• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권4호
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• pp.268-275
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• 2015

Purpose: Primary sclerosing cholangitis (PSC) is a rare condition that can be associated with inflammatory bowel disease (IBD). The aim of this study was to evaluate PSC and its association with IBD in children. Methods: We retrospectively enrolled 13 pediatric patients (<18 years) with PSC treated at Asan Medical Center between June 1989 and December 2013. Clinical findings and long-term outcomes were investigated. During the same period, the incidence of PSC among IBD patients was evaluated among 600 Crohn disease (CD) and 210 ulcerative colitis (UC) patients. Results: All 13 study patients diagnosed with PSC also presented with IBD. Eleven boys and two girls with a median age of 15.0 years old (9.0-17.8 years) were included. The cumulative incidence of PSC for UC was 5.7% (12 of 210) and 0.2% for CD (1 of 600), respectively. PSC occurred during follow-up for IBD for five patients (38.5%) whereas, IBD developed during follow-up for PSC for two patients (15.4%), and was diagnosed during the initial work-up for PSC for 6 patients (46.2%). For the 77.3 month median follow-up period, 9/13 patients (69.2%), neither the clinical symptoms nor blood test results worsened. Two cases (15.4%) developed liver cirrhosis and underwent liver transplantation. Among 13 PSC patients with IBD, two (15.4%) developed colorectal cancer, and no one developed cholangiocarcinoma. Conclusion: All patients with PSC in this study had associated IBD. The incidence of PSC was not rare compared to reports in adults. PSC should be considered during the management of IBD and vice versa in children.

• Journal of Chest Surgery
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• 제28권4호
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• pp.376-380
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• 1995

We experienced 17 skeletal muscle transpositions in chest surgery during the past 8 years. There were 3 female and 14 male patients with ranging from 5 to 71 years of age [ average 47.3 Seventeen patients underwent 27 musele flaps : 11 latissimus dorsi, 6 pectoralis major, 6 serratus anterior and 4 other muscles. An average of 2.0 previous operations was performed. Hospitalization averaged 24 days.Follow up ranged from 7 days to 45 months;There were two postoperative deaths; one, 20 days after from operation due to pneumonia and the other, 130 days after from operation due to cor pulmonale.Fifteen patients who were alive after operation had good results at the time of last follow up.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.4063-4066
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• 2012

To determine the clinical outcome of breast cancer BI-RADS 4 lesions and seek a more effective management guideline, we conducted a retrospective study of all BI-RADS4 patients diagnosed between 2003-2008 with follow up time not less than 2 years. A total of 392 cases of BI-RADS 4 were identified and 320 could be sub-categorised as 4a, 4b and 4c. Overall malignant positive results were 7.65, 38.7 and 58.percent, respectively. In all cases assigned to the close follow up group, no malignancy was detectable (P<0.02). The results of the study suggested that BI-RADS sub-categories have benefit for cancer diagnosis and treatment decisions of clinicians and it might be possible to set up a safe follow-up guideline in selected groups of patients to minimize un-necessary tissue biopsy for breast cancer detection.

• Clinics in Shoulder and Elbow
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• 제17권3호
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• pp.114-119
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• 2014

Background: To evaluate clinical and radiological outcome using AO hook locking plate in acute acromioclavicular joint injuries. Methods: This study was based on patients with Rockwood type 3 or 5 acromioclavicular joint injuries who received surgery with AO hook locking plate from June 2008 until June 2009. Among the 22 patients, 19 of them were male and 3 were female, the mean age was $44.4{\pm}15.57$ years (20-72 years) and follow-up period was $15.5{\pm}3.90$ months (12-23 months). Preoperatively, postoperatively, and at the final follow-up after the plate removal, both coracoclavicular distances were measured from the anteroposterior radiograph. Also, the Shoulder Rating Scale of the University of California at Los Angeles scores (UCLA scores), the American Shoulder and Elbow Surgeons scores (ASES scores), Constant scores, and the Korean Shoulder Society scores (KSS scores) were measured at the final followup to evaluate the function of the shoulder joint. Results: At the time of injury, the mean coracoclavicular distance of the injured side was $17.69{\pm}4.23mm$ (9.57-27.82 mm) and the unaffected side was $7.55{\pm}2.20mm$ (3.24-13.05 mm). The mean coracoclavicular distance measured postoperatively and at the final follow-up was $6.87{\pm}2.34mm$ (4.07-14.13 mm) and $8.47{\pm}2.96mm$ (4.37-17.48 mm), respectively. The mean UCLA, ASES, Constant, and KSS scores measured in the final follow-up were $33.5{\pm}1.30$ (31-35), $90.8{\pm}8.36$ (72-100), $78.6{\pm}8.80$ (62-100), and $94.4{\pm}5.08$ (84-100) each. Conclusions: From this short-term research, the surgical treatment using AO hook locking plates in acute acromioclavicular joint injuries is clinically and radiographically satisfying and considered as a useful treatment method.

• 대한관절경학회지
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• 제4권2호
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• pp.117-122
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• 2000

목적 : 전방 십자 인대 손상을 치유하기 위해 사용되는 골-슬개건-골 자가 이식건은 많은 장점이 있지만 이식후 슬개건의 공여부와 슬개대퇴 관절 주위에 합병증이 발생하는 등의 단점이 있어 현재 다른 이식건을 이용한 재건술이 많이 시행되고 있다. 그러나 합병증에 대한 대부분의 문헌이 단기간의 추시 결과에 의한 것이다 저자들은 추시 기간이 길어짐에 따라 이러한 합병증의 빈도가 현저하게 감소하는 양상을 관찰할 수 있어서 이에 대한 연구를 시행하고자 하였다. 대상 및 방법 : 술후 2년 이상 추시가 가능하였던 골-슬개건-골 자가 이식건을 이용한 전방 십자 인대 재건술을 시행받은 76례를 대상으로 2년에서 4년까지의 추시군(평균 2년 10개월)을 중기 추시군, 4년에서 7년 10개월까지의 추시군(평균 4년 6개월)을 장기 추시군으로 분류하여 임상적 및 방사선학적 결과와 슬개골 주위 합병증을 비교분석 하였다. 결과 : Lysholm Knee Score와 슬관절의 안정성은 술전에 비하여 중기 추시군과 장기 추시군 모두 호전을 보였으며 두 군간의 차이는 없었다. 이식건 공여부에 있어서 경도의 동통과 감각의 저하, 슬관절에서의 탄발음, 대퇴 사두근의 위축 등은 중기 추시군 보다 장기 추시군에서 통계학적으로 유의하게 발생빈도가 적었으며 전방 십자 인대 손상전의 운동능력으로 회복된 경우도 각각 19례$(46.3\%)$, 27례$(77.1\%)$로 두 군사이에 통계학적인 차이를 보였다. 결론 : 이상의 결과로 골-슬개건-골 자가 이식건을 이용한 전방 십자 인대 재건술에서 중기 추시군과 장기 추시군을 비교했을 때 슬관절의 안정성은 두 군 사이에 유사한 결과를 보이고 있었다. 그러나 문제시 되고 있는 슬개건 공여부와 슬개대퇴 관절 주위의 합병증은 추시 기간이 증가함에 따라 현저한 감소를 보이고 있음을 알 수 있었다.

• 대한유전성대사질환학회지
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• 제11권1호
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• pp.88-98
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• 2011

Lesch-Nyhan syndrome is a X-linked recessive disorder caused by a deficiency of the enzyme hypoxanthine-guanidine phosphoribosyltransferase (HPRT), enzyme to recycle purines. Case history: born induced vaginal delivery at 40 weeks complicated by premature membrane ruputure, body weight 2.820 gm. He showed failure to thrive showing severe protein aversion like milk products and pink daper. Developmental delay revealing rolling over at 10.5 month, followed by regression. Seizure at 2 months, His poor oral feeding was lifelong problem. Weak crying, spastic, choreoathetoid movement. Self mutilating behavior noted and diagnosed at age 3 years. No family history of consanguinity and neurological disorders. Method: Laboratory test, physical exam, imaging study and molecular. Clinical follow up Treat ment with allopurinol. Result: uric acid 10.5 mg/dL (N 3.5-7.9), APRT 151.1uM/ min/ml pro(25.7-101), HPRT 7.6 (N 233.5-701) and c.151C>T hemizygote (p,Arg51X). Abdominal sonogram showed staghorn calculi in both kidneys, brain MRI brain atrophy. Clinical follow up showed, seizure at 2 mo, developmental delay (head control and, rolling over at at 11mo, pointing body part at 2 yr 7 mo, eye hand coordination at 2 y 11mo,creeping at 3 y 7 mo, speaking words at 6 y 6 mo ),and developmental regression at 3 yr of age. Sleeping problem including insomnia and severe constipation. Self mutilating behavior (lip bite) started at 2.5 yr, neurologic sx including intermittent upward gaze accompanied by swallowing difficulty at 3 y 7 mo grand mal seizure at 4.5 yr and spastic extremity and trunchal hypotonia and choleoathetoid movement and ataxia at 6.5 yr. Scoliosis with severe spasticity at 9 yr 9 mo. Acute life threatening episode with irregular breathing at 9 yr and 9 mo, Emaciation and nephrolithiasis and recurrent pneumonia. Died suddenly at 10 yr 3 mo. Conclusion: life long feeding problem, chronic gut motility dysfunction, sleeping difficulty and progressing neurologic deterioration and nephrolithiasis despite normal serum uric acid maintence by allopurinol treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.335-339
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• 2009

The purpose of this study was to evaluate clinical and radiographic changes of regular diameter implants placed in the posterior region. A total of 47 standard diameter implants were consecutively placed in the posterior region of 20 partially edentulous patients. The diameters of the implants were 4.1mm (N=35, 74%) and 4.3mm (N=12, 26%), respectively. Peri-implant bone loss and clinical parameters such as mobility, suppuration, swelling, bleeding on probing (BOP) were evaluated at the baseline and?the final follow-up visit. The age of the patients ranged between 24~82 years (mean age: 54.7 years). The cumulative survival rate of the regular diameter implants loaded for a period of 3-24 months (Mean: $11.7{\pm}7.9$ month) was 100%. The average bone loss over the follow-up was $0.36{\pm}0.67\;mm$. Success rate was 95.7%. Only two implants failed (bone loss exceeding 1mm after 1 year of placement). Some prosthetic complications occurred, such as screw loosening (N=1) and dissolution of cementation material (N=2). The present study describes successful outcome following the use of standard-diameter-implants placed in the posterior region, and further comprehensive maintenance practices and follow-up schedules are required.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.348-356
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• 2019

Background: Recently, the number of lung transplants in South Korea has increased. However, the long-term outcome data is limited. In this study, we aimed to investigate the long-term outcomes of adult lung transplantation recipients. Methods: Among the patients that underwent lung transplantation at a tertiary referral center in South Korea between 2008 and 2017, adults patient who underwent deceased-donor lung transplantation with available follow-up data were enrolled. Their medical records were retrospectively reviewed. Results: Through eligibility screening, we identified 60 adult patients that underwent lung (n=51) or heart-lung transplantation (n=9) during the observation period. Idiopathic pulmonary fibrosis (46.7%, 28/60) was the most frequent cause of lung transplantation. For all the 60 patients, the median follow-up duration for post-transplantation was 2.6 years (range, 0.01-7.6). During the post-transplantation follow-up period, 19 patients (31.7%) died at a median duration of 194 days. The survival rates were 75.5%, 67.6%, and 61.8% at 1 year, 3 years, and 5 years, respectively. Out of the 60 patients, 8 (13.3%) were diagnosed with chronic lung allograft dysfunction (CLAD), after a mean duration of $3.3{\pm}2.8years$ post-transplantation. The CLAD development rate was 0%, 17.7%, and 25.8% at 1 year, 3 years, and 5 years, respectively. The most common newly developed post-transplantation comorbidity was the chronic kidney disease (CKD; 54.0%), followed by diabetes mellitus (25.9%). Conclusion: Among the adult lung transplantation recipients at a South Korea tertiary referral center, the long-term survival rates were favorable. The proportion of patients who developed CLAD was not substantial. CKD was the most common post-transplantation comorbidity.

• Clinics in Shoulder and Elbow
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• 제17권3호
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• pp.120-126
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• 2014

Background: To compare the treatment of the proximal humerus fracture using a Polarus nail or Philos plate, we aimed to analyze the functional recovery and the factors affecting the selection between the two types of surgery. Methods: The study included 107 patients with proximal humerus fracture who underwent surgery at our institution. Of these patients, 67 underwent surgery with Polarus nails (G1) and 40 with Philos plates (G2). In G1, the cases of two- and three-part fractures were 60 and 7 cases, in G2, the cases of two-, three-, and four-part fractures were 28, 10, and 2 cases, respectively. The average age was 61 years old, and the average follow-up period was 32.5 months. We compared radiological results, the functional recovery retrospectively. Results: The radiological union time was 6.8 weeks and 8.7 weeks on average in G1 and G2 (p < 0.05). At the one-year follow-up period, these were visual analogue scale (VAS) 1.355, forward flexion (FF) 130.968, external rotation (ER) 50.161, internal rotation (IR) L2 in G1, and VAS 0.781, FF 135.806 ER 51.25, IR L1 in G2, respectively, showing no significant differences between the two groups (p > 0.05). Similar observations were made at the final follow-up. In terms of functional recovery, no significant differences were seen at the one-year or at the final follow-up period (p > 0.05). Conclusions: For the surgical treatment of proximal humeral fracture, the selection of the type of surgery is affected by the fracture pattern. However, both methods give satisfactory outcomes and do not show significant differences in the functional outcome after the surgery.

• 대한족부족관절학회지
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• 제23권4호
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• pp.159-165
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• 2019

Purpose: This study investigated the recurrence rate after performing hallux valgus correction using scarf and Akin osteotomy, and also identified the correlation and cut-off values of both the preoperative and postoperative radiographic parameters as risk factors for the recurrence of hallux valgus. Materials and Methods: We reviewed 87 hallux valgus patients (122 feet) who received scarf and Akin osteotomy from January 2007 to August 2015. The clinical outcomes were evaluated using the visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores. The radiological outcome measures included the hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) as determined on the serial weight bearing radiographs. Recurrence was defined as more than 20 degrees of HVA noted on the final follow-up radiograph. Those radiological factors associated with recurrence were evaluated and analyzed. Results: The mean follow-up duration was 20.6 months (12.0~46.5 months) and the mean age was 44 years (13~80 years). The VAS and AOFAS scores were significantly improved at the time of the final follow-up (7.0 to 2.0, p<0.001; 78.0 to 92.0, p<0.001; respectively). Significant corrections in the HVA, IMA, and DMAA were obtained (p<0.001). Eleven (9.0%: 11/122) cases experienced recurrent hallux valgus deformity. The postoperative IMA, DMAA and HVA showed significant moderate to strong correlation with HVA at the final follow-up (Pearson correlation coefficient: 0.44, 0.70, and 0.88, respectively; p<0.001). Postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees showed statistically significant correlation with radiological recurrence at the last follow-up, and the odds ratio of each variable was high in order. Conclusion: Our radiographic results indicated that postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees can be risk factors for hallux valgus recurrence. These risk factors may be helpful for modifying surgical procedures and preventing the recurrence of hallux valgus.