• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.128-136
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• 1996

Radial nerve injury is caused by variety of etiologies, mainly traumatic. It is primarily a motor nerve and loss of it's function leads to a significant disability. Surgical treatments of radial nerve comprise of neurolysis(internal or external), neurorrhaphy(eineural, perineural or epi-perineural), nerve graft and tendon transfer. However, there is still controversies in treatment methods and time of operation. Authors experienced 23 cases of radial nerve injuries who were treated by operative methods and followed up over 1 year's duration. The male to female ratio was 18 to 5 and mean age was 30.7 years old. The causes were 13 cases in fractures, 5 cases in crushing injury, 3 cases in laceration, 1 case in CO poisoning and 1 case in unknown cause. The summary of the study were as follows ; 1. Excellent or good results were obtained in overall 16 cases among 23 cases; 5 of 9 cases in neurolysis, 3 of 3 cases in neurorrhaphy, 2 of 3 cases in nerve graft and 6 of 8 cases in tendon transfer. 2. In cases of neurorrhaphy and nerve graft, primary or delayed repair showed excellent or good results and neurolysis performed before 6 months leads to better results. But there was no correlations between the time of injury and operation in tendon transfer. 3. The radial nerve injury associated with extensive soft tissue defect or any conditions that leads to nerve ischemia results poor prognosis. 4. The patients aged under 40 years showed better prognosis in clinical results according to the age of surgical treatment. 5. If the surgeon decide the method and the time of operation through the exact evaluation of the factors which influencing the end result such as age of the patient, level and type of injury, extent of nerve lesion and the associated tissue injury, good result could be expected.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.191-195
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• 2000

Background: Vascular occlusive event is one of the etiologies of sudden sensorineural hearing loss (SNHL). Stellate ganglion block (SGB) induces dramatic and intense vasodilatation in head and neck. Based on this principle, SGB has used as one of the treatment modalities in SNHL. This study was performed to evaluate immediate response of SGB on pure tone audiogram (PTA) in SNHL. Methods: Forty patients were studied. Each patient received daily ipsilateral SGB in paratracheal approach using 0.2% bupivacaine for 2 weeks. On first, third, and fifth day of treatment, we checked their PTA twice 1 hour before (Pre-PTA) and after (Post-PTA) SGB. Pre- and Post-PTA were compared. Several factors were analyzed as a prognostic factor of therapeutic results. Results: Eleven of 40 patients revealed decreased PTA after SGB. Degree of decreased PTA were insignificant ($2.5{\pm}1.6$ dB). Initial and final PTA results was $76.2{\pm}22.5$ and $49.8{\pm}28.3$ dB, respectively. Thirty-one of 40 patients were improved their PTA over 10 dB. The recovery was mainly influenced by the severity of initial hearing loss (P<0.001) and slightly by age (P<0.05). However, the change of PTA after SGB, time interval to receive SGB, sex, site, and number of SGB were not correlated to therapeutic outcome. Conclusions: These results suggest that vasodilatation by SGB has no immediate improvement in SNHL. Therefore, we question whether SGB is beneficial to all patients with SNHL as a therapeutic modality.

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.203-209
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• 2000

Objective : The authors retrospectively analysed the factors affecting the favorable outcomes in the treatment of the Failed Back Surgery Syndrome(FBSS) or six years. Method : From March 1991 to December 1996, seventy-five patients were diagnosed as FBSS and its incidence was 3.4% of admitted patients with back pain in our department. We analysed the demographic data, etiologies, clinical menifestations, outcomes according to methods of operation, numbers of previous surgery, and time intervals between initial operation and final operation. Result : The most common etiology and previous surgical method of FBSS were insufficient surgery(54.7%) and partial laminectomy(53.3%). Patients were managed as followings ; Total laminectomy and spinal fusion with instrument in 41 cases(54.7%), total laminectomy without fusion in 23 cases(30.7%), and only partial laminectomy in 11 cases(14.7%). The overall treatment outcome was satisfactory in 48 cases(64%). Satisfactory results were observed in those patients who were treated by spinal fusion after complete laminectomy(34 cases), who had underwent only one operation previously(45 cases), and when the time interval between the initial operation and reoperation is shorter than 12 months(43 cases). Conclusion : The treatment outcome in FBSS was favorable in cases of the complete total laminectomy and spinal fusion with instrument, only one previous back surgery, and short time interval between initial and final operations.

• Journal of Chest Surgery
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• v.46 no.2
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• pp.130-134
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• 2013

Background: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. Materials and Methods: Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded. Results: There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22). Conclusion: The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly.

• Korean Journal of Clinical Laboratory Science
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• v.43 no.4
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• pp.145-149
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• 2011

Serum hepatitis is still recognized as a major public health problem in many countries. The most common etiologies are acute viral hepatitis A and B, and hepatitis B virus (HBV) was known as the pathogen of serum hepatitis. since the HBV causes chronic hepatitis. HBV infection is hyperendemic in Korea. It is known that 8% and 1% of the Korean population is chronic carriers of HBV. The total number of 487 serum specimen (old people's home 190, causal ward-Daegu hope village 297) were collected at the laboratory of Department of Clinical Pathology of Daegu medical center. The laboratory tested the specimen to detect for hepatitis B surface antigen (HBsAg) and anti-HBs using reverse passive hemag-glutination (RPHA) and passive hemagglutination (PHA) method between April, 2011 and June, 2011. In one-step test, HBsAg and anti-HBs of Humasis were used. The positive rate for HBsAg was 6.80% (33/487), and the rate in male was 6.93% (19/274) higher than that of female 6.57% (14/213). In the positive rate of HBsAg by age group, the highest positive rate group was in the group of 40-49 years in male (12.0%), and 50-59 years in female (17.65 %). The overall positive rate for anti-HBs was 42.70% (208/487), showing the higher positive rate of 43.80% in male (120/274) than that of 41.30% (88/213) in female. The highest positive rate of anti-HBs in age group was the 40-49 years group in male (52.00%) and the group of under 29 in female (66.67%).

• The Korean Journal of Pain
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• v.29 no.1
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• pp.23-28
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• 2016

Background: Sacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode ($Interstim^{(R)}$, Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration. Methods: We present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary. Results: Our experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration. Conclusions: The caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.782-786
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• 2008

Dissection intramural hematoma of the esophagus (DIHO) is a rare, but well-documented condition that is part of the spectrum of, acute esophageal injuries; these include the more common Mallory-Weiss tear and Boerhaave's syndrome. This disorder is predominantly seen in women during their sixth or seventh decade and the disease has various etiologies, but the pathogenesis has yet to be clarified. The triad of symptoms for this disorder includes retrosternal pain, hematemesis and odynophagia. It is important to differentiate esophageal submucosal dissection form other disorders that have a similar appearance, such as Mallory-Weiss syndrome and esophageal perforation because the prognosis of DIHO is excellent with conservative therapy and these other diseases require surgical treatment. We report here on a case of a dissecting intramural hematoma of the esophagus that was preoperatively misdiagnosed as the submucosal tumor of the esophagus preoperatively, and it was confirmed by Video-assisted thoracic surgery.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.239-246
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• 1999

Hyperhomocysteinemia is an independent risk factor for cardiovascular, cerebrovascular and peripheral vascular diseases complicated with atherosclerosis and thromboembolism. Increased plasma homocystein level develops from genetic defect of enzyme for homocystein metabolism or vitamine deficiency, has direct toxic effect for vascular endothelium and makes damages to antithrombotic action of vascular endothelial cell. Most of hyperhomocysteinemia is asymptomatic, but rarely develops cardiopulmonary or cerebrovascular accidents. In case of thromboembolism with unknown cause, the hyperhomocysteinemia should be considered as one of the many etiologies. The authors, first in korea, report a case of multiple thromboembolisms of deep vein of lower extremity, pulmonary vessels, superior sagittal and transverse sinus of brain in a patient with the hyperhomocysteinemia with a review of literature.

• Journal of Oral Medicine and Pain
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• v.38 no.3
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• pp.255-260
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• 2013

Bilateral sagittal split ramus osteotomy(BSSRO) of the mandible is an essential and commonly used procedure to correct dentofacial deformities and malocclusion. The possible complications associated with BSSRO include inferior alveolar nerve injury, bleeding, temporomandibular disorder, unfavorable fractures, and clinical relapse. The incidence of facial nerve palsy after orthognathic surgery recently reported is 0.1%. The probable etiologies have included facial nerve compression, complete or incomplete nerve transection, nerve traction, and nerve ischemia from anesthetic injection. Postoperative facial palsy is one of the most serious complications because it reduces the quality of life and significantly reduces social interaction. The case of a 24-year-old patient who underwent bilateral sagittal split ramus osteotomy is described. The medical records and postoperative photographs were reviewed in detail to collect information on the clinical course, treatment, and outcomes.

• Tuberculosis and Respiratory Diseases
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• v.53 no.4
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• pp.450-456
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• 2002

Idiopathic tracheal stenosis is a type of benign stenosis that possesses specific characteristics but is of unknown origin. It is a rare disease characterized by extensive fibrosis of a portion of trachea, and predominantly found in women. The lesion presents as circumferential fibrotic stenosis that usually occurs at upper trachea and the subglottic larynx, but lower trachea may also be involved. Diagnosis is made from the clinical characteristics accompanide by compatible pathologic features and by exclusion of other etiologies. Conservative management such as laser resection, dilatation and stent insertion can be tried initially, but surgical resection is recommended for definitive treatment due to frequent restenosis and maintenance problems of conservative approach. We report a case of idiopathic tracheal stenosis treated with tracheal resection and anastomosis followed by insertion of a retrievable stent for immediate relief of airway obstruction.