• 대한족부족관절학회지
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• 제24권4호
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• pp.135-141
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• 2020

Purpose: This study evaluated the results of two groups-the early group and midterm group-comparatively in the treatment of hallux valgus using a scarf osteotomy. Materials and Methods: From January 2005 to December 2009 (Group 1) and from January 2010 to December 2013 (Group 2), this study compared hallux valgus cases treated by a scarf osteotomy by a single surgeon with at least a five-year follow-up. Results: The average ages of Group 1 and Group 2 were 50.5 and 51.7 years old, respectively. The average follow-up of Groups 1 and 2 were 7.4 and 6.2 years, respectively. Groups 1 and 2 had 86 cases (53 patients) and 93 cases (64 patients) with at least a five-year follow-up, respectively. The average hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA) of Group 1 were improved from 31.3° and 13.9° preoperatively to 11.3° and 6.8° at the final follow-up, respectively (p<0.001). The average HVA and 1-2 IMA of Group 2 were improved from 31.7° and 13.4° preoperatively to 8.9° and 6.6° at the final follow-up, respectively (p<0.001). The mean American Orthopaedic Foot and Ankle Society (AOFAS) score of both groups increased from 48.5 and 45.0 points preoperatively to 73.7 and 82.4 points at the final follow-up, respectively. The numbers of patient-assessed subjective satisfaction of Groups 1 and 2 at the final follow-ups were as follows: excellent, 27 and 36 (31.4%, 38.7%); good, 34 and 49 (39.5%, 52.7%); fair, 13 and 5 (15.1%, 5.4%); poor, 12 and 3 (13.9%, 3.2%); respectively. Neither troughing nor stress fractures occurred in both groups. Conclusion: Scarf osteotomy for treating hallux valgus is an excellent surgical method with a relatively low incidence of complications. The results in Group 2 were better than those in Group 1, showing that more surgical experience and evolution of the techniques provided better results.

• Journal of Chest Surgery
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• 제26권1호
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• pp.18-23
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• 1993

Improved clinical performance was expected from the introduction of the low-profile model of the Ionescu-Shiley pericardial valve. The long-term clinical results were assessed on the consecutive 47 patients who underwent MVR + AVR with this valve between 1984 and 1988. Three patients died within 30 days of surgery[operative mortality, 6.4%], and 44 early survivors were followed up for a total of 203.8 patient-years [Mean + SD, 4.63 + 1.47 years]. One died during the follow-up with a linearized late mortality of 0.491%/patient~year[pt-yr]. None experienced thromboembolism. Bleeding and endocardiris were seen in each single patient with the incidences of complication of 0.491%/pt-yr respectively. The linearized rate of primary tissue failure [PTF] was 0.491%/pt-yr. The actuarial survival and rate of freedom from PTF were 97.6 _+ 2.4% and 92.6 +7.1% at 7 years of follow-up.These results are favorably comparable with the ones seen in the patients of MVR + AVR with the standard profile lonescu-Shiley valve in all respects except the higher mean age of the low-profile group. Although the clinical performance was compatible with other major reports, the durability of the valve remains to be proved with the prolonged follow-up.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7381-7383
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• 2013

Background: Male breast cancer accounts for less than 1% of all cancer in men and only around 1% of all diagnosed breast cancer. Despite a significant raise in the last 25 years, it still remains a rare disease. Materials and Methods: We conducted a retrospective study from 2004-2011 with 21 male breast cancer patients. We aimed to analyze the epidemiologic data (age, personal and family history), tumor characteristics (size, histological type, location, TNM stage, receptors), surgery, adjuvant chemotherapy and radiation therapy, hormonal therapy and survival (relapse, follow up, death) who reffered to our center with breast cancer. Results: The median age was $49.2{\pm}14.2$ years (range 30-83 years). A family history of breast cancer was noted in four cases. The main clinical complaint was a retroareolar mass in 85.7%of patients (n=18). Histologically, 85.7% (n=18)were invasive ductal carcinoma and 4.7% (n=1) had ductal carcinoma in situ and 9.4% (n=2) had mixed histology including invasive medullary and ductal carcinoma. Hormonal therapy was delivered to 16 cases (76.1%) due to ER or PR positivity. During median follow up of 30 months (3-84 month), distant metastases were evident in 4 cases (19%). During the follow-up period, only one patient died due to metastatic disease. The mean time to recurrence detection was 30 months. Conclusions: The percentage of cases of male breast cancer is very low compared to breast cancer in females, explaining why very few investigations have been conducted in Iran. Limited coverage in the literature make gender-specific findings difficult so future research of this entity involving multi-institutional cooperation and longer follow up is essential to provide new insights about the biological and clinical factors of this rare cancer.

• Journal of Chest Surgery
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• 제26권10호
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• pp.753-760
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• 1993

The CarboMedics valve is a bileaflet prosthesis with excellent hemodynamic characteristics, but the long term surgical experience with this valve, its durability and its biocompatibility are unknown. During a 5 year period from october 1988 to July 1993, 748 prostheses [402 mitral, 261 aortic, 58 tricuspid, 27 pulmonic] were inserted in 552 patients [mean age 40.2 years]. The operative mortality was 6.6% [37/560, 13.2% in age group below 15 years and 5.7% above 15 years]. and the main causes of death were complex congenital malformation and left ventricular failure. Follow up was totaled 1182 patient- years and mean follow up was 28.3 months/patient. No structural failure has been observed. Hemorrhage was the most frequent valve related complication[1.78% / Patient-year]. Embolism occurred at a rate of 0.93% / Patient-year. There were 5 cases of valve thrombosis [0.42% / Patient-year, two fatal]. There occurred 11 late deaths[6 valve related] and 42 valve related complications. Actuarial survival at 5 years is 97.18 0.94% and actuarial complication free survival at 5 years is 89.07 1.54%. In summary, the CarboMedics valve stands for a durable valve substitute, with low valve related complications.

• 대한족부족관절학회지
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• 제8권1호
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• pp.39-45
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• 2004

Purpose: The author modified the technique of Grice-Green, for managing flexible flat foot, with severe hindfoot valgus and possible dorsiflexion more than $15^{\circ}$. The purpose of this study was to evaluate the efficacy and results of this modified technique. Material and Methods: Total of 6 patients, 11 cases of pes planovalgus were operatively managed with Modified Grice-Green procedure from Nov. 1996 to April 2002. Total 11 cases in 6 patients were managed; 9 cases in 5 males, 2 cases in one female. The average age of the patients were 7.3 years (5.1-13.3 years). Average follow up period was 3.9 years (1.2-6.7 years). Patients were evaluated preoperatively and at last follow up radiologically and clinically. Radiologic evaluation were done by measuring the talocalcaneal and talo-$1^{st}$ metatarsal angles with the anteroposterior view; and by measuring the talo-$1^{st}$ metatarsal angles with the lateral view. The clinical outcome were rated by subjective and objective improvement level. Results: On follow up, 9 cases were complete satisfied, 2 cases were satisfied with minor reservation and no case had major reservations or dissatisfaction. Objective results were rated as excellent in 9 cases, good in 2 cases. Average preoperative talo-calcaneal and talo-$1^{st}$ metatarsal angles on anteroposterior radiograms were $34.4^{\circ}$ ($16-40^{\circ}$) and $32^{\circ}$ ($8-48^{\circ}$) respectively; which postoperatively on last follow up were $20^{\circ}$ ($3-37^{\circ}$) and $15.6^{\circ}$ ($3-34^{\circ}$) respectively. Average Preoperative talo-$1^{st}$ metatarsal angle on lateral radiogram was $18.4^{\circ}$ ($6-30^{\circ}$); which postoperatively on last follow up was $6.7^{\circ}$ ($-6-17^{\circ}$). Conclusion: Modified Grice-Green operative procedure is effective and satisfactory procedure for planovalgus deformity in children. but for more accurate results, more patients and further follow up period are needed.

• The Korean Journal of Pain
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• 제27권3호
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• pp.260-265
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• 2014

Background: To evaluate the results of conventional radiofrequency thermorhizotomy (CRT) for trigeminal neuralgia (TN) in patients with failed medical management. Methods: Patients with Trigeminal neuralgia who were referred to us for 'limited intervention' during the time frame July-2011 to Jan-2013 were enrolled for this study. CRT was administered by the Sweet technique. Pain relief was evaluated by the principle investigator. Results: Eighteen patients were enrolled and completed a mean follow-up of 18.0 months. Pain relief was observed in 14 of 18 (77.8%) patients on the post-operative day, 14 of 18 (77.8%) at 1-month follow-up, 14 of 17 (82.4%) at 3-months follow-up, 12 of 15 (80%) at 6-months follow-up, 7 of 11 (63.6%) at 1-year follow-up and 2 of 6 (33.3%) 1.5 years of follow-up. Four patients required a repeat cycle of CRT; two at six months of follow-up and two at one year of follow-up. One patient was transferred for surgical intervention at six months of follow-up. Side-effects included facial hypoesthesia (n = 6); nausea/vomiting (n = 2), diminished corneal reflex (n = 13) and difficulty in chewing (n = 11). Severity of adverse effects gradually diminished and none of the patients who are beyond 6 months of follow-up have any functional limitation. Conclusions: CRT is an effective method of pain relief for patients with Trigeminal neuralgia. Successful outcome (excellent or good) can be expected in 66.7% of patients after first cycle of CRF. The incidence and severity of adverse effects is less and the procedure is better tolerated by the patients.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제11권2호
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• pp.186-197
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• 2000

연구목적：자폐장애는 예후가 가장 좋지 않은 소아정신장애 중의 하나이나, 최근에는 과거의 연구들보다는 다소 나은 예후가 보고되기도 한다. 본 연구는 자폐장애 환자들의 증상을 중심으로 비교적 단기 경과를 탐색하고자 하였다. 방 법：DSM-III-R 진단기준의 50명 자폐장애 환자들($1{\sim}13$세)을 $4{\sim}7년(6.4{\pm}1.1년)$ 후 추적 평가하여 증상의 변화유무와 사용한 치료방법, 나이, 성별, 지능, 신체증상에 따른 자폐증상의 변화를 분석하였다. DSM-III-R의 진단 기준을 A(Social interaction, A1${\sim}$A5), B(Communication, B1${\sim}$B6), C(Activities and interests, C1${\sim}$C5)로 분류하여 비교하였다. 결 과：추적 평가시가 초기평가시에 비하여 전체적으로 뿐만 아니라, A, B, C 각각의 영역에서도 유의하게 증상의 수가 줄었다. 50% 이상 감소한 증상들로는 A1, A2, A3 증상, B1, B2, B3, B4, B5 증상, C1, C3 증상이었다. 의사소통 영역이 초기 평가시나 추적시에 가장 낮은 빈도를 보였다. 나이가 많은 군과 특수교육군에서 의사소통 능력이 더 나았으나, 성별, 지능, 신체증상에 따른 증상의 변화는 통계적으로 유의하지 않았다. 결 론：자폐장애가 청소년기까지는 시간이 지남에 따라 전반적으로 증상의 호전을 보였다. 향후 성인을 포함한 장기 추적연구가 필요할 것이며, 적극적인 조기 발견과 조기 치료적 중재를 시행하여야 할 것이다.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.273-280
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• 2001

Objectives : The purpose of this study is to assess the long-term outcome and delayed complications of Gamma Knife radiosurgery for low grade glioma(LGG). Methods : Among 31 patients of LGG who had been treated by using Leksell Gamma Knife between March 1992 and December 1996, we could follow up more than 5 years(range 5-9 years) in 17 patients and evaluated their clinical feature, changes of tumor volume and post-radiosurgical complications. Results : During the mean follow-up period of 7.6 years, the tumor was decreased in 5 patients(29.4%), unchanged in 4(23.5%), increased in 4(23.5%) and recurred in 4(23.5%). The tumor control rate was 52.9%(9/17). We have experienced eighteen postradiosurgical complications in 10 patients(58.8%). Early complication was none and delayed complications included radiation necrosis with cyst in ten cases, bleeding in five, radiation-induced edema in one and malignant transformation in one. Two patients ultimately died as a result of tumor progression during the follow-up period. The mortality rate was 11.7%. Conclusion : Gamma Knife radiosurgery may be useful as an adjunctive therapy for small volume, deep-seated LGG. Although radiosurgery can effectively prevent growth of solid tumor, several delayed complications such as radiation necrosis, cyst formation, bleeding or malignant transformation can develop during the long-term followup period. Because of the possible slow growth rate of LGG and development of the delayed complications, the long-term efficacy of radiosurgery requires further analysis.

• Journal of Chest Surgery
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• 제49권5호
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• pp.344-349
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• 2016

Background: Monocusp reconstruction with a transannular patch (TAP) results in early improvement because it relieves residual volume hypertension during the immediate postoperative period. However, few reports have assessed the long-term surgical outcomes of this procedure. The purpose of the present study was to evaluate the mid-term surgical outcomes of tetralogy of Fallot (TOF) repair using monocusp reconstruction with a TAP. Methods: Between March 2000 and March 2009, 36 patients with a TOF received a TAP. A TAP with monocusp reconstruction (group I) was used in 25 patients and a TAP without monocusp reconstruction (group II) was used in 11 patients. We evaluated hemodynamic parameters using echocardiography during the follow-up period in both groups. Results: At the most recent follow-up echocardiography (mean follow-up, 8.2 years), the mean pulmonary valve velocities of the patients in group I and group II were $2.1{\pm}1.0m/sec$ and $0.9{\pm}0.9m/sec$, respectively (p=0.001). Although the incidence of grade 3-4 pulmonary regurgitation (PR) was not significantly different between the two groups (group I: 16 patients, 64.0%; group II: 7 patients, 70.0%; p=0.735) during the follow-up period, the interval between the treatment and the incidence of PR aggravation was longer in group I than in group II (group I: $6.5{\pm}3.4years$; group II: $3.8{\pm}2.2years$; p=0.037). Conclusion: Monocusp reconstruction with a TAP prolonged the interval between the initial treatment and grade 3-4 PR aggravation. Patients who received a TAP with monocusp reconstruction to repair TOF were not to progress to pulmonary stenosis during the follow-up period as those who received a TAP without monocusp reconstruction.

• Journal of Chest Surgery
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• 제14권4호
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• pp.369-380
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• 1981

In this department 504 cases of valve replacement were done since 1968 to the end of October 1981. Since October 31, 1978 to the end of October 1981 ,333 Ionescu-Shiley bovine pericardial xenograft bioprosthetic cardiac valves were replaced in 265 patients. There were 149 males and 116 female. Ages ranged from 2 to 63 years with 25 cases under 15 years of age. Among 265 cases of Ionescu valve replacement there were 157 MVR, 36 VAR, 6 TVR, 45 MVR+ AVR, 16 MVR+TVR and 5 MVR+AVR+TVR cases with mortality of 5.7%, 8.3%, 16.7%, 8.9%, 18.8% and 20% for each group respectively. Over all mortality rate in 265 Ionescu valve replacement cases was 7.9% with 21 total deaths. Main causes of operative deaths were due to LCOS in 7, bleeding in 5, arrhythmia in 3, air embolism in 2,and heart block in 2 cases. There were 12 late complications with 6 deaths. Over all long-term survival rate was 89.8%. MVR showed the highest long-term survival rate with 92.4%, and MVR+AVR+TVR the lower with 80% lower with 80%.Average follow-up period was 14 month duration. Twenty five congenital anomaly cases were operated with Ionescu-valve replacement that consisted of 7 VSD+AI, and 5 Ebstein anomaly cases with over all operative mortality of 16% and late mortality of 14.3% among 21 operative survivors. There were 25 Ionescu valve replacement cases in pediatric patients under the age of 15 years, with 4 operative deaths. Fourteen MVR, 7 AVR, and 3 TVR cases were found. Even though long-term follow-up study was short in postoperative period with total of 33~.0 months among 244 operative survivors ranging one to 36 months, the late survivors showed beneficial long-term results two thromboembolic episodes in 244 patients were found. More cases and longer term follow-up study are warranted for valve replacement in pediatric and TVR cases with Ionescu-valves which have advantageous hemodynamic structures compared with other bio-prosthetic heart valves.