• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.264-270
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• 2009

Purpose: The elbow joint is one of the most stable joints. Dislocation and fracture can occur in elbow joint most commonly next to shoulder joint. Various injuries can occur according to generated mechanism, age of patient and impact. Despite proper treatment, various complications can occur. Materials and Methods: We describe etiology and treatment of these complications after elbow trauma such as stiffness, instability and heterotopic ossification. Results and Conclusion: Malunion, nonunion and traumatic arthritis are addressed as a possible complication after fracture around elbow joint.

• Radiation Oncology Journal
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• v.21 no.4
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• pp.276-282
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• 2003

Purpose: Although high-dose-rate intracavitary radiotherapy (HDR ICR) has been used in the treatment of cervical cancer, the potential for increased risk of late complication, most commonly in the rectum, is a major concern. We have previously reported on 136 patients treated with HDR brachytherapy between 1995 and 1999. The purpose of this study is to upgrade the previous data and confirm the correlation between late rectal complication and rectal dose in cervix cancer patients treated with HDR ICR. Materials and Methods: A retrospective analysis was peformed for 222 patients with cevix cancer who were treated for curative intent with external beam radiotherapy (EBRT) and HDR ICR from July 1995 to December 2001. The median dose of EBRT was 50.4 (30.6$\~$56.4) Gy with a daily fraction size 1.8 Gy. A total of six fractions of HDR ICR were given twice weekly with fraction size of 4 (3$\~$5.5) Gy to A point by Iridium-192 source. The rectal dose was calculated at the rectal reference point using the barium contrast criteria. in vivo measurement of the rectal dose was peformed with thermoluminescent dosimeter (TLD) during HDR ICR. The median follow-up period was 39 months, ranging from 6 to 90 months. Results: Twenty-one patients (9.5$\%$) experienced late rectal bleeding, from 3 to 44 months (median, 13 months) after the completion of RT. The calculated rectal doses were not different between the patients with rectal bleeding and those without, but the measured rectal doses were higher in the complicated patients. The differences of the measured ICR rectal fractional dose, ICR total rectal dose, and total rectal biologically equivalent dose (BED) were statistically significant. When the measured ICR total rectal dose was beyond 16 Gy, when the ratio of the measured rectal dose to A point dose was beyond 70$\%$, or when the measured rectal BED was over 110 Gy$_{3}$, a high possibility of late rectal complication was found. Conclusion: Late rectal complication was closely correlated with measured rectal dose by in vivo dosimetry using TLD during HDR ICR. If data from in vivo dosimetry shows any possibility of rectal bleeding, efforts should be made to reduce the rectal dose.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.321-328
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• 1997

Background : we have evaluated the association of age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases with postoperative pulmonary complications and identified which parameter of preoperative spirometry was a predictor of postoperative pulmonary complications. Method : In 270 patients older than 60 years, the postoperative pulmonary complications were evaluated according to age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases and the parameters of preoperative spirometry were analyzed. Results : The postoperative pulmonary complications rates were significant higher among patients older than 70 years, and among those with previous chronic pulmonary diseases or their smoking history. The pulmonary complications were increased among patients with general anesthesia or duration of surgery more than 2 hours. The pulmonary complications rates did not differ according to sex, type of operation. The patients with hypercarbia($PaCO_2$ > 45mmHg) have more increased postoperative complications. The preoperative FEV1 less than $1\;{\ell}$, FVC, MMEFR & MVV less than 50% of predicted respectively were predictive of complications. Conclusion : Age $\geq$ 70, history of smoking,duration of operation more than 2 hours, general anesthesia, previous chronic pulmonary disease and hypercarbia ($\geq$45mmHg) on preoperative arterial blood gas analysis were predictive of pulmonary complications. Among the parameters of spirometry, FEV1, FVC, MMEFR and MVV were indicator of predicting postoperative pulmonary complications.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.516-522
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• 2007

Background: Postoperative pulmonary complications are important problems that prolong the length of the hospital stay and increase patient mortality. However, our knowledge of the postoperative factors that increase the risk of these complications is less than complete. Methods: We conducted a prospective study to determine the risk factors for postoperative pulmonary complications. A total of 199 patients were referred to the Pulmonology Department for preoperative pulmonary evaluation. We reviewed the perioperative variables according to the National Surgical Quality Improvement Program (NSQIP). Postoperatively, we collected data on the occurrence of postoperative pulmonary complications and we evaluated the relationship between the perioperative variables and outcomes. Results: Twenty two patients (11%) had pulmonary complications; 6 had respiratory failure, 4 had pneumonia, 13 had pleural effusion and, 2 had atelectasis. Five variables were statistically significantly associated with pulmonary complications on the bivariate analyses. Multiple logistic regression analyses revealed that three of these variables were independently associated with an increased risk of pulmonary complications; a high cardiac risk index (OR 16.5, p=0.002), emergency surgery (OR 10.3, p=0.017), and thoracic/abdominal surgery (OR 3.8, p=0.047). Conclusion: The risk factors for postoperative pulmonary complications are a high cardiac risk index, emergency surgery and thoracic/abdominal surgery.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.111-116
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• 2011

Purpose: The purposes of this article are to review the mid-term results and the complications after reverse total shoulder arthroplasty and to analyze the influence of the etiology on the result. Materials and Methods: We conducted a systemic review of the published literature with the mid-term follow-up after reverse total shoulder arthroplasty was performed. The overall rates of problems, complications, reoperations and revisions were determined. Results: The reported complication rates varied from 0% to 68%. The first series of reverse prosthesis with at least 2 yrs of follow-up confirmed the preliminary results, with excellent functional outcomes. However, a systemic review of the published literature with a mid-term follow-up showed problems in 44% of the cases, complications in 24% of the cases, reoperations in 3.5% of the cases and revision in 10% of the cases. Conclusion: Reverse total shoulder arthroplasty has relatively high complication and revision rates. So, a reverse prosthesis should be used in patients with very disabling arthropathy and a massive cuff tear and who are over seventy (at least sixty-five) years old.

• Journal of Chest Surgery
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• v.37 no.6
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• pp.524-529
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• 2004

Background: Since the Nuss procedure for the correction of pectus excavatum is in its early stage, there have been problems that need to be solved. We examined complications in a single-institute experience of the Nuss technique in order to develop possible solutions to prevent them. Material and Method: 335 consecutive patients, who underwent the modified Nuss procedure between August 1999 and October 2002, were studied retrospectively. Median age was 8 years (range 1 to 46). 264 patients (78.8%) were in pediatric group (age$\leq$15) and 71 patients (21.2%) were in adult group (age> 15). 193 patients (57.6%) had symmetric and 142 patients (42.4%) had asymmetric pectus configurations. Risk factors predicting postoperative complications were analyzed using multi-variate logistic regression. Result: Postoperative complication rates were 18.9% (61/335) in total patients. Frequent complications were pneumothorax 24 (7.5%), bar displacement 11 (3.4%), and wound seroma 10 (3.1%) in order. Early complications (within a month, 49 cases, 15.2%) were pneumothorax (n=23, 6.9%), wound seroma (n=12, 3.6%), and bar displacement (n=8, 2.4%). Late complications (after a month, 12 cases, 3.7%) were pericarditis and pericardial effusion (n=5, 1.5%), bar displacement (n=4, 1.2%), and hemothorax (n=3, 0.9%). Techniques were modified to prevent complications especially in bar shaping and fixation, which led to decrease complication rate in later experience (Operation Date 1: 15/51 (29.4%) vs Operation Date 2: 34/284 (12.0%), p=0.004). Grand Canyon type (eccentric long canal type) showed higher complication rate than other types (GC type: 12/30(40%) vs Others: 37/305 (12.1%), p<0.001). Major risk factors are severity of pectus (OR=2.88, p=0.038), Grand Canyon type (OR=2.82, p=0.044), and Op. Date 1 (OR=4.05, p=0.001). Conclusion: Major complications were related to severe eccentric type of pectus configuration (Grand Canyon type) and lack of surgeon's experience (Op. Date 1). Com-plication rate was reduced with accumulation of experience and advancement of surgical techniques. The Nuss procedure can be performed at a low risk of complications with our current technique.

• The Monthly Diabetes
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• s.218
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• pp.34-36
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• 2008

• Proceedings of the KOR-BRONCHOESO Conference
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• 2005.04a
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• pp.37-42
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• 2005

• Proceedings of the KOR-BRONCHOESO Conference
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• 2005.04a
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• pp.42-46
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• 2005

• The Monthly Diabetes
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• s.183
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• pp.24-28
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• 2005