• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.527-535
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• 1996

Background : Cell adhesion molecules knave been Implicated In the various stages of tumor progression and metastasis. ICAM-1 plays a important roles in cell-cell interactions in inflammatory and immune response of several diseases. Recently, elevated levels of sICAM-1 in circulation was reported as association with liver metastasis in gastric, Colonic, gall bladder and pancreatic cancer, with reduced survival in malignant melanoma. This study was performed to measure the sICAM-1 in patients with lung cancer and to evaluate the relations between staging of lung cancer and level of sICAM-1. Methods : Serum sICAM-1 was measured in 36 patients with lung cancer according to the pathologic types and clinical staging before therapy and in 8 controls with ICAM-1 ELISA kit. Results : Serum sICAM-1 levels were elevated in patients with lung cancer except small cell type. Also progression and metastasis of lung cancer associated with elevation of sICAM-1 levels. Conclusion : These results suggest that higher levels of serum ICAM-1 reflect the progression and metastasis of lung cancer and it may be used as a marker with diagnostic and prognostic significance.

• Tuberculosis and Respiratory Diseases
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• v.68 no.1
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• pp.1-5
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• 2010

Background: To analyze the result of $^{18}F-FDG$ positron emission tomography (PET) in patients with a concomitant malignancy and tuberculoma in a tuberculosis (TB)-endemic area. Methods: Twelve patients with a concomitant malignancy and tuberculoma, who underwent whole-body $^{18}F-FDG$ PET, were evaluated retrospectively. The maximal standardized uptake values (SUVmax) of the malignancy and tuberculoma were compared. In 6 patients, $^{18}F-FDG$ PET was repeated during the anti-TB treatment and the changes in SUVmax were analyzed. Results: Of the 12 patients, 10 were male. The mean age was $67.2{\pm}7.9$ years. Tuberculomas were located in the lung (n=10) and lymph nodes (n=2), and tumors were located in the lung (n=6), colon (n=3), stomach (n=1), ovary (n=1) and liver (n=1). Although the mean SUVmax of malignant lesions was higher than that of tuberculomas ($5.2{\pm}3.2$ vs $3.5{\pm}2.0$), the difference was not significant. In 4 patients, the SUVmax was higher in the tuberculoma than the tumor. After anti-TB treatment in 6 patients, the mean SUVmax of the tuberculomas decreased significantly, from $3.5{\pm}2.0$ to $1.6{\pm}0.9$ (p=0.028). Conclusion: In patients with a concomitant malignancy and tuberculoma, SUVmax alone could not differentiate between them. However, $^{18}F-FDG$ PET may be useful in monitoring the response to anti-TB treatment.

• Korean Journal of Head & Neck Oncology
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• v.11 no.1
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• pp.30-35
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• 1995

Localized non-Hodgkin's lymphomas of head and neck are generally treated with radiation therapy with or without chemotherapy and the results of treatments are favorable, but the recurrences in the primary site or distant sites are a major contributor to failure, We experiened 19 cases of localized non-Hodgkin's lymphomas for 4-year period and retrogradely analized them. We treated patients with Ann Arbor stage I and low grade histology in Working formulation with radiation therapy and patients with Ann Arbor stage II, moderate to high grade histology or extensive tumor size with combination chemotherapy, The complete responses were occurred in 15 of 19 patients (radiation therapy, 5/6 (83.3%); chemotherapy 10/13(76.9%)). 3 relapses were occurred; 2 were in local relapses and 1 was in distant leptomeningeal relapse and the counter-therapeutic modalities were successful in 2 cases. Our results suggest that Ann Arbor stage is significant prognostic factor and appropriate staging with extensive methods is important to improve the results of treatment.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.139-146
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• 2000

The aim of this study was to assess whether the functional regeneration of a lyophilized autografted cartilage could be improved by implanting a vascularized muscle flap into the medullary canal of autografted proximal humerus. A hemijoint reconstruction using a lyophilized osteochondral autograft in proximal humerus was done in 4 rabbits for control, and combined with an vascularized intramedullary muscle flap in another 4 rabbits for the experimental group. Graft healing and the repair process of osteochondral graft were followed by serial radiographs and histologic changes for 9 weeks after experiments. Each two rabbits in control and in experimental group on 5th and 9th week after implantation of hemijoint were sacrified. The results were as follows: 1. All of control and experimental froups on 5th week united solidly on osteotomized site radiologically, but their articular cartilages were destroyed more seriously in the control than that in experimental group with muscle flap on 5th and 9th week after experiment... 2. Histochemically, the cartilage surface are completely destroyed and revealed with severe osteoarthritic changes on all cartilage layers in control, but cartilaginous erosions are mild to moderate and their arthritic changes are also mild with somewhat regeneration of chondrocytes on deep layers more prominetly on 9th week of the experimental group. 3. The amount of collagen and protenized matrix which was determined by Masson-Trichrome stain was markedly decreased that means the weakness of bony strength and low osteogenic potential in lyophilized cartilage. These results suggest that an intramedullary vascularized muscle flap can improve the functional results of lyophilized osteochondral autograft by providing both increased vascularity and populations of mesenchymal cells to initiate new bone formation on osteotomized site as well as the regeneration of deep layers in articular cartilage. In clinical relevances, this lyophilized hemijoint autograft combined with an intramedullary vascularized muscle pedicle graft might be used very effectively for the treatment of malignant long bone tumors to preserve the joint functions, all or partly, and so to replace it with the artificial joint after tumor excision and hemijoint autograft.

• Pediatric Infection and Vaccine
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• v.19 no.3
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• pp.141-148
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• 2012

Purpose : Ventriculoperitoneal (VP) shunt insertion is an important treatment modality in children with hydrocephalus. VP shunt infection is a major complication and an important factor that determines the surgery outcome. This 15-year study was performed to evaluate the epidemiology of VP shunt infections in pediatric patients treated at our center. Methods : A retrospective review of medical records was performed in patients 18 years old or younger who underwent VP shunt insertion surgery from April 1995 to June 2010. Results : Three hundred twenty-seven VP shunt surgeries were performed in a total of 190 pediatric patients (83 females, 107 males). The median age of the patients was 2.4 years (range, 0.02-17.9 years). Having a malignant brain tumor was the most frequent cause for VP shunt insertion. The shunt infection rate was 6.7% (22/327) per 100 operations and 9.5% (18/190) per 100 patients, and the incidence rate was 0.45 infection cases per 100 shunt operations-year. The most common pathogen was coagulase-negative staphylococcus (n=7) followed by methicillin resistant Staphylococcus aureus (n=1). Ten cases were treated with vancomycin and beta-lactam antibiotic (cephalosporin or carbapenem) combination therapy and 7 cases were treated with vancomycin monotherapy. The median duration of antibiotic treatment was 26 days (range, 7 to 58 days). Surgical intervention was performed in 18 cases (18/22, 81.8%). Conclusion : Epidemiologic information regarding VP shunt infections in pediatric patients is valuable that will help guide proper antibiotic management. Additional studies on the risk factors for developing VP shunt infections are also warranted.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.205-213
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• 1977

In order to evaluate the therapeutic effect of thoracostomy on the patients with pathological changes in pleural cavity which were caused by various etiological factors, a clinical study was carried out during a period of 5 and half years from May 1972 to September 1977 in the department of thoracic surgery, Hanyang University Hospital, and the following results were obtained. Of a total of 264 patients, 205 cases were male, and 59 female, exhibiting the ratio of male to female being 3.5 to 1. The pathological changes in pleural cavity could occur at any age from 4 months after birth to 76 years old, the peak incidence being in the third decade in either male or female. The incidence decreased in the second, fifth and fourth decade in order. The type of pathological changes observed and their frequencies of occurrences were 93 cases [35.2%] in pneumothorax, 62 cases [23.5%] in hemothorax, 48 cases [18.2%] in pyothorax, 46 cases [17. 4%] in hemopneumothorax, 13 cases [4.9%] in hydropneumothorax, and one case each in hydrothorax and chylothorax. The incidence of the primary diseases which predisposed the pathological changes in pleural cavity were, 119 cases [45-1%] in trauma, 64 cases [24.2%]in lung tuberculosis, 38 cases [14.4%] in pneumonia or empyema, 14 cases [5.3%] in lung emphysema and blebs, 13 cases [4.9%] in process after thoracotomy, 3 cases [1.1%] each in lung malignant tumor and lung paragonimiasis, one case in mechanical ventilator and 9 cases [3.4%] in unknown origin. The pathological changes in pleural cavity were located in the right side of the cavity in 124 cases, in the left side in 133 cases and in both sides in 7 cases, indicating that the difference between the incidence of the left and rightside occurences was insignificant. Of 93 cases of pneumothorax studied, 63 cases were found to have been tension pneumothorax and 30 cases non-tension pneumothorax, showing greater prevalence of tension type over non-tension type. Of 119 cases of trauma observed, 82 cases were accompanied with rib fractures and 37 cases were without any fracture [non-bone fracture]. Patients with the rib fractures were characterized by multiple rib fractures and multiple double fractures of ribs, accompanying with or without fracture of bones other than ribs, and patients with non-bone fracture were characterized by penetrating stab wound and blunt trauma. Of 264 cases who received thoracostomy, 207 cases [78.4%] demonstrated that their pathological changes in pleural cavity were removed and subsided by a simple measure of thoracostomy. In 43 cases [16.3%], various surgical measures including radical operation and thoracotomy were required for complete healing, since their pathological changes were not abolished by thoracostomy alone. The rest 14 cases [5.3%] were expired following thoracostomy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.5
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• pp.414-421
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• 2004

This is a reprospective study on the care of odontogenic infections in admission patients with geriatric diseases. The study was based on a series of 480 patients at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, From Jan. 1, 2000, to Dec. 31, 2002. The Obtained results were as follows: 1. The systemic malignant tumor was the most frequent cause of the geriatric diseases with odontogenic infectious diseases, and refractory lung disease, systemic heart disease, type II diabetes mellitus, cerebrovascular disease, bone & joint disease, senile psychologic disease were next in order of frequency. 2. Male prediction(57.5%) was existed in the odontogenic infectious patients with geriatric diseases. But, there were female prediction in senile psychologic disease, systemic heart disease and cerebrovascular disease. 3. The most common age group of the odontogenic infectious patient with geriatric disease was the sixty decade(47.9%), followed by the seventy & eighty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with geriatric disease, peak incidence was occurred as toothache(52.7%), followed by extraction wish, tooth mobility, oral bleeding, oral ulcer, fracture of restoration, gingival swelling in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis & periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(34.2%) was showed in primary endodontic treatment (pulp extirpation, occlusal reduction and canal opening drainage) and followed by scaling, incision & drainage, only drugs, pulp capping, restoration in order.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.545-550
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• 2004

Salivary glands, major and minor, are susceptible to a wide variety of pathologic conditions. Excision of the submandibular gland is a surgical procedure often undertaken. The procedure is the treatment of choice for patients with neoplasm of the submandibular gland and those with non-neoplastic submandibular disorders which are not controlled with conservative medical measures. Extirpation of the submandibular gland may also be undertaken for diagnostic purposes. We evaluated 84 patients who had been admitted to the dept. of oral and maxillofacial surgery of Pusan National University Hospital from January, 1989 to December, 2002 and had been performed submandibular gland excision. The results are as follows : 1. The patients undertaken the excision of the submandibular gland showed an age range of 16 to 71 years. The average was 49.1. 2. They consisted of 60 males(71.4%) and 24 females(28.6%), having 2.5 : 1 of genda ratio. 3. The most common symptom was swelling in 41 cases(48.8%), followed by the pain in 23 cases(27.4%). Other symptoms included mass, dysphagia, facial abnormaly and neck dyscinesia. 4. 42 cases(50.0%) showed sialadenitis and sialodochitis associated with salivary calculus. 5. According to the histopathologic study, all cases consisted of 17 neoplasmatic conditions(20.3%) and 67 non-neoplasmatic(79.7%). The neoplasmatic cases included 13 benign tumors and 4 primary malignant tumors. Sialadenitis and sialodochitis associated with or without salivary calculus were most marked, found in 50 cases(59.3%), in the non-neoplasmatic conditions. Pleoomorphic adenoma showed the highest frequency of the benign tumor.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.791-797
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• 2011

Purpose: Angiosarcoma is a rare and aggressive malignant soft tissue tumor. Due to a lack of the established optimal treatment modalities, however, an extensive resection followed by an early detection has been reported to be the best treatment of choice. We analyzed the clinical course of six patients, hence attempted to contribute to making a treatment plan for patients with angiosarcoma. Methods: Six patients who have been surgically treated between 2005 and 2010 are included. Through a retrospective analysis of the medical records, we evaluated the pattern of disease detection, a past history, time span between the detection and the primary surgery, surgical treatment modalities, time span between the primary surgery and the recurrence/metastasis, the sites of metastasis and the secondary treatment modalities. Results: The mean age of patients was 70.5 years; all male; and the sites were the scalp. Four patients underwent the reconstruction using a local flap with a skin graft and two patients using a free flap. The mean period elapsed until the primary operation since the identification was 7.3 months and until a recurrence or a metastasis occurred following the primary operation was 12 months. Four patients had pulmonary metastasis. As a secondary therapy, four patients underwent the radiotherapy and one was treated with the chemotherapy. At the present, five patients died and one undergoes a monitoring of the clinical course. Conclusion: It would be mandatory to shorten the length of hospital stay and to return patients to their daily lives as the earliest as possible using relatively simpler surgical methods, thus attempting to give them opportunity to resume their previous normal life.

• Korean Journal of Head & Neck Oncology
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• v.27 no.2
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• pp.204-209
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• 2011

Background and Objectives : The usefulness of fine needle aspiration biopsy(FNAB) for diagnosis of parotid gland tumors is controversial, because of the generalized belief requiring surgery for most parotid tumors. The aim of this study was to evaluate the efficacy of FNAB for diagnosis in parotid gland tumors. Material and Methods : FNAB was performed in 91 patients who underwent parotid surgery at Kangbuk Samsung Hospital from January 2007 to December 2010. The result of FNAB, 11 malignancies and 75 benign tumors and 5 non-neoplasms were analyzed and compared with the final histopathologic diagnoses. Sensitivity, specificity, accuracy, positive predictive value(PPV), and negative predictive value(NPV) were calculated using final histopathologic diagnosis of the surgical specimen as the standard diagnostic reference for comparative analysis. Results : 86 specimens(94.5%) were suitable for evaluation. We compared the result of FNAB and the final histopathology in 79(89.4%) cases. The sensitivity, specificity, accuracy, PPV, and NPV of FNAB for detecting pleomorphic adenoma was 95.8%, 88.4%, 92.3%, 90.2%, and 95.0%. In Warthin's tumor, results were 86.4%, 94.2%, 92.3%, 82.6%, and 95.6%. Among 11 patients who were diagnosed with malignancy on final histopathologic report, only 3(30%) patients were diagnosed with the same as on FNAB, the other 8 patients were initially diagnosed incorrectly as benign tumors in FNAB. There were no complications related to FNAB. Conclusion : Diagnostic accuracy for FNAB in benign parotid tumors was high. However, in malignant tumors, FNAB shows low diagnostic usefulness compared with benign tumors. FNAB can be effective and safe diagnostic technique for evaluating the benign parotid glands tumors.