• Journal of Yeungnam Medical Science
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• v.9 no.2
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• pp.211-217
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• 1992

망막분지정맥폐쇄는 안저출혈을 일으키는 중요한 질환의 하나로서 합병성 황반부 부종 및 망막신생혈관에 의한 초자체출혈로 인하여 시력장애를 유발하는 질환으로 전신질환중 고혈압과 가장 흔히 동반되나 당뇨병 혹은 혈액성 질환과도 동반되는 것으로 알려져있다. 초자체출혈의 경우 다른 원인에 의한 경우보다 초자체절제술에 의한 시력개선의 효과가 현저한 질환으로 심한 초자체출혈이 동반된 망막분지정맥폐쇄의 경우 평면부를 통한 초자체절제술 및 안저광응고술에 의한 수술적 처치가 필요할 것으로 사료된다.

• Journal of Gastric Cancer
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• v.7 no.3
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• pp.117-123
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• 2007

Purpose: The surgical treatment of gastric cancer that invades adjacent organs is a radical gastrectomy with combined resection including the adjacent organs or a palliative operation by performing either a gastrojejunostomy or gastrectomy. However, since it is impossible to determine the exact stage of the cancer, either T or N, in the case of palliative surgery, it is inappropriate to predict patient prognosis. This study analyzes the prognoses for patients whose final TNM stages are determined by a combined resection performed due to macroscopical infiltration into the adjacent organs. Materials and Methods: Of 2,452 patients that underwent surgery for gastric cancer at our hospital from 1983 to 2002, we evaluated 102 patients where a combined resection was performed because direct infiltration into the adjacent organs was discovered. Results: Univariate analysis showed that the survival rate differed by the depth of invasion into the gastric walls, the degree of lymph node metastasis, distant metastasis, pathological TNM stage, surgical curability, the location of tumor, and histological differentiation. By multivariate analysis, it was found that the surgical curability, the location of the tumor and the degree of lymph node metastasis were independent prognostic factors. Conclusion: It is suggested that even when infiltration into adjacent organs is suspected, radical surgery should be performed as to allow a prediction of prognosis through an exact determination of disease stage, and to improve the survival rate.

• Journal of Gastric Cancer
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• v.7 no.4
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• pp.193-199
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• 2007

Purpose: Combined resection of an invaded organ in advanced gastric cancer (AGC) with infiltration of adjacent organs is essential to achieve R0 resection. However, when the tumor invades the head of the pancreas or duodenum, R0 resection interferes with the lower resectability and results in a higher morbidity. Wereviewed these cases retrospectively and considered the proper extent of the surgical resection. Materials and Methods: We retrospectively analyzed cases where patients underwent surgery for gastric adenocarcinoma at the Department of Surgery, Presbyterian Medical Center, between January 1998 and December 2003. Among the 45 patients who were suspected to have pancreatic head or duodenum invasion by a primary tumor or metastatic lymph nodes based on the operative findings, we included 22 patients without incurable factors. The patients were classified into three groups: 4 patients that underwent a combined resection (PD group), 12 patients that underwent a palliative subtotal gastrectomy (STG group) and 6 patients that underwent bypass surgery only (GJ group). We analyzed the clinicopathological features, operative data and results. Results: The patients of the PD group achieved R0 resection by PD with D3 Dissection in all Patients. A pancreatic fistula was observed in one patient (morbidity 25%). There was no surgery-associated mortality (mortality 0%). All patients of the PD group were in stage IV. However, the 2-year survival rate (SR) was 75% and the 5-year SR was 50%. Six patients of the STG group underwent surgery with marginal resection and the other six patients of the STG group had a positive distal resection margin. The 2-year SR was 41.7% and the 5-year SR was 16.7%. Most of the patients of group GJ were of old age (mean age: $72.7{\pm}8.6$ years) or had chronic diseases. The 2-year SR was 0%. Conclusion: Combined resection of the pancreas and duodenum in AGC with pancreatic head invasion is relatively safe with moderate morbidity and a lower mortality. One can expect long-term survival if combined resectionis performed in cases without incurable factors.

• Journal of Chest Surgery
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• v.30 no.4
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• pp.396-401
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• 1997

Tailoring thoracoplasty is employed prior to, following, or concomitant with pulmonary resection when it is anticipated that insufHclent lung tissue will remain to fill the pleural space following a pulmonary resection. This study reviewed a series of eight patients treated with tailoring thoracoplasty between 1990 and 1995. Indications were to close a persistent space In four patients and to tailor the thoracic cavity to accept diminished lung volume concomitant with a pulmonary resection in the other four patients. The primary underlying disease was lung cancer in three patients and pulmonary tuberculosis In five patients, two of whom had concomitant aspcrgilloma, two, pneumothora , and one, empyema with bronchopleural fistula. In four patients with a prior pulmonary resection, the tailoring thoracoplasty was performed within eight days after the resection surgery. There was no failure to accommodate the thoracic cavity to insufficient lung tissue, even though two patients needed a second thoracoplasty. We conclude that tailoring thoracoplasty may be performed to close anticipated persistent pleural space and to accommodate diminished lung volume with acceptable cosmetic results Early, after, or concomitant with pulmonary resection in selected patients.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.2
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• pp.138-145
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• 2009

Purpose: Giant cell tumor of the spine is very rare, and the treatment is very difficult. However, surgical techniques and diagnostic modalities are developed, and postoperative functional results are improved. To evaluate the efficacy of total spondylectomy for giant cell tumor of the spine, the clinical results of the surgical treatments for the giant cell tumor of the spine with intralesional curettage or total spondylectomy were evaluated. Materials and Methods: From April 1987 to March 2006, 10 patients who were underwent surgical treatments using total spondylectomy or intralesional curettage were studied. There were 3 men and 7 women. The mean age of the patients was 32 years (range, 25~44 years). The mean duration of follow-up was 8 years (range, 3~15 years). Locations of the tumor were 2 cervical spines, 4 thoracic spines, 2 lumbar spines and 2 sacrum. Initial main symptom of 10 patients was pain, and 7 patients had neurologic impairments too. Four patients were treated with total spodylectomy using anterior and posterior combined approach, 1 patient was treated with total sacrectomy using posterior approach only, and 5 patients were treated with intralesional curettage using anterior approach. Results: Nine patients improved pain and neurologic impairments. Local recurrences developed in 4(40%) patients (2 cervical spines, 1 thoracic spine, 1 sacrum). While a local recurrence developed from 5 total spondylectomy, 3 local recurrences developed from 5 intralesional curettage. Conclusion: Local recurrence rate after surgical treatment with intralesional curettage for the giant cell tumor of the spine was very high. Total spondylectomy using anterior and posterior approach is advisable to prevent the local recurrence after surgical treatment.

• Journal of Chest Surgery
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• v.29 no.6
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• pp.681-688
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• 1996

Most patients with carcinoma of the cervico-thoracic esophagus present with locally advanced disease. For this reason, therapeutic efforts have been largely palliative, focused on eradicating locoregional dis- ease, and have been attended by high morbidity rates. A 61 year old man was diagnosed to advanced cervicothoracic esophageal cancer(Type 1) and reli ved concurrent chromo-radiotherapy for 2 months in St. Mary's Hospital. And then he underwent transhiatal subtotal esophagectomy and radical dissection of cervical and superior mediastinal Iymph nodes with thoracoscopy. The histologic diagnosis was early esophageal cancer(Type 0-llb, SM2) and the curability of operation was calculated to highly curative(Clll). And the postoperative course was unevenful.

• Journal of Gastric Cancer
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• v.7 no.1
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• pp.42-46
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• 2007

Usually in the subtotal gastrectomy, the left and the right gastric arteries, as well as the left and the right gastroepiploic arteries are ligated. Thus, to avoid a blue stomach surgeons preserve the spleen and the short gastric arteries. When a radical subtotal gastrectomy with splenectomy is performed, meticulous caution is necessary; otherwise, the subtotal gastrectomy might have to be changed to a total gastrectomy to prevent a blue stomach. We report the case of a 67-year-old woman who had distal stomach cancer with a splenic solitary mass, for which splenic meatastasis could be excluded. We planned and performed a laparoscopy-assisted radical subtotal gastrectomy with splenectomy as the diagnostic and therapeutic option. In this case, to avoid a remnant stomach infarction or total gastrectomy we saved the left gastric artery and vein with clearing perivascular soft tissue, lymphatics, and lymph nodes. Thus the radical therapeutic goal was reached, and serious complications were avoided.

• Journal of Chest Surgery
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• v.40 no.9
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• pp.617-623
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• 2007

Background: Invasive pulmonary aspergillosis, a frequent fungal infection in immunocompromised patients, is known to have a poor prognosis despite the use of antifungal therapy in leukemic patients. We studied the outcome of surgical resection of invasive pulmonary aspergillosis where bleeding tendency, localized recurrence of infection, and incidence could be reduced. Material and Method: We retrospectively reviewed 14 patients with a hematological malignancy where invasive pulmonary aspergillosis was diagnosed during the 10 years between 1998 and 2007. From the medical records, we reviewed the type and treatment of the hematological malignancy, including the diagnostic methods of invasive pulmonary aspergillosis, the preoperative hematological conditions and their management, and the surgical methods and records. We also analyzed the development of postoperative complications and patient mortality, the recurrence of postoperative invasive pulmonary aspergillosis, and if the patients had a bone marrow transplant. Result: Fourteen patients with invasive pulmonary aspergillosis and a hematological malignancy underwent a pulmonary lobectomy. One patient had a complication of bronchopleural fistula, but there were no other serious complications such as bleeding or wound infection, and none of the patients died postoperatively. Conclusion: We have shown that pulmonary lobectomy is a safe and effective therapy for invasive pulmonary aspergillosis in patients with hematological malignancies that allow further treatment of the hematological malignancy.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.63-65
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• 2008

We treated a 37-year-old male with traumatic hematoma in the suprapatellar bursa that had developed in the form of persistent swelling on suprapatellar area of left knee after blunt trauma. Though there were no obvious abnormal findings on plain roentgenographs, an isolated suprapatellar cystic lesion with fluid-fluid level on T2-weighted sagittal image of MRI was noted. We found the suprapatellar plica with complete septum and no synovitis in the knee joint proper by arthroscopy. We incised the plica and found leakage of blood-stained fluid from the suprapatellar bursa. There were no findings of pigmented villonodular synovitis or other tumorous lesions. At 6 months after surgery, the patient felt symptom-free and there was no recurrence.

• Journal of Gastric Cancer
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• v.7 no.2
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• pp.74-81
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• 2007

Purpose: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. Results: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 0.8%. Conclusion: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.