• Archives of Plastic Surgery
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• v.36 no.3
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• pp.344-347
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• 2009

Purpose: Malignant soft tissue tumors, known as sarcomas, are well known to be locally aggressive, frequently metastatic, and highly recurrent. In other hands, intermediate soft tissue tumors often recur locally with adjacent tissue infiltration so the clinical management is difficult as sarcoma. In the present study, we evaluate the clinical course of the intermediate soft tissue tumors and consider the management plan for those. Methods: From March, 1998 to April 2008, total 3 patients of intermediate soft tissue tumors underwent operations. A patient with fibrohistiocytic neoplasm, a free flap reconstruction was performed, and he underwent several more operations because of recurrences. Other patients with desmoids - type fibromatosis showed local invasion and adhesion, and one of them underwent reoperation due to local recurrence. Results: 2 of 3 patients underwent recurrences of tumors and reoperations were performed. In another patient with no recurrence, follow-up period was just 5 months, so there may be recurrence of tumor in long term follow-up. Conclusion: The clinical course of intermediate soft tissue tumors shows high recurrence rate. So clinically, intermediate soft tissue tumors should be considered as sarcomas. The successful management requires wide resection, carefully planned reconstruction, and close follow up with radiologic evaluation.

• Journal of Korean Neurosurgical Society
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• v.38 no.2
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• pp.111-115
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• 2005

Objective : Upper lumbar disc herniation is rare disease, compared with lower. The lamina of this high level lumbar vertebra is narrower than that of low level, and this have taken surgeon into important consideration for surgical methods because partial removal of lamina for discectomy weakens the base of the articular process and may result in fracture. The authors an accurate preoperative diagnosis that enables the surgeon to operative approach for preserving the facet joint. Methods : Thirteen patients with upper lumbar disc herniation have underone surgical procedure by midline approach for removal of ruptured disc fragment and paraspinal approach for removal of residual disc materials simultaneously without instrumentation. All patients who underwent surgery were analyzed and long-term follow-up was conducted. Results : At a mean follow-up of 24months, there were complete resolution of presenting radiating leg pain in 85% of the patients, 7.5% were left with minimal residual discomfort, and 7.5% derived little or no benefit from surgery. The follow-up radiologic findings of all patients shows that lamina and facet joint have preserved safely and no instability. Conclusion : Simultaneously, paraspinal with midline approach provides highly satisfactory operating methods by simplifying exposure and greatly limiting the risk of complications. This provides the basis for a planned surgical approach in which destruction of the facet joint can be avoided.

• Advances in pediatric surgery
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• v.17 no.1
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• pp.58-64
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• 2011

Minimally invasive techniques for pediatric inguinal hernia repair have been evolving in recent years. We applied the laparoscopic method to repair pediatric inguinal hernia using the techniques of sac transection and intra-corporeal ligation. Between November 2008 and August 2010, 67 pediatric patients (47 boys and 20 girls) with inguinal hernias were included in this study. Postoperative activities, pain, and complication were checked prospectively at regular follow-up. One patient presented with clinically bilateral hernia, and three patients had metachronous hernias. Thirty-two cases out of 63 patients with unilateral hernias had a patent processus vaginalis on the contralateral side. Mean operation time was $35{\pm}11.4$ minutes for unilateral hernias and $43{\pm}11$ minutes for bilateral hernias. There were no intra-operative complications. One patient had a small hematoma on the groin postoperatively, which subsided spontaneously in a week. Recurrence and metachronous hernia were not found at follow up. In summary, laparoscopic inguinal repair in children is safe, easy to perform and has an additional advantage of contralateral exploration. Further studies should include long term follow-up.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.108-114
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• 2001

Objective : Posterior lumbar interbody fusion(PLIF) provides the favorable outcome to degenerative lumbar disease, especially isthmic spondylolisthesis. To determine the long-term effect of PLIF using psterior movable segment, we analysed the results of follow-up radiologic changes and surgical outcome retrospectively Patients and Method : During the past 11 years(1989. 1.-1999. 9.), 148 patients with symptomatic lumbar spondylolisthesis were managed at our department and the clinical wants were throughly recieved and final outcome is determined at last follow up. PLIF using antogenous bone(posterior movable segment, iliac bone and rib) were performed in 106 case. Results : After an average follow-up period of 33 months(range ; 15-58 months), the results were excellent in 66 cases, good in 37 cases, fair in 2 cases and poor in 1 cases. And the satisfactory results were 103 cases(98.2%) in PLIF,. Conclusion : In conclusion, patients who underwent PLIF with autologous bone graft had good clinical and radiological outcomes without significant neurological complications.

• Clinics in Shoulder and Elbow
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• v.22 no.2
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• pp.100-105
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• 2019

Suture anchors are commonly used in shoulder surgeries, especially for rotator cuff tears. Peri-anchor cyst formation, however, is sometimes detected on follow-up radiologic image after surgery. The purpose of this report is to discuss the case of a patient who presented with regression of extensive peri-anchor cyst on postoperative 4-year follow-up magnetic resonance imaging and had good clinical outcome despite peri-anchor cyst formation after arthroscopic rotator cuff repair.

• Korean Journal of Radiology
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• v.2 no.3
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• pp.164-170
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• 2001

Objective: To evaluate the technical feasibility and the clinical effectiveness of sclerotherapy for the treatment of peritoneal inclusion cysts (PICs). Materials and Methods: Between June 1996 and February 2001, eight PICs in seven female patients aged 28-43 (mean, 36) years were instilled with sclerosant (povidone-iodine in three, ethanol in three, both povidone-iodine and ethanol in one). All seven patients subsequently experienced less abdominal pain. After drainage via an 8.5-Fr pigtail catheter inserted in the PICs (transabdominally in six cases, transvaginally in one), sclerosant equivalent in volume to about one-third that of drained fluid was introduced daily until the drained volume was less than 5ml. Follow-up by means of clinical procedures and ultrasound was performed every three months, at which time the success rate, possible complications and recurrence were determined. Results: Sclerotherapy was technically successful in all seven patients, though immediately after the procedure, minor complications were noted in three patients (mild pain in two, mild fever in one). During the follow-up of 4-60 (mean, 24.7) months, sclerotherapy proved successful and without long-term complications in all seven patients: lower abdominal pain disappeared and the diameter of the cysts decreased more than 50%, with complete regression in four cases. During the follow-up period there was no recurrence. Conclusion: Sclerotherapy following catheter insertion is technically feasible and effective for the treatment of PICs.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.483-486
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• 2012

Background: The hepatocellular carcinoma is very common in China. Our aim in this report was to investigate clinical and pathological factors based on the current decade data that could influence prognosis of HCC patients after hepatectomy. Methods: Between 2002 and 2009, all patients undergoing hepatectomy for HCC were followed up and reviewed retrospectively. Prognostic factors were studied by univariate and multivariate analysis, with Kaplan-Meier and Cox multivariate survival analyses. Results: Complete clinicopathologic and follow-up data were available for 114 patients. The estimated cumulative survival rates at 1, 3, and 5 yr were 84.6%, 60.2% and 51.8%, respectively. On univariate analysis, key prognostic factors were AFP level, GGT level, tumor size, number of tumors, portal vein invasion, liver cirrhosis status and TNM stage. In the multivariate analysis, tumor size, GGT level, liver cirrhosis status and portal vein invasion were significantly associated with patients' prognosis. Conclusion: Through follow-up of a relatively large cohort of Chinese patients, tumor size, GGT level, liver cirrhosis status, portal vein invasion were revealed as important factors for long-term survival after hepatectomy. Early diagnosis for tumor and the improvement of liver function before surgery are important ways to improve the prognosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.2
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• pp.224-235
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• 1996

Early implantation before sufficient ossification has taken place usually results in osseointegartion failure due to reduced bone-fixture interface area. However, various studies have shown successful osseointegration results following immediate implants concurrently with GTR. The clinical trends have been to shorten the patients' edentulous state by immediate implantation, and reduce the alveolar bone resorption. However, it may be difficult to attain the complete soft tissue coverage of the sites, increasing the chance of infection. Furthermore, there may be more studies needed on the clinical behaviors of e-PTFE membranes, various modofications in the membrane materials and bone graft materials. Various animal and clinical studies have been reported on the successful osseointagration following immediate implantation, but the long-term follow-up studies are limited. The present study investigated 16 immediately-implanted implants with GTR therapy with or without calcium carbonate grafting on 11 patients 3 years after installation and 24-30 months after functional loading. Based on the clinical, radiographic and histologic findings, the following results have been attained. 1. Clinically, stability has been shown on all 16 implants throughout the investigated periods. 2. Radiologically, the alveolar bone loss has progressed up to the polished neck portion but not beyond it, suggesting the progressive osseointegration from the GTR therapy. 3. The GTR method used in the present study is easy to use clinically, and may be appied in the regeneration of ossoeous defects around implants and in the immediate implantation. 4. The difficulty in complete tissue coverage may be avoided by delaying the installation for 2 to 3 weeks after the extraction allowing certain degree of soft tissue healing.

• Journal of Chest Surgery
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• v.26 no.9
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• pp.677-685
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• 1993

Experience with bileaflet mechanical valve replacement at the Inha Hospital in 192 patients, operated on from June 1986 until April 1993. Two hundred fourty-one prostheses [51 Duromedics, 79 St.Jude Medical, and 111 CafboMedics]were implanted during the total 195 operations. Mitral valve replacment[MVR]was done in 113 cases, aortic valve replacement[AVR]in 34, tricuspid valve replacement[TVR]in 2, and double valve replacement[DVR]in 46 cases.Of the total patients, 63.0% were women and 37.0% were men. The mean age of the patients was 40.8 years, ranged from 14 to 67years. Overall early mortality was 9.2\ulcorner%[18 out of 195]; 9.7%[11 out of 113]for MVR, 14,7% [5 out of 34]for AVR, and 4.3%[2 out of 46]for DVR. All of the operative survors were followed over a period of one to 83 months with a mean of 37 months, for total 543 patient-years. So far, eleven patients[6.7% of the long-term survivors]were lost to follov-up after a mean postoperative follow-up of 22.8 months. There were nine late deaths; three deaths due to prostetic valve endocarditis, two due to persistent heart failure, one due to cerebral hemorrhage, one due to aortic dissection after Bentall oreration, and two sudden deaths. Actuarial survival rate at 6.9 years was 94.8%, There were seventeen valve-related complications; three prosthetic valve thromboses, three thrombembolisms, three instances of prosthetic valve endocarditis, two paravalvular leakages, and six hemorrhagic complications related to anticoagulation. The actuarial rate of freedom from all valve-related complications at 6.9years was 91.3%. There were significant decreases in the heart size postoperatively that can be demonstrated by comparison of cardio-thoracic ratios on simple chest X-ray and left ventricle dimensions on echocardiography. We conclude that this midterm follow-up shows good results in terms of hemodynamics and durability although further long-term evaluations are mandatory.

• Journal of Chest Surgery
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• v.49 no.4
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• pp.264-272
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• 2016

Background: We analyzed the long-term results of ascending aortic replacement and arch aortic replacement in acute DeBakey type I aortic dissections to measure the differences in the distal aortic changes with extension of the aortic replacement. Methods: We reviewed 142 cases of acute DeBakey type I aortic dissections (1996-2015). Seventy percent of the cases were ascending aortic replacements, and 3 0% of the cases underwent total arch aortic replacement, which includes the aorta from the root to the beginning of the descending aorta with the 3 arch branches. Fourteen percent (20 cases) resulted in surgical mortality and 86% of cases that survived had a mean follow-up period of $6.6{\pm}4.6years$. Among these cases, 64% of the patients were followed up with computed tomography (CT) angiograms with the duration of the final CT check period of $4.9{\pm}2.9years$. Results: There were 15 cases of reoperation in 13 patients. Of these 15 cases, 13 cases were in the ascending aortic replacement group and 2 cases were in the total arch aortic replacement group. Late mortality occurred in 13 cases; 10 cases were in the ascending aortic replacement group and 3 cases were in the total arch aortic replacement group. Eight patients died of a distal aortic problem in the ascending aortic replacement group, and 1 patient died of distal aortic rupture in the total arch aortic replacement group. The follow-up CT angiogram showed that 69.8% of the ascending aortic replacement group and 35.7% of the total arch aortic replacement group developed distal aortic dilatation (p=0.0022). Conclusion: The total arch aortic replacement procedure developed fewer distal remnant aortic problems from dilatation than the ascending aortic replacement procedure in acute type I aortic dissections.