• Journal of the Korean Academy of Pediatric Dentistry
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• v.26 no.2
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• pp.350-364
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• 1999

The distribution of mast cells and nerves were investigated in the submandibular and sublingual glands of postnatal rats, using morphometric, histochemical and immunohistochemical techniques. Mast cells were observed in the submandibular and sublingual glands of postnatal development. Number of mast cells gradually increased in both glands following development. At birth, mast cells were relatively fewer in submandibular gland than those in sublingual gland, and they were mainly distributed in parenchymal tissues. At $2{\sim}4$ weeks, most of the mast cells were observed in the connective tissues, surrounding neurovascular elements, but some mast cells were closely related with the acini of submandibular gland. PGP 9.5 immunoreactive nerve fibers were found in the submandibular and sublingual glands of all developmental age. The nerve fibers were showed in varicose shape, and mainly located in adjacent area of ducts and vascular components of both glands. The number of nerve fibers were increased rapidly until 8 weeks, but they were not increased any more until 24 weeks. Therefore, it is suggested that mast cells and nerve fibers related with each other, and that their interactions may play roles not only in maturation of secretory units but also growth and differentiation of the tubular structures of the rat submandibular and sublingual glands during postnatal development.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.53-61
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• 2009

Purpose: This study was designed to evaluate the clinical usefulness of serial ultrasonography (USG) after arthroscopic rotator cuff repair and to assess the re-tear rate and the re-tear time according to the tear sizes and the repair method. Materials and Methods: Between January 2008 and June 2008, 52 patients were treated with arthroscopic rotator cuff repair, Of the 52 patients, 29 patients that had undergone more than six months follow-up underwent preoperative USG examinations and subsequent arthroscopic examinations. MRI and USG findings were compared with intraoperative results of arthroscopic examinations. The postoperative integrity of the rotator cuff was observed using serial USG examination performed postoperatively at two weeks, six weeks, three months, and six months. Results: Small to medium rotator cuff tear were identified in 10 patients where the double pulley suture bridge (DPSB) technique was performed; the re-tear rate was 20%. For 19 patients with large to massive rotator cuff tears, the re-tear rates was 100% for six patients who had undergone tendon to tendon (TT) repair, the re-tear rate was 50% for two patients who had undergone tendon to tendon and bone to tendon (TTBT) repair and the re-tear rate was 55% for11 patients where the DPSB technique was performed. Re-tear rates according to follow-up periods were 7% from two to six weeks, 66% from six weeks to three months and 27% from three to six months postoperatively. Conclusion: Serial USG examinations after arthroscopic rotator cuff repair were useful to assess the re-tear rate and the re-tear time. In addition, USG examination were useful for treatment planning during postoperative rehabilitation.

• The Korean Journal of Nuclear Medicine
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• v.33 no.6
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• pp.466-474
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• 1999

Purpose: The purpose of this study was to evaluate the diagnostic accuracy of [$^{18}F$]FDG PET in the diagnosis of recurrent head and neck cancer after the completion of surgery and radiotherapy in patients with head and neck cancers. Materials and Methods: In fifty-nine patients with head and neck cancers whole body [$^{18}F$]FDG PET studies were performed. According to the different therapeutic modalities, patients were divided into four groups (Group I; pre-treatment, Group II: surgery, Group III; radiotherapy, Group IV; both surgery and radiotherapy). [$^{18}F$]FDG PET images were compared with clinical, CT and histopathologic findings. Results: for detection of metastatic lymph nodes in 14 patients of pre-treatment group (group I), the sensitivity and specificity of PET were 100% (10/10) and 75% (3/4), and those of CT were 80% (8/10) and 100% (4/4). For detection of recurrence in 45 patients of post-treatment group, overall sensitivity and specificity of PET were 96.2% (25/26) and 78.9% (15/19) [(100% and 75% in group II, 80% and 10% in group III, and 100% and 100% in group IV)] without significant difference from pre-treatment group (P>0.1). In detecting recurrence, the sensitivity and specificity of [$^{18}F$]FDG PET were 90.9% (10/11) and 20% (1/5) in 16 patients who underwent [$^{18}F$]FDG PET within 2 months after the completion of treatment. The specificity of these patients was significantly lower than that of 29 patients (100% of sensitivity and specificity) who underwent [$^{18}F$]FDG PET 2 months after treatment (p<0.05). Conclusion: [$^{18}F$]FDG PET is an accurate diagnostic modality for the detection of recurrence in head and neck cancer. Post-therapy [$^{18}F$]FDG PET should be obtained at least 2 months after the completion of surgery or radiotherapy.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.125-133
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• 1998

This study was designed to identify the efficiency of serum troponin-T(s-TnT) level as a diagnostic indicator for the perioperative myocardial damage with open heart surgery(OHS) and to compare with the conventional myocardial enzyme tests such as isoenzyme fraction of creatine kinase(% CK-MB) and isoenzyme ratio of lactate dehydrogenase(LDH1/LDH2 ratio). The study was performed on 30 adult patients who underwent OHS from Jan. 1996 to June 1996 at Inje University Pusan Paik Hospital, and they were divided into two groups accor- ding to aortic clamping time(ACT) duration : group I(ACT＜60 minutes, n=15); group II (ACT＞60 minutes, n=15). S-TnT, % CK-MB, and LDH1/LDH2 ratio were measured in serial blood samples from all subjected patients. The results were obtained as follows. 1. In both groups, s-TnT concentrations increased gradually during OHS and elevated significantly at CPB-10(p＜0.001). The peak level was noticed at POD 1 in group I(1.10 $\pm$0.19 ng/ml), whereas, at CPB-off in group II(1.88$\pm$0.42 ng/ml). The elevated levels remained until POD 7 in both groups. 2. %CK-MB was risen significantly with the initiation of operations(p＜0.001) and the peak levels were noticed at CPB-off in both groups(7.14$\pm$0.86% in group I, 10.69$\pm$1.27% in group II). Thereafter, these levels returned to normal values at POD 3. 3. There were no significant changes in the values of LDH1/LDH2 ratio during and after OHS compared with the control levels(p＞0.05). 4. The serial changes of s-TnT were relatively well correlated with those of changes of % CK-MB(r=0.64, p＜0.05). 5. The serial s-TnT levels were significantly higher in group II than group I from B-ACR to POD 1(p＜0.05), suggesting that duration of aortic clamping time was a major factor concerned with perioperative myocardial injury. In conclusion, measurement of s-TnT is a very useful indicator in assessing the myocardial cell damage and therefore it is expected that serial checking and evaluation of the s-TnT is very available for identification of the perioperative myocardial damage and for postoperative cares in patients with OHS.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.672-683
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• 2004

Background: The treatment results of the advanced lung carcinoma is not satisfactory with the present therapeutic modalities: surgical resection, anti-cancer chemotherapy, and radiotherapy or combination therapy. To predict the prognosis of the non-small-cell lung carcinoma, TNM classification has been was as the basic categorization; however, it has been not satisfactory. It is necessary to consider the causes and the prognosis of the lung carcinoma from another points of view rather the conventional methods. We intended to find out the relationship between the major apoptotic factor, p53 gene and the prognosis of the patient with lung carcinoma. Material and Method: Three hundreds and fifty-nine patients with lung carcinoma who underwent surgery were analysed. We observed p53 protein accumulated in the cellular nuclei. The p53 protein was detected by immuno-histo-chemical method. We collected information of the patient retrospectively. Result: p53 protein densities were observed in 40% in average as a whole. The protein density was 44 percent in man, 25 percent in woman, 49 percent in the squamous cell carcinoma, and 38 percent in the adenocarcinoma. There were significant correlations between the p53 protein density and the mortality in the squamous cell carcinoma (p=0.025), follow-up duration in TNM stage I group (p=0.010), and follow-up duration in the lobectomy patient group (p=0.043), and tumor cell differentiation (p=0.009). p53 protein densities were significantly different between the lobectomy and the pneumonectomy group (p=0.044). Conclusion: The authors found that p53 protein had some correlations with the prognosis of the lung cancer partially in some factors. We suggest the p53 protein density could be used as a marker of prognosis in the non-small-cell lung carcinoma.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.20-27
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• 1998

It is well known that troponin T(below TnT) is present in the myocardial cells and released during myocardial damage, so it`s very specific enzyme to myocardium. Availability of cardiac specific TnT in assessing perioperatively myocardial damage was evaluated from 34 open heart surgery patients. They consisted of 11 ischemic heart, 13 acquired valvular heart and 10 congenital heart cases. Patients were divided into two groups, group A(patients with myocardial damage) and group B(patients without myocardial damage), according to the symptom of chest pain suspecting angina and the ECG findings of ST segment and T wave changes which show myocardial ischemia and injury. Serum TnT levels were measured by enzyme immunoassay method preoperatively, immediately postoperatively, postoperative day 1, day 2, day 3, and day 7. We observed and analyzed the changes of serum TnT levels in two groups and compared the serum TnT levels with CK-MB levels measured at the same time. In group A, serum TnT levels showed 1.37$\pm$0.26$\mu$g/L, 3.16$\pm$0.66$\mu$g/L, 2.39$\pm$0.74$\mu$g/L, 2.49$\pm$0.76$\mu$g/L, and 1.23$\pm$0.60$\mu$g/L, immediate postoperatively, postoperatively day1, day2, day3, and day7, respectively. It was observed there were significant differences compared with those of group B(0.38$\pm$0.04$\mu$g/L, 0.34$\pm$0.05$\mu$g/L, 0.25$\pm$0.03$\mu$g/L, 0.24$\pm$0.04$\mu$g/L, and 0.11$\pm$0.03$\mu$g/L) during identical periods(P<0.01). Serum CK-MB level in group A significantly elevated to 145.04$\pm$35.08 IU/L on the postoperative day 1 compared to group B(31.28$\pm$5.87 IU/L, P<0.05), However, it stiffly decreased from day 2 and returned to preoperative level at day 3. When serum TnT level more than 1.0$\mu$g/L is thought to reflect myocardial damage, serum TnT had 100% of sensitivity and 87% of specificity in diagnosing the postoperative myocardial damage(p<0.01). I conclusion, serum TnT levels increased significantly at very early stage of myocardial damage and persisted much longer period than CK-MB. This suggests that serum TnT has more advantage and availability in assessing the perioperatively myocardial damage than any other tests.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.1
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• pp.7-13
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• 2012

Purpose: The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma. Materials and Methods: From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared. Results: The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision. Conclusion: In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.45-51
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• 2019

Purpose: The clinical and radiological results of patients with type 3 talar neck fractures treated with the anteromedial approach using medial malleolar osteotomy and large distractor were analyzed retrospectively. Materials and Methods: From March 2009 to August 2016, 12 patients with a type 3 talar neck fracture, who underwent the anteromedial approach using a medial malleolar osteotomy and large distractor and who could be followed-up for more than 12 months after the operation, were examined. The patients were examined for the presence of Hawkins signs by anteroposterior and lateral radiographs and osteonecrosis by magnetic resonance imaging (MRI) on the postoperative 3 months. Subsequently, every 3 months, radiographic union was assessed by a simple radiograph and clinical symptoms. Twelve months postoperatively, posttraumatic arthritis was assessed and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was analyzed. Results: In 7 cases, osteonecrosis was found on MRI performed 3 months after surgery. On the other hand, at the 12 months follow-up, all of them obtained AOFAS scores of 83.86±4.53 without surgical treatment. Radiographic union was achieved in all cases. The mean union period was 5.3 months. In 10 cases, traumatic arthritis was found after the radiographical and clinical evaluation. In addition, all of them could carry on everyday life by conservative treatment. The AOFAS ankle-hindfoot score was measured to be 85.17 on average. Other complications included superficial wound infection in 2 cases. Conclusion: An anteromedial approach using a medial malleolar osteotomy and a large distractor in the surgical treatment of patients with type 3 talar neck fractures can achieve anatomical reduction of the displaced fragment without a lateral dissection. This is considered to be another good surgical option.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.737-744
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• 2005

Purpose : Infants and children with cardiovascular diseases often present with respiratory symptoms. However, missed or delayed evaluation for potential airway problem may complicate overall prognosis. The aim of this study is to determine the clinical characteristics of these patients and explore the cause of airway problem. Methods : We reviewed the medical records of 64 patients(M : F=33:31, mean age : $6.3{\pm}7.5$ months) whose airway problems were proven by computed tomography or bronchoscopy in perioperative periods at the Asan Medical Center from January 1997 to June 2004. Patients were divided into two groups based on the duration of ventilator care : ${\leq}7$ days(group 1 : 23 cases, M : F=10 : 13) and >7 days(group 2 : 41 cases, M : F=23 : 18). Results : The patients in group 2 significantly developed more post-operative respiratory symptoms than group 1(P<0.001) and had more airway problems including extrinsic obstruction, intrinsic anomaly, and combined problem than group 1 although not significantly different(P=0.082). Among underlying diseases, the most common diseases were vascular anomaly(26.2 percent) and aortic arch anomaly(26.2 percent) in group 1 and pulmonary atresia with ventricular septal defect(22.4 percent) in group 2. The most frequent respiratory symptoms were recurrent wheezing pre-operatively and failure of ventilator weaning post-operatively. The major types of airway anomaly were tracheomalacia and tracheal stenosis(in each case 18.2 percent). Nineteen patients with persistent airway problems underwent aortopexy or other vascular correction. Of the 19 patients, 13(68.4 percent) were improved, but 2 failed in weaning ventilator and 4 died of non-airway problems. Conclusion : Early evaluation and treatment for potential airway problems may affect natural or surgical prognosis in patients with cardiovascular diseases presenting with respiratory symptoms.

• Tuberculosis and Respiratory Diseases
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• v.49 no.3
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• pp.353-364
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• 2000

Background : Bronchoscopy is a useful diagnostic tool, for accurate localization of the bleeding site and the management of hemoptysis. However, there is some controversy about the optimal timing of bronchoscopy. Method : To determine the optimal timing of bronchoscopy in hemoptysis, we reviewed the medical records of 118 patients and analyzed the following relationships amongst simple chest PA findings, namely, the duration and amount of hemoptysis, and the timing of bronchoscopy retrospectively. Results : The major causes of hemoptysis were active tuberculosis(28.8%), inactive tuberculosis(10.2%), bronchiectasis(17.0%), lung cancer(7.6%), and aspergilloma(7.6%). Localization of the bleeding focus by bronchoscopy was possible in 87.5% (21/24 cases) during active bleeding, and it was possible in 40.4% after bleeding had stopped(p<0.05). The localization rate of bleeding focus was 59.8% when the chest PA showed certain abnormalities, but it decreased to 27.8% when the chest PA finding was normal(p<0.05). When chest PA showed diffuse abnormalities or its finding was normal, the localization rate of bleeding focus significantly increased if bronchoscopy was performed during bleeding or within 48 hours of the cessation of active bleeding. The localization rate was higher as the amount of hemoptysis became larger(p<0.05). The localization rate of early bronchoscopy(during bleeding or within 48 hours of the cessation of active bleeding) was significantly higher when the duration of hemoptysis was less than 1 week, but there was no advantage if the duration was 1 week or longer. Early bronchoscopy was also necessary to localize the bleeding focus for surgical resection in 4 patients, and the bronchoscopy itself was therapeutic in 1 patient whose bleeding was successfully managed with thrombin-application via bronchoscope. Conclusion : It is concluded that flexible bronchoscopy is useful at not only localizing the bleeding focus but also in preparing a therapeutic plan, and early bronchoscopy is more favorable in hemoptysis.