Maxillofacial Trauma Trends at a Tertiary Care Hospital: A Retrospective Study / 대한악안면성형재건외과학회지

PURPOSE: Maxillofacial fractures are rapidly increasing from car accidents, industrial accidents, teenaged criminal activity, and sports injuries. Accurate assessment, appropriate diagnosis, and preparing individual treatment plans are necessary to reduce surgical complications. We investigated recent trends of facial bone fracture by period, cause, and type, with the objective of reducing surgical complications. METHODS: To investigate time trends of maxillofacial fractures, we reviewed medical records from 2,196 patients with maxillofacial fractures in 1981~1987 (Group A), 1995~1999 (Group B), and 2008~2012 (Group C). We analyzed each group, comparing the number of patients, sex ratio, age, fracture site, and etiology. RESULTS: The number of patients in each period was 418, 516, and 1,262 in Groups A to C. Of note is the increase in the number of patients from Group A to C. The sex ratios were 5.6:1, 3.5:1, and 3.8:1 in Groups A, B, and C. The most affected age group for fracture is 20~29 in all three groups. Traffic accidents are the most common cause in Groups A and B, while there were somewhat different causes of fracture in Group C. Sports-induced facial trauma was twice as high in Group C compared with Group A and B. Mandible fracture accounts for a large portion of facial bone fractures overall. CONCLUSION: We observed an increase in facial bone fracture patients at Kyungpook National University Dental Hospital over the years. Although facial injury caused by traffic accidents was still a major cause of facial bone fracture in all periods, the percentage decreased. In recent years, isolated mandible fracture increased but mandible and mid-facial complex fracture decreased, possibly because of a reduction in traffic accidents.

Anatomical and Functional Recovery of Intracapsular Fractures of the Mandibular Condyle: Analysis of 124 Cases after Closed Treatment / 대한악안면성형재건외과학회지

PURPOSE: The purpose of this study is to evaluate the influence of intracapsular fracture lines of the mandibular condyle on the anatomical and functional recovery after non-surgical closed treatment. METHODS: Clinical and radiological follow-up of 124 patients with intracapsular fractures of the mandibular condyle was performed after closed treatment between 2005 and 2012. The intracapsular fractures were classified into three categories: type A (medial condylar pole fracture), type B (lateral condylar pole fracture with loss of vertical height) and type M (multiple fragments or comminuted fracture). RESULTS: By radiological finding, fracture types B and M lost up to 24% vertical height of the mandibular condyle compared to the height on the opposite side. In Type M, moderate to severe dysfunction was observed in 33% of the cases. Bilateral fractures were significantly associated with the risk of temporomandibular joint (TMJ) dysfunction in fracture types A and B. Bilateral fracture and TMJ dysfunction were not statistically significantly associated in type M fractures. CONCLUSION: Most of the mandibular intracapsular condylar fractures recovered acceptably after conservative non-surgical treatment with functional rehabilitation, even with some anatomical shortening of the condylar height. The poor functional recovery encountered in type M fractures, especially in cases with additional fracture sites and bilateral fractures, points up the limitation of closed treatment in such cases.

Reconstruction plates used in the surgery for mandibular discontinuity defect

OBJECTIVES: The purpose of this study was to analyze the survival rate of reconstruction plates that were used to correct mandibular discontinuity defects. MATERIALS AND METHODS: We analyzed clinical and radiological data of 36 patients. Only discontinuous mandibular defect cases were included in the study. Reconstruction plate survival rate was analyzed according to age, gender, location of defect, defect size, and whether the patient underwent a bone graft procedure, coronoidectomy, and/or postoperative radiation therapy (RT). RESULTS: Plate-related complications developed in 8 patients, 7 of which underwent plate removal. No significant differences were found in plate survival rate according to age, gender, location of defect, defect size, or whether a bone graft procedure was performed. However, there were differences in the plate survival rate that depended on whether the patient underwent coronoidectomy or postoperative RT. In the early stages (9.25+/-5.10 months), plate fracture was the most common complication, but in the later stages (35.75+/-17.00 months), screw loosening was the most common complication. CONCLUSION: It is important to establish the time-related risk of complications such as plate fracture or screw loosening. Coronoidectomy should be considered in most cases to prevent complications. Postoperative RT can affect the survival rate and hazard rate after a reconstruction plate is fitted.

A Case of Primary Leiomyosarcoma of the Liver Presenting with Acute Bleeding / 대한소화기학회지

Leiomyosarcoma is a rare tumor of the liver. It usually arises from many other organs including uterus, gastrointestinal tract, retroperitoneum, and soft tissues. Primary hepatic leiomyosarcoma progresses very slowly and is not associated with chronic liver disease. When the tumor is detected early enough to be treated by operation, the prognosis is favorable. While several cases of primary hepatic leiomyosarcoma have been reported in Korea, there was no case associated with acute bleeding. We report a 80-year old male patient with huge primary hepatic leiomyosarcoma, who presented with acute bleeding and IVC obstruction. The patient was treated by embolization and IVC stenting.

Efficacy of Niti-S ComVi Stents for Palliation of Malignant Gastrointestinal Obstruction / 대한소화기내시경학회지

BACKGROUND/AIMS: Niti-S ComVi stents are flexible and retain the shape-memory of the original configuration. ComVi stents are effective in preventing tumor ingrowth because polytetrafluoroethylene is inserted between two stent wires. The aim of this study was to examine the efficacy of Niti-S ComVi stents for the palliation of a malignant gastrointestinal obstruction. METHODS: Between April 2004 and April 2006, 17 patients (20 cases) underwent Niti-S ComVi stenting, using a through-the- scope method. The technical and clinical success, complication, and outcome were analyzed. RESULTS: Stent insertion was technically successful in 18 cases (90%). Malposition to the afferent loop occurred in 2 cases. Symptomatic improvement was achieved in 14 cases (70%). The mean gastric outlet obstruction score was 0.2 before stenting and 1.6 after stenting. The complications encountered were stent migration (2 cases) and obstruction (5 cases), which were treated by re-stenting and balloon dilatation. Twelve patients died with a median survival of 67 days. Five patients were still alive with a median follow up of 151 days. The overall median stent patency time was 60 days. The mean waist diameter of the stents was expanded to 57% of full expansion immediately after deployment, and 77% after 36 hours. CONCLUSIONS: Niti-S ComVi stenting is an effective palliative technique for inoperable or postoperative recurrent tumors, and significantly improves the quality of life.

A Case of Peutz-Jeghers Polyp that was Diagnosed using Capsule Endoscoy and the Polyp was Removed by Means of Double Balloon Enteroscopy / 대한소화기내시경학회지

Peutz-Jeghers syndrome is an autosomal dominant hereditary disease that's characterized by hamartomatous polyps of the gastrointestinal tract and mucocutaneous melanin pigmentation. Hamartomatous polyps can arise anywhere in the gastrointestinal tract, but they are most common in the small intestine. The major symptoms of Peutz-Jeghers syndrome are abdominal pain, intussusception and anemia due to gastrointestinal bleeding, which are all caused by harmatomatous polyp. Capsule endoscopy has been reported to have a higher diagnostic yield than small bowel barium radiography for patients with Peutz-Jeghers syndrome and who have small bowel polyp. Small bowel polyp in patients with Peutz-Jeghers syndrome can be resected by double balloon enteroscopy without laparotomy. We report here on a patient with melena that was caused by small bowel polyps, and this was found by using capsule endoscopy. Polyp in the distal ileum was resected by using colonoscopy and the patient was diagnosed as suffering with Peutz-Jeghers syndrome. The other proximal ileum polyp was resected by using double balloon enteroscopy without complication.

A Case of Endoscopic Polypectomy Using a Hand-Made Detachable Snare Made of Nylon Fishing Line / 대한소화기내시경학회지

Hemorrhage is the most common complication of polypectomy. Though most bleeding stops spontaneously and can be managed with conservative therapies, some may necessitate intensive therapies. The detachable snare was firstly introduced in 1986. It has been reported that the use of detachable snare can effectively prevent both immediate and delayed bleeding. The detachable snare has been reformed, and now a commercial article is used in practice. But, it is expensive and cannot be used in larger polyps measuring over its fixed size of loop. A hand-made detachable snare made of nylon fishing line was introduced to prevent postpolypectomy bleeding in 2003. We have further improved it and experienced a case of successful removal of a large colonic polyp using our hand-made snare. The hand-made detachable snare is inexpensive and seems to be practical in ligating the polyp regardless of its size.

A Case of Idiopathic Hypereosinophilic Syndrome Complicated with Pulmonary Thromboembolism and Disseminated Intravascular Coagulation / 결핵및호흡기질환

The idiopathic hypereosinophilic syndrome (HES) comprises a heterogeneous group of disorders with unknown pathogenesis characterized by persistent peripheral blood and bone marrow eosinophilia. And the eosinophil infiltrates of multiple organs in HES lead to severe organ dysfunction. The disseminated intravascular coagulation (DIC) is a rare complication of HES. We have experienced a case of HES complicated with DIC and pulmonary thromboembolism. After intravenous injection of methylprednisone, blood eosinophil count was normalized but DIC was persisted. With cortico steroid and cyclosporine therapy, the disease activity was favorably remitted.

A Case of Tuberculosis Affecting Stomach and Duodenum Simultaneously, Mimicking Malignant Tumor / 대한소화기내시경학회지

Gastrointestinal tuberculosis has steadily decreased with the development of anti-tuberculous treatment, improvement of personal hygiene resulting from a rise in the standard of living, early diagnosis of pulmonary tuberculosis, and so forth. However, gastrointestinal tuberculosis can occasionally be found clinically in South Korea where the prevalence of tuberculosis is as much as 2.2%. Prevalence of gastric tuberculosis is low, compared with other gastrointestinal tuberculosis. While there have recently been several reports on the occurrence of gastric tuberculosis and duodenal tuberculosis assuming the form of malignancy, few cases have been reported of the tuberculosis affecting stomach and duodenum simultaneously. In this article we report the case in which tuberculosis affects both stomach and duodenum, which was initially misconceived as a double primary cancer.

A Case of Ovarian Squamous Cell Carcinoma in a Patient with Microinvasive Squamous Cell Carcinoma of Cervix / 대한산부인과학회잡지

Squamous cell carcinoma of the ovary is rare and usually arise from preexisting cystic teratomas, endometriosis or Brenner tumors which undergo carcinomatous degeneration in their epithelial elements. Some of squamous cell carcinoma of the ovary is known to be associated with cervical neoplasm, but the pathogenesis is still unknown. Recently we experienced one case of ovarian squamous cell carcinoma in patients with microinvasive squamous cell carcinoma of uterine cervix. We report this case with possible pathogenesis and brief review of literatures.

Clinicopathologic Characteristics and Prognosis of Endometrial Cancer : A Study of 100 Cases / 대한산부인과학회잡지

No abstract available.

A Clinical Profiles of 7 Patients with Glassy Cell Carcinoma of Uterine Cervix / 대한산부인과학회잡지

No abstract available.

Changes in SGOT and CK - MB Levels during for Open Heart Surgery Anesthesia / 대한마취과학회지

The purpose of this study were to investigate the changes in serum SGOT, CK and CK-MB levels and the significance of these changes during general anesthesia for open heart surgery. Fourteen patients, who had open heart surgery at Kyungpook National University hospital, were chosen at random their serum SGOT, CK and CK-MB levels were recorded before anesthesia(control group), pre cardiopulmonary bypass, during cardiopulmonary bypass and in the recovery room. The results were as follows: The serum SGOT levels were 21.83+/-4.91 IU/L, 27.20+/-11.83, 34.81+/-16.60 and 72.58+/-37.77, respectively. They very significantly increased (p<0.01) during cardiopulmonary bypass and recovery room compared with pre anesthesia. The serum CK levels were 58.07+/-6.31 IU/L, 91.79+/-44.58, 141.93+/-66.55 and 347.43+/-84.61 respectively. They significantly increased (p<0.05) at pre cardiopulmonary bypass, very significantly increased(p<0.01) during cardiopulmonary hypass and recovery room compared with the preanesthesia. The serum CK-MB levels were 0.00 U/L, 4.54+/-11.80, 14.66+/-17.61 and 80.07+/-34.72 respectively. They very significantly increased(p<0.01) during the cariopulmonary bypass and recovery room.

A Case of Spina Bifida Occulta with Faun - tail Nevus / 대한피부과학회지

This 22-year-old female patient has had a lozenge shaped hair tuft with terminal hair on the lumbosacral area since birth. A limping gait due to discrepancy of the length of the lower extremities has also been noted since 5 year age. Subsequently multiple, recurrent trophic ulceration developed on the left foot because of sensory loss. Simple cervico-lumbar spine x-ray showed spina bifida occulta of L-2 to sacrum. Lumbar myelography revealed widened vertebral canal without other spinal anomaliea.