The purpose of this study is to evaluate the relationship of the factors which could be influenced by orthognathic surgery especillay SSRO. We measured the amounts of the maximum opening, lateral movements, maximum velocity and pattern of mandibular path during the opening and closing of mandible at the following times ; preoperative, 1 month after operation, 6 months after operation respectively using MKG. And the results were compared according to the categorized subgroups. Following results were obtained : 1. The change of the amounts of mandibular lateral movement and maximum opening velocity were statistically different between male and female (p<0.05), but the others were not. 2. According to the method of operation, there was no difference in the change of the mandibular movements between the group of SSRO and SSRO plus LeFort I osteotomy (p>0.05). 3. According to the amounts of mandibular movement, the recovery of left lateral movement of the group of 6~10mm was better than the other groups (p<0.05). 4. In the frontal pattern of the opening and closing of the mandible, the complex deflected type (F5), simple deflected type (F4), complex deviated type (F3), simple deviated type (F2), straight type (F1) were obtained in order at the time of preoperative, simple deflected type, simple deviated type, complex deviated type, straight type, complex deflected type in order at the time of 1 month after surgery, and the result at the time of 6 months after surgery was the same with that of the time of preoperative. In the sagittal pattern, non-coincident type (S2) was predominant at the time of preoperative, and coincident type (S1) was predominant at the time of 1 month after surgery. After 6 months, the result was also the same with that of the preoperative in sagittal pattern. 5. There was not a statistical difference in the change of the mandibular movement between group of presence of the preoperative TMJ symptoms and non-presence group (p>0.05). 6. There was not a statistical difference in the change of the mandibular movement between repositioning device applied group and non-applied group (p>0.05). 7. Sixty three percents of the patients who had preoperative TMJ symptoms were improved after surgery and preoperative TMJ symptoms were more improved after operation in the repositioning device non-applied group statistically (p<0.05).
Female ; Humans ; Male ; Mandible ; Orthognathic Surgery* ; Osteotomy ; Temporomandibular Joint

PURPOSE: The aim of this study is to assess the safety and the efficacy of laparoscopic colorectal surgery compared to those of conventional open surgery and to determine the feasibility of laparoscopic colorectal surgery based on oncologic principles. METHODS: From March 2001 to January 2002, 27 consecutive patients were assessed for the possible use of laparoscopic surgery. Thirty patients were included in the open group. Forty-seven patients were included in the laparoscopic group. The decision regarding the suitability of a patient for the procedure was made by the surgeon. RESULTS: Laparoscopic surgery was attempted on 47 patients, and in 31 patients, it was completed successfully. Patients who underwent laparoscopic surgery required a smaller dose of analgesics and had an earlier bowel passage recovery and shorter hospital stay than patients who underwent open surgery. The mean operation times for the open group, the conversion group, and the laparoscopic group were 252 min, 269 min, and 272 min respectively (P>0.05). There was no difference in the number of lymph nodes dissected nor the length of the distal margin of the resected bowel in the case of anterior resection and low anterior resection of the laparoscopic group compared to the open and the conversion groups (P>0.05). Complications in the laparoscopic surgery group were anastomosis site leakage and bowel obstruction. In the open group, wound infection, urinary retention, anastomosis site leakage and bowel obstruction were found. The morbidities of the open group, the conversion group, and the laparoscopic group were 23.3%, 37.5%, and 12.9%, respectively. One mortality was observed in the conversion group. CONCLUSIONS: In this study, there is no evidence that the laparoscopic technique is inadequate for following the cancer surgery principle, So laparoscopic colorectal surgery is a safe and feasible treatment. The overall morbidity and mortality in this study were acceptable. Sufficient lymph node dissection and distal margin of the resected bowel were accomplished with laparoscopic surgery. Further long-term follow up, however, will be necessary to confirm the value of this technique.
Analgesics ; Colorectal Neoplasms ; Colorectal Surgery* ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Urinary Retention ; Wound Infection

PURPOSE: The aims of this study were to assess the oncologic safety of laparoscopic colorectal surgery compared to that of conventional open surgery and to compare the disease-free survival (DFS) rates between laparoscopic and open colorectal surgery for radical treatment of colorectal cancer. METHODS: From January 2001 to December 2005, 583 patients underwent laparoscopic or conventional open surgery. To address only radical treatment of colorectal cancer, we excluded subjects who had undergone emergency or palliative operation. Four hundred ninety patients were identified for this study. The laparoscopic (LG) and open group (OG) had 74 and 166 patients, respectively, for colon cancer, and 92 and 158 patients, respectively, for the rectal cancer. RESULTS: No difference was noted in the lengths of the distal margins of the resected bowels between the LG and the OG for rectal cancer (P>0.05). In addition, no significant difference was found in DFS rates between the LG and the OG for both colon and rectal cancer (P>0.05). CONCLUSIONS: The laparoscopic technique does not seem to present any disadvantages and is safe and feasible for the treatment of colorectal cancer. No difference was found between laparoscopic and open surgery in terms of DFS for colorectal cancer.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Colorectal Surgery ; Disease-Free Survival ; Emergencies ; Humans ; Laparoscopy ; Rectal Neoplasms

Accidents, Traffic ; Facial Bones ; Female ; Head ; Humans ; Incidence ; Male ; Malocclusion ; Mouth ; Neck Injuries ; Occupational Groups ; Occupations ; Retrospective Studies ; Sex Ratio

Metastatic colorectal cancer is rare and its origins are difficult to define if the gross features of colorectal cancer mimic primary colorectal cancer. However, accurate diagnosis is essential because the treatment and prognosis may vary depending on the origin of the cancer. This report is about a 74-year-old female patient with metastatic sigmoid colon cancer of ovarian origin that mimicked primary sigmoid colon cancer. She spent a 3-year period disease-free from ovarian cancer after surgery and adjuvant chemotherapy. At the time of initial diagnosis, the cancer was diagnosed as a primary sigmoid colon cancer, because the cancer appeared to be a solitary intra-luminal fungating mass. However, the final pathologic result showed that the cancer was metastatic sigmoid colon cancer of ovarian origin and it was confirmed by immunohistochemical staining of cytokeratins-7, -20, and Wilms tumor-1. Therefore, even if colorectal cancer is a single intra-luminal lesion, patients should be suspected of having metastatic colorectal cancer if they have other cancer histories. At this time, immunohistochemical staining using various cancer markers may be a useful tool to distinguish the origin of cancer.
Aged ; Chemotherapy, Adjuvant ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Diagnosis ; Female ; Humans ; Immunohistochemistry ; Neoplasm Metastasis ; Ovarian Neoplasms ; Prognosis ; Sigmoid Neoplasms

PURPOSE: This study was undertaken to describe the clinicopathologic characteristics and evaluate the appropriate management of appendiceal tumors. METHODS: During 5 years between Sep. 2000 and Sep. 2005, 28 appendiceal tumors were identified in a retrospective review of 3,744 cases of appendectomy or right hemicolectomy pathology. RESULTS: Carcinoids were found incidentally as appendicitis. Mucinous cystadenomas were common in women older than 50 aged; half of the cases presented with appendicitis and the other half presented with non-specific abdominal symptoms such as palpable mass, intestinal obstruction and intussusception. Carcinomas were common in the older patients (mean age: 62.8 years) and this presented as periappendiceal abscess. Right hemicolectomy was undertaken when there was evidence of tumor spread beyond the resection margin, and carcinoma and tumors were located in the appendiceal base. Recurrence and metastasis were identified only in the carcinoma cases. CONCLUSION: Most appendiceal tumors presented with appendicitis and periappendiceal abscess. One stage curative resection was possible in more than 76% of the patients, and the prepoperative diagnosis rate was less than 35%. The preoperative diagnosis did not have much impact on the clinical course, and the postoperative pathology was important in determining the additional treatment. Close follow-up is needed for the early detection of recurrence, and all the carcinomas that were advanced as serosal involvement, peritoneal seeding and liver metastasis.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Carcinoid Tumor ; Cystadenoma, Mucinous ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Intestinal Obstruction ; Intussusception ; Liver ; Neoplasm Metastasis ; Pathology ; Recurrence ; Retrospective Studies

0.05) 2. The mean electric activity of the masticatory muscles was found to have decreased during more clenching than resting, but there was no statistically significant difference because of individual difference of measuring values. (p>0.05) 3. The asymmetry index of masticatory muscles in asymmetric groups was significantly greater during clenching compared with controls. (p<0.05) In conclusion, no right-left difference of muscle activities was found in patients with facial asymmetry before orthognathic surgery and 4weeks afterwards. Not only muscular functioning but also many other factors, such as occlusion, temporomandibular joint disorder and trauma, probably affect facial asymmetry and will be analyzed in future studies. And we will need long term follow-up after orthognathic surgery.]]>
Deglutition ; Electromyography ; Facial Asymmetry ; Follow-Up Studies ; Humans ; Individuality ; Masticatory Muscles ; Orthognathic Surgery ; Prognathism ; Temporal Muscle ; Temporomandibular Joint Disorders

PURPOSE: Failure of hemodialysis access is the main medical problem in chronic renal failure patients. This resulted from complications such as thrombosis, infection, pseudoaneurysm, steal syndrome and so on. This study was undertaken in an attempt to describe the clinical characteristics and significances of dialysis failure due to iatrogenic fistula between prosthetic graft and native vein at puncture site. METHODS: During 5 years between Feb. 2005 and Feb. 2009, five Iatrogenic fistulas were identified in a retrospective review of 133 patients performed 220 times fistulography due to dialysis failure in PTFE (polytetrafluoroethylene) graft. RESULTS: Overall incidence is 3.8 % in PTFE graft cases. Mean age is 50 (28~75) years, male to female ratio 2:3. Median 1st patency period is 20 months (6~36). All iatrogenic fistula is usually located in not venous but arterial limb of forearm loop, combined with the stenosis in venous limb and anastomosis site. More than 70% venous anastmotic stenosis in 4 cases (80%) and diffuse stenosis of venous limb in 3 cases (60%), revised concomitantly either by patch angioplasty or ballooning. Medial follow-up period is 8 months (5~12), graft occlusion occurred in one case. CONCLUSION: All iatrogenic fistula usually occurs in not venous but arterial limb of forearm loop graft. Most iatrogenic fistula is combined with the stenosis in venous limb and anastomosis sites, must be revised concomitantly either by patch angioplasty or ballooning. Close assessment to superficial vein and graft is needed for early detection. Fistulography is the most useful diagnostic tool. Careful cannulation method is required to prevent the occurrence of iatrogenic fistula in chronic renal failure patients.
Aneurysm, False ; Angioplasty ; Catheterization ; Constriction, Pathologic ; Dialysis ; Extremities ; Female ; Fistula ; Follow-Up Studies ; Forearm ; Humans ; Incidence ; Kidney Failure, Chronic ; Male ; Polytetrafluoroethylene ; Punctures ; Renal Dialysis ; Retrospective Studies ; Thrombosis ; Transplants ; Veins

True aneurysm of the radial artery is very rare, and the false aneurysms are more common. True aneurysms of the radial artery are usually secondary to trauma or iatrogenic injury. A 71-year-old male presented with a several year history of a left forearm-pulsating mass. He suffered from a brain infarct and had received acupuncture for his hemiplegia for the previous year. The physical examination revealed two pulsating masses on the left forearm. The left ulnar and radial arteries were palpable. The laboratory values were normal. Computerized tomography showed two 40x25 and 37x20 mm-sized saccular true aneuryms containing mural thrombosis in the left proximal radial artery with atherosclerotic change. The aneurysms were resected with reconstruction by using the cephalic vein. Distal flow was reestablished by using end-to-end anastomosis. No complications have been observed during the 4 weeks of follow-up.
Acupuncture ; Aged ; Aneurysm ; Aneurysm, False ; Brain ; Follow-Up Studies ; Forearm ; Hemiplegia ; Humans ; Male ; Physical Examination ; Radial Artery ; Thrombosis ; Veins

PURPOSE: Colorectal cancers occurring in young people are usually found in advanced stage and have worse prognosis. The aim of this study was to investigate the clinical characteristics of young patients with colorectal cancer and survival rate of patients with colorectal cancer younger than 40 years. METHODS: The total of 534 patients with colorectal cancer underwent surgeries between March 1997 and February 2003. 487 patients were 40 or older than 40 years (control group) and the remaining 47 patients were younger than 40 years (study group). We compared age, sex, curability, tumor location, stage, histological type between the two groups. The survival rate by stages and overall survival rate were retrospectively analyzed. RESULTS: No significant difference was shown in the comparison of the distribution by stage and histologic grade at the time of diagnosis. There were more female in the study group (P=0.005). The three-year and five-year overall survival rates were 79.3% and 74.0% in study group, and 68.2% and 60.2% in control group (P>0.05). The three-year and five-year survival rates according to stage were not significantly different between the two groups. CONCLUSION: In the comparison of patients with colorectal cancer younger than 40 years old and 40 or older than 40 years old, no significant difference was shown in clinical characteristics and survival rate except sex distribution.
Adult ; Colorectal Neoplasms* ; Diagnosis ; Female ; Humans ; Prognosis ; Retrospective Studies ; Sex Distribution ; Survival Rate*