• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.8-12
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• 2006

회전근 개 파열이 왜 통증을 일으키며 어떤 경우 통증을 일으키는가에 대해 아직도 모르는 부분이 많다. 그러나 생 역학적으로 회전근 개 질환을 이해하고 접근하면 순리적으로 풀어져 나가는 부분도 많다. 회전근 개가 파열되었어도 통증이 미약하다면 수술보다는 적극적인 보존적 치료가 원칙이다. 만약 수술을 하는 경우 고식적인 방법으로 충분한 경험을 쌓은 후 관절경술을 시도하여야 한다. 물론 최근 관절경술로 파열된 회전근 개를 봉합하여 주는 것이 선호되고 있으며 치료 결과 역시 관절경술이 더 좋을 수는 있으나 불안정성과 마찬가지로 전례에서 가능한 것도 아니고 만족한 결과를 모든 정형외과 의사가 공히 얻는 것은 아니다. 특히 회전근 개 봉합술은 고도의 관절경술 수기가 요구되는 것이므로 충분한 연마가 요구된다.

• The Journal of the Korean bone and joint tumor society
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• v.8 no.3
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• pp.83-89
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• 2002

Purpose: To analyze the postoperative functional and radiographic follow-up results in patients who underwent percutaneous radiofrequency ablation therapy after the diagnosis of osteoid osteoma. Materials and Methods: Seven patients, who were clinically and radiographically diagnosed with osteoid osteoma from July 1999 to January 2001, and received percutaneous radiofrequency ablation therapy. The average follow-up period was 15.5 months(range, 8~25 months). For the diagnosis and accurate localization of the lesion, simple radiography, computed tomography and magnetic resonance imaging(MRI) were performed preoperatively. Simple radiographs and MRI were taken periodically for the follow-up studies. Results: In all 7 patients, symptoms completely disappeared within 3 days after the operation. The average period of hospitalization was 2.4 days, excluding 1 patient who needed an additional burn treatment. The average postoperative night and day pain scores were 1.8 and 1.3, respectively. The average vocational and recreational activity scores were 1 and 0.6, respectively. Conclusions: Satisfactory functional results were obtained with percutaneous radiofrequency ablation therapy for the elimination of osteoid osteoma. Compared to conventional treatment, the advantages of this therapy were short hospitalization period, no internal fixation and bone graft for preventing fracture, and no limitation of joint motion by long fixation period.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.371-376
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• 2005

Background: Retrospective study was carried out on patients with primary spontaneous pneumothorax with the aim of determining if conventional thoracoscopic wedge resection is superior to modified transaxillary minithoracotomy with thoracoscopy in the surgical treatment. Material and Method: 160 patients, aged 14 to 35 years with primary spontaneous pneumothorax were involved in this study. Patients were assigned to two groups by surgical technique; Conventional thoracoscopic wedge resection (group A; n=80) and modified transaxillary minithoracotomy with thoracoscopy (group B; n=80). Apical pleural abrasion & talc poudrage were performed in all cases. This study evaluated the following factors: duration of operation, days of analgesics used after operation, number of no air leak on the first postoperative day, duration of indwelling chest tube, hospital stay, postoperative complications, chronic chest pain (during follow-up) and resumption of normal activity. Relapses (ipsilateral recurrence after discharge) during follow-up periods were evaluated. Result: No significant differences were found in any of the factors studied in either group. Conclusion: Conventional thoracoscopic wedge resection and modified transaxillary minithoracotomy with thoracoscopy offer similar results in the surgical treatment of primary spontaneous pneumothorax. The rate of complication is low and the level of pain is acceptable without long-term sequele. Therefore, modified transaxillary minithoracotomy with thoracoscopy method appears as a valuable alternative surgical technique.

• Korean Journal of Head & Neck Oncology
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• v.10 no.2
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• pp.152-156
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• 1994

Stomal recurrence after total laryngectomy presents serious therapeutic problems despite aggressive treatment methods. The purpose of this study is to evaluate the critical analysis of etiology and treatment results and to clarify the treatment plans and prevention of stomal recurrence. Among 159 cases who had undergone total laryngectomy for cancers of larynx(135 cases) and hypopharynx(24 cases) during recent 10 years, stomal recurrence occured in 12 cases(1 case with type I, 2 cases with type II, 2 cases with type III, 3 cases of type IV and unclassified 4 cases according to Sisson's classification) and the retrospective analysis of results were as follows: 1) Average duration of stomal recurrence was $8.2{\pm}4.35$ months after cessation of primary treatment. 2) The overall incidence of stomal recurrence was 7.6%. 3) The suggested etiology in the pathogenesis of stomal recurrence could be inadequate surgical margin, delayed laryngectomy after initial tracheostomy and improper management of metastatic nodes. 4) Mean survival time was $7.3{\pm}5.61$ months and one case with type I underwent surgical salvage is still alive out of 7 cases with chemotherapy and radiotherapy and 5 cases with surgical salvage and adjacent therapy. In summary, aggressive surgical resection should be recommended in cases with high risks of stomal recurrence.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.203-210
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• 2019

The aim of this review was to evaluate minimally invasive lateral lumbar interbody fusion on the latest update. Lumbar interbody fusion was introduced recently. This study performed, a literature review of the indications, clinical outcomes, fusion rate, and complications regarding recently highlighted minimally invasive lateral lumbar interbody fusion. The indications of lateral lumbar interbody fusion are similar to the conventional anterior and posterior interbody fusion in degenerative lumbar diseases. In particular, lateral lumbar interbody fusion is an effective minimally invasive surgery in spinal stenosis, degenerative spondylolisthesis, degenerative adult deformity, degenerative disc disease and adjacent segment disease. In addition, the clinical outcomes and fusion rates of lateral lumbar interbody fusion are similar compared to conventional lumbar fusion. On the other hand, non-specific complications including hip flexor weakness, nerve injury, vascular injury, visceral injury, cage subsidence and pseudohernia have been reported. Lateral lumbar interbody fusion is a very useful minimally invasive surgery because it has advantages over conventional anterior and posterior interbody fusion without many of the disadvantages. Nevertheless, nonspecific complications during lateral lumbar interbody fusion procedure remain a challenge to be improved.

• Radiation Oncology Journal
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• v.27 no.2
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• pp.55-63
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• 2009

Purpose: This study was performed to objectively evaluate the rate of tumor response to hypofractionated radiotherapy for advanced squamous cell carcinomas of the head and neck. Materials and Methods: Thirty-one patients with advanced squamous cell carcinoma of the head and neck, who were treated by hypofractionated radiotherapy with 3 Gy per fraction for palliative purpose between 1998 and 2008, were reviewed retrospectively. Every tumor-volume was measured and evaluated from CT (computed tomography) images obtained before and 2~3 months after radiotherapy. The radiation toxicity was assessed during and after radiotherapy. A statistical analysis was performed to investigate overall survival, progressionfree survival, and the prognostic factors for survival and response. Results: The median age of the study patients was 70 years. In addition, 85% of the patients were in stage 4 cancer and 66.7% had an ECOG performance status of 1~2. The mean tumor-volume was 128.4 cc. Radiotherapy was administered with a total dose of 24~45 Gy (median: 36 Gy) over 10~25 days. Twenty-nine patients were treated with 30 Gy or more. The observed complete response rate was 12.9% and the partial response rate was 61.3%. Median survival time was 8.9 months and the 1-year progression-free survival rate was 12.9%. The treatment response rate was confirmed as a prognostic factor in the rate of survival. The primary site, stage, tumor-volume, radiotherapy field and overall radiation-dose showed a significant relationship with survival and treatment response. No grade 4 toxicity was observed during and after radiotherapy. Conclusion: There was an objective tumor-regression in about 74% of patients treated by hypofractionated radiotherapy. Further evaluation is needed to select the appropriate fraction-size and patient who may require the additional radiotherapy.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.35-43
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• 2003

Purpose :To analyze the survival period, prognostic factors and complications of patients having undergone high-dose-rate intraluminal brachytherapy (HDR-ILB) as a salvage radiation therapy, while having a catheter, for percutaneous transhepatic billary drainage (PTBD), inserted due to biliary obstruction caused by a secondary malignant biliary tumor Methods and Materials : A retrospective study was performed on 24 patients having undergone HDR-ILB, with PTBD catheter Insertion, be)ween December 1992 and August 2001. Their median age was 58.5, ranging from 35 to 82 years. The primary cancer site were the stomach, gallbladder, liver, pancreas and the colon, with 12, 6, 3, 2 and 1 cases, respectively. Eighteen patients were treated with external beam radiation therapy and HDR-lLB, while slx were treated with HDR-lLB only. The 4otal external beam, and brachytherapy radiations dose were 30$\~$61.2 and 9$\~$30 Gy, with median doses of 50 and 15 Gy, respectively. Results : Of the 24 patients analyzed, 22 died during the follow-up period, with a median survival of 7.3 months. The 6 and 12 months survival rates were 54.2 (13 patients) and 20.8$\%$ (5 patients), respectively. The median survivals for stomach and gailbladder cancers were 7.8 and 10.2 months, respectively, According to the unlvariate analysis, a significant factor affecting survival of over one year was the total radiation dose (over 50 Gy) (o=0.0200), with all )he patients surviving more than one year had been Irradiated with more than 50 Gy. The acute side effects during the radiation therapy were managed with conservative treatment. During the follow-up period, 5 patients showed symptoms of cholangltis due to the radiation therapy Conclusion :An extension to the survival of those patients treated with HDR-ILB is suggested compared to the median historical survival of 4hose patients treated with external biliary drainage. A boost radiation dose could be effectively given, by performing HDR-lLB, which is a prognostic factor In addition, the acute complications of radiation therapy were effectively controlled by conservative management, and It could be regarded as a safe treatment.

• The Journal of the Korea Contents Association
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• v.14 no.3
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• pp.215-222
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• 2014

Recent years, mirror therapy or mirror neuron therapy has been used to improve neural damage of upper extremities among stroke patients. This systematic review was conducted to assess the clinical effect of mirror therapy used for the treatment of upper extremities for patients with stroke. After literature search, researchers selected for 9 randomized controlled clinical trial studies registered up to October 2013 based on PubMed database, using the following search terms: mirror therapy, mirror neuron, stroke, paresis, hemiplegia, upper extremity. There were significant improves of distal upper extremity function in the use of mirror therapy groups but the research using range of motion(ROM) as outcome measure. In conclusion, mirror therapy was more effective than conventional therapies or sham therapies for upper recovery of distal upper extremity function among stroke patients.

• Radiation Oncology Journal
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• v.26 no.1
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• pp.1-9
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• 2008

Purpose: To evaluate the impact of postoperative radiotherapy on loco-regional failure in patients with vulvar carcinoma and to determine the treatment strategy for inguinal lymph nodes. Materials and Methods: Sixty-six patients who received treatment for primary vulvar carcinoma at Seoul National University Hospital, from October 1979 through June 2004, were retrospectively analyzed. Sixteen patients were excluded from the analysis due to the following reasons: distant metastases in two patients; palliative intent for six patients; previous radiotherapy given to the pelvis in three patients; follow-up loss after surgery for four patient; insufficient medical records for one patient. Of 50 eligible patients, 35 were treated with surgery alone(S), ten were treated with surgery followed by radiotherapy(S+RT), and five were treated with radiotherapy alone. Results: The 5-year overall survival(OS) and disease-free survival(DFS) rates of all patients were 91% and 78%, respectively. Twelve patients(26%) experienced treatment failures and the sites of initial failure were as follows: a primary site in eight patients; regional lymph nodes in three patients; the lung in one patient. Although risk factors for failure were more common in the S+RT group than the S group of patients(p<0.05), the DFS rates were similar for the two groups(5-year DFS rates, 78% vs. 83%, p=0.66). The incidences of occult lymph node metastases was 10%. Ten of 31 patients with clinically negative lymph nodes did not received inguinal lymph node dissection, but no patient experienced regional failure. Conclusion: Postoperative radiotherapy may have a potential benefit for patients with risk factors for failure. The omission of inguinal dissection or elective radiotherapy to the inguinal lymph nodes may be considered in low-risk patients with clinically negative lymph nodes.

• Neonatal Medicine
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• v.16 no.2
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• pp.146-153
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• 2009

Purpose: The aim of this study is to investigate the current use of dexamethasone rescue therapy (DRT) for bronchopulmonary dysplasia (BPD). Methods: This is a retrospective study of 251 BPD patients managed in the neonatal intensive care units at Seoul National University Childrens Hospital and Seoul National University Bundang Hospital between March 2004 and August 2008. The demographic data and clinical characteristics of the mothers and infants were analyzed. The infants were compared based on DRT responsiveness. The DRT complications were investigated. Results: Ninety-three patients (37.1%) were classified with severe BPD, DRT was only given to patients with severe BPD. Dexamethasone was administered to 24 patients (9.6%) whose respiratory status had precluded extubation, which indicated that conventional BPD management had failed. Fourteen patients (58.3%) who received DRT were responsive. DRT non-responders required more oxygenation and more complicated with pulmonary arterial hypertension (PAH). Responder had shorter length's of hospitalization and lower mortality rates. High dose dexamethasone was no more effective in weaning neonates from the ventilatior than low dose dexamethasone. Sepsis was the most common complication of DRT. Conclusion: DRT is a valuable treatment for severe BPD ahead of PAH development. DRT should not be performed in BPD patients with PAH due to the possibility of complications.