• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.294-304
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• 2020

Anterior cruciate ligament (ACL) reconstruction is a successful procedure independently by patient selection, timing of surgery, surgical technique, choice of graft, and fixation methods. Among these factors, graft selection and fixation methods might be the most critical yet controversial questions for surgeons. Although recent studies showed that grafts have advantages and drawbacks, there is still no ideal graft. Similarly, many fixation methods of femoral and tibial tunnels have been proposed over the last few decades, with no clear superiority of one technique over another. Surgeons should be familiar with a variety of grafts, fixation techniques, and their specific associated surgical procedures as well as the advantages and disadvantages of each. Therefore, this article summarizes the current literature and discusses the current state of graft selection and fixation methods in the treatment of an ACL injury.

• Journal of Digestive Cancer Research
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• v.4 no.1
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• pp.32-35
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• 2016

Pseudomyxoma peritonei (PMP) is a rare clinical syndrome characterized by profuse jelatinous materials in the abdominal cavity and pelvis with mucinous implants on the peritoneal surface. There are some studies for serum tumor markers, including carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125), to assess the risk of recurrence following cytoreductive surgery and intraperitoneal chemotherapy. However, rare cases were reported about recurrence with increasing serum CEA levels. Herein, we report a case of recurrence of PMP according to serially elevated serum CEA.

• Journal of Chest Surgery
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• v.37 no.6
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• pp.492-498
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• 2004

Background: In this study, we investigated the risk factors for the development or progression of aortic regurgitation(AR) in patients with type I ventricular septal defect (VSD) to determine the optimal surgical timing and strategy. Material and Method: Three-hundred and ten patients with type I VSD with or without AR were included. The mean of age was 73.7$\pm$114.7 (1-737) months. One hundred and eighty six patients (60%) had no AR, 83 (27%) had mild AR, 25 (8%) had moderate AR and 16 (5%) had severe AR. Aortic valve was repaired in 5 patients and replaced in 11 patients with closure of VSD in the first operation. Four patients required redo aortic valve repair and 11 patients required redo aortic valve replacement. Age at operation, association with aortic valve prolapse, Qp/Qs, systolic pulmonary arterial pressure, VSD size and systolic pulmonary artery to aortic pressure ratio(s[PAP/AP］) were included as risk factors analysis for the development of AR. The long-term result of aortic valve repair and aortic valve replacement were compared. Result: Older age at operation, association with aortic valve prolapse, high Qp/Qs, and s[PAP/AP] were identified as risk factors for the development of AR (p<0.05, Table 2). The older the patient at the time of operation, the higher the severity of preoperative AR and the incidence of postoperative AR (p<0.05, Table 1, Fig. 1). For the older patients at operation, aortic valve repair had higher occurrence of AR compared to those who had aortic valve replacement (p<0.05, Fig. 2). Conclusion: From the result of this study, we can concluded that early primary repair is recommended to decrease the progression of AR. Aortic valve repair is not always a satisfactory option to correct the aortic valve pathology, which may suggest that aortic valve replacement should be considered when indicated.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.1-10
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• 2004

The habit of finger sucking is a reflex occurring in the oral stage, due to nutritive and psychological desire. The habit of finger sucking is considered to be normal till 3 years of age. Dento-skeletal effect on maxillo-mandibular complex including occlusion is naturally correction, when habit stopped before 3 years. If finger sucking continues till $3{\sim}4$ years, Finger sucking leads to severe malocclusion and remarkable discrepancy maxillo-mandibular complex, which is difficult in expectation of natural correction. It is necessary to positive treatment. Treatment of malocclusion, as related to finger sucking is classified two methods. (psychological approach and orthodontic appliance) To stop a habit and to correct severe skeletal discrepancy and malocclusion, $fr\ddot{a}nkel$ appliance is very effective device. This study is to report two cases of treatment of malocclusion, as related to finger sucking. 2 years 10 months old girl with severe overjet, maxillo-mandibular skeletal discrepancy and severe convex facial profile was treated with a FR-II appliance. Finger sucking habit stopped immediately After 16 months, severe overjet, maxillo-mandibular skeletal discrepancy and severe convex facial profile was corrected. 4 years 2 months old girl with midline deviation, mandibular right shift, collateral posterior crossbite and facial asymmetry was treated with a FR-III appliance. Finger sucking habit stopped immediately. After 10 month, Midline deviation, mandibular right shift, collateral posterior crossbite and facial asymmetry were corrected. FR-appliance is a recommendable appliance for a habit breaker and correction of skeletal discrepancy.

• Neonatal Medicine
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• v.18 no.2
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• pp.337-344
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• 2011

Purpose: To report our experience of gastrointestinal operations performed in neonates including low birth weight infants and to evaluate their clinical characteristics. Methods: We retrospectively reviewed the medical records of patients who underwent neonatal gastrointestinal surgery or had necrotizing enterocolitis (NEC) or inguinal hernia from January 2008 to December 2010 at Pusan National University School of Medicine. Results: The main disease was anorectal malformation and male patients were dominant. Twenty four patients (19.2%) had one or more associated anomalies including hydronephrosis and congenital heart disease. Eighteen patients (43.9%) of anorectal malformation had other anomalies. Seventy six percent of NEC cases were very low birth weight infants. Concerning mean days of full enteral feeding after operation, NEC patients needed 30.8 days, which was the longest period. Overall mortality of operation (except NEC and inguinal hernia operation) was 1.6%. The mortality of NEC with surgical treatment was 18.8%. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC patients. Conclusion: The morbidity and mortality after neonatal gastrointestinal surgery were excellent. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.187-192
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• 1992

Local control is the important prognostic factor in cancer treatment because local control decrease the relative risk of metastatic spread and inclose distant metastasis free suwival. IORT is the modality which could increase local control without incressing complication, combined with curative operation. Eventhough we could achieve significant deacreased local failure by IORT and curative resection, it should not be committed as a main treatment modality without proving acceptable complications. Therapeutic Radiology Department of Yeungnam University Medical Center have tried 58 IORT from June 15, 1988, and performed 53 IORT En patients with gastric cancer. No local failure has been reported by regular follow up so far. Nine cases ($17\%$) of treatment related complicaiton were reported including intestinal obstrution, hemorrhage, sepsis, and bone marrow depression. These complications could be comparable to Jo's $25.2\%$ (chemotherapy + operation), Kim's $18\%$ (chemotherapy only in inoperable patients), because our treatment regimen is consisted of IORT (1500 cGy), external irradiation (--4500 cGy) and extensive chemotherapy(FAM, 5FU + MMC, BACOP).

• Journal of The Korean Ophthalmological Society
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• v.59 no.12
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• pp.1173-1180
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• 2018

Purpose: We evaluated the postoperative accuracy of intraocular lens power prediction for patients undergoing phacotrabeculectomy and identified preoperative factors associated with refractive outcome in those with primary open-angle glaucoma (POAG). Methods: We retrospectively reviewed the medical records of 27 patients who underwent phacotrabeculectomy to treat POAG. We recorded all discrepancies between predicted and actual postoperative refractions. We compared the data to those of an age- and sex-matched control group that underwent uncomplicated cataract surgery during the same time period. Preoperative factors associated with the mean absolute error (MAE) were identified via multivariate regression analyses. Results: The mean refractive error of the 27 eyes that underwent phacotrabeculectomy was comparable to that of the 27 eyes treated via phacoemulsification (+0.02 vs. -0.01 D, p = 0.802). The phacotrabeculectomy group exhibited a significantly higher MAE (0.65 vs. 0.35 D, p = 0.035) and more postoperative astigmatism (-1.07 vs. -0.66 D, p = 0.020) than the phacoemulsification group. The preoperative anterior chamber depth (ACD) and the changes in the postoperative intraocular pressure (IOP) were significantly associated with a greater MAE after phacotrabeculectomy. Conclusions: POAG treatment via combined phacoemulsification/trabeculectomy was associated with greater error in terms of final refraction prediction, and more postoperative astigmatism. As both a shallow preoperative ACD and a greater postoperative change in IOP appear to increase the predictive error, these two factors should be considered when planning phacotrabeculectomy.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.638-653
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• 2021

Purpose To compare the recurrence pattern, disease-free survival (DFS), and overall survival (OS) after curative surgery for pancreatic ductal adenocarcinoma (PDAC) in patients who underwent preoperative evaluation with CT alone or in combination with MRI, and to compare the prognosis according to the first recurrence site. Materials and Methods We retrospectively evaluated 152 patients who underwent R0 resection of PDAC. Preoperative CT or combined CT and MRI were performed for 103 and 49 patients, respectively. Two radiologists recorded the location and date of the first recurrence in consensus. The recurrence pattern, DFS, and OS were compared between the two groups. OS was analyzed according to the first recurrence site. Results In both groups, liver metastasis was the most common recurrence pattern. DFS (p = 0.247) or OS (p = 0.067) showed no significant difference between the two groups. OS according to the first recurrence site was the lowest for liver metastasis, followed by locoregional recurrence (p < 0.001). Conclusion There were no significant differences in the recurrence pattern, DFS, or OS between patients evaluated with preoperative CT alone or with CT and MRI after curative resection of PDAC. Liver metastasis was the most common tumor recurrence pattern with the lowest OS.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.305-312
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• 2008

Background: Anatomic and functional abnormalities of the systemic atrioventricular (AV) valve are common in single ventricle. pathologies and continue to be associated with poor early and late outcomes in surgically palliated single. ventricle patients. We aggressively performed valvuloplasty for atrioventricular valve regurgitation (AVVR) during the course toward a Fontan operation. Material and Method: Between January 1995 and December 2004, 209 patients underwent a Fontan operation in our institution. We retrospectively evaluated the prevalence of AVVR and the influence of AV valve repair on outcome, and we analyzed the progression of AVVR after the Fontan operation for 168 patients where echocardiographic follow up results for more than 6 months after the Fontan operation were available. During the course toward a Fontan operation, 25 patients underwent 30 procedures for AVVR. These procedures. were. carried out during placement of a bidirectional cavopulmonary shunt (BCPS) for nine patients, between the time of placement of a BCPS and the Fontan operation for four patients, and during the Fontan operation for 17 patients. Five patients underwent procedures for AVVR twice. Result: The late mortality rate after the Fontan operation was 4.2% (n=7), with a median follow-up duration of 52 months (range, $6{\sim}123$ months). Seven patients (4%) had unfavorable outcomes such as significant (moderate or severe) AVVR in six patients, and significant AV valve stenosis in one patient was determined at the last follow up after the Fontan operation. Among the seven patients, four patients underwent AV valve repair after the Fontan operation, and one patient underwent subsequent AV valve replacement. Progression to AVVR of equal to or greater than grade 2 was noted in 30 patients (18%) at the last follow up after the Fontan operation, including 12 patients that underwent previous AV valve procedures. Initial grading of AVVR, a previous AV valve operation, and specific AV valve morphology such as a common AV valve or mitral atresia were significant risk factors for the progression of AVVR after the Fontan operation. Conclusion: In our surgical series, a small percentage of patients showed unfavorable outcomes. related to AVVR during the course toward a Fontan operation. However, a closer follow-up is required to evaluate the progression of the AVVR after a Fontan operation, especially for patients showing poor AV valve function at the first presentation and specific AV valve morphology.

• Journal of Chest Surgery
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• v.29 no.7
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• pp.769-776
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• 1996

The application of video-assisted thoracic surgery (VATS) in the examination of the thoracic cavity can be a new option in patients with mediastinal tumor because it provides outstanding visibility of the structures of the mediastinum. By clear viewing through the thoracoscope, a mediastinal tumor can be biopsied or resected, depending on the findings during an operation. We reviewed all patients who underwent curative or diagnostic operations from March 1990 to August 1995 under the impression of a mediastinal mass. The total number of patients were 113 with 59 males and 54 females. Group A underwent resection of tu or by thoracotomy(38 patients: 18 males, 20 females), and group B underwent resection of tumor by VATS (36 patients : 20 males and 16 females). Seven patients in group B were excluded because they underwent thoracotomy due to pleural adhesion or intra-operative bleeding ; therefore, the true VATS group numbered 29 cases. Group C underwent Iymph node biopsy by VATS(33 patients'16 males, 17 females), and group D(6 patients: 5 males, 1 female) underwent Iymph node biopsy through anterior mediastinotomy. The mean age in group A was 36.2 years compared to 41.3 years In group B. We compared operation time, frequency of injection for pain control, duration of chest tube insertion, postoperative hospital stay, and diagnostic yield. In group A, they were 164 minutes, 3.4 times, 5.2 days, and 11.3 days, respectively, in comparison to 152 minutes, 2 times, 4.7 days, and 8.3 days, respectively, in group B. These data revealed that the day of discharge was significantly shorter in group B (p valu : 0.03). In group C, the mean age was 45.8 years (range 1 ∼70). The operation time was from 30 to 335 minutes (mean 105), pain control was required from 0 to 15 times(mean 3.2), and a chest tube was needed for 1 to 36 days (mean 6.1). In group D, mean age was 53.3 years, operation time 121 minutes, pall control injec- tion frequency 2.6 times, and mean chest tube duration 10.5 days. The diagnostic yield in group C was 8 oyo compared to 100 oyo in group D although the number of patients in group D is small.