• Journal of Korean Neurosurgical Society
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• v.30 no.2
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• pp.150-155
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• 2001

Between January 1995 and May 1998, 177 patients with proven lumbar disc herniation were treated by microdiscectomy or by percutaneous endoscopic discectomy(PED). Among them, 43(24.2%) patients underwent PED and were followed for long term outcome. We included only those patients who were followed up more than 13 months. Three patients who did not improved immediately after PED and underwent microdiscectomy were excluded for this study. Of remaining 40 patients, there were 22 men and 18 women who ranged in age from 23 to 68 years (mean 38.1 years). The disc herniations were located at L1-2(1), L2-3(1), L3-4(1), L4-5(26) and L5-S1(11). Three patients were treated by biportal approach. The mean follow up period was 34.7 months(range 13-47 months). Overall, excellent and good results were achieved in 12(30%) and 19(47.5%) patients, and fair and poor results in 7(17.5%) and 2(5%) patients, respectively. Thirty-eight(95%) patients returned to their previous works and the mean duration was 5.7 months. Thirty-three(82.5%) patients answered that they would recommend this procedure to others. There was no complication except for one patient who suffered from discitis. The indication of PED is restricted to contained or small subligamentous lumbar disc herniation without stenosis, spondylolisthesis and sequestration. PED can be performed under local anesthesia and tissue trauma, risk of epidural scarring, hospitalization time and postoperative morbidity are minimal. The result of the present study justify the assumption that PED can be a surgical alternative for patients suitable for its indications.

• International journal of thyroidology
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• v.11 no.2
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• pp.109-116
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• 2018

It is very important to identify recurrent laryngeal nerve (RLN) and prevent RLN injury during thyroid surgery. The intraoperative neuromonitoring (IONM) for the prevention of RLN injury is a useful method because it can identify the location and status of RLN and predict postoperative vocal cord function easily. The IONM consists of a stimulating side that applies electrical stimulation to the nerve and a recording side that measures the surface electromyography (EMG) of the vocal cord muscle through electrode endotracheal tube. The nerve stimulator and surgical dissector are separate instruments. So, during IONM for the prevention of the RLN injury in conventional, endoscopic, or robotic thyroid surgery, repeated exchanging between surgical instruments and the nerve stimulator is inconvenient and time consuming. On the recording side, the accuracy of the electrode endotracheal tube which measures the EMG of the vocalis muscle can be affected by contact with between electrode and vocal fold and position change of patient. We would like to introduce recent several researches to overcome the current limitations of IONM.

• Journal of Digestive Cancer Research
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• v.11 no.3
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• pp.165-170
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• 2023

Gastric cancer is histologically classified into two types. One is the intestinal and diffuse type according to Lauren's classification, and the other is the differentiated and undifferentiated type based on Nakamura's classification. In 2007, Japanese groups proposed a new type of well-differentiated gastric adenocarcinoma in the gastric fundic glands with distinct endoscopic and clinicopathologic features. This is gastric adenocarcinoma of the fundic-gland type (GA-FG), a rare variant of gastric cancer. In a 2012 Korean study, of 6,000 cases of gastric cancer tissues, only three cases of GA-FG were identified. GA-FG is usually located in the upper third of the stomach and not known to be associated with the Helicobacter pylori infection. We herein report a case of GA-FG diagnosed in a 63-year-old man. A gastric polyp was incidentally detected during an upper endoscopy screening while conducting a health check-up, and he was diagnosed with GA-FG after an endoscopic mucosal resection (EMR) was conducted for diagnostic and therapeutic purposes. Our case suggests that for both diagnostic and therapeutic purposes, EMR may be beneficial in case of gastric polyps with suspected GA-FG.

• Korean Journal of Clinical Laboratory Science
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• v.56 no.1
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• pp.89-98
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• 2024

Gross examination techniques (GETs) of specimens collected from cancer surgery or endoscopy comprise the act of recording visual information about cancer for accurate histopathological diagnosis and collecting sections of the lesion to create microscopic specimens. GETs must include concise and accurate expressions, appropriate structuring, sufficient resections, error-free standardization of important information, and photo-diagramming of complex specimens. To increase the satisfaction of pathological interpretation, it is a task that must be performed accurately and carefully to gain confidence on a theoretical and practical basis with a sufficient understanding of gross examination. Based on the experience of clinical pathologists in the field of GETs, additional specimen types should be identified as viable candidates. Also, their needs and concerns regarding treatment should be carefully considered. In addition, departments at each institution should review the national focus on clinical partnerships, continuous professional training, diagnostic errors, and value-based healthcare provision.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.536-542
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• 1999

Background: The purpose of this study is to improve the quality of the diagnostic procedures in the preoperative evaluation so as to reduce the unnecessary thoracotomy and to ensure resectability in non-small cell lung cancer. Material and Method: Of 616 patients who underwent thoracotomy for primary lung cancer from January 1990 to December 1996, 59 patients(9.6%) turned out to have inoperable lesions after the thoracotomy. We reprospectively reviewed the bronchoscopic findings, methods of tissue diagnosis, CT scans, pulmonary function test and lung perfusion scan, reasons for nonresectability, and adjuvant therapy, and then followed up on the survival rate after exploratory thoracotomy. Result: The cell types were squamous cell carcinoma in 38, adenocarcinoma in 15, large cell carcinoma in 3 and others in 3. Primary loci were RUL in 20, RML in 6, RLL in 8, LUL in 13, LLL in 4 and others in 8. The reasons for non-resectability were various; direct tumor invaison to mediastinal structures(n=41), seeding on pleural cavity(n=8), poor pulmonary function(n=2), invasions to extranodal mediastinal lymph node(n=2), technical non- resectability due to extensive chest wall invasion (n=3), small cell carcinoma (n=1), malignant lymphoma(n=1), and multiple rib metastases(n=1). In the follow-up of 58 patients, 1-year survival rate was 55.2% and 2-year survival rate was 17.2% and the mean survival time was 14 months. When compared according to cell types or postoperative adjuvant therapeutic modalities, no significant difference in the survival rates were found. The squamous cell carcinoma was frequently accompanied by local extension to contiguous structures and was the main cause of non-resectability. In adenocarcinoma, pleural seeding with malignant effusion was frequently encountered, and was the major reason for non-resectability. Conclusion: These data revealed that if appropriate preoperative diagnostic tools had been available, many unnecessary thoracotomies could have been avoided. Both the use of thoracoscopy in selected cases of adenocarcinoma and the more aggressive surgical approach to the locally advanced tumor could reduce the incidence of unnecessary thoracotomies for non-small cell lung cancers.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.444-447
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• 2004

A 59 year-old male diagnosed as unstable angina underwent off-pump coronary artery bypass surgery using in situ left internal mammary and right gastroepiploic artery grafts. During harvesting the right gastroepiploic artery, there was no abnormal finding in intraabdominal organs including stomach and liver. He was discharged at the 3rd postoperative day without complication. In case of using in situ right gastroepiploic artery, we recommend gastrofberscopic study at regular follow-up, The patient underwent the gastrofiberscopic study at postoperative 3rd month and diagnosed as advanced gastric cancer on the posterior wall of gastric fundus. At 5th postoperative month, total gastrectomy without intraoperative injury of the right gastroepiploic artery was performed at the department of general surgery. He was discharged at the 9th postoperative day. Follow-up coronary angiography performed at the 1st postoperative year demonstrated patent grafts including right gastroepiploic artery.

• Journal of Gastric Cancer
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• v.10 no.1
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• pp.40-44
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• 2010

The natural history of gastric cancer is unclear. We report here on a rare case of advanced gastric cancer for which we performed curative gastrectomy 78 months after the diagnosis. A 74-year-old woman with epigastric pain underwent esophagogastroscopy in January, 2000 and she was diagnosed with advanced gastric cancer. Suspicious omental cake was noted on CT. After refusing all kinds of treatment, she underwent a follow up CT scan on September, 2002, which no longer suggested omental cake. She once again refused treatment, but she visited the hospital in June, 2006 due to severe epigastric pain and a decreased oral intake. Abdominal CT showed no distant metastasis, and so radical subtotal gastrectomy with regional lymph node dissection was performed in July, 2006 and the TNM stage was T2bN1M0 (stage II).

• Journal of Chest Surgery
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• v.36 no.1
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• pp.21-25
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• 2003

Video-assisted thoracoscopic surgery (VATS) for decortication or debridement in the management of empyema thoracis has increased the available treatment options but requires validation. We present and evaluate our technique and experience with thoracoscopic management of pleural empyema, irrespective of chronicity. Material and Method : VATS debridement or decortication was performed with endoscopic shaver system in 40 consecutive patients presented with pleural space infections. A retrospective review was performed and the effect of this technique on perioperative outcome was assessed. Result : VATS evacuation of infected pleural fluid and decortication was successfully performed in 35 of 40 patients. The mean duration of preoperative symptoms before referral was 23$\pm$1.8 days. The mean duration of hospitalization before transfer was 13.5$\pm$1.5 days. Blood loss was 250 to 200 mL. Intercostal drainage was required for 5$\pm$3 days. The postoperative hospital stay was 5 $\pm$0.7 days. There were no operative mortalities. Conclusion : Video-assisted evacuation of infected pleural fluid and decortication is an effective modality in the management of the fibropurulent stage of empyema. An organized empyema should be approached thoracosco-pically, but may require open decortication.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.697-701
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• 2018

Background and Objectives The aim of this study was to evaluate surgical completeness in endoscopic total thyroidectomy with central neck dissection via unilateral axillo-breast approach (UABA) compared with bilateral axillo-breast (BABA) and open approach (OA) by means of the radioactive iodine uptake (RAIU) ratio and thyroglobulin (Tg) of remnant thyroid. Subjects and Method From July 2010 to March 2013, 82 patients who had underwent total thyroidectomy with central neck dissection and postoperative radioactive iodine (RAI) ablation for papillary thyroid carcinoma were enrolled. Of these patients, 27 patients underwent UABA, 24 patients BABA, and 31 patients OA. Clinicopathologic data, surgical outcome, stimulated Tg and RAIU ratio on the first postoperative RAI ablation scan were compared among 3 groups. Results Patients in the endoscopic surgery groups (UABA, BABA) were younger than those in the OA groups. Invasiveness such as operation time, postoperative pain, and drain amount in UABA was less than that in BABA and severer than that in OA. Other variables regarding clinicopathologic and surgical data were not significantly different. Stimulated Tg and RAIU ratio did not show significant differences among 3 groups (p=0.659 and p=0.664). Conclusion The completeness of UABA was comparable with that of BABA and OA. The UABA may be a safe option for patients who need endoscopic thyroidectomy for papillary thyroid carcinoma.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.1
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• pp.10-15
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• 2009

Purpose: The manner of rectal bleeding of auto-amputated polyps (AP) is similar to juvenile polyps (JP) or Meckel's diverticula (MD). We conducted this study to characterize the clinical spectrum of AP. Methods: Fourteen patients were enrolled this study who were diagnosed AP due to painless rectal bleeding. The clinical data of AP was assessed and then compared with the clinical data of JP and MD retrospectively. Results: The prevalence of AP was 10.4% (14/135) and high in younger patients compared with that of JP (p=0.042 below 2 years). Whereas JP was more common in patients aged 2 to 5 years (p=0.005). Male was predominant in AP (p=0.008 AP vs JP). The manner of rectal bleeding in AP group was sudden and transient. There was no significant difference in time interval between onset of rectal bleeding and diagnosis between the 3 groups. However AP was diagnosed in 9 patients (64.3%) within 7 days after onset of rectal bleeding, but JP was diagnosed in 5 patients (4.1%) in the same period (p<0.001). All of AP were located in the rectum and the sigmoid colon. The mean hemoglobin was 11.3${\pm}$1.5 g/dL in AP, 11.8${\pm}$1.3 g/dL in JP, and 8.4${\pm}$1.2 g/dL in MD (p<0.001, only significant in MD). Conclusion: AP may be considered in male older than 1 year with transient and sudden onset or increase of painless rectal bleeding without drop of hemoglobin level.