• Proceedings of the Computational Structural Engineering Institute Conference
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• 2010.04a
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• pp.280-283
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• 2010

척추경 나사못을 이용한 요추 유합술은 가장 보편적으로 사용되는 수술 적 치료 방법이다. 과거 여러 연구들에서 이러한 척추 유합술의 임상적 우수성은 이미 입증 되었으며, 척추경 나사못은 시술 부위의 운동을 완전히 제한함으로써 높은 유합율을 얻을 수 있으나, 상대적으로 인접 분절의 조기 퇴행성 변화의 요인 중 하나로 보고되고 있다. 또한 유합술을 수행 할 때 후방조직의 절제 또한 인접 분절의 퇴행을 초래하는 원인으로 보고되고 있다. 따라서 본 연구에서는 유한요소해석 방법을 이용하여 척추경 나사못 과 후방조직을 절제하는 시술 방법을 비교하여 척추체의 운동범위의 증가량을 계산하였고, 척추경 나사못 모델과 후방조직을 제거한 모델을 개발하여 시술하기 전 정상모델과 비교하였다. 개발된 모델과 정상 모델을 생체 역학적 측면에서 분석하여 인접분절의 조기 퇴행성 변화를 일으키는 가장 큰 원인이 무엇인지 정량적으로 분석하였고, 이를 근거 하여 임상적 효과와 그 이론적 근거를 제시하고자 한다.

• 대한미세수술학회:학술대회논문집
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• 1994.11a
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• pp.107.2-108
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• 1994

• Journal of Chest Surgery
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• v.32 no.4
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• pp.408-412
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• 1999

Since sclerosing hemangioma of the lung was first described by Liebow and Hubbell in 1956, there have been several reports on cases occurring as a solitary nodule; however, sclerosing hemangiomas occurring as multiple nodules are extremely rare. The histogenesis of this tumor remains controversial and there are several hypotheses of the etiology. Three separate nodules were found in a 57-year-old housewife, one found in the right middle lobe, one in the apicoposterior segment of the left upper lobe, and one in the superior segment of the left lower lobe. The only symptom or sign presented was a dry cough. Apicoposterior segmentectomy of the left upper lobe and wedge resection of the superior segment of the left lower lobe were performed. The postoperative course was uneventful and the patient was discharged on the postoperative 15th day.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.1
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• pp.51-55
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• 2008

As survival rate of patients in osteosarcoma improves, both patients and surgeons are increasingly interested in long-term functional outcome. For resection and reconstruction of tumors on either side of knee joint, if feasible, conservation of normal joint apparatus seems preferable method over use of tumor prosthesis. However, we should not trade off the sound surgical margin with expected functional gain. We report one case of osteosarcoma who was treated by wide, intercalary resection and reconstruction with autogenous pasteurized bone but, showed local recurrence at 44 months postoperatively.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.82-85
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• 1998

Benign tumors of the trachea are rare and are usually misdiagnosed as bronchial asthma because of the similarity of the symptoms and signs. Although the prognosis of neurofibroma which originats from Schwann cells is good, it may recur or undergo malignant change, so segmental resection of the trachea is recommended. Recently, we experienced a case of primary neurofibroma of the trachea treated successfully by segmental resection of the trachea and end-to-end anastomosis. We report it with a brief review of literatures.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.1
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• pp.10-16
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• 2000

Object : The aim of the current study is to assess the results of segmental resection and replantation for primary malignant or aggressive tumors of the upper limb. Materials and Methods : From 1986 to 1994, ten patients who had primary malignant or aggressive tumors of the upper limb were managed with segmental resection and replantation method. The average duration of follow-up was 7 years and 7 months. Primary indication of this method is stage II B tumors which, because of their extend, could otherwise be adequately treated only by amputation. Three patients had chondrosarcoma, two had osteosarcoma, two had giant cell tumors with pathologic fracture, one had extensive chondroblastoma, one had Ewings sarcoma, and one had leiomyosarcoma. The location of the tumor was humerus in 6 patients, scapula in 3 patients, and soft tissue of forearm in 1 patient. Wide resection margins were achieved in 7 patients and marginal margin in three. Results : One patient died on 40 months after surgery due to systemic metastasis. Nine patients have remained disease free without local recurrence or metastasis. The average overall functional rating was 65% (43~90%) for ten patients on the last follow-up by the functional rating system of Enneking. The mean grasping power and pinching power of operative hand was 75%(28~95%) and 65%(43~90%) of the opposite hand, respectively. Complications associated with this surgical method included three wound dehiscences and one nerve injury that resolved with proper wound care and time. Conclusion : It was concluded that segmental resection and replantation might be used for partial limb salvage in selected cases for the treatment of primary malignant or aggressive tumors of the upper limb.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.95-105
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• 2008

Purpose: To identify which is the best procedure in recycling autograft according to the resection & reconstruction type and recycling methods, and so when the recycling autograft is used in limb salvage surgery. Materials and Methods: We have treated fifty-eight patients (34 male, 24 female; age range 5 to 74 years, mean age 36.5 years), who had the malignant musculoskeletal tumors, with recycling autograft (47 patients with extracoporeal irradiation, 11 patients with pasteurization) from December 1995 to February 2006. The resection and reconstruction type was 3 cases with fragmentary, 8 intercalary, 23 rAPC (recycling-Autograft-Prosthesis composite), 18 osteoarticular, 5 total joint and 1 soft tissue (achilles tendon). The result was evaluated by the radiologic union at junctional site, the functional score by musculoskeletal tumor society score and complications according to the resection & reconstruction type and recycling methods. Results: The junctional union was obtained at 15.0 months in extracoporeal irradiation and 12.6 months in pasteurization. Also the mean radiologic union was shown at 6.0 months in fragmentary, 12.8 months in intercalary, 10 months in rAPC, 23.3 months in osteoarticular and 15.6 months in total joint. The functional score was 65.5% in fragmentary, 60.8% in intercalary, 62.8% in APC (except pelvis), 66.0% in osteoarticular and 66.6% in total joint. We have experienced 1 infection, 1 prutrusio acetabuli in pasteurization (18.1%) and other 22 complications (3 deep infections, 8 nonunions, 2 fractures, 2 epiphyseal problems, 5 joint instabilities, 2 local recurrence) in extracoporeal irradiation (46.8%). Also we have experienced 3 complications (3 nonunions) in intercalary (37.5%), 9 complications (4 nonunions, 1 deep infection, 1 periprosthetic fracture, 1 epiphyseal problem, 1 local recurrence, 1 protrusio acetabuli) in rAPC (50.0%), 6 complications (2 deep infections, 2 nonunions, 1 epiphyseal problem, 1 pathologic fracture) in osteoarticular (33.3%), 5 complications (5 joint instabilities) in total joint (100%) and 1 complication(1 local recurrence) in soft tissue (100%). Conclusion: In our experience, according to the resection & reconstruction type fragmentary and intercalary may have several advantages such as good radiologic and functional result and low rate of complication. And it seems that rAPC was available in case which have no sufficient residual bone stock. Also the pasteurization may have more advantages than that of the extracorporeal irradiation.

• Journal of Chest Surgery
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• v.40 no.7 s.276
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• pp.485-491
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• 2007

Background: Thoracoplasty has become a rarity in current clinical practice, although it has been widely employed for well over a century as a procedure for reducing the capacity of the thoracic cavity. Yet we have perform tailoring thoracoplasty following or concomitant with pulmonary resection in 20 patients. The aim of this study is to evaluate the early and late clinical results and also the significance of tailoring thoracoplasty. Material and Method: From March 1995 to June 2005, modified thoracoplasty following or concomitant with pulmonary resection was performed in 20 patients out of a total of 298 pulmonary resections for closing air leaks and for treating persistent pleural space following pulmonary resections, and to tailor the thoracic cavity to accept a diminished lung volume. Of the 20 patients, 14 patients had tailoring thoracoplasty performed concomitant with pulmonary resection, and the remaining 6 patients also had tailoring thoracoplasty performed following pulmonary resection. The subjects ages ranged from 24 to 77 (mean $59.1{\pm}6.4$) and a male preponderance was noted (17 : 3); the number of left and right surgeries was equal. The preoperative primary underlying diseases were lung cancer in 7 patients, pneumothorax with giant bullous change in 6 patients, bronchiectasis in 2 patients, previous pulmonary tuberculosis associated with aspergilloma in 2 patients, empyema with fibrothorax in 2 patients and multiple lung abscesses & destruction due to previous trauma in 1 patient. The operative methods were apicolysis and subperiosteal removal of the 2nd, 3rd and 4th ribs (the costochondral junction to the posterior portions of the ribs) with preservation of the first rib and compression of the anterior chest via cotton bags and elastic bandages. Result: The mean duration of the air leaks after thoracoplasty was $1.6{\pm}0.2$ days (range: $0{\sim}7$ days) and the mean duration of an indwelling chest tube was 7 days (range: $5{\sim}11$ days); the mean duration of hospitalization was $19.2{\pm}2.8$ days (range: $8{\sim}47$ days). The postoperative complications were wound infection (2) and pneumonia (2); reoperation was done due to bleeding (1) in one patient who underwent concomitant thoracoplasty and there was 1 case of wound infection (1) after postresection thoracoplasty. The mortality was 1 patient in the early phase and 4 patients in the late phase. Conclusion: We conclude that tailoring thoracoplasty may be performed to close anticipated persistent pleural spaces and to accommodate the diminished lung volume with acceptable cosmetic results when this procedure is combined with pulmonary resection in selected patients.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.702-706
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• 2004

Pulmonary arteriovenous fistula is usually considered as a subset of congenital anomalies or acquired causes which can produce a variety of conditions such as dyspnea, cyanosis, and pulmonary vascular bruit. The diagnostic methods can be diverse such as arterial blood gas analysis (ABGA), chest X-ray, chest CT and pulmonary angiogram but the most accurate diagnostic modality is thought to be the pulmonary angiogram. The complications of this disease are a rupture that can cause hemothorax, brain abscess, and cardiovascular accident, and the treatment options are either segmental resection or therapeutic embolization. A twenty-six year old female developed sudden dyspnea and visited our emergency room. The patient was diagnosed as having pulmonary arteriovenous fistula (size; 4${\times}$4${\times}$3 cm) in the superior segment of the right lower lobe, evidenced by chest CT and pulmonary angiogram. Consequently, she underwent an emergency right lower lobectomy. We report this rare case of combined hemothorax that we have experienced, from diagnosis to treatment.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.2
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• pp.51-58
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• 2001

Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.