• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.483-489
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• 2014

This study describes a surgical technique and evaluates the clinical outcomes in small breed dogs with cranial cruciate ligament rupture (CCLR) treated with tibial plateau leveling osteotomy (TPLO). Seven skeletally mature dogs weighing less than 15 kg underwent unilateral TPLO to stabilize the stifle joint with CCLR. Clinical evaluation was performed via visual lameness score, range of motion (ROM), and thigh girth circumference (TC). Postoperative complications were recorded. All patients reached a grade 1 score at 1 week and grade 0 at 8 weeks postoperatively. The mean operated limb extension angle was 98.11%, 99.07%, and 98.73% of the mean extension angle of the contralateral limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. The mean operated limb flexion angle was 98.07%, 95.88%, and 96.35% of the mean flexion angle of the contralateral limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. The mean TC of the operated limb was 92.95%, 93.68%, and 95.44% of the mean TC of the normal limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. Our outcomes for TPLO in small breed dogs are not worse than those previously reported for large breed dogs. Based on the result in the present study, CCLR in small dogs can be successfully managed with TPLO, as done in large breed dogs.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.112-123
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• 2007

Purpose: Evaluate the clinical results of humerus neck nonunion treated with Polarus intramedullary nail. Materials and Methods: 8 patients who underwent surgery for nonunion of humerus surgical neck fracture were included. All patients were female, the average age was 65 years. 5 out the total 8 cases initially received surgery, open reduction and internal fixation with metal plate in 1 case, Ender nail insertion in 2 cases, external fixator in 1 case and closed reduction and percutaneous pinning in 1 case. The other 3 non union cases initial received conservative managemnent. The average period of nonunion was 9 months in the operated group and 6.2 months in the conservative group. All 8 cases received closed reduction with intrameedullary Polarus nail and auto iliac bone graft. Union was confirmed radiologically, and functional evaluation was done with the UCLA functional criteria. Results: All 8 cases showed union on radiologic evaluation. Average time to union was 3.5 months, average follow up period was 27 months. Average UCLA shoulder evaluation score was 7.6 points preoperatively which improved to 26.3 points after surgery. Active shoulder flexion was 40.7 degrees preoperatiely which increased to 104 degrees after surgery. Shoulder abduction improved from 32.9 degrees preoperatively to 96.3 degrees after surgery. UCLA functional criteria was good in 5 cases and fair in 3 cases, which no poor cases. Conclusion: Polarus IM nailing and AIBG is a useful method for treating nonunion of humerus neck fracture with improvement in union and function.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.352-361
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• 1999

Purpose: Carotid endarterectomy nay benefit patients with bilateral carotid stenosis by improving cerebro-vascular hemodynamics of ipsilateral as well as contralateral cerebral hemispheres. We investigated cerebro-vascular hemodynamics after carotid endarterectomy in patients with contralateral carotid occlusion by acetazolamide stress brain SPECT. Materials and Methods: Subjects were 14 symptomatic patients (all men, mean age 66 yrs) with carotid stenosis (>50%) with contralateral carotid occlusion. Acetazolamide stress Tc-99m ECD brain SPECTs were performed within 2 weeks before and after carotid endarterectomy using one day protocol. Cerebral blood flow (CBF) and cerebrovascular reserve (CVR) were assessed visually. In 12 patients, correlation between the patency of proximal anterior cerebral or anterior communicating arteries (A1/A-comm) and the improvement of CBF or CVR after endarterectomy was assessed. Results: Preoperative SPECT showed reduced CBF in 2 ipsilateral and 10 contralateral hemispheres. CVR was reduced in 4 ipsilateral and 9 contralateral hemispheres. Of 12 hemispheres with reduced CBF, 2 hemispheres (16.7%) showed improvement of CBF after endarterectomy. However, reduced CVR was improved in all 4 ipsilateral and 7 of 9 (78%) of contralateral hemispheres after endarterectomy. Three of4 with stenotic Al/A-comm and 4 of 8 with patent A1/A-comm had reduced contralateral CVR. Reduced contralateral CVR improved in all 3 patients with stenotic A1/A-comm and 3 of 4 with patent A1/A-comm. Conclusion: Acetazolamide stress brain SPECT demonstrated improvement of compromised cerebrovascular reserve in not only ipsilateral but also contralateral hemispheres of patients with contralateral carotid occlusion after carotid endarterectomy, and may, therefore, be useful for evaluating cerebral blood flow and cerebrovascular reserve after carotid endarterectomy.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.235-241
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• 2004

Purpose: This study was performed to evaluate the effectiveness of the serum tumor markers CEA, CA 19-9, and CA 72-4 in monitoring the recurrence of gastric cancer and in its preoperative assessment. Materials and Methods: Two hundred fifty-five patients who underwent potentially curative surgery during period from January 1995 to December 2000 at the Department of Surgery were assessed. Serum samples were obtained preoperatively, 2 weeks after the surgery, and at 6-month intervals. The cut-off levels were established as 5 ng/ml for CEA, 36 U/ml for CA 19-9, and 4 U/ml for CA 72-4. The tumor stage was described according to the 5th edition of the Union Internationale Contra la Cancer (UICC) TNM classification in 1997. Results: The preoperative positivities were $10.5\%$ for CEA, $9.7\%$ for CA 19-9, and $12.4\%$ for CA 72-4. The serum levels of the three tumor markers decreased after curative surgery. The preoperative serum levels of the three tumor markers were significantly related to the depth of invasion, the tumor size, lymph-node metastasis, the pathologic stage, and recurrence, except that CEA was not associated with tumor size. The marker sensitivities in recurrent cases were $43.3\%$ for CEA, $\%41.8$ for CA 19-9, and $50.0\%$ for CA 72-4, and the marker specificities were $85.1\%$ for CEA, $96.8\%$ for CA 19-9, and $87.8\%$ for CA 72-4. Conclusion: The preoperative serum levels of CEA, CA 19-9, and CA 72-4 are not useful for the initial diagnosis of gastric cancer because of their low positivity. However, we should consider their relationship with depth of invasion, lymph-node metastasis, tumor size, pathologic stage, and recurrence. Also, the follow-up levels of the three markers have a statistical relationship with recurrence of gastric cancer even though their sensitivities are low.

• Tuberculosis and Respiratory Diseases
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• v.49 no.4
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• pp.474-485
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• 2000

Background : Current studies on multimodal strategy for N2 non-small cell lung cancer are being high interest, have drawn much attention. N2 lung cancer, however, is composed of is divided into several sub groups with that have different prognoses. The prognostic factors still remain controversial. Methods : Between January 1990 and June 1999, 180 patients with N2 lung cancer who underwent surgical resection were investigated, excluding 10 of these for surgical mortality. All patients underwent mediastinal lymph node dissection. 20 clinicopathologic factors were investigated by univariable and multivariable analyses to identify significant prognostic factors among resected N2 disease. Results : The overall 5-year survival rate was 20.6%. Multivariable analyses among overall patients revealed 3 significant prognostic factors : Age, Histologic type, Vascular invasion. Based on the result, 49 patients with both age more than 60 and pathologic Non-squamous cell showed a 5-year survival of 5.0%, whereas 37 patients with neither of the factors showed a 5-year survival of 56.6%(p<0.001). And 12 patients with both vascular invasion and pathologic Non-squamous cell showed a 5-year survival of 11.9%, whereas 67 patients with neither of the factors showed a 5-year survival of 33.6%(p=0.01). Conclusion : The prognosis of surgically resected N2 disease varies according to the 3 significant prognosis factors. Tumor size may be an additional influencing factor in the prognosis of N2 disease.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.148-154
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• 2005

Purpose: To evaluate the long term results of surgical treatment for sacral chordoma. Material and Method: We reviewed the records of 4 patients with sacral tumor treated surgical resection. Mean follow-up duration was 8.3 year(3~11). All cases were performed complete resection of tumor mass through posterior approach in 3 cases and anterior-posterior approach in one. The most caudad nerve-roots spared were the second sacral roots in one and the third sacral roots in 3 cases. Functions of voiding and defecation including neurological symptoms of lower extremities, other complications of surgical treatment, and local recurrence or distant metastasis of tumor were evaluated. Result: There was no motor deficit in all cases, but radiating pain was developed in one and wound infection in one. Bladder function was preserved in 2 cases, intermittent incontinence in one, and doing intermittent catheterization in one. Bowel function was preserved in one and 2 cases were suffered from constipation. At the last follow-up, disease-free was in one, local recurrence in one, and local recurrence with distant metastasis in one. Conclusion: The result of surgical resection for sacral chordoma is satisfactory showing average 8 years survival. Early detection and aggressive surgical treatment is the best to prolong survival and to minimize functional deficit with preservation of upper sacral nerves.

• Journal of Chest Surgery
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• v.30 no.6
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• pp.613-616
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• 1997

We present a case of 58-year-old (tamale with dilated cardiomyopathy(DCMP) in whom we performed left ventricular(LV) remodeling surgery(Batista operation) to reduce the left ventricle diameter and improve left ventricular unction. The patient was admitted September 1996 with heart failure NYHA class IV. There was severe orthopnea and peripheral edema. 2-D echocardiography(Echo) showed DCMP with the ejection fraction(EF) I5%, LV end diastolic dimension(LVEDD) 80mm, mitral regurgitation(MR) grade IV, tricuspid regurgitation ('m) grade ll. Preoperative cardiac output(CO) was 1.5/L/min and cardiac index(Cl) was 1.0 L/min/m2. We proceeded with LV remodeling surgery by resection a part of LV lateral wall between both papillary muscle, from the mitral annulus to the LV apex. Size of resected LV wall was 90 $\times$ 100 $\times$ 15 mm. At the mean time, mitral valve and tricuspid valve were repaired. Postoperative 2-D Echo showed the EF 37%, LVEDD 50 mna, trivial MR, no TR. CO was 3.SL/min and Cl was 2.3 L/min/m2. Her fuctional NYHA class was 1.

• The Journal of the Korea Contents Association
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• v.22 no.7
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• pp.652-662
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• 2022

Currently, in the field of spinal surgery around the world, various new technologies have been rapidly developed and applied to patients. The author believes that it is necessary to discuss whether these new technologies are being fully reviewed for efficacy and safety before being applied to patients. To consider this issue, the author analyzed the basic research data and clinical application process of the intradiscal electrothermal therapy, which was developed as a new technology for discogenic pain disease in the 2000s and has been widely used worldwide. As a result, it was found that this procedure has been performed on patients in a state where there is insufficient base research on efficacy and safety. The author judges that this case reveals an essential problem related to the clinical operation of new medical technologies in the field of spine surgery. Therefore, the author believes that in order to minimize the side effects that new medical technology in the field of spinal surgery may have on patients, more full-fledged basic research and higher clinical acceptance standards should be established.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.362-373
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• 2022

For a full-mouth fixed prosthetic treatment of the edentulous patient, it is essential to confirm the proper tooth position and thorough evaluation of the remaining alveolar bone and soft tissue before surgery. CAD-CAM dentistry and guided implant surgery have such advantages of providing simultaneous planning of surgery and prosthetic treatment to ensure pre-knowledge of the treatment. In this clinical case, using the digital technology, digital temporary denture fabrication, esthetic evaluation before fixed prostheses treatment, and guided surgery planning was possible. After the surgery, previously obtained data was used for fabricating fixed temporary prostheses. Definitive zirconia prostheses transferred from the provisional prostheses were fabricated and functionally and esthetically satisfying results were obtained.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.74-83
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• 1999

In diabetics, the frozen shoulder has been difficult to treat. They tend to respond poorly to manipulation. In this report we present the rationale and results of arthroscopic selective capsular release for those patients. Nine patients, who were diabetics, developed frozen shoulders which failed to respond to conservative management. They had persistent pain, stiffness, and limited function. An arthroscopic release was performed by progressively releasing the anterior structures from superior to inferior. Postoperatively physiotherapy was carried out daily to maintain the range of movement. At a follow up of 12 to 37 months the patients were assessed using the American Shoulder Society scheme. In addition, the patients were assessed preoperatively and postoperatively on four criteria: pain, external rotation, abduction and function. We found that the patients were statistically significantly improved in all four categories. Three of the nine patients had no pain, full range of motion compared with the opposite side and full function. There was one poor result of no improvement. The remaining five patients had improved but still had residual abnormalities. We consider arthroscopic release to be an effective treatment for the resistant diabetic frozen shoulder.