• 대한정형외과스포츠의학회:학술대회논문집
• /
• 2004.09a
• /
• pp.58-58
• /
• 2004

• Journal of Korean Neurosurgical Society
• /
• v.65 no.5
• /
• pp.710-718
• /
• 2022

Objective : Although endovascular treatment for intracranial aneurysms is considered effective and safe, its durability is still debated. Also, few studies have described angiographic follow-up plan after endovascular treatment of intracranial aneurysm, especially in ruptured cases. Hence, we report the long-term results of follow-up angiography protocol. Methods : Radiological records of 639 cases of coil embolization with ruptured aneurysms from March 2003 to December 2016 were retrospectively reviewed. Patients who received treatment of a saccular aneurysm less than 7 mm resulted with near complete occlusion were included. Two hundred thirty-eight aneuryms which received the follow-up angiography at least once were enrolled. We classified four periods of follow-up as follows : post-treatment 1 year (defined as the first period), from 1 to 2 years (the second period), 2 to 5 years (the third period), and over 5 years (long-term). Results : We identified 14 cases (6.4%) of recurrence from 218 aneurysms in follow-up angiography in the first period. Among 143 aneurysms in the second period, five cases (3.5%) of recurrence were identified. There were no findings suspicious of recanalization in 97 patients in the third period. Of the total 238 cases, there were 19 recurrences, for a recurrence rate of 8.0%. Six (31.6%) out of 19 recurrences showed a tendency toward repeat recurrences even after additional treatment. Twenty-eight received long-term follow-up over 5 years and there was no recurrence. Conclusion : Most of the recurrence were found during the first and the second year. We suggest that at least one digital subtraction angiography examination may be necessary around post-treatment 2 years, especially in ruptured cases. If the angiographic results are favorable at 2 years post-treatment, long-term result should be favorable.

• Journal of Chest Surgery
• /
• v.26 no.1
• /
• pp.24-31
• /
• 1993

The long term clinical results following valve replacement with Hancock and Carpentier-Edwards bioprostheses were compared between tow valve models and between tow groups totaling 249 patients who were discharged after valve replacement from 1976 to 1986. The two groups of patients were treated with nonrandomized fashion. Follow-up was 87% complete. Cummulative duration of follow-up was 1909 patient-years, with maximum follow-up duration of 15 years. The actuarial survival for 122 patients with Hancock valves was 95.2%[\ulcornerstandard deviation] and 84.4% after 5 and 10 years of follow-up, respectively. Comparable figures for 127 patients undergoing valve replacement with Carpentier-Edwards valves were 87.3% and 76.4%, respectively[p=NS]. The probability of freedom from structural valve deterioration after 5 and 10 years of follow-up was 97.2% and 60.6%, respectively, with Hancock valves and 97.2% and 55.7%, respectively, with Carpentier-Edwards valves[p=NS]. Considering all 249 patients, multivariate [Cox model] regression revealed that ejection fraction was only significant predictor of structural valve deterioration. The probability of freedom from thromboembolism after 5 and 10 years of follow-up was 91.3% and 86.4%, respectively, with Hancock valves and 94.2% and 82.5%, respectively, with Carpentier-Edwards valves[p=NS]. Hence more strict control of anticoagulation should be done on patients with left atrial factors. In summary, there were no significant differences in actuarial survival rate and major valve related complications between tow valve models. These results suggests that its use should be confined to older patients or patients with a contraindication of anticoagulation.

• Journal of Chest Surgery
• /
• v.56 no.5
• /
• pp.322-327
• /
• 2023

Background: Superior vena cava (SVC) stenosis during follow-up is a major concern after heart transplantation, and many technical modifications have been introduced. We analyzed the surgical results of the SVC intima layer-only suture technique in heart transplantation. Methods: We performed SVC anastomosis with sutures placed only in the intima during heart transplantation. We measured the area of the SVC at 3 different points (above the anastomosis, at the anastomosis, and below the anastomosis) in an axial view by freely drawing regions of interest, and then evaluated the degree of stenosis. Patients who underwent cardiac computed tomography (CT) at 2 years postoperatively between June 2017 and May 2020 were included in this study. Results: We performed heart transplantation in 41 patients. Among them, 24 patients (16 males and 8 females) underwent follow-up cardiac CT at 2 years postoperatively. The mean age at operation was 49.4±4.9 years. The diagnoses at time of operation were dilated cardiomyopathy (n=12), ischemic heart disease (n=8), valvular heart disease (n=2), hypertrophic cardiomyopathy (n=1), and congenital heart disease (n=1). No cases of postoperative bleeding requiring intervention occurred. The mean CT follow-up duration was 1.9±0.7 years. At follow-up, the mean areas at the 3 key points were 2.7±0.8 cm², 2.7±0.8 cm², and 2.7±1.0 cm² (p=0.996). There were no SVC stenosis-related symptoms during follow-up. Conclusion: The suture technique using only the SVC intimal layer is a safe and effective method for use in heart transplantation.

• Journal of Korean Foot and Ankle Society
• /
• v.16 no.4
• /
• pp.223-228
• /
• 2012

Purpose: To treat hallux valgus in old age patients with chevron metatarsal osteotomy and to see the subsequent clinical and radiological outcomes. Materials and Methods: 23 cases of 18 hallux valgus patients of age 60 years or older who received proximal or distal corrective osteotomy from April 2007 to August 2009 and were followed up for at least 1 year were included in the study. The mean age at operation was 65 years (range, 60~81 years), and the mean follow-up period was 2 years and 6 months (range, 1 year~3 years 6 months). Clinical outcome was assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) score, complications, satisfaction rate, as well as measurements and comparison of pre- and postoperative hallux valgus angles, the 1st~2nd intermetatarsal angle, and the position of hallucal medial sesamoid bone. Results: The AOFAS score was improved from preoperative average of 35.1 (range, 13-47) to average 85.1 at last follow-up (range, 75-100). Patients were satisfied about the operation in 21 cases (91.3%). Preoperative hallux valgus angle was $31.7^{\circ}$ on average (range, $19.1^{\circ}-48.9^{\circ}$), and $4.9^{\circ}$ on average at last follow-up (range, $0.3^{\circ}-21.2^{\circ}$). The 1st~2nd intermetatarsal angle was $14.4^{\circ}$on average (range, $8.7^{\circ}-25.7^{\circ}$) and $3.1^{\circ}$ on average at last follow-up (range, $0.6^{\circ}-7.5^{\circ}$). The hallucal medial sesamoid bone position was improved from preoperative average 3.5 (range, 3-4) to postoperative average 1.0 (range, 0-2). Conclusion: Proximal and distal metatarsal osteotomy treatment yielded good clinical and radiological outcomes in old age hallux valgus patients.

• Clinical and Experimental Pediatrics
• /
• v.64 no.7
• /
• pp.313-321
• /
• 2021

Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

• Journal of Yeungnam Medical Science
• /
• v.40 no.2
• /
• pp.187-192
• /
• 2023

Background: This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. Methods: This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. Results: The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01). Conclusion: A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.

• The Journal of Advanced Prosthodontics
• /
• v.14 no.3
• /
• pp.133-142
• /
• 2022

PURPOSE. A large number of studies have suggested the practicability and predictability of immediate implant function, but few studies have reported marginal bone level changes during sequential loading periods. The purpose of this study was to evaluate the marginal bone remodeling of immediately loaded self-tapping implants both at each time point and during each loading period between two time points. MATERIALS AND METHODS. The patients included in this retrospective study were treated with immediately loaded NobelSpeedy Replace implants between August 2008 and July 2009. Differences in the marginal bone level (MBL) at each time point and the marginal bone level change (ΔMBL) between two time points were analyzed with Bonferroni correction (P < .05). RESULTS. Overall, 24 patients (mean age, 47.3 ± 12.8 years) with 42 immediately loaded implants and a median follow-up of 6.5 years (IQR, 67.8 months) were included. The cumulative survival rate after 10 - 12 years was 95.2%. Continuous but slow marginal bone loss was observed during long-term follow-up. MBL at both 7.5 years and 11 years was significantly lower than that at loading, 6 months, 2 years and 4 years (P < .05). No bone loss difference was found in any period before 4 years of follow up (P > .05). The loading period of 4 years to 7.5 years showed the largest ΔMBL compared to those of other time periods (P < .05). CONCLUSION. Slight bone loss occurred continuously, and more radical changes of marginal bone can be observed during the period of 4-7.5 years. Thus, long-term effective follow-up of immediately loaded implants is needed.

• Clinics in Shoulder and Elbow
• /
• v.22 no.4
• /
• pp.220-226
• /
• 2019

Background: This retrospective study was undertaken to evaluate mid-term clinical and radiological outcomes of lattisimus dorsi (LD) tendon transfer in patients with irreparable massive rotator cuff tears (MRCT). We hypothesize that LD tendon transfer would provide safe and satisfactory clinical outcomes at mid-term follow-up. Methods: From November 2008 to December 2016, 23 patients ($57.5{\pm}4.4years$; 20 male, 3 female) who underwent LD tendon transfer for massive tears, were enrolled. Inclusion criteria were irreparable MRCT. Exclusion criteria included full thickness subscapularis tear, rotator cuff arthropathy, anterosuperior rotator cuff tear, and osteoarthritis. Mean follow-up period was $4.7{\pm}4.0years$ (range, 2-12 years). Clinical assessment (American Shoulder and Elbow Surgeons [ASES], University of California, Los Angeles [UCLA], Simple Shoulder Test [SST]) and radiographic assessment (osteoarthritis [OA], acromiohumeral distance [AHI]) were evaluated. Results: ASES, UCLA and SST scores, and range of motion (ROM), except internal rotation, improved significantly at the last followup (p<0.05). Also, AHI was significantly improved at the last follow-up, from 6.6 mm to 8.2 mm (p=0.008). At the final follow-up, the radiologic stages of the glenohumeral osteoarthritis were determined as stage 1 in 9 patients, stage 2 in 10 patients, stage 3 in 2 patients, and stage 4 in 2 patients. Complications were observed in 21.7% cases: 3 re-tears and 2 infections were noted in our study. Conclusions: LD tendon transfer for irreparable MRCT provides satisfactory clinical outcomes at mid-term follow-up. Mild degenerative osteoarthritis (stage 1, 2) of the shoulder joint are common at the mid-term follow-up. Also, complications such as tear, infection should be considered.

• Journal of Chest Surgery
• /
• v.25 no.2
• /
• pp.137-148
• /
• 1992

Until March 1991, 435 St. Jude Medical valves and 330 CarboMedics valves were implanted in 358 and 251 patients, respectively. 300 patients were male and 309 were female with the mean age of 35.6 years[from 2 month to 68 years]. 458 valves were implanted in the mitral, 272 in the aortic, 25 in the tricuspid, and 10 in the pulmonic position. Postoperatively, all patients except for very young patients were given coumadin with or without dipyridamole for anticogulation Operative mortality was 7.3%[45 deaths per 618 operations]. A total follow-up of 1244.8 patient-years was achieved for the operative survivors with a follow-up rate of 96.8%, [mean follow-up period=26.3 months /patient, ranging from 1 to 80 months]. Functional improvement was evident; 66.7% of these patients were in NYHA functional class III or IV preopratively, whereas 98.4% are in class I or II pos-toperatively. There occurred 13 late deaths[7 valve-related] and 55 valve-related complications. Linearized rates of late death and valve-related complications were 1.0%/ patient-year, 4.42%/patient-year, respectively. Rates of thromboembolism, anticoagluation-related hemorrhage were 1.12%/patient-year, 1.69% /patient-year, respectively. Actuarial survival at 5 years is 96.0% and complication-free survival at 5 years is 83.9%. No difference in survival and incidence of complications was found between the St. Jude and CarboMedics valves. On the basis of this experience, we believe that the pyrolytic carbon bileaflet mechanical valves are safe and preferable choice among current valve prostheses.