• Title/Summary/Keyword: Long-term follow-up

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Long-term Outcome after Surgery for Biliary Atresia (Study of 10 patients surviving more than 10 years) (담도 폐쇄증으로 Kasai 수술 받은 환아들의 장기간의 추적관찰 (10년 이상 생존한 환아들을 대상으로))

  • Rhim, Si-Youn;Jung, Poong-Man
    • Advances in pediatric surgery
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    • v.13 no.1
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    • pp.1-12
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    • 2007
  • Biliary atresia (BA) is the result of fibrosing destructive inflammatory process affecting intrahepatic and extrahepatic bile ducts, which lead to cirrhosis and portal hypertension. Kasai portoenterostomy has been the standard operative procedure in biliary atresia. Recently, there has been remarkable increase in the survival rate in cases of BA. However, long-term survivors are not clearly evaluated in Korea. To define long-term prognosis factors of patients who underwent surgery for BA, a retrospective study was undertaken of 10 (37 %) patients surviving more than 10 years among 27 patients who underwent one of Kasai procedures between 1981 and 1995. Hepatomegaly was present in 4 and splenomegaly in 7 patients. Serum bilirubin was normalized at 1 year after operation. Aspartate aminotransferase (AST, GOT), Alanine aminotransferase(ALT, GPT) were normalized at 12 years and alkaline phosphatase(ALP) was normalized at 13.5 years. Cholangitis developed mainly within 5 years after operation so close follow up is needed. Life long follow-up is needed because of progressive deterioration of liver function even after 10 years.

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Long Term Follow Up of Surgical Treatment of Axillary Osmidrosis and Hyperhidrosis by Instrumental Shaving and Manual Shaving (Instrumental Shaving과 Manual Shaving을 병용한 액와부 액취증 및 다한증의 수술적 치료 후 장기 추적관찰)

  • Kim, Ki Yup;Cho, Sung Duck
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.709-715
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    • 2008
  • Purpose: Axillary osmidrosis is caused by excessive apocrine gland secretion, which causes an unpleasant odor. Axillary osmidrosis causes difficulty in social activities and personal handicap. We studied the long term follow up results of our surgical procedures and sought to find a best surgical treatment methods. Methods: From January 1991 to December 2006, a total of 1864 patients(587 men, 1277 women) had been treated with this procedure for axillary osmidrosis and hyperhidrosis. Follow up periods varied from 10 to 15 years. We used the subdermal excision technique, using two small incisions over the axilary folds and using a Kawata dissector(instrumental shaving) and additional manual subdermal excision(manual shaving). Results: Among the total patients, 782 patients were followed up. Except a pure hyperhidrosis patients, 759 osmidrosis patients was included. 588 patients(77.4%) had a good results, 148 patients(19.5%) had a moderate results and 23 patients(3.1%) had a recurrence. Complication developed in 189 patients(10.1%): hematoma or seroma in 25 patients, wound dehiscence in 86 patients, partial skin necrosis in 45 patients, and infection in 28 patients. Conclusion: We conclude that our method has several advantages such as 1) short operation time, 2) minimal scaring, 3) lower complication rates, 4) high satisfactory rates.

Covered Stenting Is an Effective Option for Traumatic Carotid Pseudoaneurysm with Promising Long-Term Outcome

  • Wang, Kai;Peng, Xiao-xin;Liu, Ao-fei;Zhang, Ying-ying;Lv, Jin;Xiang, Li;Liu, Yun-e;Jiang, Wei-jian
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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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.

Long-Term Follow-Up Results of Anterior Cervical Inter-Body Fusion with Stand-Alone Cages

  • Kim, Woong-Beom;Hyun, Seung-Jae;Choi, Hoyong;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.385-391
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    • 2016
  • Objective : The purpose of this study was to evaluate long-term follow-up radiologic/clinical outcomes of patients who underwent anterior cervical discectomy and inter-body fusion (ACDF) with stand-alone cages (SAC) in a single academic institution. Methods : Total 99 patients who underwent ACDF with SAC between February 2004 and December 2012 were evaluated retrospectively. A total of 131 segments were enrolled in this study. Basic demographic information, radiographic [segmental subsidence rate, fusion rate, C2-7 global angle, and segmental angle changes)/clinical outcomes (by Odom's criteria and visual analog score (VAS)] and complications were evaluated to determine the long-term outcomes. Results : The majority were males (55 vs. 44) with average age of 53.2. Mean follow-up period was 62.9 months. The segmental subsidence rate was 53.4% and fusion rate was 73.3%. In the subsidence group, anterior intervertebral height (AIH) had more tendency of subsiding than middle or posterior intervertebral height (p=0.01). The segmental angle led kyphotic change related to the subsidence of the AIH. Adjacent segmental disease was occurred in 18 (18.2%) patients. Total 6 (6%) reoperations were performed at the index level. There was no statistical significance between clinical and radiological outcomes. But, overall long-term clinical outcome by Odom's criteria was unsatisfactory (64.64%). The neck and arm VAS score were increased by over time. Conclusion : Long-term outcomes of ACDF with SAC group were acceptable but not satisfactory. For optimal decision making, more additional comparative long-term outcome data is needed between ACDF with SAC and ACDF with plating.

A Follow-up Study of Clinical Characteristics of Recurrent Aphthous Stomatitis Patients Treated with Herbal Medicine (한약 치료를 시행한 재발성 아프타성 구내염 환자의 임상소견에 관한 추적 관찰 연구)

  • Ha, Na-yeon;Lee, Jae-hyung;Lee, Jung-eun;Nam, Seong-uk;Ko, Whee-hyoung;Hwang, Mi-ni;Kim, Jin-sung
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.812-819
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    • 2017
  • Objectives: The purpose of this study was to report the long-term efficacy of herbal medicine for treatment of patients with recurrent aphthous stomatitis (RAS). Methods: We reviewed the clinical records of 17 patients with RAS who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from September 1st, 2014 to August 29th, 2017. The patients were treated with herbal medicine for more than 3 consecutive weeks, followed by a telephone survey. We evaluated the clinical characteristics of RAS, and compared the short-term and long-term efficacy of herbal medicine treatment. Results: After treatment with herbal medicine, the clinical characteristics improved in the 17 patients with RAS, especially in terms of the duration and interval of recurrence. Prolonged effects were reported upon the follow-up telephone survey. Conclusion: Herbal medicine treatment may have a long-term effect in patients with RAS.

Long-term Follow-up of Metaphyseal Sclerotic Lines in Children Treated with Pamidronate (파미드로네이트 치료받은 환자에서 발생한 골간단 경화성 선에 대한 장기간 추적 연구)

  • Choi, Yu-Mi;Suh, Jin-Soon;Cho, Byoung-Soo
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.92-97
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    • 2014
  • Purpose: Bisphosphonates are widely used for the management steroid-induced osteoporosis (SIO) in children. With the increasing use of bisphosphonates, there have been reports of abnormal radiological findings in the growing skeleton. Therefore, their use in pediatric patients remains controversial. The present study was conducted to evaluate the long-term follow-up radiographic features, particularly metaphyseal sclerotic lines, in children who receive pamidronate therapy for nephropathy. Methods: Twenty-four children with nephropathy treated with oral calcium and pamidronate (mean duration, 9 months; dose, 100 mg daily), were evaluated retrospectively. All patients had SIO secondary to chronic glucocorticoid therapy for treating nephropathy. Long bone radiographic imaging was performed before treatment with pamidronate, and at follow-up, several years later. Physeal growth rates were estimated by measuring the distance that the sclerotic lines moved on the radiographs during the corresponding time intervals. Results: The mean follow-up period was 138 months. Long bone radiographs showed well-defined sclerotic lines at the metaphyseal ends, progressively moving from the physeal plate to the diaphysis, in all patients. The mean rate of movement of the sclerotic line was 6.21 mm per year. In 12 patients, the lines disappeared. The mean rate of growth in height was 7.33 cm per year. Conclusions: Results of long-term follow-up suggest that the metaphyseal sclerotic lines associated with pamidronate treatment tend to disappear without affecting overall skeletal growth. Bisphosphonate treatment for SIO in children with nephropathy seems to be safe, although further studies in larger number of patients are needed.

Medium and Long-Term Data from a Series of 96 Endoscopic Transsphenoidal Surgeries for Cushing Disease

  • Buruc Erkan;Muhammed Bayindir;Ebubekir Akpinar;Osman Tanriverdi;Ozan Hasimoglu;Lutfi Sinasi Postalci;Didem Acarer Bugun;Dilara Tekin;Sema Ciftci;Ilkay Cakir;Meral Mert;Omur Gunaldi;Esra Hatipoglu
    • Journal of Korean Neurosurgical Society
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    • v.67 no.2
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    • pp.237-248
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    • 2024
  • Objective : Postoperative data on Cushing's disease (CD) are equivocal in the literature. These discrepancies may be attributed to different series with different criteria for remission and variable follow-up durations. Additional data from experienced centers may address these discrepancies. In this study, we present the results obtained from 96 endoscopic transsphenoidal surgeries (ETSSs) for CD conducted in a well-experienced center. Methods : Pre- and postoperative data of 96 ETSS in 87 patients with CD were included. All cases were handled by the same neurosurgical team between 2014 and 2022. We obtained data on remission status 3-6 months postoperatively (medium-term) and during the latest follow-up (long-term). Additionally, magnetic resonance imaging (MRI) and pathology results were obtained for each case. Results : The mean follow-up duration was 39.5±3.2 months. Medium and long-term remission rates were 77% and 82%, respectively. When only first-time operations were considered, the medium- and long-term remission rates were 78% and 82%, respectively. The recurrence rate in this series was 2.5%. Patients who showed remission between 3-6 months had higher long-term remission rates than did those without initial remission. Tumors >2 cm and extended tumor invasion of the cavernous sinus (Knosp 4) were associated with lower postoperative remission rates. Conclusion : Adenoma size and the presence/absence of cavernous sinus invasion on preopera-tive MRI may predict long-term postoperative remission. A tumor size of 2 cm may be a supporting criterion for predicting remission in Knosp 4 tumors. Further studies with larger patient populations are necessary to support this finding.

A Case of Extramedullary Plasmacytoma of the Sinonasal Cavity (Extramedullary Plasmacytoma of the Sinonasal Cavity 1예)

  • Lim, Sang-Chul;Shin, Myung-Seok
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.167-170
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    • 2006
  • Extramedullary plasmacytoma is rare tumor of plasma cell tumor, which involve soft tissue without any signs of systemic spread and occurs predominantly in the head and neck, especially the nasal cavity and the paranasal sinuses. Ten to twenty percent of extramedullary plasmacytoma have regional lymph metastasis at the time of diagnosis and approximately one third of patients with extramedullary plasmacytoma will subsequently develop multiple myeloma during long-term follow-up. Primary treatment modality is moderate-dose radiation and surgery is rarely used. Extramedullary plasmacytoma has good prognosis, but requires long-term systemic evaluation and follow-up. We report a case of extramedullary plasmacytoma of the sinonasal cavity with a review of literature.

Approach in the Surgical Management of Cardiac Myxoma - Clinical Experience and Long-term Result - (심장 점액종의 외과적 고찰임상 경험 및 장기 성적)

  • 김응수
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.518-525
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    • 1988
  • Between 1977 and 1987, 8 patients underwent excision of cardiac myxomas at the Hanyang University Hospital. All had a left atrial myxoma. There were 4 female and 4 male patients ranging from 15 to 62 years of age. Preoperative findings consist of symptoms and signs of congestive heart failure except one. Diagnosis was confirmed by echocardiography[8 cases] and angiography[2 cases], preoperatively. A biatrial operative approach was utilized in all but 2, who were small sized. Complete excision of the tumor with a cuff of normal tissue[1 was atrial wall and 7 were atrial septum] was performed. all heart chambers were carefully explored for presence of multicentric myxomas or tumor debris. There were no operative deaths or intraoperative embolization. Follow-up has been 1/3 to 10 years. There has been 1 late death, due to recurrence and 1 patient had reoperation for mitral regurgitation due to dilatation of the annulus by a huge tumor mass. Surgical excision of the myxoma can be performed with low morbidity, and it provides excellent and sustained symptomatic relief. The recurrence rate is low, but long-term follow-up and serial echocardiography are advisable.

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Long-term Follow-up of Limited T3 Symathicotomy in Palmar Hyperhidrosis (수장부 다한증에 제한적 교감신경절간 절단술의 장기 고찰)

  • Chai, Jin-Ho;Choi, Bong-Chun;Lee, Yong-Chul
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.56-60
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    • 2001
  • Background: Conventional thoracoscopic sympathectomy or sympathicotomy is an effective method in treating localized hyperhidrosis; however, this may result in a postoperatively compensatory hyperhidrosis or facial anhidrosis in the treatment of palmar hyperhidrosis. We modified the conventional sympathicotomy by limiting the extent of nerve transection (limited T3 sympathicotomy) since May 1998. However, there are many reports of a good short-term outcome of limited T3 sympathicotomy. Therefore, we reviewed long-term follow-up of limited T3 sympathicotomy based on outcomes analysis using a questionnaire. Methods: Fifty four patients with palmar hyperhidrosis underwent a limited T3 sympathicotomy between May 1998 and March 1999 and had a complete follow-up over two years using a questionnaire (the mean follow-up was 2.6 years). The patients' postoperative satisfaction was determined by their subjective responses to the questionnaires; the degree of compensatory hyperhidrosis, the effects on foot hyperhidrosis, gustatory hyperhidrosis and facial dryness, and recurrence, and patient's satisfaction. Results: Of the total, 87% of patients had a compensatory hyperhidrosis and 3.7% of them were disabled. 31.5% of patients showed improvement in foot hyperhidrosis, while 68.5% of patients demonstrated no change or got worse. 31.5% of patients had gustatory hyperhidrosis and facial dryness and 22.2% of patients showed a mild palmar hyperhidrosis. The postoperative patients' satisfaction was significantly in 96.3% of patients. Conclusions: The limited T3 sympathicotomy is a highly effective treatment of palmar hyperhidrosis and has a low rate of postoperative compensatory hyperhidrosis, gustatory hyperhidrosis, and facial dryness.

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