• Journal of Gastric Cancer
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• v.7 no.1
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• pp.31-37
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• 2007

Purpose: A pancreas-preserving total gastrectomy (PPTG) was introduced to decrease the postoperative complications due to pancreatic resection. However, some complications, such as leakage of pancreatic juice, are still reported. Thus, the purpose of this study was to propose a supplementary procedure based on the results of treatment for gastric cancer at our hospital. Materials and Methods: From Jan. 1997 to Dec. 2004, the cases of 141 patients who underwent a PPTG for gastric cancer were reviewed retrospectively. The patients were divided into Group A (38 cases), patients who were treated using a conventional PPTG, and Group B (103 cases), patients who were treated using a new and improved PPTG. Their postoperative complications were compared. Results: No statistically significant differences in clinicopathologic data were noted between the two groups. The comparison of complications showed for groups A and B, respectively, 4 and 0 cases of pancreatic fistula, 1 and 0 cases of intraabdominal abscess, 2 and 0 cases of intraoperative pancreatic necrosis, and 2 and 2 cases of minor leakage. The difference in the prevalence of complications between the two groups was statistically significant (P=0.0001). Conclusion: In order to reduce the risk of PPTG-related complications, we used vascular clamps to observe the necrosis of the pancreatic tail before dividing the splenic artery, and this method resulted in a significant decrease in postoperative complications. Thus, we conclude that our use of vascular clamps in a PPTG is a simple and useful method for preventing postoperative complications.

• Journal of Chest Surgery
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• v.40 no.1 s.270
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• pp.8-16
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• 2007

Background: We performed a prospective clinical study to evaluate the ultrastructural integrity of the myocardium after using Histidine-Tryptophan-Ketoglutarate (HTK) solution in comparison with blood cardioplegic solution during congenital heart surgery. Material and Method: Twenty two patients with acyanotic heart disease, who were scheduled for elective open heart surgery, were randomized into two groups. The HTK Group (n=11) received HTK cardioplegic solution; the blood group (n=11) received conventional blood cardioplegic solution during surgery. The preoperative diagnoses included ventricular septal defect (n=9) and atrial septal defect (n=2) in each group. A small biopsy specimen was taken from the right ventricle's myocardium, and this was processed for ultrastructural examination at the end of 30 minutes of reperfusion. Semiquantitative electron microscopy was carried out 'blindly' in 4 areas per specimen and in 5 test fields per area by 'random systematic sampling' and 'point and intersection counting'. The morphology of the mitochondrial membrane and cristae were then scored. The interstitial edema of the myocardium was also graded. Result: The semiquantitative score of the mitochondrial morphology was $19.65{\pm}4.75$ in the blood group and $25.25{\pm}5.85$ in the HTK group (p=0.03). 6 patients (54.5%) in the blood group and 3 patients (27.3%) in the HTK group were grade 3 or more for the interstitial edema of the myocardium. Conclusion: The ultrastructural integrity was preserved even better with HTK solution than with conventional blood cardioplegic solution.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.150-156
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• 2021

Purpose: To determine how the location, displacement, intra-articular involvement, comminution of a 5th metatarsal base fracture affect results of early weight-bearing treatment. Materials and Methods: From January 2013 to July 2017, 34 cases of 34 patients diagnosed with a fracture of the zone I and II 5th metatarsal base were enrolled. The mean follow-up period was 13 months (6-15 months). One patient was excluded as a refracture during the follow-up period, and 33 patients underwent conservative treatment. Anteroposterior, lateral, and simple oblique radiography and computed tomography of the foot were performed to evaluate the location and displacement of the fracture, the degree of joint involvement, and comminution. In all 33 patients, a short leg cast or boot brace was selected immediately after the injury, tolerable weight bearing was allowed. If the pain disappeared, full weight bearing was performed after wearing a plain shoe or postoperative shoe. As a clinical result, the American Orthopedic Foot and Ankle Society (AOFAS) score was evaluated at the final follow-up. During outpatient follow-up, a simple radiograph of the foot was taken to confirm the time of radiological bone union and return to work. Results: Nine males and 24 females, with an average age of 48.7 years, were enrolled in the study. Twenty-four patients had zone I fractures, and nine patients had zone II fractures. Twenty-two out of 33 patients had a fracture displacement of 2 mm or more. Nine and five patients had joint involvement and comminution, respectively. There was a statistically significant return to work from zone I to zone II. The AOFAS score was excellent at the final follow-up and there was no significant difference. When classifying and comparing the degree of fracture displacement, joint involvement, and comminution, there were no significant differences in the radiological union time and return to work. In all cases, satisfactory results were obtained at the final follow-up. Conclusion: Satisfactory clinical results can be obtained by allowing early weight-bearing regardless of the fracture location, displacement, joint involvement, or comminution in zone I and II 5th metatarsal base fractures.

• Journal of Yeungnam Medical Science
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• v.19 no.1
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• pp.49-54
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• 2002

The central pain in patient with spinal cord injury is a common and disabling sequela. The microsurgical DREZ(Dorsal Root Entry Zone)otomy is a surgical procedure effective in the treatment of intractable pain and spasticity in spinal cord injured patients. It consists of a microsurgical lesions performed in the ventrolateral region of the dorsal root entry zone at the selected levels. This report presents one case with incomplete paraplegia patient, who had chronic central neuropathic pain ineffective to many conservative treatments in bilateral T10 and right T11 segments and both lower extremities, is relieved from the pain after microsurgical DREZotomy. In conclusion, microsurgical DREZotomy is one method of effective treatments for spinal cord injured patients with intractable central neuropathic pain.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1972.03a
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• pp.16.1-16
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• 1972

In 1971 there were 5 cases of the tongue cancer in stage I & II treated concomitantly with interstitial radium implantation and Cobalt-60 irradiation at the Yonsei University Hospital Cancer Center. This is the interim report of the course of the primary site of those treated cases.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.154-158
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• 2002

Purpose: To compare the results of open and arthroscopic method in recurrent anterior should erinstability. Materials and Methods: The 68 patients who have been taken the open or arthroscopic Bankartrepair for the period of Jan. 1995 to April. 2000. One group (23 patients) had elected an arthroscopic Bankart repair, the other group (45 patients) had chosen open stabilization. Patients were followed up12 to 63 months (ave. 34 months) after surgery. Results: We found 2 cases of subluxation out of open repair group, and then treated by conservative method. There were another 2 cases of dislocation and 2 cases of subluxation out of arthroscopicrepair group, and we have taken out 1 case of reoperation by open method. Using the functional scales by Rowe, the patients who have taken the open method posted at the average point of 87, while the arthroscopic method posted 85 points. Patients satisfaction points were 84.6 and 72.5 respectively. There were no criteria of statistically significant except stability and motion score. Conclusion: Open Bankart repair would be better in stability, and arthroscopic method in ROM gain. Proper patient selection based on physical examination and arthroscopic inspection to optimize the indications contributed to successful treatment.

• Radiation Oncology Journal
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• v.25 no.2
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• pp.70-78
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• 2007

[ $\underline{Purpose}$ ]: This study analyzed the tumor response, overall survival, progression free survival and related prognostic factors in patients with muscle invasive bladder cancer subjected to bladder preserving treatment. $\underline{Materials\;and\;Methods}$: Between August 1995 and June 2004, 37 patients with muscle invasive (transitional cell carcinoma, clinically stage T2-4) bladder cancer were enrolled for the treatment protocol of bladder preservation. There were 33 males and 4 females, and the median age was 67 years (range $38{\sim}86\;years$). Transurethral resection of the bladder (TURB) was performed in 17 patients who underwent complete resection. The median radiation dose administered was 64.8 Gy (range $55.8{\sim}67\;Gy$). The survival rate was calculated by the Kaplan-Meier method. $\underline{Results}$: An evaluation of the response rate was determined by abdomen-pelvic CT and cystoscopy at three months after radiotherapy. A complete response was seen in 17 patients (46%). The survival rate at three years was 54.7%, with 54 months of median survival (range $3{\sim}91$ months). During the study, 17 patients died and 13 patients had died from bladder cancer. The progression free survival rate at three years was 37.2%. There were 24 patients (64.9%) who had disease recurrence: 16 patients (43.2%) had local recurrence, 6 patients (16.2%) had a distant recurrence, and 2 patients (5.4%) had both a local and distant recurrence. The survival rate (p=0.0009) and progression free survival rates (p=0.001) were statistically significant when compared to the response rate after radiotherapy. $\underline{Conclusion}$: The availability of complete TURB and appropriate chemoradiotherapy were important predictors for bladder preservation and survival.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.389-398
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• 1998

Purpose : To evaluate the role of conventional postoperative adjuvant radiotherapy in the management of supratentorial malignant glioma and to determine favorable prognostic factors affecting survival. Materials and Methods : From Sep. 1985 to Mar. 1997, the number of eligible patients who received postoperative radiotherapy completely was 69. They ranged in age from 7 to 66 years (median, 47). Forty-two (61$\%$) patients were glioblastoma multiforme and the other 27 (39$\%$) were anaplastic astrocytoma. Twenty patients (29$\%$) had Karnofsky score equal or more than 80 preoperatively. Forty-three patients (62$\%$) had symptom duration equal or less than 3 months. Twenty-four patients (35$\%$) had gross total resection and forty patients(58$\%$) had partial resection, the remaining five patients (7$\%$) had biopsy only. Radiotherapy dose ranged from 50.4 Gy to 61.2 Gy (median, 55.8; mode, 59.4) with fraction size of 1 8 Gy-2.0 Gy for 33-83 days(median, 48) except three patients delivered 33, 36, 39 Gr, respectively with fraction size of 3.0 Gy due to poor postoperative performance status. Follow-up rate was 93$\%$ and median follow-up period was 14 months. Results : Overall survival rate at 2 and 3 years and median survival were 38$\%$, 20$\%$, and 16 months for entire patients; 67$\%$, 44$\%$, and 34 months for anaplastic astrocytoma; 18$\%$, 4$\%$, and 14 months for glioblastoma multiforme, respectively (p=0.0001). According to the extent of surgery, 3-year overall survival for gross total resection, partial resection, and biopsy only was 38$\%$, 11$\%$, and 0$\%$, respectively (p=0.02) The 3-year overall survival rates for patients age 40>, 40-59, and 60< were 52$\%$, 8$\%$, and 0$\%$, respectively (p=0.0007). For the variate of performance score 80< vs 80>, the 3-year survival rates were 53$\%$ and 9$\%$, respectively (p=0.008). On multivariate analysis including covariates of three surgical and age subgroups as above, pathology, extent of surgery and age were significant prognostic factors affecting overall survival. On another multivariate analysis with covariates of two surgical (total resection vs others) and two a9e (50> vs 50<) subgroups, then, pathology, extent of surgery and performance status were significant factors instead of age and 3-year cumulative survival rate for the five patients with these three favorable factors was 100$\%$ without serious sequela. Conclusion : We confirmed the role of postoperative conventional radiotherapy in the management of supratentorial malignant glioma by improving survival as compared with historical data of surgery only. Patients with anaplastic astrocytoma, good performance score, gross total resection and/or young age survived longest. Maximum surgical resection with acceptable preservation of neurologic function should be attempted in glioblastoma patients, especially in younger patients. But the survival of most globlastoma patients without favorable factors is still poor, so other active adjuvant treatment modalities should be tried or added rather than conventional radiation treatment alone in this subgroup.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.379-385
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• 2009

The purpose of this study was to present basic data that is needed in comprehension of dysesthesia after mandibular nerve injury and grasp meaning. We analyzed medical records of 59 patients who were diagnosed as dysesthesia after mandibular nerve injury from January 2007 to July 2009. The results are summarized as follows. 1. The most frequent cause was implant surgery (59%) and the most frequent injured branch of mandibular nerve was inferior alveolar nerve(81%). 2. The period passed after nerve injury showed significant interrelationship with level of pain. Visual Analogue Scale(VAS) increased from 4.82 to 6.91 after 6 month. 3. The period passed after nerve injury did not show significant interrelationship with recovery of dysesthesia. But, when conservative treatment was offered at earlier stage, ratio of patients who showed recovery of symptom tended to increase. 4. In computed tomography, level of invasion into inferior alveolar nerve canal did not show significant interrelationship with level of pain and recovery of dysesthesia. Conclusively, in the patients with dysesthesia of mandibular nerve, inferior alveolar nerve injury by dental implant surgery dominated most significant problem. Although level of invasion into inferior alveolar nerve is the most important factor to initiation of dysesthesia, there are other various factors exert more influence on the level of pain or recovery of dysesthesia. Therefore, begining conservative therapy at earlier stage is encouraged. Also, because nerve injuries can occur without direct invasion into nerve canal, so leaving enough safe space from nerve canal is needed for prevention of indirect nerve injury.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.142-149
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• 2002

Purpose : The purpose of this study is to compare with result of repair and resection in displaced bucket handle medial meniscal tear. Materials and Methods : From Sep. 1998 to Dec. 2001, we experienced 46 cases, 45 patients. We classified them into repair group (group I, 23 cases) and resection group (group II, 23 cases). We analyzed the time interval between injury and operation, zone of tear, the status of reduction and quality of displaced fragment of all cases. Average follow-up period is 29, 28 months, respectively. We evaluated the final results of both groups as Lysholm knee score, radiologic changes and 2nd look arthroscopy. Results : Mean age was 25 years old in both group, respectively. Mean interval between injury and surgical treatment was 12 and 17 weeks. respectively. In group I, 6 of 7 cases were evaluated as clinical success in red-red zone, 12 of 15 cases were assessed as clinical success in red-white zonal tear, stable reduction. Another case which is evaluated as clinical failure showed red-white zonal tear, unstable reduction and poor quality meniscal fragment. 5 cases showed variant degrees of tibio-femoral compartment symptom. In group II, red-white zone (9 cases) and white-white zone (14 cases) were treated as resection and got good results. Conclusion : Considering zone of tear, reducibility and quality of meniscal fragment before treatment will improve the success rate of meniscal repair.