Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 99
Filtrar
1.
Archives of Plastic Surgery ; : 185-185, 2019.
Artigo em Inglês | WPRIM | ID: wpr-762801

RESUMO

No abstract available.

2.
Archives of Craniofacial Surgery ; : 255-259, 2019.
Artigo em Inglês | WPRIM | ID: wpr-762779

RESUMO

Craniofacial cleft is a rare disease, and has multiple variations with a wide spectrum of severity. Among several classification systems of craniofacial clefts, the Tessier classification is the most widely used because of its simplicity and treatment-oriented approach. We report the case of a Tessier number 3 cleft with wide soft tissue and skeletal defect that resulted in direct communication among the orbital, maxillary sinus, nasal, and oral cavities. We performed soft tissue reconstruction using the straight-line advanced release technique that was devised for unilateral cleft lip repair. The extension of the lateral mucosal and medial mucosal flaps, the turn over flap from the outward turning lower eyelid, and wide dissection around the orbicularis oris muscle enabled successful soft tissue reconstruction without complications. Through this case, we have proved that the straight-line advanced release technique can be applied to severe craniofacial cleft repair as well as unilateral cleft lip repair.


Assuntos
Classificação , Fenda Labial , Fissura Palatina , Anormalidades Congênitas , Anormalidades Craniofaciais , Pálpebras , Seio Maxilar , Órbita , Doenças Raras , Procedimentos de Cirurgia Plástica
3.
Healthcare Informatics Research ; : 125-135, 2012.
Artigo em Inglês | WPRIM | ID: wpr-141273

RESUMO

OBJECTIVES: The goal of this paper is to examine the security measures that should be reviewed by medical facilities that are trying to implement mobile Electronic Medical Record (EMR) systems designed for hospitals. METHODS: The study of the security requirements for a mobile EMR system is divided into legal considerations and sectional security investigations. Legal considerations were examined with regard to remote medical services, patients' personal information and EMR, medical devices, the establishment of mobile systems, and mobile applications. For the 4 sectional security investigations, the mobile security level SL-3 from the Smartphone Security Standards of the National Intelligence Service (NIS) was used. RESULTS: From a compliance perspective, legal considerations for various laws and guidelines of mobile EMR were executed according to the model of the legal considerations. To correspond to the SL-3, separation of DMZ and wireless network is needed. Mobile access servers must be located in only the smartphone DMZ. Furthermore, security measures like 24-hour security control, WIPS, VPN, MDM, and ISMS for each section are needed to establish a secure mobile EMR system. CONCLUSIONS: This paper suggested a direction for applying regulatory measures to strengthen the security of a mobile EMR system in accordance with the standard security requirements presented by the Smartphone Security Guideline of the NIS. A future study on the materialization of these suggestions after their application at actual medical facilities can be used as an illustrative case to determine the degree to which theory and reality correspond with one another.


Assuntos
Humanos , Complacência (Medida de Distensibilidade) , Registros Eletrônicos de Saúde , Inteligência , Jurisprudência , Medidas de Segurança
4.
Healthcare Informatics Research ; : 125-135, 2012.
Artigo em Inglês | WPRIM | ID: wpr-141272

RESUMO

OBJECTIVES: The goal of this paper is to examine the security measures that should be reviewed by medical facilities that are trying to implement mobile Electronic Medical Record (EMR) systems designed for hospitals. METHODS: The study of the security requirements for a mobile EMR system is divided into legal considerations and sectional security investigations. Legal considerations were examined with regard to remote medical services, patients' personal information and EMR, medical devices, the establishment of mobile systems, and mobile applications. For the 4 sectional security investigations, the mobile security level SL-3 from the Smartphone Security Standards of the National Intelligence Service (NIS) was used. RESULTS: From a compliance perspective, legal considerations for various laws and guidelines of mobile EMR were executed according to the model of the legal considerations. To correspond to the SL-3, separation of DMZ and wireless network is needed. Mobile access servers must be located in only the smartphone DMZ. Furthermore, security measures like 24-hour security control, WIPS, VPN, MDM, and ISMS for each section are needed to establish a secure mobile EMR system. CONCLUSIONS: This paper suggested a direction for applying regulatory measures to strengthen the security of a mobile EMR system in accordance with the standard security requirements presented by the Smartphone Security Guideline of the NIS. A future study on the materialization of these suggestions after their application at actual medical facilities can be used as an illustrative case to determine the degree to which theory and reality correspond with one another.


Assuntos
Humanos , Complacência (Medida de Distensibilidade) , Registros Eletrônicos de Saúde , Inteligência , Jurisprudência , Medidas de Segurança
5.
Healthcare Informatics Research ; : 145-152, 2012.
Artigo em Inglês | WPRIM | ID: wpr-141269

RESUMO

OBJECTIVES: Seoul National University Bundang Hospital, which is the first Stage 7 hospital outside of North America, has adopted and utilized an innovative and emerging information technology system to improve the efficiency and quality of patient care. The objective of this paper is to briefly introduce the major components of the SNUBH information system and to describe our progress toward a next-generation hospital information system (HIS). METHODS: SNUBH opened in 2003 as a fully digital hospital by successfully launching a new HIS named BESTCare, "Bundang hospital Electronic System for Total Care". Subsequently, the system has been continuously improved with new applications, including close-loop medication administration (CLMA), clinical data warehouse (CDW), health information exchange (HIE), and disaster recovery (DR), which have resulted in the achievement of Stage 7 status. RESULTS: The BESTCare system is an integrated system for a university hospital setting. BESTCare is mainly composed of three application domains: the core applications, an information infrastructure, and channel domains. The most critical and unique applications of the system, such as the electronic medical record (EMR), computerized physician order entry (CPOE), clinical decision support system (CDSS), CLMA, CDW, HIE, and DR applications, are described in detail. CONCLUSIONS: Beyond our achievement of Stage 7 hospital status, we are currently developing a next-generation HIS with new goals of implementing infrastructure that is flexible and innovative, implementing a patient-centered system, and strengthening the IT capability to maximize the hospital value.


Assuntos
Logro , Desastres , Registros Eletrônicos de Saúde , Eletrônica , Elétrons , Sistemas de Informação Hospitalar , Sistemas de Informação , América do Norte , Assistência ao Paciente , Segurança do Paciente , Qualidade da Assistência à Saúde
6.
Healthcare Informatics Research ; : 145-152, 2012.
Artigo em Inglês | WPRIM | ID: wpr-141268

RESUMO

OBJECTIVES: Seoul National University Bundang Hospital, which is the first Stage 7 hospital outside of North America, has adopted and utilized an innovative and emerging information technology system to improve the efficiency and quality of patient care. The objective of this paper is to briefly introduce the major components of the SNUBH information system and to describe our progress toward a next-generation hospital information system (HIS). METHODS: SNUBH opened in 2003 as a fully digital hospital by successfully launching a new HIS named BESTCare, "Bundang hospital Electronic System for Total Care". Subsequently, the system has been continuously improved with new applications, including close-loop medication administration (CLMA), clinical data warehouse (CDW), health information exchange (HIE), and disaster recovery (DR), which have resulted in the achievement of Stage 7 status. RESULTS: The BESTCare system is an integrated system for a university hospital setting. BESTCare is mainly composed of three application domains: the core applications, an information infrastructure, and channel domains. The most critical and unique applications of the system, such as the electronic medical record (EMR), computerized physician order entry (CPOE), clinical decision support system (CDSS), CLMA, CDW, HIE, and DR applications, are described in detail. CONCLUSIONS: Beyond our achievement of Stage 7 hospital status, we are currently developing a next-generation HIS with new goals of implementing infrastructure that is flexible and innovative, implementing a patient-centered system, and strengthening the IT capability to maximize the hospital value.


Assuntos
Logro , Desastres , Registros Eletrônicos de Saúde , Eletrônica , Elétrons , Sistemas de Informação Hospitalar , Sistemas de Informação , América do Norte , Assistência ao Paciente , Segurança do Paciente , Qualidade da Assistência à Saúde
7.
Healthcare Informatics Research ; : 57-64, 2012.
Artigo em Inglês | WPRIM | ID: wpr-155524

RESUMO

OBJECTIVES: This study aims to investigate the suitability of electronic health record (EHR) systems in Korea for global certification and to propose functions for future global systems by comparing and analyzing the certification criteria for Certification Commission for Health Information Technology (CCHIT) Certified Ambulatory EHR with BESTCare, which is the EHR system at Seoul National University Bundang hospital. METHODS: Domain expert groups were formed to analyze the inclusion of BESTCare functions and the types of differences for each of the CCHIT Certified 2011 Ambulatory EHR Certification Criteria. The types of differences were divided into differences in functions (F), differences in business processes (B), and differences in government policies (P). RESULTS: Generally, the criteria that showed differences in functions pertained to the connection between the diagnosis/problem list and order, the alert and warning functions for medication-diagnosis interactions, and the reminder/instruction/notification messages related to the patient's immunization status; these absent functions were enhanced clinical decision support system (CDSS) functions related to patient safety and healthcare quality. Differences in government policies were found in the pharmacy's electronic prescription functions, while differences in business processes were found in the functions constrained by the local workflow or internal policy, which require some customization. CONCLUSIONS: Functions that differed between the CCHIT certification criteria and the BESTCare system in this study should be considered when developing a global EHR system. Such a system will need to be easily customizable to adapt to various government policies and local business processes. These functions should be considered when developing a global EHR system certified by CCHIT in the future.


Assuntos
Certificação , Comércio , Registros Eletrônicos de Saúde , Prescrição Eletrônica , Imunização , Coreia (Geográfico) , Informática Médica , Segurança do Paciente , Qualidade da Assistência à Saúde
8.
Healthcare Informatics Research ; : 259-565, 2012.
Artigo em Inglês | WPRIM | ID: wpr-90524

RESUMO

OBJECTIVES: The cloud computing-based virtual desktop infrastructure (VDI) allows access to computing environments with no limitations in terms of time or place such that it can permit the rapid establishment of a mobile hospital environment. The objective of this study was to investigate the empirical issues to be considered when establishing a virtual mobile environment using VDI technology in a hospital setting and to examine the utility of the technology with an Apple iPad during a physician's rounds as a case study. METHODS: Empirical implementation issues were derived from a 910-bed tertiary national university hospital that recently launched a VDI system. During the physicians' rounds, we surveyed patient satisfaction levels with the VDI-based mobile consultation service with the iPad and the relationship between these levels of satisfaction and hospital revisits, hospital recommendations, and the hospital brand image. Thirty-five inpatients (including their next-of-kin) and seven physicians participated in the survey. RESULTS: Implementation issues pertaining to the VDI system arose with regard to the highly availability system architecture, wireless network infrastructure, and screen resolution of the system. Other issues were related to privacy and security, mobile device management, and user education. When the system was used in rounds, patients and their next-of-kin expressed high satisfaction levels, and a positive relationship was noted as regards patients' decisions to revisit the hospital and whether the use of the VDI system improved the brand image of the hospital. CONCLUSIONS: Mobile hospital environments have the potential to benefit both physicians and patients. The issues related to the implementation of VDI system discussed here should be examined in advance for its successful adoption and implementation.


Assuntos
Humanos , Adoção , Androsterona , Registros Eletrônicos de Saúde , Pesquisa Empírica , Unidades Móveis de Saúde , Sistemas de Informação Hospitalar , Hipogonadismo , Pacientes Internados , Doenças Mitocondriais , Oftalmoplegia , Satisfação do Paciente , Privacidade
9.
Healthcare Informatics Research ; : 266-271, 2012.
Artigo em Inglês | WPRIM | ID: wpr-90523

RESUMO

OBJECTIVES: The objective of this paper is to assess which wide type monitor configurations are preferred when physicians use an Electronic Medical Record (EMR) system in an outpatient clinic setting. METHODS: We selected three kinds of monitor configurations available for adoption at outpatient clinics with reference to monitor market trends. Fifteen attending physicians of the Seoul National University Bundang Hospital used each monitor configuration in their outpatient clinics. After completing the outpatient sessions, they selected the best monitor configuration for criteria described in five questionnaire items. We counted the number of votes and reviewed opinions of participants. RESULTS: The Wide Quad High Definition (WQHD) 27-inch single monitor configuration was most preferred for all questionnaire items. All participants answered that the WQHD 27-inch single monitor configuration was the best for desk space utilization. Eleven out of fifteen participants chose the WQHD 27-inch single monitor configuration as the most suitable monitor for outpatient practice. CONCLUSIONS: This study found that physicians preferred the WQHD 27-inch single monitor configuration in outpatient clinic settings. Healthcare organizations need to consider this finding when they purchase wide type monitors for EMR systems instead of the standard type monitor.


Assuntos
Humanos , Adenina , Adoção , Instituições de Assistência Ambulatorial , Carbamatos , Terminais de Computador , Atenção à Saúde , Desoxicitidina , Combinação de Medicamentos , Registros Eletrônicos de Saúde , Eletrônica , Elétrons , Combinação Elvitegravir, Cobicistat, Emtricitabina e Fumarato de Tenofovir Desoproxila , Organofosfonatos , Compostos Organotiofosforados , Pacientes Ambulatoriais , Satisfação Pessoal , Quinolonas , Tiazóis , Interface Usuário-Computador , Inquéritos e Questionários
10.
Journal of the Korean Microsurgical Society ; : 34-40, 2012.
Artigo em Coreano | WPRIM | ID: wpr-724738

RESUMO

Prevention of acute rejection in composite tissue allotransplantation without continuous immunosuppression lacks reports in worldwide literature. Recently dendritic cells (DC) gained considerble attention as antigen presenting cells that are also capable of immunologic tolerance induction. This study assesses the effect of alloantigen-pulsed dendritic cells in induction of survival in a rat hindlimb allograft. We performed hindlimb allotransplantation between donor Sprague-Dawley and recipient Fischer344 rats. Recipient derived dendritic cells were harvested from rat whole blood and cultured with anti-inflammatory cytokine IL-10. Then donor-specific alloantigen pulsed dendritic cells were reinjected into subcutaneous tissue before limb transplantation. Groups: I) untreated (n=6), II) DC injected (n=6), III) Immunosuppressant (FK-506, 2 mg/Kg) injected (n=6), IV) DC and immunouppressant injected (n=6). Graft appearance challenges were assessed postoperatively. Observation of graft appearance, H-E staning, immunohistochemical (IHC) study, and confocal immunofluoreiscece were performed postoperatively. Donor antigen pulsed host dendritic cell combined with short-term immunosuppression showed minimal mononuclear cell infiltration, regulator T cell presence, and could prolong limb allograft survival.


Assuntos
Animais , Humanos , Ratos , Células Apresentadoras de Antígenos , Células Dendríticas , Extremidades , Membro Posterior , Terapia de Imunossupressão , Interleucina-10 , Isoantígenos , Rejeição em Psicologia , Tela Subcutânea , Doadores de Tecidos , Transplante Homólogo , Transplantes
11.
Journal of the Korean Cleft Palate-Craniofacial Association ; : 48-52, 2011.
Artigo em Coreano | WPRIM | ID: wpr-101587

RESUMO

PURPOSE: Many advances have been made in lower eyelid reconstruction surgical procedures after tumor ablative therapy. These include skin grafts, local flaps, free flaps, and skin expansion. When a full-thickness defect of the lower eyelid is reconstructed with many free flaps, ectropion and deformity of the medial and lateral canthal areas are common late complications caused by gravitational descent. The radial forearm free flap is widely used because of its lack of bulk, ease of dissection, malleability, and hairlessness. This report introduces a novel method for preventing ectropion using a composite radial forearm free flap reconstruction and palmaris longus suspension technique. METHODS: A 70-year-old man had a malignant melanoma on his left lower eyelid. The patient was referred to our department after a biopsy confirmed the initial diagnosis. A full-thickness wide resection with a 25 mm free margin was performed, and a 5 x 8 cm radial forearm flap was elevated with a vascularised palmaris longus tendon. The palmaris longus tendon was fixed to the medial and lateral orbital rim perisoteum and the deep temporal fascia. The buccal mucosa was grafted to reconstruct the inner conjunctival layer. The pedicle vessels were anastomosed to the left superficial temporal artery and vein. RESULTS: The postoperative clinical course was uneventful. The flap showed good texture and color match. No ectropion was noted 14 months after surgery and the tumor did not recur. The patient was quite satisfied with the final outcomes. CONCLUSION: Use of a radial forearm free flap and the palmaris longus tendon is an effective method for a full-thickness lower eyelid reconstruction.


Assuntos
Idoso , Humanos , Biópsia , Anormalidades Congênitas , Ectrópio , Pálpebras , Fáscia , Antebraço , Retalhos de Tecido Biológico , Melanoma , Mucosa Bucal , Órbita , Pele , Artérias Temporais , Tendões , Transplantes
12.
Journal of Korean Burn Society ; : 16-20, 2011.
Artigo em Coreano | WPRIM | ID: wpr-172350

RESUMO

PURPOSE: To treat burn and burn scar contracture, many types of dermal substitutes have been manufactured and used recently. Allogenic dermis is known to have best cellular affinity to the host, but it is the thinnest product among artificial dermis. Processed thick allogenic dermis (Allocover(R)) has been developed and applied to overcome the problems of preexisting materials as a permanent dermal substitute. METHODS: From June 2007 to May 2009, we have grafted thick acellular human dermal allograft with thin split-thickness skin graft on burn wound and burn scar contracture of feet and legs in 14 patients who had hypertrophic scar, joint contracture and various skin defect areas. Intraoperatively, we fixed spilt thickness skin graft to artificial dermis with suture fixation for avoiding the mobilization between them. RESULTS: Thirteen patients out of 14 patients had no problem. One patient underwent partial skin loss and secondary healing process. During the 18 months of follow up period, no contracture recurrence or skin loss was observed. CONCLUSION: The thick acellular human dermal allograft (Allocover(R)) could be very useful in the management of skin loss and burn scar contractures. Its vascularization has occurred fast enough that wounds can be covered in an adequate layer of dermal augmentation with minimal contracture and good cosmetic results.


Assuntos
Humanos , Derme Acelular , Queimaduras , Cicatriz , Cicatriz Hipertrófica , Contratura , Cosméticos , Derme , Seguimentos , , Articulações , Perna (Membro) , Recidiva , Pele , Suturas , Transplante Homólogo , Transplantes
13.
Journal of the Korean Cleft Palate-Craniofacial Association ; : 67-70, 2011.
Artigo em Coreano | WPRIM | ID: wpr-171527

RESUMO

PURPOSE: Epidermal nevi are hamartomas of the skin with multiple clinical variants. Normally, epidermal nevi present at an early age, are found on the head and neck area, and have a female predominance. Only very rarely do epidermal nevi have an adult onset. Most lesions are small and giant Epidermal nevi (> 5 cm at its greatest diameter) are quite rare. Huge verrucous plaque was observed on the scalp of a 70-year-old man. He had been reclusive for a long time, and this problem might have played a crucial role in the development of the giant epidermal nevi. METHODS: A punch biopsy and MRI imaging were performed. The huge mass was resected. A local flap and split thickness skin graft was used for reconstruction. RESULTS: The histology examination revealed the characteristic findings of epidermal nevus. Postoperatively, the patient did not suffer from complications or recurrence. CONCLUSION: A rare case of a huge epidermal nevus on the scalp of an elderly man was treated with a surgical excision. This is the oldest patient reported with an adult onset epidermal nevus in Korea.


Assuntos
Adulto , Idoso , Feminino , Humanos , Biópsia , Hamartoma , Cabeça , Coreia (Geográfico) , Pescoço , Nevo , Couro Cabeludo , Pele , Transplantes
14.
Journal of the Korean Society of Plastic and Reconstructive Surgeons ; : 649-654, 2011.
Artigo em Inglês | WPRIM | ID: wpr-107989

RESUMO

PURPOSE: Split-or full-thickness skin grafts are used to reconstruct palmar skin and soft tissue defects after trauma or to release burn scar contracture on the hand. Glabrous skin defects should be substituted with similar skin to preserve function and aesthetics. The authors report their experiences with a technique that uses a full-thickness graft taken from glabrous skin on the ulnar edge of the palm for the reconstruction of soft tissue defects of the hand. METHODS: During a three-year period from 2007 to 2010, 22 patients with burn scar contracture and 12 patients with post-traumatic skin defects on their hands were treated with full-thickness skin graft operations. The palmar skin and soft tissue defects after release of burn scar contracture or debridement of post-traumatic wounds were reconstructed with full-thickness skin grafts harvested from the ulnar border of their palms. All donor-site wounds were primarily closed. RESULTS: The followup periods ranged from 3 to 25 months. Contractures of the hand were corrected without recurrence, and the grafts showed relatively good contour and color match to the adjacent fields. There were no reported complications such as significant color change or hypertrophic scarring. The grafted skin showed an average 5.9mm static two-point discrimination obtained in fingertip reconstruction cases, indicating satisfactory reinnervation. CONCLUSION: Glabrous full-thickness grafts harvested from the palmar ulnar border is a very useful way of reconstructing soft tissue defects on hands, including fingertips, for function restoration, favorable aesthetic results, and low donor-site morbidity.


Assuntos
Humanos , Queimaduras , Cicatriz , Cicatriz Hipertrófica , Contratura , Desbridamento , Discriminação Psicológica , Estética , Traumatismos dos Dedos , Seguimentos , Mãos , Recidiva , Pele , Transplante de Pele , Transplantes
15.
Journal of the Korean Society of Plastic and Reconstructive Surgeons ; : 655-662, 2011.
Artigo em Coreano | WPRIM | ID: wpr-107988

RESUMO

PURPOSE: The anterolateral thigh flap is versatile flap for soft-tissue reconstruction for defects located at various sites of the body. This useful flap offers a thick and vascular fascia lata component with large amounts that can be soft tissue coverage for different reconstructive purposes. We present our clinical experience with the use of vascular fascia lata, combined with anterolateral thigh flap for various reconstructive goals. METHODS: From April 2008 to February 2011, we transferred anterolateral thigh flaps with fascia lata component to reconstruct soft-tissue defects for different purposes in 11 patients. The fascia lata component of the flap was used for tendon gliding surface in hand/forearm reconstruction in 4 patients, for reconstruction medial and lateral patellar synovial membrane and retinaculum in 2 patients, for reconstruction of plantar aponeurosis in the foot in 2 patients, for reconstruction of fascial and peritoneal defect in the abdominal wall in 2 patient, and for dural defect reconstruction in the scalp in the remaining one. RESULTS: Complete loss of the flap was not seen in all cases. Partial flap necrosis occurred in 2 patients. These complications were treated successfully with minimal surgical debridement and dressing. Infection occurred in 1 patient. In this case, intravenous antibiotics treatment was effective. CONCLUSION: Anterolateral thigh flap has thick vascular fascia with large amounts. This fascial component of the flap is useful for different reconstructive aims, such as for tendon, ligament, aponeurosis defects, abdominal wall or dura reconstruction. It should be considerated as an important advantage of the flap, together with other well-known advantages.


Assuntos
Humanos , Parede Abdominal , Antibacterianos , Bandagens , Desbridamento , Fáscia , Fascia Lata , , Retalhos de Tecido Biológico , Imidazóis , Ligamentos , Necrose , Nitrocompostos , Couro Cabeludo , Membrana Sinovial , Tendões , Coxa da Perna
16.
Journal of the Korean Society of Plastic and Reconstructive Surgeons ; : 867-870, 2011.
Artigo em Coreano | WPRIM | ID: wpr-107885

RESUMO

PURPOSE: The authors would like to introduce two patients who presented with velopharyngeal inadequacy. We emphasize the importance of nasaopharyngeal endoscopy in evaluating the velopharyngeal function and the usefulness of biofeedback trial therapy. METHODS: Two patients visited our clinic due to velopharyngeal inadequacy. Both of the patients showed hypernasality, nasal emission and compensatory articulation such as glottal stop. During oral examination and nasopharyngeal endoscopy both showed no evidence of structural deformities. One inconsistently showed a small gap during articulation. The other showed a rather large gap during compensatory articulation. Both received a simultaneous biofeedback trial therapy using the nasopharyngeal endoscope. RESULTS: Both patients were successfully diagnosed and treated at once using biofeedback trial therapy with nasopharyngeal endoscopy. By giving direct visual feedback to the patient, they were both able to achieve complete velopharyngeal closure during production of 2~3 nonsence syllables and hypernasality was not detected in both of them. CONCLUSION: The authors were able to help patients with velopharyngeal inadequacy to have velopharyngeal closure through biofeedback trial therapy. The accurate evaluation of velopharyngeal function and the possibility of closure prevented unnecessary operations.


Assuntos
Humanos , Biorretroalimentação Psicológica , Anormalidades Congênitas , Diagnóstico Bucal , Endoscopia , Retroalimentação Sensorial , Insuficiência Velofaríngea
17.
Journal of the Korean Society of Plastic and Reconstructive Surgeons ; : 871-874, 2011.
Artigo em Coreano | WPRIM | ID: wpr-107884

RESUMO

PURPOSE: In some patients with velopharyngeal insufficiency(VPI), Hypernasality can persist after surgical management. Continuous Positive Airway Pressure(CPAP) is applied to these patients for treating hypernasality. The purpose of this study is to report follow-up results of postoperative CPAP therapy. METHODS: After performing palatal lengthening, CPAP therapy was applied to three patients for eight weeks from July of 2008 to November of 2009. Perceptual evaluation, nasometry, and nasopharyngeal endoscopy were performed to evaluate hypernasality, nasalance and size of the gap at velopharyngeal port. Each evaluation was made before surgery, right after CPAP therapy and during follow- up of more than a year after CPAP therapy. RESULTS: All of the patients showed improvement in hypernasality right after CPAP therapy according to the auditory perceptual evaluation, nasometry and nasopharyngeal endoscopy. But the improvement in hypernasality in these patients did not last during follow-up. CONCLUSION: In this study, our results suggest that CPAP therapy is effective in reducing hypernasality for postoperative VPI patients immediately after the therapy, but hypernasality may be worsen in some patients during follow-up. Therefore we recommend follow-ups after CPAP therapy to see if the efficacy of CPAP therapy lasts.


Assuntos
Humanos , Endoscopia , Seguimentos , Insuficiência Velofaríngea
18.
Journal of the Korean Cleft Palate-Craniofacial Association ; : 111-115, 2011.
Artigo em Coreano | WPRIM | ID: wpr-48658

RESUMO

PURPOSE: Reconstruction of a full thickness defect of the nose is a difficult task for plastic surgeons because the anatomical characteristic, shape, and function of the nose all need to be taken into consideration. Most often, a local flap or a composite graft is used, but for a large defect, reconstruction using free flaps is the most ideal method. In free flap reconstruction, the chondrocutaneous preauricular area can be a suitable donor site. We performed a chondrocutaneous preauricular free flap with an interpositional vascular graft for reconstruction of a nasal ala. METHODS: A 46 year-old male presented to the hospital with a right alar deformity induced by a dog bite. During the surgery, the existing scar tissue was removed and thereby a newly formed full thickness defect was reconstructed using the chondrocutaneous preauricular free flap with an interpositional vascular graft harvested from the descending branch of the lateral femoral circumflex vessel between the facial and superficial temporal vessels of the free flap. RESULTS: The flap survived without flap loss and showed symmetry in its overall shape, contour, texture, and color. The patient was satisfied with the results and the surgery yielded no additional scars at the nasolabial fold area. CONCLUSION: The chondrocutaneous preauricular free flap is a valuable method in reconstruction of full thickness defects of the nose, and using the descending branch of the lateral femoral circumflex vessel as the interpositional vascular graft at the anastomotic site produces reliable results.


Assuntos
Animais , Cães , Humanos , Masculino , Mordeduras e Picadas , Cicatriz , Anormalidades Congênitas , Retalhos de Tecido Biológico , Glicosaminoglicanos , Sulco Nasogeniano , Nariz , Deformidades Adquiridas Nasais , Succinatos , Doadores de Tecidos , Transplantes , Enxerto Vascular
19.
Journal of the Korean Society of Plastic and Reconstructive Surgeons ; : 273-278, 2011.
Artigo em Inglês | WPRIM | ID: wpr-21969

RESUMO

PURPOSE: It has always been an aspiration for Asians to look more balanced and feminine, considering their facial features regarding relatively flat midface with marked prominences of the zygoma. Many studies have been dealt in this subject. However, the authors would like to emphasize the concept and introduce the technique of repositioning of the malar complex to a cosmetically beneficial point and stationing it on proper position by fixation on zygoma body and arch. METHODS: From January 1998 to December 2007, this method was performed in 50 patients of mild to moderate prominence and malposition of the malar complex. A simplified technique of lateral orbital osteotomy and oblique osteotomy on zygomatic arch through intraoral and preauricular incision was developed. Then, liberal malar complex can be moved to a supero-posterior direction and repositioned to a more cosmetically beneficial point. To maintain the stationed position and to protect from vector affected by the attached masticating muscle to zygomatc bone, fixation was done on both zygoma body and arch. RESULTS: We have obtained satisfactory results using this procedure without any observable complications. The advantages of this procedure are proper exposure, inconspicuous scar, safe, more natural contour, improved stability, and shorter healing time. CONCLUSION: The authors suggest that reduction malarplasty should be approached with underlying concept of repositioning and fixation. In mild moderate malar prominent cases, our technique will provide with maintenance of aesthetic concept, equal to the malar reduction performed under coronal approach and provide with more natural facial contour with stability even with less invasive surgical approach.


Assuntos
Humanos , Povo Asiático , Cicatriz , Músculos , Órbita , Osteotomia , Zigoma
20.
Journal of the Korean Society of Plastic and Reconstructive Surgeons ; : 458-464, 2011.
Artigo em Coreano | WPRIM | ID: wpr-209849

RESUMO

PURPOSE: Metacarpal fractures are common hand injury that may require operative intervention to ensure adequate reduction and stabilization. Traditionally, titanium miniplate was used for rigid fixation of bone fractures. However, the use of permanent plate lends itself to multiple complications such as infection, exposure of the hardware, tendon adhesions, tendon rupture, prolonged pain, bony atrophy and osteoporosis (stress shielding), metal sensitization, and palpation under the skin. This study evaluated the usefulness and stability of biodegradable plates and screws for treatment of metacarpal bone fractures. METHODS: There was 17 patients who had surgery for metacarpal bone fracture from April 2007 to June 2010. All patients had open reduction and internal fixation. We used absorbable plates and screws (Inion CPS(R)) for internal fixation. Postoperative results were assessed with x-ray. Stability of plates and screws, healing process and its complications were observed by clinical and radiographic assessment. RESULTS: All patients were successfully reduced of bone fracture, and fixations with absorbable plates and screws were stable. The mean follow up period was 7.1 months. 2 patients complained postoperative pain, but they were relieved with analgesics. All patients experienced transient stiffness, but they were relieved with active assistive range of motion after removal of splint. No patients suffered complications which could be occurred by using metallic plate. CONCLUSION: There was no critical complications such as re-fracture or nonunion among patients. No patients suffered side effects related with metallic implants. Biodegradable implants can offer clinically stable and attractive alternative to metallic implants to stabilize metacarpal bone fractures in the hand.


Assuntos
Humanos , Implantes Absorvíveis , Analgésicos , Atrofia , Sacarose Alimentar , Seguimentos , Fixação de Fratura , Fraturas Ósseas , Mãos , Traumatismos da Mão , Ossos Metacarpais , Osteoporose , Dor Pós-Operatória , Palpação , Amplitude de Movimento Articular , Ruptura , Pele , Contenções , Tendões , Titânio
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA