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Congenital Brachymetatarsia of the First Metatarsal with Hallux Varus Treated by Callotasis -A Case Report- (가골 신연술로 치료한 무지내반증을 동반한 선천성 제 1중족골 단축증증 -증례 보고-)

  • Hwang, Sung-Kwan;Oh, Jin-Rok;Lee, Doo-Hee
    • Journal of Korean Foot and Ankle Society
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    • v.3 no.1
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    • pp.33-39
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    • 1999
  • Brachymetatarsia of the first metatarsal is uncommon. It may occur as a congenital condition. Hallux varus is the name given to a medially deviated position of the first metatarsophalangeal joint with a nonpurchasing hallux in varus position. To have a patient with not only both hallux varus and brachymetatarsia, but for the brachymetatarsia to occur about the first metatarsal, is extremly rare. We experienced a case of the brachymetatarsia of the first metatarsal with hallux varus treated by callotasis. Excellent cosmetical and funtional outcome were obtained. So we reporting the case with a review of the literatures.

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EFFECTS OF PTERYGOMAXILLARY SEPARATION ON SKELETAL AND DENTAL CHANGES FOLLOWING SURGICALLY-ASSISTED RAPID MAXILLARY EXPANSION (외과적 급속상악확장술시 익돌상악 접합부의 분리 유무에 따른 치열궁 변화)

  • Han, In-Ho;An, Jin-Suk;Gu, Hong;Kook, Min-Suk;Park, Hong-Ju;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.4
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    • pp.320-328
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    • 2006
  • Purpose: The aim of this study was to evaluate the effects of pterygomaxillary separation on dimensional changes of dental arch following surgically-assisted rapid maxillary expansion (SARME). Patients and Methods: Eighteen adults who had been treated by SARME for transverse maxillary deficiency from May 2000 to August 2005 were evaluated. Thirteen patients (Group 1) were treated with subtotal Le Fort I osteotomy including pterygomaxillary separation and anterior midpalatal osteotomy. The same operation was performed in five patients (Group 2) except pterygomaxillary separation. Dental study casts were taken before operation and after removal of expansion device. And then, skeletal and dental parameters were measured pre- and post-operatively. Results: 1. Changes of mean interdental width 1) In group 1, mean maxillary interdental width was increased 70%($47{\sim}99%$), 95%($84{\sim}115%$), and 77%($57{\sim}94%$) of total expansion on canine, first premolar, and first molar region, respectively after retention. 2) In group 2, mean maxillary interdental width was increased 77%($59{\sim}100%$), 78%($45{\sim}107%$), and 86%($57{\sim}116%$) of total expansion on canine, first premolar, and first molar region, respectively after retention. 3) There was a statistical difference between the change of interdental width of group 1 and group 2 at first premolar(p<0.05). 2. Changes of mean interalveolar width 1) In group 1, mean maxillary alveolar bone width was increased 66%($42{\sim}84%$), 74%($42{\sim}104%$), and 57%($31{\sim}78%$) of total expansion on canine, first premolar, and first molar region, respectively after retention. 2) In Group 2, mean maxillary alveolar bone width was increased 73%($55{\sim}98%$), 67%($36{\sim}89%$), and 59%($48{\sim}73%$) of total expansion on canine, first premolar, and first molar region, respectively after retention. 3) There were no statistical differences between group 1 and group 2 at each teeth area. Conclusion: These results suggest that SARME without pterygomaxillary separation may allow the relatively equal expansion at both anterior and posterior teeth area and most amounts of maxillary interdental expansions were acquired with the expansion of the maxilla by SARME.

Effect of Chewing Gum on Abdominal Discomfort, the First Defecation, and Constipation after Spine Surgery (척추 수술 후 껌씹기가 복부 불편감, 변 배출시간과 변비 정도에 미치는 효과)

  • Kim, Hyung Ja;Kim, Jeoung Hee
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.1
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    • pp.85-93
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    • 2018
  • Purpose: This study aim to determine the effect of chewing gum on the reduction of postoperative ileus and recovery after surgery. Methods: The study was conducted as a randomized controlled trial among 82 patients who underwent spine surgery between May 2015 and October 2015. Patients in experimental group chewed sugarless gum 3 times daily for 30 minutes each time until POD 5. Abdominal discomfort, the first defecation, and CAS score (Constipation Assessment Scale) were monitored. Results: After the experiment, abdominal discomfort was significantly decreased in the experimental group compared to that of the control group (F=2.46, p=.044). However, the first defecation occurred on postoperative hour 69.6 in the chewing gum group and on hour 60.2 in the control group (t=-1.63, p=.107). CAS was significantly decreased in the experimental group compared to that of the control group (F=3.51, p=.012). Conclusion: Chewing gum is expected to help patient recover after surgery as safe nurse intervention which can reduce abdominal discomfort and constipation during early postoperative days after spine surgery.

Preoperative Serum CEA and CA19-9 in Gastric Cancer - a Single Tertiary Hospital Study of 1,075 Cases

  • Zhou, Yang-Chun;Zhao, Hai-Jian;Shen, Li-Zong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2685-2691
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    • 2015
  • To evaluate the clinical impact of preoperative serum CEA and CA19-9 on resectable gastric cancer (GC), a total of 1,075 consecutive cases with gastric adenocarcinoma were obtained retrospectively from January 2012 and December 2013 in a single tertiary hospital, and the relationships between serum CEA, CA19-9 and clinicopathologic features were investigated. Positive preoperative serum rates of CEA and CA19-9 were 22.4% and 12.3% respectively, levels significantly correlating with each other and depth of invasion, lymph node involvement, pTNM and stage. The CEA level also presented a remarkable association with lymphovascular invasion. Both CEA and CA19-9 positivity significantly and positively correlated with depth of invasion, nodal involvement, pTNM stage, lymphovascular invasion, tumor size and tumor location. Stratified analyses according to gender or tumor location showed preoperative CEA or CA19-9 had different associations with clinicopathologic features in different gender subgroups or location subgroups. Preoperative serum CA19-9 positivity may be more meaningful for tumor size rather than CEA. In conclusion, preoperative serum CEA and CA19-9 correlate with disease progression of GC, and may have applications in aiding more accurate estimation of tumor stage, decision of treatment choice and prognosis evaluation.

The Correction of Clinodactyly on Thumb by Bone Graft from Deformed Metacarpal Region-Previous Correction of Polydactyly: Case Report (무지에 합지증이 동반된 사지증의 치험례)

  • Choi, Chi Won;Nam, Su Bong;Bae, Yong Chan
    • Archives of Plastic Surgery
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    • v.33 no.3
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    • pp.379-382
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    • 2006
  • Clinodactyly is defined as an angulation of a digit in the radio-ulnar plane. This anomaly can be congenital, dominantly inherited, or acquired due to trauma or inflammation. Although the deformity usually causes little functional impairment, correction is made because of cosmetic problems. Male subject, with polydactyly on thumb(Wassel's type VII) received first surgery at the age of one. And at the age of six, abnormal growth on the radial side of the first metacarpal bone and ulnar deviation of the distal phalanx of the thumb at the interphalangeal joint had developed. The authors used the growing bony segment from the first metacarpal bone as a bone graft for the correction of clinodactyly on thumb. Z-plasty incision was made on the concave(ulnar) side of thumb and a wedge osteotomy was made on the distal phalanx. The bone graft was inserted into the gap of the distal phalanx of the thumb and fixed it with K-wires. Deformity of the metacarpal bone and clinodactyly on thumb was corrected effectively without donor site morbidity with noticible growth of the grafted metacarpal bone 12 months after surgery.

A forehead hematoma as the initial clinical sign of lung cancer

  • Park, Jonghyun;Kang, Shin Hyuk;Kim, Woo Seob;Kim, Han Koo;Bae, Tae Hui
    • Archives of Craniofacial Surgery
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    • v.21 no.3
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    • pp.198-201
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    • 2020
  • Primary lung cancer commonly metastasizes to the brain, bones, liver, and adrenal glands. In some cases, bone metastasis serves as the first presenting sign of lung cancer with bone pain and headache, but it is not common. The incidence of skull metastasis in lung squamous cell carcinoma (SCC) is low, and there have been only a few cases of skull metastases serving as the first sign of malignancy with skull mass and epidural bleeding; however, no similar cases have been reported regarding that of hematoma. We report a case of an 84-year-old man who first presented with a simple forehead hematoma and was eventually diagnosed with SCC of the lung.

A new rationale for preservation of the mandibular third molar in orthognathic patients with missing molars

  • Baik, Un-Bong;Kim, Yoon-Ji;Chae, Hwa-Sung;Park, Je-Uk;Julian, Stefania;Sugawara, Junji;Lee, Ui-Lyong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.1
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    • pp.63-67
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    • 2022
  • Controversies exist regarding the need for prophylactic extraction of mandibular third molars in patients who plan to undergo orthognathic surgery. An 18-year-old male patient was diagnosed with mandibular prognathism and maxillary retrognathism with mild facial asymmetry. He had a severely damaged mandibular first molar and a horizontally impacted third molar. After extraction of the first molar, the second molar was protracted into the first molar space, and the third molar erupted into the posterior line of occlusion. The orthognathic surgery involved clockwise rotation of the maxillomandibular complex as well as angle shaving and chin border trimming. Patients who are missing or have damaged mandibular molars should be monitored for eruption of third molars to replace the missing posterior tooth regardless of the timing of orthognathic surgery.

Clinical and Histopathological Analysis of 66 Cases with Cardiac Myxoma

  • Zheng, Jian-Jie;Geng, Xi-Gang;Wang, Hai-Chen;Yan, Yang;Wang, Hong-Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1743-1746
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    • 2013
  • Background and Purpose: Cardiac myxoma is a major primary heart tumor which often causes unexpected symptoms or sudden death. This present study was designed to investigate its clinical pathological features and biological behavior. Methods: A retrospective analysis of the clinical pathologic and immunohistochemical features of 66 cases with cardiac myxoma was conducted. Results: In 66 patients with cardiac myxoma, 61 cases had involvement of the left atrium, one case in both the right ventricular and left atria. The female: male ratio was 2.7:1. Patients had symptoms of blood flow obstruction and systemic alterations with performance of arterial embolization. Tumors were spherical, lobulated or irregular in shape, and soft and brittle. Immunohistochemical markers of vimentin and CD34 in tumor cells were positive. Conclusion: Cardiac myxoma always exists in the left atrium and is more common in women, with diverse clinical manifestations and pathomorphism. Although proliferative activity and the recurrence rate are low, in addition to thorough surgical resection, strengthened review is important for young patients.

Optimal First-Line Antibiotic Treatment for Pediatric Complicated Appendicitis Based on Peritoneal Fluid Culture

  • Aiyoshi, Tsubasa;Masumoto, Kouji;Tanaka, Nao;Sasaki, Takato;Chiba, Fumiko;Ono, Kentaro;Jimbo, Takahiro;Urita, Yasuhisa;Shinkai, Toko;Takayasu, Hajime;Hitomi, Shigemi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.6
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    • pp.510-517
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    • 2021
  • Purpose: Consensus is lacking regarding the optimal antibiotic treatment for pediatric complicated appendicitis. This study determined the optimal first-line antibiotic treatment for pediatric patients with complicated appendicitis based on peritoneal fluid cultures. Methods: This retrospective study examined the cases of pediatric patients who underwent appendectomy for complicated appendicitis at our institution between 2013 and 2019. Peritoneal fluid specimens obtained during appendectomy were cultured for the presence of bacteria. Results: Eighty-six pediatric patients were diagnosed with complicated appendicitis. Of them, bacteria were identified in 54 peritoneal fluid samples. The major identified bacteria were Escherichia coli (n=36 [66.7%]), Bacteroides fragilis (n=28 [51.9%]), α-Streptococcus (n=25 [46.3%]), Pseudomonas aeruginosa (n=10 [18.5%]), Enterococcus avium (n=9 [16.7%]), γ-Streptococcus (n=9 [16.7%]), and Klebsiella oxytoca (n=6 [11.1%]). An antibiotic susceptibility analysis showed E. coli was inhibited by sulbactam/ampicillin in 43.8% of cases versus cefmetazole in 100% of cases. Tazobactam/piperacillin and meropenem inhibited the growth of 96.9-100% of the major identified bacteria. E. coli (100% vs. 84.6%) and P. aeruginosa (100% vs. 80.0%) were more susceptible to amikacin than gentamicin. Conclusion: Tazobactam/piperacillin or meropenem is a reasonable first-line antibiotic treatment for pediatric complicated appendicitis. In the case of aminoglycoside use, amikacin is recommended.

Treatments for the Plantar Pain of the First Metatarsal Head (제 1 중족골 두 족저부 동통의 치료)

  • Park, Yong-Wook;Chung, Yung-Khee;Yoo, Jung-Han;Park, Hong-Jun;Yu, Sun-O;Kim, Wan-Hong
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.2
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    • pp.72-78
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    • 2000
  • Purpose: To validate the major bony causes and postoperative results of the first metatarsal head plantar pain. Materials and Methods: We experienced one case of the fracture and non-union of the medial sesamoid treated by autogenous calcaneal bone graft, one case of the fracture and non-union and two cases of the hypoplasia of the medial sesamoid treated by excision of medial sesamoid, one case of the arthrosis between the first metatarsal head and the medial sesamoid treated by plantar 1/2 partial excision of the medial sesamoid, and two cases of the metatarsus primus nexus treated by basal metatarsal closing wedge osteotomy between October 1995 and September 1999. The mean follow-up period was 28 months. We evaluated the results by using of the clinical rating systems for the hallux and the radiographic findings. Results: An excellent results were achieved in all cases except one which was preoperatively diagnosed as metatarsus primus nexus. But, clinically this one case also satisfied with the postoperative result. Radiologically, We did not find the malunion or nonunion of the medial sesamoid treated by bone graft and of the metatarsus primus flex us treated by basal metatarsal closing wedge osteotomy. And also we did not find the postoperative fracture of the medial sesamoid treated by plantar 1/2 partial excision. There were no postoperative complications in all cases. Conclusion: We think that the good results may be achieved from the patients with the plantar pain of the first metatarsal head by the exact diagnosis and aggressive treatments.

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