• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.138-140
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• 2016

Vocal cord polyps are generally removed using a direct laryngoscope and surgical microscope. In some case of laryngeal microsurgery, laryngeal exposure with surgical microscope is difficult because of severalfactors. We experienced a case of vocal polyp with difficult laryngeal exposure in a 56 year old male patient. The vocal cord polyp was removed successfully through endoscopic approach.

• Proceedings of the KOR-BRONCHOESO Conference
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• 2003.09a
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• pp.111-111
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• 2003

부식제 섭취로 인한 가장 흔한 합병증은 인두-식도 협착이며, 이로 인한 구강섭취 장애는 심각한 문제를 초래한다 이의 치료에 있어 기존의 수술적 치료가 소개되었으나 만족스럽지 못한 결과를 가져왔다. 부식제 섭취로 인한 인두-식도 협착에 있어 본원에서 시행한 수술적 치료 결과에 대해 알아봄으로써 향후 인두-식도 협착 치료에 도움을 주고자 하였다. 2001년 12월부터 2003년 8월까지 본원 이비인후과와 일반외과에서 부식제 섭취로 인한 인후두 및 식도의 완전협착으로 진단 받고 치료를 시행 받은 4예를 대상으로 의무기록을 통하여 술전 이학적 소견, 수술적 치료방법, 술후 합병증, 구강 섭취 시기를 후향적으로 분석하였다. 모든 환자에서 술전 내시경 검사로 인두-식도 접합부에 협착소견을 확인하였으며, 이중 경구 식이가 전혀 가능하지 못하였던 3명의 환자는 전후두인두식도 절제술 및 대장대체술 시행 하였으며, Levine- tube로 관급식이가 가능하였던 1명의 환자는 내시경적 확장술만 시행 받았다. 전 후두인두식도 절제술 및 대장대체술을 시행받은 3명의 환자 모두에서 문합부 유루, 출혈은 없었으나, 그 중 1명에서 술후 재협착으로 내시경적 확장술을 시행 받았고 이 환자를 제외한 2명의 환자에서 술후 10일과 13일에 경구섭취가 가능하였고 재협착이 있었던 환자는 술후 43일에 경구섭취가 가능하였다. 대장대체술을 시행 받았던 환자에서는 연식 이상의 식사가 가능하였으나, 내시경적 확장술을 시행 받은 환자는 관급식이만 가능하였다. 부식제 섭취에 인한 인후두 및 식도 협착에 있어 대장을 이용한 대장 대체술식을 이용하여 인두-식도 협착 치료에 좋은 결과를 얻었으며, 대장대체술은 합병증 및 구강 섭취에 있어 좋은 결과를 가져다 주는 술식으로 판단되었다.결과를 이용하여 향후 전개될 홈 네트워크 서비스 및 관련시장의 발전 방향을 전망해 보고 이에 따른 기업이나 정부차원의 대응전략을 파악하고자 한다.육구에서는 큰 변화를 나타내고 있지 않았다(p<0.05). 운동과 비운동시킨 참돔의 지질 함량의 변화는 운동시킨 참돔은 운동으로 인한 에너지 소비로 인하여 함량이 유의적으로 감소했으며(r=-0.35), 비운동사육구에서는 절식으로 인하여 지질함량이 감소하였다(r=-0.38). 파괴강도와 가장 밀접한 영향을 가지는 콜라겐은 운동과 비운동 모두 사육기간동안 큰 변화는 보이지 않았다. 초기의 파괴강도값은 1.45±0.02kg(운동사육구), 1.36±0.18kg(비운동사육구)이였으며 사육기간동안 운동사육구는 파괴강도값이 증가한 반면, 비운동수조에서는 참돔의 파괴강도는 사육기간동안 큰 유의차가 없었다. 각 성분간의 상관도를 살펴보면, 수분함량과 파괴강도는 상관성을 가졌으며, 지질함량과 파괴강도도 같은 경향은 나타내었다. 운동기간동안의 파괴강도와 콜라겐 사이에는 상관성의 거의 없었다. 이는 운동기간에 따른 파괴강도의 증가가 콜라겐의 함량의 증가보다는 지질함량의 감소와 수분함량의 증가와 같은 성분과의 상관성이 크다고 판단된다. 다음으로는, 운동횟수에 의한 영향으로써 운동시간을 1일 6시간으로 설정하여, 운동횟수를 결정하기 위하여 오전, 오후에 각 3시간씩 운동시키는 방법과 오전부터 6시간동안 운동시키는 두 방법을 이용하여 품질을 비교하였다. 각 조건에 따라 운동시킨 참돔의 수분함량을 나타낸 것으로, 2회(오전 3시간, 오후 3시간)에 나누어서 운동시키기 위한 육의 수분함량은 73.37±2.02%를 나타냈으며, 1회(6시간 운동)운동시키기 위한 육은 71.74±1.66%을 나타내었다. 각각의 운동조건에서 양식된 참돔은

• Journal of Gastric Cancer
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• v.7 no.1
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• pp.42-46
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• 2007

Usually in the subtotal gastrectomy, the left and the right gastric arteries, as well as the left and the right gastroepiploic arteries are ligated. Thus, to avoid a blue stomach surgeons preserve the spleen and the short gastric arteries. When a radical subtotal gastrectomy with splenectomy is performed, meticulous caution is necessary; otherwise, the subtotal gastrectomy might have to be changed to a total gastrectomy to prevent a blue stomach. We report the case of a 67-year-old woman who had distal stomach cancer with a splenic solitary mass, for which splenic meatastasis could be excluded. We planned and performed a laparoscopy-assisted radical subtotal gastrectomy with splenectomy as the diagnostic and therapeutic option. In this case, to avoid a remnant stomach infarction or total gastrectomy we saved the left gastric artery and vein with clearing perivascular soft tissue, lymphatics, and lymph nodes. Thus the radical therapeutic goal was reached, and serious complications were avoided.

• Journal of Veterinary Clinics
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• v.32 no.1
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• pp.9-15
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• 2015

Purpose of this study is to determine the reasonable portal approach for thoracoscopic right middle lung lobectomy in small sized dogs under 10 kg. Ten healthy beagle dogs weighing $8.67{\pm}0.49kg$ were included. Under general anesthesia, one-lung ventilation (1LV) was achieved using endobronchial blocker with guidance of fiber-optic bronchoscope. Two portal approaches were used; 8-6-10 intercostal space (ICS) and 8-6-5 ICS approach. Thoracoscopic right middle lung lobectomy was performed using endoscopic linear self-cutting stapler and specimen retrieval bag. Each approach was evaluated by scoring 0; bad, 1; endurable, 2; good, 3; excellent in following five category, 1) visualization, 2) triangulation; instrumental sword fighting in the thoracic cavity, 3) approach to hilar pedicle; application of stapler, 4) any obstacles in applicating Lap Bag, and 5) the operator's convenience. Favorable working space was secured by 1LV and thoracoscopic right middle lung lobectomy was successfully completed in all dogs. There was no need to change the portal location and iatrogenic complication. Most of scores were good to excellent in both approaches. Consequently, both approaches are feasible methods for thoracoscopic right middle lung lobectomy with one lung ventilation using endoscopic linear self-cutting stapler in dogs weighing less than 10 kg.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.917-923
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• 2001

Background : Bronchial sleeve resection for centrally located primary lung cancer is a lung-parenchyma-sparing operation in patients whose predicted postoperative lung function is expected to diminished markedly. Because of its potential bronchial anastomotic complications, it is considered to be an alternative to pneumonectomy. However, since sleeve lobectomy yielded survival results equal to at least those of pneumonectomy, as well as better functional results, it became and accepted standard procedure for patients with lung cancer who have anatomically suitable tumors, regardless of lung function. In this study, from analyzing of occurrence rate of postoperative complication and survival rate, we wish to investigate the validity of sleeve resection for primary lung cancer. Material and Method : From January 1989 to December 1998, 45 bronchial sleeve resections were carried out in the Department of Thoracic Surgery of Seoul National University Hospital. We included 40 men and 5 women, whose ages ranged from 23 to 72 years with mean age of 57 years. Histologic type was squamous cell carcinoma in 35 patients, adenocarcinoma in 7, and adenosquamous cell carcinoma in 1 patients. Right upper lobectomy was peformed in 24 patients, left upper lobectomy in 11, left lower lobectomy in 3, right lower lobectomy in 1, right middle lobecomy and right lower lobectomy in 3, right upper lobectomy and right middle lobecomy in 2, and left pneumonectomy in 1 patient. Postoperative stage was Ib in 11, IIa in 3, IIb in 16, IIIa in 13, and IIIb in 2 patients. Result: Postoperative complications were as follows; atelectasis in 9, persistent air leakage for more than 7 days was in 7 patients, prolonged pleural effusion for more than 2 weeks in 7, pneumonia in 2, chylothorax in 1, and disruption of anastomosis in 1. Hospital mortality was in 3 patients. During follow-up period, bronchial stricture at anastomotic site were found in 7 patients under bronchoscopy, Average follow-up duration of survivals(n=42) was 35.5$\pm$29 months. All of stage I patients were survived, and 3 year survival rate of stage II and III patients were 63%, 21%, respectively. According to Nstage, all of N0 patients were survived and 3 year survival rates of Nl and N2 were 63% and 28% respectively. Conclusion: We suggest that this sleeve resection, which is technically demanding, should be considered in patients with centrally located lung cancer, because ttlis lung-saving operation is safer than pneumonectomy and is equally curative.

• Journal of Chest Surgery
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• v.41 no.2
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• pp.281-284
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• 2008

Bronchial foreign bodies commonly occur through aspiration or inhalation. Here we present a very rare case of migration of a non-metallic foreign body into the bronchus 5 years after lobectomy. The foreign body, a Teflon pellet used to control parenchymal bleeding in the lung, was removed by a bronchofiberscope. Although the mechanism of migration remains unknown, our case and a previous Japanese case provide evidence that non-metallic foreign bodies can migrate from the lung parenchyma to the bronchus.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.35-41
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• 2006

Background: The radial arteries are being used more often for coronary artery bypass grafting, We tried to the endoscopic radial artery harvest to reduce the cosmetic problems and neurologic complications of the conventional open harvesting and report the techniques and early results. Material and Method: The 86 patients underwent coronary artery bypass grafting between May 2003 and April 2005 had their nondominant radial artery endoscopically removed through a 2 cm incision at the wrist. The radial pedicle was dissected and was divided at antecubial area through a 5 mm counterincision. Result: The 23 patients complained of neuralgias on territory of superficial raidal none but no one complained of neuralgias on territory of lateral antebrachial cutaneous none. There was no functional impairment of the hand. There was no wound complication except a localized hematoma. All patients were contacted by telephone after postoperative 7.9$\pm$3.6 months. The 4 patients still complained of neuralgia. All the patients were satisfied with the aesthetics of the wounds. The multidetectional tomography was done on the 66 patients for the estimation of early patency of radial artery. There were 2 cases of stenosis and a case of occlusion. Conclusion: Endoscopic radial artery harvest had no functional impairment of the hand, lesser rate of neurologic complications and outstanding aesthetics. The results of early patency of the radial artery was similar to conventional methods. Therefore, we think that endoscopic radial artery harvest is the optimal procedure.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.19-26
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• 2003

Purpose : Maxillary sinus cancers are usually locally advanced, and involve the structures around sinus, but the regional lymphatic spread is uncommon. Therefore, the local control of these cancers is important for their cure. We reviewed our experience of 55 patients with squamous cell carcinomas of the maxillary sinus, treated with radiation therapy, and looked for the role of radiation therapy in maxillary sinus cancers. Materials and Methods : Between November 1982 and October 1999, 55 patients with squamous cell carcinomas of the maxillary sinus underwent either radiation therapy only, or combined with surgery or with concurrent chemoradlation therapy. All patients were restaged according to the 1997 AJCC staging systems. The T classifications of the tumors of the patients were as follows 1.8$\%$ (1/55) for 72, 81.8$\%$ (45/55) for 73 and 16.4$\%$ (9/55) for 74. Thirteen patients were diagnosed with lymph node involvement. With the surgical procedures, 12 patients were managed by biopsy only, 21 were resected by FESS (funclienal endoscopic sinus surgery) and 22 by partial/medical/total rnaxillectomies. The details of the treatments were as follows 8 patients were treated with radiation therapy only, 17 with a combination of FESS and radiation therapy, 22 with a combination of a maxillectomy and radiation therapy, 4 with a combination of preoperative radiation therapy and surgery, and 4 with concurrent chemoradiation therapy. The mean follow-up for all patients was 25 months, ranging from 2.8 to 125 months. Results : The 4-year local control and survival rates for all Patients were 45.5 and 33.3$\%$, respectively. The 4-year local control and suHival rates, due to the extent of surgery, were as follows 32.1, and 21.4$\%$ for biopsy; 41.9, and 31.7$\%$ for FESS; and 56.8, and 52.7$\%$ for maxillectomy, respectively. Twenty-nine (52.7$\%$) patients were not cured, and of these 29 patients, 23 (79.3$\%$) patients had a iocal recurrence following treatment. Conclusions :This study has shown that the major failure sites following treatment to be the local regions, and that the completeness of surgery was important for improving the local control and survival of patients with squamous cell carcinoma of the maxillary sinus.

• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.512-518
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• 2021

Purpose: This study compared the change in foraminal space on magnetic resonance imaging (MRI) and the clinical outcome after anterior cervical discectomy and fusion (ACDF) versus foraminotomy in cervical foraminal stenosis. Materials and Methods: A retrospective case-control study was conducted from January 2018 to March 2019 on 186 patients who underwent ACDF and foraminotomy. One hundred and two cases were selected considering age, sex, and body mass index. MRI was performed before and on the 5^th day after surgery to compare the changes in the foraminal diameter between the ACDF group (group A-51) and foraminotomy group (group B-51). Results: Between groups A and B, the average change in foraminal vertical diameter was 1.7 mm and 1.2 mm, respectively; group A was 0.5 mm larger difference (p=0.042). The average change in foraminal transverse diameter was 1.2 mm and 1.8mm, respectively; group B showed a 0.6 mm larger change (p=0.21). Both the neck disability index (NDI) and Japanese orthopaedic association (JOA) scores improved in both groups. Group A showed more improvement, but there was no significant difference (p=0.356, p=0.607, respectively). Conclusion: Foraminotomy is a useful option for patients with foraminal stenosis of the cervical spine because it showed comparable clinical and morphological results to ACDF and could minimize motion segment loss and muscle and ligament damage.

• Journal of Chest Surgery
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• v.34 no.3
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• pp.256-259
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• 2001

식도 결핵은 아주 드문 질환으로 연하곤란과 흉통이 가장 흔한 증상이면 다량의 토형은 드문 것으로 되어 있다. 본원에서는 다량의 토형을 동반한 식도 결핵에 의한 식도 대동맥루를 가진 환자를 지험했다. 4세 남자 환자는 다량의 토혈로 응습실을 통해 입원했다. 내원 당시 응급으로 시행한 내시경 검사상 incisor로부터 25cm 하방에 0.7 cm의 풍부한 혈관성의 육아종성 병변을 발견하고, 응급개흉술로 식도의 종양성 병변에 대해 쐐기 절제술을 시행하였다. 식도의 종양성 병변부위는 대동맥과 심게 유착되어 있었고 식도에서 대동맥쪽으로의 식도루를 이중 결찰했다. 환자는 술후 8일째 갑작스런 흉관을 통한 다량의 출혈과 구토 후 토형이 있어 응급 재 개흉술을 시행하여 대동맥파열과 식도 문합부 파열을 확인하였으나 더 이상의 교정이 불가능하여 사망하였다. 이에 문헌고찰과 함께 보고하는 바이다.