• Journal of Chest Surgery
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• v.31 no.6
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• pp.598-603
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• 1998

Excessive sweating of the palms, axillae, and face has a strong negative impact on the quality of life for many people. The existing non-operative therapeutic options seldom give sufficient relief and have a transient effect. But a definitive cure can be obtained by upper thoracic sympathectomy. From June 1997 to October 1997, 117 cases of the needle (2 mm) thoracoscopic thoracic sympathectomies were performed in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center Yong-dong Severance Hospital in Seoul, Korea. We have followed up on 94 cases which include palmar hyperhidrosis (n=85), facial hyperhidrosis(n=5) and axillary hyperhidrosis(n=4). There were 42 males and 52 females whose ages ranged from 14 to 63 years(median:23 years). The T2 ganglia and T3-4 ganglia were excised by electrocuting with a hook and endoscissors and were removed for histologic examination. There have been no mortalities or life-threatening complications. The surgical results were classified as excellent(much improvement,very dry) in 93.6%, good(some improvement, minimally wet) in 2.1%, and fair(slight improvement, still wet) in 4.2%. Five patients(5.3%) required closed thoracostomy drainage because of pneumothorax in the immediate postoperative day. Horner's syndrome occurred in one case. The compensatory sweating occurred in 67 cases(71.2%) and was embarrassing in 21 cases(22.3%) and disabling in 9 cases(9.6%) of these cases. Primary failure occurred in one case. The patient with primary failure underwent successful operation. Fifty-one patients had concomitant hyperhidrosis. Our experiences indicate needle thoracoscopic sympathectomy is a very effective, safe, and time- saving procedure for essential hyperhidrosis.

• Journal of Gastric Cancer
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• v.5 no.4 s.20
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• pp.252-259
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• 2005

To clarify the clinicopathologic features of small-cell carcinomas (SCC) of the stomach, we reviewed three cases of surgically treated SCC. The first case was a pure SCC, with severe pancreatic invasion and peritoneal seeding. A gastro-jejunostomy was performed. Postoperative chemotherapy was performed with CDDP and VP-16 (8 cycles) but showed disease progression (PD); a consecutive chemotherapy with CDDP and irinotencan (2 cycles) also showed PD. A third line with CDDP, VP16, ifosfamide, and mesna was followed by a 4th line (CDDP and Taxol). The male patient died with liver metastasis and peritoneal seeding 14 months after the operation. The second case was a SCC mixed with a poorly differentiated adenocarcinoma. Profound lymphadenopathy and liver metastasis were found. Two cycles of preoperative chemotherapy with TS-1 and CDDP were performed, which showed nearly complete remission for lymphadenopathy and partial response for the primary tumor site and liver metastatic lesion. A total gastrectomy and extended lymphadenectomy was performed. There were no viable cancer cells in 35 retrieved lymph nodes. Postoperative chemotherapy using the same regimen was performed for 4 cycles. Enlarged liver metastasis was found at the follow-up CT scan, so a posterior segmentectomy of liver was performed. After liver surgery, the chemotherapy regimen was changed to irinotecan and cisplatin. This male patient has been in good health for the f4 months since gastric surgery. The third case was a pure SCC, and a subtotal gastrectomy was performed curatively. That male patient received 5 cycles of TS-1 and is still in good health 14 months after operation.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.84-87
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• 2013

At the posterior aspect of distal thigh, major nerves, vessels, muscles and tendons were located. So, if abscess occurs within deep muscular fascia of posterior aspect of distal thigh, it can be widely and deeply spread to proximal thigh, popliteal fossa, posterior proximal leg, surrounding areas of knee joint along deep fascia, muscles and tendons. In that case, it is difficult to eradicate the abscess using antibiotics without surgical drainage and debridement. But, it is often impossible to obtain satisfactory view of operative field with conventional technique and critical damage to major nerves and vessels in the popliteal fossa during operation may occur. We performed endoscopic treatment for extensive deep abscesses occurred in posterior aspect of distal thigh in 64-year-old man, and obtained satisfactory result without injury to the normal structures including major nerves and vessels. So we report this case with a review of relevant literatures.

• Journal of Korean Clinical Nursing Research
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• v.24 no.2
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• pp.147-158
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• 2018

Purpose: This study was conducted to identify the effects of educational video program delivered using Tablet PC on physical discomfort, uncertainty, state anxiety, and nursing education satisfaction among early gastric cancer patients undergoing endoscopic submucosal dissection. Methods: The study design was nonequivalent control group pretest-posttest design. The subjects were 60 patients who were hospitalized to undergo endoscopic submucosal dissection. The experimental group watched educational video using Tablet PC (n=30) and the control group received only the usual education (n=30). The collected data were analyzed using independent t-test to examine study hypothesis. Results: The level of physical discomfort (t=3.05, p=.003) and nursing education satisfaction (t=-2.20, p=.032) in the experimental group were significantly different from that of the control group. However, the level of uncertainty (t=-0.82, p=.418) and state anxiety (t=-1.69, p=.097) in the experimental group were not different from that of the control group. Conclusion: The study findings confirm that the educational video program delivered using Tablet PC as an effective intervention alleviating physical discomfort and improving satisfaction regarding nursing education among early gastric cancer patients undergoing endoscopic submucosal dissection. Based on the findings, we believe that the educational video program can be helpful in decreaseing physical discomfort, and it also can be utilized to improve nursing education satisfaction.

• Journal of Gastric Cancer
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• v.9 no.4
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• pp.207-214
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• 2009

Purpose: Subtotal distal gastrectomy has been accepted as the standard treatment for early gastric cancer that's developed on the gastric body. EMR and ESD have been introduced to minimize the incidence of postgastrectomy syndrome, but these procedures can not detect lymph node metastasis and they have a risk for gastric perforation. Segmental gastrectomy has recently been applied for treating early gastric cancer, but its usefulness has not been clarified. The aim of this study was to compare segmental gastrectomy and distal gastrectomy with Billroth I reconstruction for treating early gastric cancer that's developed on the gastric body. Materials and Methods: We performed a retrospective review of all the patients who were diagnosed as having early gastric cancer that developed on the gastric body at Chungnam National University Hospital from January 2004 through July 2007. During this period, 41 patients received segmental gastrectomy and 40 patients underwent subtotal distal gastrectomy. All the patients were studied via a biannual review of the body systems, a physical examination, endoscopy, computed tomography and the laboratory findings. Results: There were no significantly differences of the clinicopathologic characteristics between the two groups. The changes of the nutritional status (Hb, TP, Alb and TC) and the body weight change were not significantly different between the 2 groups. There were significantly more residual food in the SG group than that in the SDG group (RGB classification, Residual>Grade 2), but there were no differences for epigastric discomfort (P>0.05). Esophagitis developed at a similar rate for both two groups (LA classification, >Grade A), and bile reflux was found in only one patient of each group. Conclusion: We expected the reduction of esophagitis and gastritis and the improvement of nutritional status according to the type of procedure. Yet the results of our study showed no significant differences between the two study groups. More patients and a longer follow up time are needed for determining the advantage sand disadvantages of segmental gastrectomy.

• Journal of Chest Surgery
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• v.30 no.4
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• pp.453-456
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• 1997

Acquired tracheoesophageal fistula is a rare but serious condition which is usually a result of prolonged intubation or tracheostomy statc, and is difficult to treat. A fifty-seven year old woman who was in a state of prolonged intubation and tracheostomy following a traf%c accident, presented with recurrent aspirati n. A tracheoesophageal fistula was demonstrated ) cm above the carina by csophagogram. We confirmed a subglottic web and tracheoesophageal fistula by bronchoscopic examination. Fistulectomy was performed with collor incision and partial sternotomy. The esophagus was repaired by two-layer interrupted suture using 4-0 Vicr)1, and the trachea was repaired by single layer suture using a 4-0 PDS. The sternohyoid muscle was interposed between the trachea and the esophagus. A T-tube was inserted through the previous tracheostomy site for easy tracheal suction and maintenance of the tun:on. The T-tube was removed on the 14th postoperative day, and the patient recovered well without any complications.

• 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.37 no.10
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• pp.888-891
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• 2004

Basaloid-squamous cell carcinoma, a biologically high-grade variant of squamous cell carcinoma, is predominantly located at upper aerodigestive tract but it is extremely rare in the esophagus. Recently we experienced a case of basaloid-squamous cell carcinoma of esophagus. A 64 year-old man was referred to our hospital because of mucosal nodularity at 35 cm apart from the incisor in endoscopic examination. Result of Biopsy was squamous cell carcinoma. Left transthoracic esophagectomy was performed. Histologically, the lesion of tumor was basaloid-squamous cell carcinoma and no lymph node metastasis was found.

• Journal of Digestive Cancer Research
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• v.11 no.1
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• pp.15-20
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• 2023

Endoscopic submucosal dissection (ESD) is a minimally invasive and effective treatment for early gastric cancer. The criteria for determining the suitability and success of ESD have expanded, with changes in the histopathological classification of gastric carcinoma, including results from molecular research. Treatment methods have also diversified to include targeted therapies and immuno-oncology agents. To improve communication between clinicians and pathologists, it is crucial to understand the standardized diagnostic forms of gastric cancer. This study aims to examine the handling method of ESD specimens and describe the pathological findings of gastric tumors.

• Journal of Gastric Cancer
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• v.6 no.1
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• pp.1-5
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• 2006

Purpose: A proximal gastrectomy is performed for gastric cancer in the upper part of the stomach to preserve the function of the stomach after surgery. An esophagogastrostomy is one of the common reconstruction methods for a proximal gastrectomy, but this method results in a high incidence of reflux esophagitis. This study was undertaken to compare subjective and functional results between esophagogastrostomy and jejunal interposition reconstructions. Materials and Methods: From June 1998 to December 2002, proximal gastrectomies were performed in 33 patients with tumors in the upper third of the stomach; 8 had reconstruction using jejunal interposition between the esophagus and the remnant stomach (JI group) while 25 had reconstruction using esophagogastrostomy (EG group). The postroperative courses of the patients were reviewed in terms of symptoms, weight changes, and endoscopic findings. Results: The mean age of the patients was 59 years; 26 were men and 7 were women. There were no significant differences in general complications, operating times, or histologic features between the two groups. Fifty-two percent (52%) of the EG group complained of dysphagia, and 16% them experienced heartburn and acid belching. Twelve percent (12%) of the JI group complained of dysphagia, but heartburn and acid belching did not occur. Incidences of reflux esphagitis (36%) and balloon dilatation for anastomotic stricture (16%) were more common in the EG group than in the JI group (0% and 12%). Conclusion: To prevent or minimize complications, such as reflux esophagitis and postoperative symptoms, a proximal gastrectomy with a jejunal interposition is an alternative method as an organ-preserving surgical strategy to improve quality of life for patients. (J Korean Gastric Cancer Assoc 2006;6:1-5)