1.Revisit the Original Whitehead Hemorrhoidectomy The postoperative results of W-shaped circular incision & preservation of perianal skin.
Ji Hun KIM ; Dong Wan KANG ; Byung Ho SUN
Journal of the Korean Society of Coloproctology 1998;14(1):101-107
Since Whitehead had described a circular hemorrhoidectomy in 1882, many surgeons adopted it for decades for patients with protruding anal deformity. After a few decades of performing Whitehead operation, devastating complications such as anal stricture, fecal incontinence, and wet anus with mucosal eversion had been reported on the literatures and then it was buried as an abandoned procedure by surgeons for a long period. Recently, a few prominent anal surgeons reported that they could avoid such devastating complications by introducing diverse modifications of the original Whitehead's operation. The authors analyzed 22 patients who had undergone original Whitehead circular hemorrhoidectomy with the technique of preserving most of the perianal skin and W-shaped circular incision during the period from 1991 to 1996, with special regard to the com plications such as anal stricture and anal mucosal eversion which have been debated on so far and reviewed the articles about these issues. In immediate postoperative period, suture failure and resultant non-surgery requiring, mild anal stricture were documented in 3 of the 22 cases(13.6%). On long-term follow-up with the mean period of 44 months (18~79 months) in 14 cases, except those 8 cases that were lost, with phone-call questionaire, 13 patients(93%) had quite normal anal functions. The authors would like to suggest that the original Whitehead's circular hemorrhoidec tomy is a valuable surgical technique to manage the protruding anal deformity if surgeons can avoid well known complications such as anal stricture and anal mucosal eversion by choosing a correct location of initial W-shaped incision to preserve as much perianal skin as possible.
Anal Canal
;
Congenital Abnormalities
;
Constriction, Pathologic
;
Fecal Incontinence
;
Follow-Up Studies
;
Hemorrhoidectomy*
;
Humans
;
Postoperative Period
;
Skin*
;
Sutures
2.A Clinical Study of Open Tibia Fractures
Wan KANG ; Kyoo Ho SHIN ; Byung Jik KIM
The Journal of the Korean Orthopaedic Association 1988;23(5):1237-1247
The treatment of open tibia fracture is challenging to Orthopedic Surgeon with its high infection rate and other complications. We had wound culture of open tibia fracture at emergency room in all cases, and treated using various External Fixators. The author analized the 134 cases of the open tibia fractures from March 1979 to February 1987. The average follow-up was one year. The results were as follws : 1. Type I open fracture was 23 cases, Type II 58 cases, Type IIIA 33, Type IIIB and Type IIIC was 10 cases each. The most frequent type of fracture was Type II, 58 cases by Gustilo classification. 2. The union time of Type I fracture was 6.5 months in average, and that of Type II and Type III was 9.5 months, 11.2 months. 3. Of those 52 cases whose initial culture was positive, 12 cases developed infection. The low infection rate would probably be due to combined administration of cephalosporin and firm application of external fixator to severe open tibia fractures.
Classification
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Clinical Study
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Emergency Service, Hospital
;
External Fixators
;
Follow-Up Studies
;
Fractures, Open
;
Orthopedics
;
Tibia
;
Wounds and Injuries
3.Preimplantation Development and Apoptosis of Mouse Embryos in the Medium Containing Extracellualr Matrix.
Byung Moon KANG ; In Pyo SOHN ; Byung Mok CHUNG ; Kyoo Wan CHOI ; Myung Chan GYE
Korean Journal of Fertility and Sterility 2000;27(3):253-259
OBJECTIVE: To verify the effect of Matrigel, a ECM complex from Engelbreth-Holm-Swarm(EHS) mouse sarcoma on the preimplantation development and apoptosis of mouse fertilized eggs. METHOD: Late Pronucleus stage eggs were cultured through the blastocyst stage in the presence of Matrigel (0.5%, v/v). Characteristics of apoptosis and cell number assessed by Hoecst staining and TUNEL labeling at the blastocyst stage, respectively. RESULTS: Morphological development, number of cells per embryo was significantly increased but rate and number of TUNEL positive nuclei of the embryo were decreased in the presence of Matrigel. CONCLUSION: This result suggested that at low concentration of Matrigel improves both viability and morphological development in the preimplantation mouse embryos.
Animals
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Apoptosis*
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Blastocyst
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Cell Count
;
Eggs
;
Embryonic Structures*
;
In Situ Nick-End Labeling
;
Mice*
;
Ovum
;
Sarcoma
;
Zygote
6.Analysis of Factors Related of Location of Initial Visual Field Defect in Normal Tension Glaucoma.
Byung Wan KANG ; Yong Sok JI ; Sang Woo PARK
Journal of the Korean Ophthalmological Society 2011;52(12):1478-1484
PURPOSE: To investigate the risk factors related to the location of visual field defects in normal tension glaucoma. METHODS: Eighty-one eyes diagnosed as normal tension glaucoma in patients with early glaucomatous visual field defects were divided into central visual field defects and peripheral visual field defects. The difference between the 2 groups based on the intra-individual comparison were assessed with several ocular risk factors such as sex, age, hypertension, diabetes mellitus, smoking, laterality, intraocular pressure, central corneal thickness, cup-disc ratio, peripapillary atrophy, mean deviation, pattern standard deviation, best corrected visual acuity, and refractive errors. RESULTS: The incidence of hypertension in the central visual field defects group (60.6%) was higher than in the peripheral visual field defects group (22.9%, p = 0.001). The central corneal thickness in the central group (533.1 +/- 18.2 microm) was thinner than in the peripheral group (545.0 +/- 30.0 microm, p = 0.003). Hypertension was the only risk factors for central visual field defects (p = 0.001). In both the central group and peripheral group, upper visual field defects were more common than lower defects. CONCLUSIONS: Hypertension in patients with normal tension glaucoma was a factor involved in central visual field defects. Additionally, numerous visual field defects were mainly found the superior portion.
Atrophy
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Diabetes Mellitus
;
Eye
;
Humans
;
Hypertension
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Incidence
;
Intraocular Pressure
;
Low Tension Glaucoma
;
Risk Factors
;
Smoke
;
Smoking
;
Visual Acuity
;
Visual Fields
7.Bone density around the fixture after function of implant molar prosthesis using CBCT.
Jae Hyun JUNG ; In Taik HWANG ; Byung Hyun JUNG ; Jae Duk KIM ; Dong Wan KANG
Korean Journal of Oral and Maxillofacial Radiology 2010;40(1):1-7
PURPOSE: The purpose of this study was to examine the significance of increased bone density according to whether bone grafts were applied using demographic data with Cone Beam Computed Tomography (CBCT) and to compare the bone densities between before and after implant prosthesis using the Hounsfield index. MATERIALS AND METHODS: Thirty-six randomly selected computed tomography (CT) scans were used for the analysis. The same sites were evaluated digitally using the Hounsfield scale with V-Implant 2.0(TM), and the results were compared with maxillary posterior bone graft. Statistical data analysis was carried out to determine the correlation between the recorded Hounsfield unit (HU) of the bone graft and implant prosthesis using a Mann-Whitney U test and Wilcoxon Matched-pairs test. RESULTS: The bone grafted maxillary posterior teeth showed an increase in the mean values from-157 HU to 387 HU, whereas non-grafted maxillary posterior teeth showed an increase from 62 HU to 342 HU. After implantation, the grafted and non-grafted groups showed significantly higher bone density than before implantation. However, the grafted group showed significantly more changes than the non-grafted group. CONCLUSION: Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density (Hounsfield scale) and bone grafts in the maxillary molar area.
Bone Density
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Cone-Beam Computed Tomography
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Data Interpretation, Statistical
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Dental Implants
;
Molar
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Prostheses and Implants
;
Tooth
;
Transplants
8.The Management and Characteristics of Posterior Cerebral Artery Aneurysms.
Dong Wan KANG ; Byung Kwan CHOI ; Chang Hwa CHOI
Korean Journal of Cerebrovascular Surgery 2006;8(2):107-113
Posterior cerebral artery (PCA) aneurysm is a rare disease, and has some distinctive features compared with aneurysms located elsewhere. This study is to investigate results of the management and characteristics of posterior cerebral artery aneurysm. Between 1996 and 2005, we treated 8 patients (4 male, 4 female) via endovascular or surgical approach. Six patients underwent endovascular treatment and two were treated with open surgery. The Glasgow Outcome Scale (GOS) was used for estimating the results. Five patients had ruptured PCA aneurysms and three had unruptured aneurysms. The locations were one case of P1 branch, two cases of P1-P2 junction, four cases of P2-P3 junction and one case of distal P4 branch. Among 8 patients, five had good recovery, two had a moderate disability and another one was expired due to rebleeding. Optimal treatment of PCA aneurysms is able to perform via surgical or endovascular approach. Endovascular treatment is effective and an alternative method for PCA aneurysm because of the difficulty and several complications of surgical approach.
Aneurysm
;
Glasgow Outcome Scale
;
Humans
;
Intracranial Aneurysm*
;
Male
;
Passive Cutaneous Anaphylaxis
;
Posterior Cerebral Artery*
;
Rare Diseases
9.The role of the hamstrings as antagonists of quaadriceps inmaintaining knee joint stability.
Koon Soon KANG ; Jun Seop JAHNG ; Jae Ho MOON ; Hui Wan PARK ; Kyu Hyun YANG ; Byung You JANG
The Journal of the Korean Orthopaedic Association 1991;26(3):945-949
No abstract available.
Knee Joint*
;
Knee*
10.Laparoscopic Versus Open for Complicated Appendicitis.
Dong Wan KANG ; Man Ki KIM ; Ji Hun KIM ; Byung Soo KIM ; Hong Jin CHUN ; Byung Ho SUN
Journal of the Korean Surgical Society 1999;56(4):570-578
BACKGROUND: For complicated appendicitis, in contrast to simple appendicitis, laparoscopic appendectomy (LA) is considered a relative or absolute contraindication because of the higher postoperative complication rate than that of open appendectomy (OA), especially, high incidence of intra-abdominal abscess. The purpose of this article is to assess the feasibility of LA for complicated appendicitis. METHODS: A retrospective review of 35 LA and 128 OA for the cases of gangrenous, perforated appendicitis, and periappendiceal abscess between May 1995 and June 1997 was performed. Patients were identified through the hospital pathology registry. We compared data from both groups with respect to operative times, postoperative pain, duration of ileus, length of hospital stay, and complication rate, with special attention to the incidence of intra-abdominal abscess. RESULTS: 1) The male:female ratio of LA (1:1.2) was significantly lower than that of OA (1:0.45) (p<0.05). There was no significant difference in the age distribution between both groups. 2) The mean operative time of LA (58.3 minutes) was significantly longer than that of OA (51.8 minutes) (p<0.05). 3) The mean number of injections of analgesics and the mean duration of ileus represented an advantage for LA (1.2 times and 1.8 days) than those of OA (1.6 times and 2.0 days). But these differences did not reach statistical significance. 4) The length of hospital stay of LA (6.5 days) was shorter than that of OA (7.8 dyas) (p<0.05). 5) Overall postoperative complication rate was lower in LA (11.4%) compared with OA (11.7) (p>0.05). But LA was associated with higher incidence of postoperative intra-abdominal abscess (3/35, 8.6%) than OA (3/128, 2.3%) (p=0.114). There was one serious intra-abdominal abscess in the LA, which required reoperation. The rest 2 cases in the LA and all 3 cases in the OA were treated conservatively. CONCLUSIONS: LA for complicated appendicitis could afford the merits of shorter hospital stay, reduced incidenceof wound infection, and comparable incidence of overall complication rate. To reduce the incidence of postoperative intra-abdominal abscess, copious irrigation and adequate drainage should be recommended.
Abdominal Abscess
;
Abscess
;
Age Distribution
;
Analgesics
;
Appendectomy
;
Appendicitis*
;
Drainage
;
Humans
;
Ileus
;
Incidence
;
Length of Stay
;
Operative Time
;
Pain, Postoperative
;
Pathology
;
Postoperative Complications
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Reoperation
;
Retrospective Studies
;
Wound Infection