• The Journal of Korean Physical Therapy
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• v.12 no.2
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• pp.229-238
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• 2000

A properly prescribed wheelchair may be able to normalize tone. decrease pathologic reflex activity, improve postural symmetry, enhance range of movement, maintain and/or improve skin conduit)n. increase comfort and sitting tolerance, decrease fatigue, and improve function of the autonomic nervous system. Whereas a poorly prescribed one can actually exacerbate the problems associated with a disability. Maintained for longer without relief, pressure concentrations may also lead to tissue breakdown. Pressure sores continue to be a major problem for many disabled individuals. Many groups of disabled individuals have a very high incidence of pressure sores, including those individuals with spinal cord injuries. hemiplegia, multiple sclerosis. cancer. and the disabled geriatric population. It is important to understand the factors which predispose an individuals to the development of a pressure sores. Those factors can divided into extrinsic factors, related to the individual's immediate environment and intrinsic factors. related to their medical or physical condition. Pressure sores are generally preventable through sensible pressure management based on an understanding of the causes of pressure sores, risk factors and methods of redistributing pressure.

• Clinical and Experimental Reproductive Medicine
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• v.11 no.1
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• pp.9-16
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• 1984

This study was conducted to determine whether patients could engage in sexual activity following total cystectomy with ileal conduit. Sixteen male bladder cancer patients treated by total cystectomy with or without preoperative irradiation. Patients ranged in age from 48 to 70 years (mean 59.6 years). The interval from therapy ranged from 7 to 82 months (mean 33.8 months).Prior to therapy 11 /16 patients (68.8 %) reported they were engaging some form of sexual activity at least once per month. All were able to achieve an erection and were orgasmic. Following total cystectomy, 6 patients (37.5%) continued to engage in sexual activity at least once per month and were experiencing orgasm. 3 patients (18.8%) reported they were able to achieve an erection. The spontaneous resumptiom of sexual activity by almost one third of the patients in this study refutes the assumption that sexual activity would be impossible following total cystectomy.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.26-32
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• 2000

Background and Objectives: Various flaps are using for reconstruction of hypopharyngeal and esophageal defect. However, complication and indication of each flap are not fully analyzed. Patient and Methods: Records of 52 hypopharyngeal cancer patients who had surgical treatment and 13 other head and neck cancer patients who underwent hypopharyngeal and/or esophageal reconstruction with flap were retrospectively analyzed. Eighty three percent(54 cases) of patients needed reconstruction other than primary pharyngeal closure. Five split thickness skin graft, 1 pectoralis major myocutaneous flap, 20 forearm free flap, 13 jejunal free flap, 15 gastric pull up were used. Result: Flap failure was noted in 2 cases who had subsequent gastric transposition. Wound dehiscence and fistula were most common problem of forearm free flap. Most fistulas were developed in patients with conduit type reconstruction of forearm flap while there wasn't any fistula in patient with patch type reconstruction. Stenosis of lower anastomosis was the frequent problem of jejunal transfer. Gastric pull-up has frequent com-plication of stomal stenosis. All but three patients had reached oral feeding postoperatively. Conclusion: Based on this study, forearm flap is effective in partial hypopharyngeal defect while jejunum is the choice for circumferential defect. Gastric pull-up is for combined esophageal defect.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.157-163
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• 2005

Background: Clinical outcomes of esophageal cancer have not been satisfactory in spite of the development of surgical skills and protocols of adjuvant therapy. We analyzed the results of corrective surgical patients for esophageal cancer from January 1992 to July 2002. Material and Method: Among 129 patients with esophageal cancer, this study was performed in 68 patients who received corrective surgery. The ratio of sex was 59 : 9 (male : female) and mean age was $61.07\pm7.36$ years old. Chief complaints of this patients were dysphagia, epigastric pain and weight loss, etc. The locations of esophageal cancer were 4 in upper esophagus, 36 in middle, 20 in lower, 8 in esophagogastric junction. 60 patients had squamous cell cancer and 7 had adenocarcinoma, and 1 had malignant melanoma. Five patients had neoadjuvant chemotherapy. Result: The postoperative stage I, IIA, IIB, III, IV patients were 7, 25, 12, 17 and 7, respectively. The conduit for replacement of esophagus were stomach (62 patients) and colon (6 patients). The neck anastomosis was performed in 28 patients and intrathoracic anastomosis in 40 patients. The technique of anastomosis were hand sewing method (44 patients) and stapling method (24 patients). One of the early complications was anastomosis leakage (3 patients) which had only radiologic leakage that recovered spontaneously. The anastomosis technique had no correlation with postoperative leakage, which stapling method (2 patients) and hand sewing method (1 patient). There were 3 respiratory failures, 6 pneumonia, 1 fulminant hepatitis, 1 bleeding and 1 sepsis. The 2 early postoperative deaths were fulminant hepatitis and sepsis. Among 68 patients, 23 patients had postoperative adjuvant therapy and 55 paitents were followed up. The follow up period was $23.73\pm22.18$ months ($1\~76$ month). There were 5 patients in stage I, 21 in stage 2A, 9 in stage IIB, 15 in stage III and 5 in stage IV. The 1, 3, 5 year survival rates of the patients who could be followed up completely was $58.43\pm6.5\%,\;35.48\pm7.5\%\;and\;18.81\pm7.7\%$, respectively. Statistical analysis showed that long-term survival difference was associated with a stage, T stage, and N stage (p<0.05) but not associated with histology, sex, anastomosis location, tumor location, and pre and postoperative adjuvant therapy. Conclusion: The early diagnosis, aggressive operative resection, and adequate postoperative treatment may have contributed to the observed increase in survival for esophageal cancer patients.