• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.590-597
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• 2020

Objective : Covered stenting is an optional strategy for traumatic carotid pseudoaneurysm, especially in malignant conditions of potential rupture, but the long-term outcomes are not clear. Our aim was to determine if covered stenting is an effective option for traumatic carotid pseudoaneurysm with promising long-term outcomes. Methods : Self-expanding Viabahn and balloon-expandable Willis covered stents were separately implanted for extra- and intracranial traumatic carotid pseudoaneurysm. The covered stent was placed across the distal and proximal pseudoaneurysm leakage under roadmap guidance. Procedural success was defined as technical success (complete exclusion of the pseudoaneurysm and patency of the parent artery) without a primary end point (any stroke or death within 30 days after the procedure). Long-term outcomes were evaluated as ischemic stroke in the territory of the qualifying artery by clinical follow-up through outpatient or telephone consultation and as the exclusion of the pseudoaneurysm and patency of the parent artery by imaging follow-up through angiography. Results : Five patients with traumatic carotid pseudoaneurysm who underwent covered stenting were enrolled. The procedural success rate was 100%. No ischemic stroke in the territory of the qualifying artery was recorded in any of the five patients during a mean clinical follow-up of 44±16 months. Complete exclusion of the pseudoaneurysm and patency of the parent artery were maintained in all five patients during a mean imaging follow-up of 39±16 months. Conclusion : Satisfactory procedural and long-term outcomes were obtained, suggesting that covered stenting is an effective option for traumatic carotid pseudoaneurysm.

• 대한두개안면성형외과학회지
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• 제11권1호
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• pp.1-6
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• 2010

Purpose: Many surgical approaches for reconstruction of blow out fracture have been introduced, which include subciliary incision, transconjunctival incision and transcaruncular incision. Recently endoscopic approach has been attempted. This study was intended to show the effectiveness of the approach through transconjunctival incision combined with transnasal reduction in reconstructing blow out fracture to its original position. Methods: Medical recoreds of 43 patients from March 2008 to March 2009 who underwent surgery for orbital fracture were reviewed, retrospectively. All fractures were operated through transconjuctival incision approach combined with transnasal reduction. The average follow-up period was 10.1 months. To evaluate the surgical outcomes of orbital fracture, we performed CT of the facial bone before and after the surgery. In addition, preoperative and postoperative data of enophthalmos, diplopia and the limitation of extraocular motion was assessed with physical examination. Results: Post-operative CT scan of 43 patients assured that the bone fragments of the orbital fractures were restored to their original positions. Although a few patients developed postoperative transient diplopia or impairment of ocular movement, most of the patients recovered during the follow-up period without complication. Conclusion: From this study, we were able to demonstrate the effectiveness of the transnsasal reduction technique combined with the approach through transconjunctival incision. This technique can be considered as very useful means of repairing orbital fracture. It is not only easy to perform but also it can minimize the damage to the orbital bone. Furthermore, it can restore the fracture to its original position as much as possible.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.195-200
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• 2011

Objective : To present the profiles of spinal cord tumors that can be removed through a unilateral hemilaminectomy and to demonstrate its usefulness for benign spinal cord tumors that significantly occupy the spinal canal. Methods : From June 2004 to October 2010, 25 spinal cord tumors were approached with unilateral hemilaminectomy. We calculated the cross-sectional occupying ratio (CSOR) of tumor to spinal canal before and after the operations. Results : The locations of the tumors were intradural extramedullary in 20 cases, extradural in 2, and intramedullary in 3. The levels of the tumors were lumbar in 12, thoracic 9, and cervical 4. In all cases, the tumor was removed grossly and totally without damaging spinal cord or roots. The mean height and width of the lesions we195re 17.64 mm (3-47.5) and 12.62 mm (4-32.7), respectively. The mean CSOR was 69.40% (range, 27.8-96.9%). Postoperative neurological status showed improvement in all patients except one whose neurologic deficit remained unchanged. Postoperative spinal stability was preserved during the follow-up period (mean, 21.5 months) in all cases. Tumor recurrence did not develop during the follow-up period. Conclusion : Unilateral hemilaminectomy combined with microsurgical technique provides sufficient space for the removal of diverse spinal cord tumors. The basic profiles of the spinal cord tumors which can be removed through the unilateral hemilaminectomy demonstrate its role for the surgery of the benign spinal cord tumors in various sizes.

• 환경위생공학
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• 제23권3호
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• pp.59-71
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• 2008

In this study, we intend to present the uncontrolled landfill maintenance plans by diversely reviewing the operating conditions of landfill and environmental effects and economical issues resulted from the operation of landfill for the purpose of suggesting the optimal maintenance plans applicable to the uncontrolled landfill and unused landfill located in Korea. We perform the basic and precise surveys against three landfill sites showing the biggest problem out of 8 unsanitary landfills sites located in Y County. We compare and review the treatment plans prepared and operated by the N Landfill. The compared and reviewed results show that the local stabilization plan is more effective than the excavation and transfer treatment plan when considering the economic efficiency only. However, the excavation and transfer treatment plan is valid when considering the diverse elements. The G Landfill is operated with separated into living waste landfill section and construction waste landfill section. However, some landfill gas collection bores or holes are installed in its living waste landfill section, which has not been used for about 20 years, as a part of follow-up control. The element causing the environmental damage is considerably reduced in its living waste landfill section. However, the effort to keep the follow-up control through the local stabilization work is required. The landfill is under processing in the construction waste landfill section. However, most of buried wastes are the inorganic wastes such as waste materials and concrete, so the maintenance plan focused on the use of top land by installing the local stabilization facilities is considered as an effective plan. The landfill is under processing in the K Landfill. It seems to be difficult to maintain this landfill through the local stabilization. The excavation and transfer treatment plan to completely remove the potential environmental pollution source is considered as the valid plan.

• 한국운동역학회지
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• 제13권2호
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• pp.65-74
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• 2003

The purpose of this study was to analyze kinematic variables in the badminton smash motion through 3-dimensional image analysis. The kinematic variables were velocity of joints in upper limbs, the angle of wrist in the impact, and the angular velocity of the top of racket head. The smash motions of four male badminton players in H University and four male students at department of the physical education in K University who were not majoring in badminton were analyzed kinematically and the attained conclusions were as follow. 1. The velocity of segments in upper limbs of the unskilled group was faster than that of the skilled group. The movement pattern was fast back swing-slow impact moment-fast fellow through in the unskilled group, but slow back swing-fast impact moment-slow follow through in the sullied group. 2. As the BS phases, the velocity of segment in right shoulder was different significantly between groups. Right elbow and right wrist segments, velocity of racket head was different significantly between groups(p<.05) by IP phases. As the FT phases, there was no significant difference. 3. The angle of right wrist at the impact, the angle of palm flexion and the angle of palm flexion in aspect were shown that the skilled group was higher than unskilled group. There was no significant difference. 4. The velocity of racket head was shown that the unskilled group has fast velocity, but the angle velocity was shown the unskilled group has slow. 5. The angle velocity of racket head in aspect were no significant difference between groups, but maximal angle velocity was different significantly between groups(p<.05).

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.109-113
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• 2018

A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.61-70
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• 2019

Objective : Corpectomy of the first lumbar vertebra (L1) for the management of different L1 pathologies can be performed using either an anterior or posterior approach. The aim of this study was to evaluate the usefulness of a retroperitoneal extrapleural approach through the twelfth rib for performing L1 corpectomy. Methods : Thirty consecutive patients underwent L1 corpectomy between 2010 and 2016. The retroperitoneal extrapleural approach through the 12th rib was used in all cases to perform single-stage anterior L1 corpectomy, reconstruction and anterior instrumentation, except for in two recurrent cases in which posterior fixation was added. Visual analogue scale (VAS) was used for pain intensity measurement and ASIA impairment scale for neurological assessment. The mean follow-up period was 14.5 months. Results : The sample included 18 males and 12 females, and the mean age was 40.3 years. Twenty patients (67%) had sensory or motor deficits before the surgery. The pathologies encountered included traumatic fracture in 12 cases, osteoporotic fracture in four cases, tumor in eight cases and spinal infection in the remaining six cases. The surgeries were performed from the left side, except in two cases. There was significant improvement of back pain and radicular pain as recorded by VAS. One patient exhibited postoperative neurological deterioration due to bone graft dislodgement. All patients with deficits at least partially improved after the surgery. During the follow-up, no hardware failures or losses of correction were detected. Conclusion : The retroperitoneal extrapleural approach through the 12th rib is a feasible approach for L1 corpectomy that can combine adequate decompression of the dural sac with effective biomechanical restoration of the compromised anterior loadbearing column. It is associated with less pulmonary complication, no need for chest tube, no abdominal distention and rapid recovery compared with other approaches.

• Journal of Chest Surgery
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• 제56권1호
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• pp.42-48
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• 2023

Background: With recent advances in cardiac surgery through minimal access, mini-thoracotomy has emerged as an excellent alternative for cardiac myxoma resection. This study analyzed the surgical results of this approach, focusing on postoperative cerebral embolism and tumor recurrence. Methods: We retrospectively reviewed 64 patients (mean age, 56.0±12.1 years; 40 women) who underwent myxoma resection through mini-thoracotomy from October 2008 to July 2020. We conducted femoral cannulation and antegrade cardioplegic arrest in all patients. Patient characteristics and perioperative data, including brain diffusion-weighted magnetic resonance imaging (DWI) findings, were collected. Medium-term echocardiographic follow-up was performed. Results: Thirteen patients (20.3%) had a history of preoperative stroke, and 7 (11.7%) had dyspnea with New York Heart Association functional class III or IV. Sixty-one cases (95.3%) had myxomas in the left atrium. The mean cardiopulmonary bypass and cardiac ischemic times were 69.0±28.6 and 34.1±15.0 minutes, respectively. Sternotomy conversion was not performed in any case, and 50 patients (78.1%) were extubated in the operating room. No early mortality or postoperative clinical stroke occurred. Postoperative DWI was performed in 32 (53%) patients, and 7 (22%) showed silent cerebral embolisms. One patient underwent reoperation for tumor recurrence during the study period; in that patient, a genetic study confirmed the Carney complex. Conclusion: Mini-thoracotomy for cardiac myxoma resection showed acceptable clinical and neurological outcomes. In the medium-term echocardiographic follow-up, reliable resection was proven, with few recurrences. This approach is a promising alternative for cardiac myxoma resection.

• 한국운동역학회지
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• 제17권2호
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• pp.145-156
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• 2007

The purposes of this study were to investigate kinematic parameters of racket head and upper extremities during squash back hand stroke and to provide quantitative data to the players. Five Korean elite male players were used as subjects in this study. To find out the swing motion of the players, the land-markers were attached to the segments of upper limb and 3-D motion analysis was performed. Orientation angles were also computed for angular movement of each segment. The results were as follows. 1) the average time of the back hand swing (downswing + follow-through) was 0.39s (0.24 s + 0.15 s). 2) for each event, the average racket velocity at impact was 11.17m/s and the velocity at the end of swing was 8.03m/s, which was the fastest swing speed after impact. Also, for each phase, 5.10m/s was found in down swing but 7.68m/s was found in follow-through. Racket swing speed was fastest after the impact but the swing speed was reduced in the follow-through phase. 3) in records of average of joints angle, shoulder angle was defined as the relative angle to the body. 1.04rad was found at end of back swing, 1.75rad at impact and it changes to 2.35 rad at the end of swing. Elbow angle was defined as the relative angle of forearm to upper arm. 1.73rad was found at top of backswing, 2.79rad at impact, and the angle was changed to 2.55rad at end of swing. Wrist angle was defined as the relative angle of hand to forearm. 2.48rad was found at top of backswing, 2.86rad at impact, and the angle changes to 1.96rad at end of swing. As a result, if the ball is to fly in the fastest speed, the body has to move in the order of trunk, shoulder, elbow and wrist (from proximal segment to distal segment). Thus, the flexibility of the wrist can be very important factor to increase ball speed as the last action of strong impact. In conclusion, the movement in order of the shoulder, elbow and the wrist decided the racket head speed and the standard deviations were increased as the motion was transferred from proximal to the distal segment due to the personal difference of swing arc. In particular, the use of wrist (snap) may change the output dramatically. Therefore, it was concluded that the flexible wrist movement in squash was very important factor to determine the direction and spin of the ball.

• Radiation Oncology Journal
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• 제10권1호
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• pp.21-26
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• 1992

가톨릭의대 강남성모병원 치료방사선과에서는 1988년 7월부터 1991년 11월 사이 40개월 동안에 26명의 수술 불가능한 뇌동정맥기형 환자에 대하여 6 MV선형가속기를 이용하여 뇌정위다방향 단일 방사선치료를 실시하였다. 환자연령은 6세부터 63세였고(중앙값 29세), 남녀의 비는 21:5였다. 치료 종료 후 추적기간은 4개월$\~$40개월 간이었다(중앙값 15개월). 뇌동정맥기형의 크기는 직경 1 cm부터 $43cm^3$까지였으며 환자 연영, 병소의 크기 및 뇌내 위치에 따라 4$\~$7회의 부분회전 조사를 실시하여 15$\~$30 Gy를 단일 조사하였다. 모든 환자는 임상적 그리고 CT또는 MRI나 뇌혈관조영술을 병행하여 방사선치료 전 및 후 6개월간격으로 뇌동정맥기형의 크기변화를 추적 분석하였다. 2년 이상된 예의 추적 검사를 분석한 결과 완전 관해 6($23\%$), 부분관해 8($31\%$), 무변화 1($4\%$)명 씩으로 분석되었다. 11($42\%$)명은 방사선치료한지 1년 미만의 무반응군으로 간주되었다. 이상으로 치료후 2년째 반응율은 $54\%$(14예)였다. 치료에 따른 부작용은 아직 관찰되지 않았다.