• Archives of Plastic Surgery
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• 제37권6호
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• pp.742-748
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• 2010

Purpose: The method of using ultrasound-assisted liposuction and excision of the remaining glandular tissue is the preferred method for treating gynecomastia and is currently used worldwide. Herein, this article described the role of ultrasound-assisted liposuction before a surgical excision in the treatment of gynecomastia. The cosmetic results were objectively evaluated. Methods: 11 patients (22 breasts) underwent ultrasoundassisted liposuction and suction-assisted lipectomy between April 2007 and January 2009. At the end of the liposuction, the remaining glandular tissue was removed through the incision used for liposuction. We evaluated the cosmetic results using ordinary scale methods on the basis of four categories (recurrence, symmetry, contour irregularity, and scar). Results: The volume of aspirates ranged between 50 and 200 cc per breast and the average weight of tissue removed by excision was 65g per breast. No complications were recorded. Regarding the cosmetic evaluation, the recurrence, contour irregularity, and scar were excellent, the symmetry was good, and the overall results represented all those cases were mostly excellent. Conclusion: Ultrasound-assisted liposuction has many advantages in the treatment of gynecomastia. When excising the remaining glandular tissue, bleeding is decreased by the use of a tumescent technique. The glandular tissue is easily mobilized and excised after being "morselized" with ultrasound-assisted liposuction. The glandular tissue is simply dissected via the suction surface. Compared the residual mound of glandular tissue beneath the nipple and areola to the periphery, it facilitates precise control of the excision.

• Archives of Plastic Surgery
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• 제45권1호
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• pp.23-28
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• 2018

Background Condylar process fractures account for one-third of all mandibular fractures, and the distal fragment is prone to dislocate to the medial side due to the pulling of the lateral pterygoid muscle. Retromandibular approaches are commonly used, but the intraoperative view becomes limited in medially dislocated fractures. This study summarized a series of cases of retromandibular reduction for medially dislocated condylar process fractures and described our supplementary procedure to realign the dislocated condylar process. Methods Nine patients with medially dislocated condylar process fractures underwent surgical correction from January 2012 to December 2016. In 6 of them, it was possible to realign the fractures with a conventional retromandibular approach, but for 3 cases of severe dislocation to the middle cranial fossa, a supplementary transoral procedure was carried out. The angle difference between the ramus and condyle, ramus height, and maximal mouth opening (MMO) were evaluated. Results All 9 cases were restored to the proper anatomical alignment without any major complications, and postoperative images revealed successful union. The angle difference was $8.94^{\circ}{\pm}4.11^{\circ}$ preoperatively, and $0.99{\pm}0.49^{\circ}$ at the 6-month follow-up. The pretreatment ramus height difference was $6.12{\pm}6.09mm$, and the postoperative difference was $0.18{\pm}0.10mm$. These changes after surgery were statistically significant. The MMO before surgery was $11.44{\pm}3.0mm$, and the postoperative MMO was $37.2{\pm}2.9mm$, reflecting a significant increase after reduction. Conclusions Retromandibular reduction is a useful method in medially dislocated condylar process fractures, and additional transoral assistance should be considered to realign condylar processes that severely dislocate to the middle cranial fossa.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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• pp.358-368
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• 2019

Purpose: Pediatric Crohn's disease (CD) is directly related to growth and has a high probability of requiring surgical intervention(s); therefore, more active treatment for CD is required for children. This study investigated the impact of biologics on growth and disease course associated with surgery. Methods: This was a retrospective cohort study involving patients diagnosed with CD at the Seoul National University Children's Hospital (Seoul, Korea) between January 2006 and October 2017. The aim was to determine the characteristics of pediatric patients with CD and whether biologics affected growth and the surgical disease course. Results: Among patients who underwent surgery for CD, the mean number of operations per patient was 1.89. The mean time from initial diagnosis to surgery was 19.3 months. The most common procedure was fistulectomy (34%), followed by incision and drainage (25%). In all patients, the use of biologics increased the height (p=0.002) and body mass index (BMI) (p=0.005). Among patients who underwent surgery, height (p=0.004) and BMI (p=0.048) were increased in the group using biologics. Patients who used biologics exhibited a low operation rate only within 2 years after diagnosis, with no differences thereafter (p=0.027). Conclusion: Although biologics could not mitigate the operation rate in pediatric patients who underwent surgery for CD, biological therapy delayed disease progression within 2 years of disease onset. Additionally, biologics conferred growth and BMI benefits in this window period. Therefore, it may be helpful to use biologics for optimal growth in pediatric patients with a high probability of undergoing future surgery.

• 대한두개안면성형외과학회지
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• 제22권6호
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• pp.319-323
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• 2021

Background: Prophylactic antibiotics are used to prevent surgical wound infection; however, proper indications must be followed with careful consideration of the risks and benefits, especially in clean or clean-contaminated wounds. Nasal bone fractures are the most common type of facial bone fracture. The most common method for treating nasal bone fracture is closed reduction, which is performed inside the nasal cavity without an incision. The purpose of this study was to determine the need for antibiotic use in the closed reduction of nasal bone fractures. Methods: A retrospective study was conducted using data from the National Insurance Service Ilsan Hospital of the Republic of Korea between 2016 and 2018. The records of patients who underwent closed reduction of nasal bone fracture were reviewed and classified according to sex, age, comorbidities, perioperative antibiotic usage, postoperative complications, nasal packing, anesthesia type, surgeon's specialty, and operation time. Results: Among the 373 patients studied, the antibiotic prescription rate was 67.3%. Just 0.8% of patients were prescribed preoperative antibiotics only, 44.0% were prescribed postoperative antibiotics only, and 22.5% were prescribed both preoperative and postoperative antibiotics. There were no cases that satisfied the definition of "surgical site infection." Furthermore, 2.1% of infection-related complications (e.g., mucosal swelling, synechia, and anosmia) occurred only in the antibiotic usage group. The use of nasal packing, anesthesia type, and surgeon's specialty did not show any difference in infection-related complication rates. Conclusion: According to the study findings, the routine use of perioperative antibiotics is not recommended in uncomplicated nasal bone fracture surgery.

• 한국임상수의학회지
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• 제41권2호
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• pp.117-122
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• 2024

A 3-year-old spayed female Russian blue cat was presented for dyspnea, nasal discharge, and stertorous breathing. Plain thoracic radiography revealed no specific findings. Computed tomography (CT) was performed to differentiate upper airway tract disorders. It revealed the presence of an iso-attenuating mass measuring 10.0 × 7.9 × 15.6 mm, with mild homogeneous contrast enhancement occupying the rostral nasopharynx. The mass was surgically debulked via a longitudinal incision in the soft palate. Histopathological and immunohistochemistry analysis of the surgically excised mass revealed CD3-/CD79a+ B cell lymphoma with an incomplete margin. The patient underwent hypofractionated radiation therapy, receiving a total of 36 Gray (Gy) in 6 Gy fractions over a six-week period. A follow-up CT examination was performed after 27 months of irradiation and the patient was confirmed to have achieved a complete response. There were no complications related to irradiation. The patient was alive for 40 months without recurrence. This study suggests that hypofractionated radiation therapy combined with surgical debulking could be considered as a treatment option for feline nasopharyngeal lymphoma.

• 전자공학회논문지
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• 제53권12호
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• pp.169-174
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• 2016

본 연구에서는 실제적인 환자의 모델을 바탕으로 가상현실 기반의 수술환경을 제작하는 방법에 대한 고찰과 함께 치과 임플란트 수술 술기를 배울 수 있는 가상현실을 활용한 수술 모델에 대한 평가를 시행하고자 한다. 환자의 안면 해부학적 모델은 실제 환자의 CT 데이터를 바탕으로 안면부위 골에 대한 삼차원 모델을 먼저 완성한 후 각각의 근육을 표현하고 안면부에 대한 삼차원 스캔 그리고 치아의 3차원 스캔 후 모델링을 통해 각각의 해부학적 구조물을 표현하였다. Unity3D를 활용해 단계별 시나리오를 게임으로 구성하였다. 처음 절개를 시행하는 단계에서부터 환자의 현재 상태에 필요한 상악동 거상술에 대한 술기를 표현하고, 임플란트 식립과정 그리고 골이식술을 하는 과정을 단계별로 포함하였다. 단계별로 중요한 과정의 효과적인 습득을 위해 HMD(Head Mount Display) 및 Leap motion과 연동하여 3차원 모델에 기구를 위치시키고 수술행위를 재현해볼 수 있게하여 몰입감을 높이면서 실제 수술을 하고있는 느낌을 재현하고자 하였다. 총 20명의 수련의를 대상으로 가상현실 시뮬레이션을 수행한 후에 설문조사를 시행하였다. 임플란트 수술 교육 프로그램은 치과 대학생들과 수련의들의 교육 도구로서 수술 술기를 습득하고 평가하는데 사용할 수 있는 가능성을 보여주었다. 통상적으로 수술 술기 교육 방법이 많지 않은 현실에서 HMD 와 Leap motion이라는 비교적 저렴한 기기를 이용하여 몰입감을 높일 수 있는 가상현실 기반의 수술 교육은 장점이 있다고 말할 수 있다.

• 한국어류학회지
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• 제29권1호
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• pp.22-31
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• 2017

메기, Silurus asotus의 외과적 시술시 상처 회복 및 스트레스 반응을 알아보기 위하여, 수술 과정에 의한 스트레스 호르몬의 변화 양상과 회복과정을 분석하였다. 수술 후 clove oil (1,000 ppm) 마취한 군의 생존율은 수술 후 3~42일 동안 약 90%를 보였으며 무마취군은 약 74%를 보였다. 즉, 마취를 한 후 수술하였을 때 무마취군 보다 생존율이 높게 나타났다. Clove oil로 마취한 군의 혈장 cortisol 농도가 무마취군 보다 높았으며(P<0.05) 아울러, clove oil로 마취한 군의 혈장 lactic acid 농도 역시 무마취군 보다 높았다(P<0.05). 수술 후 14일과 28일째는 아직 봉합사의 흔적이 남아 있었고 움직임도 활동적이지 않았지만 35일째 되었을 때는 봉합자국은 사라졌고 수술 후 42일에는 봉합사도 관찰되지 않았으며, 봉합 상처도 회복이 되었다. 따라서 메기의 외과시술시, 마취를 한 후 수술하였을 때 무마취군 보다 생존율이 높게 나타났고, 수술 후 받는 스트레스 양도 적다는 것을 알 수 있다. 즉, 본 연구의 메기에서의 외과적 상처 회복은 마취제 사용시 성공적으로 이루어짐을 보였다.

• 대한기관식도과학회지
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• 제10권2호
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• pp.68-71
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• 2004

Thymic cysts are uncommon tumors which usually occur in the neck and mediastinum. It is known to arise from embryonic remnants of the thymopharyngeal duct or from inflammation of thymic tissues. Patients with thymic cyst are often asymptomatic and identified after surgical removal and histologic examination. We experienced a 73 year-old man with recently developed dyspnea. During the examination, chest CT showed a $5\times6cm$ sized cystic mass causing deviation of the trachea. It was located in between the right thyroid gland and anterior mediastinum. It also caused tracheal narrowing noted by bronchoscopy. Right anterior cervical incision and removal of the mass was performed and a histological diagnosis of thymic cyst was confirmed. The patient was discharged without complication.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.152-157
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• 1998

Disturbances of the interrelationship among the host, environment, microorganism will cause the infection clinically. Infection can be classified into bacterial, viral, fungal origin, Bacterial infection is most common due to dental caries, periodontal disease. These infections have the potential to spread via the fascial spaces in the head and neck region. We have undertaken clinical studies on infections in the oral and maxillofacial regions by analyzing 78 hospitalized patients in the Dept. of Oral and Maxillofacial Surgery, Dong-A University Hospital from 1994 to 1997. The results were as fellows; l. Odontogenic infections were most common with the incidence of 84.6%. 2. Considering the number of involved space, single space was 83.3%, double or more space was 16.6%. The most common fascial space involved was submandibular space and followed by buccal space, 3. The most causative organism isolated from the pus cultures was streptococci group 35.4%. 4. Antibiotics were administrated in all cases, and surgical incision and drainage was performed in 87.2%. 5. Combined administration of penicillin and aminoglycoside was most common in 34.6%.. 6. 7 cases were diagnosed as Ludwig's angina and tracheostomy was done in 2 cases of them.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권3호
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• pp.353-357
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• 1996

비절개식 봉합법의 하나인 이 술식은 이론적인 배경은 너무나 잘 알려진 술식이나 적용시에 저자가 제안한 예정 중검선의 설정방법은 실제 술중에 간단하면서도 중검선이 개개인의 검판의 모양에 따라 형성되기에 유용한 방법으로 합병증의 가능성이 낮아서 임상에서 유용하게 상용될 수 있다고 생각된다. 결찰시 실을 이용한 봉합 매듭의 고정법, 그리고 발사를 하기 때문에 결찰하여 매몰된 실에 의한 염증을 피할 수 있는 장점은 비절개식 중검술의 적응증인 경우에 유용하게 사용될 수 있다고 사료된다.