• 대한의용생체공학회:의공학회지
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• 제41권5호
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• pp.173-178
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• 2020

Remote control intervention surgery robotic system improves treatment effect on cardiovascular patients and reduces X-ray exposure. However, at the time of the first procedure, CT (computerized tomography) and other ultrasound diagnostic equipment should be used because the operator must insert the cannula directly into the patient's leg. Improvements to this have been un-met-needs of hospitals. In this paper, we developed a system that can insert the cannula intuitively and quickly by displaying blood vessels at a glance through the system using smart wearable glasses. The core development method is as follows. In order to project augmented reality onto the surgical image, CT scan angiography image is extracted and processed. In the process, three CT-Markers are used to create a coordinate system of blood vessel images. Additionally, a reference marker is photographed on a single camera to obtain a camera coordinate system. Since the CT marker and the reference marker are in the same position, 3D registration is performed. In the text, a detailed explanation will be given.

• Archives of Plastic Surgery
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• 제42권6호
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• pp.761-768
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• 2015

Background Surgical scars on the palmar surface of the hand may lead to functional and also aesthetic and psychological consequences. The objective of this study was to introduce a new incision technique for periarterial sympathectomy of the hand and to compare the results of the new two-step incision technique with those of a Koman incision by using an objective questionnaire. Methods A total of 40 patients (17 men and 23 women) with intractable Raynaud's disease or syndrome underwent surgery in our hospital, conducted by a single surgeon, between January 2008 and January 2013. Patients who had undergone extended sympathectomy or vessel graft were excluded. Clinical evaluation of postoperative scars was performed in both groups one year after surgery using the patient and observer scar assessment scale (POSAS) and the Wake Forest University rating scale. Results The total patient score was 8.59 (range, 6-15) in the two-step incision group and 9.62 (range, 7-18) in the Koman incision group. A significant difference was found between the groups in the total PS score (P-value=0.034) but not in the total observer score. Our analysis found no significant difference in preoperative and postoperative Wake Forest University rating scale scores between the two-step and Koman incision groups. The time required for recovery prior to returning to work after surgery was shorter in the two-step incision group, with a mean of 29.48 days in the two-step incision group and 34.15 days in the Koman incision group (P=0.03). Conclusions Compared to the Koman incision, the new two-step incision technique provides better aesthetic results, similar symptom improvement, and a reduction in the recovery time required before returning to work. Furthermore, this incision allows the surgeon to access a wide surgical field and a sufficient exposure of anatomical structures.

• 대한치과의사협회지
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• 제53권12호
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• pp.949-957
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• 2015

We investigate the clinical characteristics of odontoma in childhood and adolescence. A retrospective analysis was performed in 105 patients under 15 years old who were diagnosed with odontoma in Kyungpook National University Dental Hospital, the department of pediatric dentistry between 1 January 2008 and 31 December 2013. The ratio of compound odontoma, immature odontoma and complex odontoma were 67.6%, 21.9% and 10.5%, respectively. Odontoma was more prevalent in males and the ratio of males to females was 1.5:1. The age of patients ranged from 3 to 14 years old with an average age of 9.3 years old. The odontoma was more frequently located in the maxilla (73.3%) than in the mandible(26.7%). In 98 cases, it was treated by surgical removal. Among adjacent teeth impacted by odontoma, 26 cases (34.7%) of successional permanent teeth were erupted when only odontoma were removed and 6 cases (8.0%) were erupted when surgical exposure was performed. Orthodontic tractions were performed in 43 cases (57.3%). In conclusion, odontoma could cause complications such as impaction of teeth. If they are found early and treated properly, high eruption success of successional permanent teeth can be obtained. The occurrence frequency of immature odontoma are higher than that of complex odontoma, and they are observed intensively in anterior maxillary teeth. Therefore, it is considered that they are important causes of dental impaction in anterior maxillary teeth.

• Archives of Plastic Surgery
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• 제48권5호
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• pp.483-493
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• 2021

Background Direct-to-implant (DTI) breast reconstruction after nipple-sparing mastectomy (NSM) with the use of acellular dermal matrix (ADM) provides reliable outcomes; however, the use of ADM is associated with a higher risk of complications. We analyzed our experiences of post-NSM DTI without ADM and identified the predictive factors of adverse surgical outcomes. Methods Patients who underwent NSM and immediate DTI or two-stage tissue expander (TE) breast reconstruction from 2009 to 2020 were enrolled. Predictors of adverse endpoints were analyzed. Results There were 100 DTI and 29 TE reconstructions. The TE group had a higher rate of postmastectomy radiotherapy (31% vs. 11%; P=0.009), larger specimens (317.37±176.42 g vs. 272.08±126.33 g; P=0.047), larger implants (360.84±85.19 g vs. 298.83±81.13 g; P=0.004) and a higher implant/TE exposure ratio (10.3% vs. 1%; P=0.035). In DTI reconstruction, age over 50 years (odds ratio [OR], 5.43; 95% confidence interval [CI], 1.50-19.74; P=0.010) and a larger mastectomy weight (OR, 1.65; 95% CI, 1.08-2.51; P=0.021) were associated with a higher risk of acute complications. Intraoperative radiotherapy for the nipple-areolar complex increased the risk of acute complications (OR, 4.05; 95% CI, 1.07-15.27; P=0.039) and the likelihood of revision surgery (OR, 5.57; 95% CI, 1.25-24.93; P=0.025). Conclusions Immediate DTI breast reconstruction following NSM is feasible in Asian patients with smaller breasts.

• Archives of Plastic Surgery
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• 제46권1호
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• pp.57-62
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• 2019

Background Full-thickness nail bed defects with significant exposure of the distal phalanx are typically challenging to reconstruct. We describe a novel method of nail bed defect reconstruction using a thenar fascial flap combined with nail bed grafting. Methods Full-thickness nail bed defects were reconstructed in a 2-stage operation involving the placement of a thenar fascial flap and subsequent nail bed grafting. A proximally-based skin flap was designed on the thenar eminence. The flap was elevated distally to proximally, and the fascial layer covering the thenar muscle was dissected proximally to distally. The skin flap was then closed and the dissected fascial flap was turned over (proximal to distal) and inset onto the defect. The finger was immobilized for 2 weeks, and the flap was dressed with wet and ointment dressings. After 2 weeks, the flap was divided and covered with a split-thickness nail bed graft from the great toe. Subsequent nail growth was evaluated on follow-up. Results Nine patients (9 fingers) treated with the novel procedure were evaluated at follow-up examinations. Complete flap survival was noted in all cases, and all nail bed grafts took successfully. Five outcomes (55.6%) were graded as excellent, three (33.3%) as very good, and one (11.1%) as fair. No donor site morbidities of the thenar area or great toe were observed. Conclusions When used in combination with a nail bed graft, the thenar fascial flap provides an excellent means of nail bed reconstruction.

• Journal of Korean Neurosurgical Society
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• 제64권2호
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• pp.247-254
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• 2021

Objective : The subaxial cervical pedicle screwing technique shows powerful biomechanical properties for posterior cervical fusion. When applying a pedicle screw using the freehand technique, it is essential to analyse cervical computed tomography and plan the surgery accordingly. Normal cervical computed tomography is usually performed in the supine position, whereas during surgery, the patient lies in a prone position. This fact leads us to suppose that radiological evaluations may yield misleading results. Our study aimed to investigate whether there is any superiority between preoperative preparation on computed tomography performed in the prone position and that performed in the supine position. Methods : This study included 17 patients (132 pedicle screws) who were recently operated on with cervical vertebral computed tomography in the prone position and 17 patients (136 pedicle screws) who were operated on by conventional cervical vertebral computed tomography as the control group. The patients in both groups were compared in terms of age, gender, pathological diagnosis, screw malposition and complications. A screw malposition evaluation was made according to the Gertzbein-Robbins scale. Results : No statistically significant difference was observed between the two groups regarding age, gender and pathological diagnosis. The screw malposition rate (from 11.1% to 6.9%, p<0.05), mean malposition distance (from 2.18 mm to 1.86 mm, p <0.05), and complications statistically significantly decreased in the prone position computed tomography group. Conclusion : Preoperative surgical planning by performing cervical vertebral computed tomography in the prone position reduces screw malposition and complications. Our surgical success increased with a simple modification that can be applied by all clinicians without creating additional radiation exposure or additional costs.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.413-417
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• 2022

The authors present a unique case of osteonecrosis of a cortical half of a fibula free flap that has not been reported in the literature yet. This complication was associated with the impairment of the vascularization of periosteum in the cortical half of fibula that was fixated with a nonlocking reconstructive 2.0-mm plate and screws but other factors could have been involved. The patient was submitted to excision of a cemento-ossifying fibroma that resulted in a left hemimaxilectomy mesoinfrastructure defect classified as the Cordeiro type 2B. The 42-year-old female patient was submitted to reconstruction with an osteomusculocutaneous fibula free flap plus a segment of fibula graft. The two bone segments of the free flap used to reconstruct the anterior and left alveolar crest were fixated with a reconstructive 2.0-mm plate of matrixMANDIBLE system. The only reported complication was an oronasal fistula that healed with conservative treatment and the referred osteonecrosis of the external cortical half of the fibula free flap with plate exposure at 2.5 years postoperatively. Surgical excision of the osteonecrosed cortical half of the fibula with the plate and screws was performed, while the other cortical underwent bone union as corroborated by computed tomography scans.

• Parasites, Hosts and Diseases
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• 제50권1호
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• pp.53-56
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• 2012

Treatment of hydatid disease is mainly surgical, with medical treatment being reserved as a coadjuvant treatment. Use of effective scolicidal agents during surgery of cystic echinococcosis is essential to reduce the recurrence rate. The goal of this study was to evaluate the in vitro scolicidal effects of hydroalcoholic extracts of $Satureja$ $khuzestanica$ leaves and aqueous extracts of $Olea$ $europaea$ leaves on hydatid cyst protoscolices. $Echinococcus$ $granulosus$ protoscolices were collected from the liver of sheep infected with the hydatid cyst. Various concentrations of plant extracts were used in different exposure times for viability assay of protoscolices. Among the olive leaf extracts tested, 0.1% and 0.01% concentrations had strong scolicidal effects in 120 min. $S.$ $khuzestanica$ 0.1% had very strong scolicidal effects in 30, 60, and 120 min of exposure times and the mortality rate decreased with the lower concentration. The finding have shown that the scolicidal activity of $S.$ $khuzestanica$ against cystic echinococosis protoscolices were more effective, while the $O.$ $europaea$ extract showed less effects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권6호
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• pp.482-487
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• 2004

Aims: This study was designed to determine the incidence of altered sensation in patients undergoing orthognathic surgery. Method: Seventy two patients who underwent orthognathic surgery between January, 1999 and December, 1999 constituted the study group. Seven patients were excluded because of lack of follow up. Sixty five patients were followed using objective and subjective neurologic testing during the period immediately following operation, 1 month, 2 months, 6 months, and 1 year postoperatively. Age ranged from 17 to 38 years, with a mean of 24.5 years. Male patients were 21, female 44. Twenty eight bilateral sagittal splitting ramus osteotomy(BSSRO) of mandible were performed, 35 BSSRO with genioplasty, 2 genioplasties. Information on the degree of intraoperative nerve encounter was obtained from the surgical reports in 47 patients and was divided into the following three categories: (1) the nerve was not encountered in 23 patients; (2) the nerve was exposed in 11 patients; (3) the nerve was exposed and repositioned from the proximal segment in 13 patients. Results: Four patients reported altered nerve sensation of lower lip and/or chin(6.2%) at final follow up. Two patients underwent BSSRO and the other two patients BSSRO with genioplasty. Three of the patients underwent nerve exposure during the operation. Conclusion: We suggest that the nerve exposure during the operation might be partly responsible for nerve dysfunction after orthognathic surgery.

• 대한기관식도과학회지
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• 제5권2호
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• pp.138-142
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• 1999

Background and objectives : During the last century, various incisions for parotidectomy has introduced and among them, the modified Blair incision has been the one most commonly used. The modified facelift incision, in another hand, has only been introduced and applied recently for better aesthetic results, but also has been criticized for its potentially limited anterior exposure. The purpose of this study is to compare the modified facelift incision with the modified Blair incision in its indications, results and complications. Materials and methods : All parotidectomies done at Kang-nam St. Mary's Hospital for benign parotid masses from Jan. 1995 to Aug. 1998 were reviewed. They were then divided into 2 groups according to their surgical approach, and the parameters included age, gender, complications length of follow-ups, the aesthetic results and the pt's satisfaction. Results : There were no significant differences in the incidence of complications in both groups and the aesthetic results and patient's satisfaction were greater in the modified facelift group. Conclusion : The modified facelift incision provides improved aesthetic results in patients with benign parotid masses without the disadvantage of limited exposure and complications.