, it is protected with splint dressings for 6 weeks, and the dressing is regularly changed by the surgeon. The height of the nipple grafts ranges from 4 to 8 mm. This technique was performed in 9 patients with an average follow-up of 2.9 years (range, 1-4.5 years). Apposition between the nipple graft and its bed is crucial for the success of this technique. When correctly applied, we observed rapid revascularization of the graft.

• Physical Therapy Korea
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• v.6 no.3
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• pp.110-120
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• 1999

Lymphedema, regardless of etiology, is essentially incurable but different treatment approaches which serve to contain swelling exist. The objectives of treatment are to reduce swelling, restore shape, educate about the self-maintenance methods, and prevent inflammatory episodes, eg, recurrent cellulitis. The purpose of this report is to provide therapists and other medical staff with a general guideline through the example treatment procedure of two patients with lymphedema admitted to Samsung Medical Center. This study demonstrates the effects of the various treatments used and how they helped to achieve improvement in mobility and reduction in swelling of the lower limbs. The basic conservative treatments were sequential intermittent pneumatic pumps, elevation, and CDP (complex decongestive physiotherapy). The surgical procedures (Homan's operation) were carried out after maximal volume reduction through conservative programs. In these cases, we can see greater than 50% reduction in the lymphedema in those treated by conservative and surgical procedures. This presents a simple, reliable, variable method yielding satisfactory cosmetic and functional results for patients suffering from chronic both-leg lymphedema. Futhermore, I suggest that the outcomes are best when treatment is administered by a multidisciplinary team including a physiotherapist, surgeon, nurse, et al.

• The Journal of the Korean dental association
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• v.52 no.10
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• pp.615-622
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• 2014

Oral cancer ablation surgery results in tissue defects with functional loss. Accompanying neck dissection results in facial nerve weakness and dysmorphic changes. To minimize the complications after oral cancer surgery, accurate dissection without damaging facial nerve and vital structures are mandatory. Marginal mandibular branch of facial nerve should be dissected or contained in the superficial layer of deep cervical fascia to minimized facial palsy after operation. Reconstruction after cancer ablations is routine procedures and free flap reconstruction is the most commonly used. Radial forearm free flap is the most versatile flap to reconstruct soft tissue defects and it is easy to design according to the defect size and shape. However, donor site scar and secondary skin graft from thigh result in unesthetic and cumbersome wounds. Double layered collagen graft in the donor site could reduce secondary donor site for skin graft. In conclusion, oral and maxillofacial surgeon should know the exact anatomy of the face and neck during neck dissection. Radial forearm free flap is most versatile flap for soft tissue reconstruction and double collagen graft can reduce postoperative scar and there is no need for secondary skin graft.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1535-1538
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• 2015

Background: The objectives of the study were to: 1) determine the frequency of incidental malignancy in unsuspected/grossly normal looking gall bladders; 2) determine the frequency of malignancy in suspected/grossly abnormal looking gall bladders. Materials and Methods: This prospective, cross sectional study was carried out at a tertiary care hospital in Pakistan, during a four year period (Jan 2009-dec2012). All the cholecystectomy cases performed for gallstone diseases were examined initially by a surgeon and later on by a pathologist for macroscopic abnormalities and accordingly assigned to one of the three categories i.e. grossly normal, suspicious, abnormal/malignant. Frequency of incidental carcinoma in these categories was observed after receiving the final histopathology report. Results: A total of 426 patients underwent cholecystectomy for cholelithiasis, with a 1:4 male: female ratio. Mean age of the patients was 45 years with a range of 17-80 years. The frequency of incidental gallbladder carcinoma was found to be 0.70 %(n=3). All the cases of gallbladder carcinoma were associated with some macroscopic abnormality. Not a single case of incidental carcinoma gallbladder was diagnosed in 383 'macroscopically normal looking' gallbladders. Conclusions: Incidental finding of gall bladder cancer was not observed in any of macroscopically normal looking gall bladders and all the cases reported as carcinoma gallbladder had some gross abnormality that made them suspicious. We suggest histopathologic examination of only those gall bladders with some gross abnormality.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.1-8
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• 1997

The anterior cruciate ligament(ACL) is, perhaps, the most intriguing component of the knee joint. Initially referred to crucial ligament because of the cruciate or crossed arrangement or the anterior and posterior ligaments within the knee. the irony or the ACL being crucial to the well-being or the joint has only recently appreciated. The anterior cruciate ligament of human knee joint is a complex structure and its orientation, construct and biology arc directly related to the knee function as a constraint of knee joint motion. In addition to its functional role as a static stabilizer or the knee. the ACL has a unique neurovascular system. The vascular anatomy of the ACL plays a crucial role in the repair and reconstruction of the ligament, and the neuroreceptors found in its substance suggest a possible proprioceptive role for the ligament. The structural complexity of the ACL allows the ligament to function through the normal range of motion as a static stabilizer or the knee. hut it also makes the exact duplication of this structure very difficult. A comprehensive knowledge or the anatomy of the ACL can provide the orthopedic surgeon with a blueprint for the idealized repair and reconstruction of this most complex structure.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.66-71
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• 1997

The all inside anterior cruciate ligament reconstruction technique places an anterior ligament substitutes within two bony sockets rather than hone tunnel. This approach is accomplished through arthroscopic three portal which avoids the surgical exposure and morbidity associated with creating traditional bone tunnel. This technique has several distinct advantages when compared with the traditional ACL reconstruction through the bone tunnels. It offers the surgeon a less morbid method for ACL reconstruction that positions an ACL substitute at the anatomic attachment sites of the original ACL with two bone sockets, obviating the need for traditional bone tunnels. Graft fixation at or near the anatomic attachment points of the original ACL minimizes creep with early range of motion and reduces the abrasive 'wind-shield wipe' motion of the graft which occur with bone plugs positioned inside bone tunnels. The sagittal posterior angle to the tibial socket increases fixation strength to pullout with anterior translation force for the tibia on the femur. This technique is not graft specific and can accomodate any graft in which graft length can be customized to the intraarticular native ACL length.

• Journal of Korean Neurosurgical Society
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• v.51 no.1
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• pp.66-70
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• 2012

Thoracic pedicle screw fixation techniques are still controversial for thoracic deformities because of possible complications including neurologic deficit. Methods to aid the surgeon in appropriate screw placement have included the use of intraoperative fluoroscopy and/or radiography as well as image-guided techniques. We describe our technique for free hand pedicle screw placement in the thoracic spine without any radiographic guidance and present the results of pedicle screw placement analyzed by computed tomographic scan in two human cadavers. This free hand technique of thoracic pedicle screw placement performed in a step-wise, consistent, and compulsive manner is an accurate, reliable, and safe method of insertion to treat a variety of spinal disorders, including spinal deformity.

• Korean Journal of Adult Nursing
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• v.26 no.1
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• pp.98-106
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• 2014

Purpose: The purpose of this study was to explore the effect of glove changing during surgery for colon cancer on reducing the degree of contamination of surgical gloves. Methods: The randomized posttest control group design was used. Total 72 surgeries of colon cancer in the K University Hospital in Seoul performed by the team of A-Surgeon and B-Scrub nurse were randomly assigned to one of the three groups. Glove changing with single-gloved state was implemented in the Experimental Group I and outer glove changing with double-gloved state was executed in the Experimental Group II. Single-gloved state was carried in the Control Group. Following the surgical procedure, specimens for bacterial culture were collected the from scrub nurse's gloves to compare the degree of contamination among the three groups. Data were analyzed with One-way ANOVA and the Scheff$\acute{e}$'s multiple comparison test. Results: The degrees of contamination of the Experimental Group I and II were significantly lower than that of the Control Group. There was no significant difference between Experimental Group I and II. Conclusion: Glove changing during surgery with either single or double-gloved state is effective in reducing the degree of contamination of surgical gloves, therefore these methods should be utilized in clinical practice.

• Korean Journal of Adult Nursing
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• v.24 no.5
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• pp.489-498
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• 2012

Purpose: The purpose of the study was to identify reports of workplace violence, stress and turnover intention among perioperative nurses. Methods: The data were collected using questionnaire from 162 perioperative. Results: All of the nurses in the study reported incidents of violence within six months of the study. Doctors and specifically operating surgeons were cited as perpetrating workplace violence. The stated source of the violence was failure or shortage of surgical equipment or instrument and fall out of surgeon's preference. Subjects reported (87.7%) workplace abuse from nurses and most often from senior nurses. Nurse abuse was in the form of verbal abuse. Fatigue and stress stemming from heavy workload were cited as the source of the workplace violence. The subjects reported stress levels of 7.39 out of a possible ten points from workplace violence. A little more than thirty five percent of the subjects reported having intentions to leave because of workplace violence. These nurses reported higher level of stress and experienced more workplace violence from nurses and doctors as compared to those nurses who reported no turnover intention. Conclusion: The results of this study indicate that a third of the employed nurses reported wanting to leave their positions due to workplace violence. Workplace violence is a serious problem for nurses whether it is from physicians or from other nurses.