• 대한세포병리학회지
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• 제3권2호
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• pp.37-51
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• 1992

The fine needle aspiration (FNA) cytology findings in 19 cases of primary neoplasia of the pancreas are reported. The aspirates were obtained under ultrasound guidance in 16 cases and under direct vision intraoperatively in three cases. These cases represented 79% of 24 diagnoses in a series of 30 pancreatic FNAs. Of these 30 cases no cytologic diagnoses were made in six cases (20%) because of insufficient or inadequate samples The cytologic diagnoses were confirmed by histologic examination following resection or biopsy of the tumors. The diagnoses included 9 duct ceil adenocarcinomas, 1 mucinous adenocarcinoma, 2 mucinous cystadenocarcinomas, 1 acinar cell carcinoma, 1 papillary cystic tumor 3 islet ceil tumors, 1 neuroendocrine carcinoma and 1 leiomyosarcoma. The cytologic features of the neoplasia were detailed and the differential diagnosis was discussed. The important criteria for the cytodiagnosis of pancreatic tumors were reviewed. This review leads us to think that nonoperative (percutaneous) cytologic approaches to the diagnosis of pancreatic tumor are advantageous for the management of patients, and that correct cytologic diagnosis with pancreatic FNAs can easily be made, if adequate samples are obtained.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.6-11
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• 1998

Shoulder is a common site for calcific deposit and is frequently asymptomatic. There is a general agreement that calcific tendinitis should be initially treated nonoperatively and excision reserved for cases unresponsive to the conservative measures. There are several reports that arthroscopic excision of symptomatic calcific deposit is proved to be efficient in the calcific tendinitis refractory to nonoperative management. The results of arthroscopic treatment of chronic resistant calcific tendinitis of the shoulder in eleven patients were evaluated. Each patient had shoulder pain for more than one year prior to the arthroscopic surgery. The average age of the patients was 48 years(range 35-70). Arthroscopic calcium removal and subacromial bursectomy was performed in all patients. Arthroscopic acromioplasty was additionally done in four patients. The results turned out to be good in nine patients with full range of motion and complete pain relief. One patient with full motion and occcasional episodes of pain was satisfactory. One patient with persistent pain was unsatisfactory which converted to satisfactory six months later after subacromial injection. So we conclude that the arthroscopic treatment is a reasonable alternative in treatment of the chronic calcific tendinitis resistant to conservative treatment.

• Journal of Chest Surgery
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• 제23권4호
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• pp.750-757
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• 1990

Empyema with bronchopleural fistula is an uncommon, but serious problem. Early diagnosis and adequate drainage of the empyema cavity are well established principles for the initial management of this condition and will enable patient to recover from the toxic effects of loculated pus. 37 patients of empyema with bronchopleural fistula were treated at the department of the chonbuk National University Hospital between 1981 and 1988. The age group of fifty and sixty decades occupied 64.8%. Bacteriologic cultures of the pus were postive in 56.8%. The most common organism of the culture was staphylococci(42.9%). And the others were Pseudomonas(19%). Klebsiella(14.3%), and E. doli. No growth of pathologic organism was reported 43.2%. 24 patients of empyema with bronchopleural fistula were nonoperative causes : There were 10 pulmonary tuberculosis, 3 abscess, 9 ascending infection, one bronchiectasis and one tumor, respectively. The remaining 13 were occurred as postoperative complications ; pneumonectomy in 6, lobectomy in 4, decortication in 2, and lobectomy with segmentectomy in 1. When used as the initial mode of drainage, closed thoracostomy was performed to almost all of the patients, but 4 patients were died during this treatment. Main operations were performed except 4 died patients ; open thoracostomy in 21, open thoracostomy with myoplasty in 3, decortication in 5, decortication with resection in 3, and completion pneumonectomy in 1. Open thoracostomy was performed in 21 patients which results were favorable except one death. Permanent open thoracostomy is an old but still useful minor operation in patients with empyema with bronchopleural fistula. The overall mortality rate was 15% (6 patients) and the causes of the death were respiratory insufficiency or sepsis, or both.

• 대한정형외과스포츠의학회지
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• 제2권2호
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• pp.119-126
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• 2003

Overhead athletes에서 특히 자주 볼 수 있는 불안정성 SLAP 병변, Internal impingement, 회전근 개 병변 등의 질환은 개별적으로 나타나는 것이 아니라 여러 질환이 동반되어 나타나므로 진단이나 치료에 어려움이 많다. 어깨 관절 손상의 성공적인 치료 및 운동으로의 복귀를 위하여는 각각의 운동의 생역학적인 측면과 개개의 질환의 증상 및 정확한 진단, 병리기전에 대한 확실한 이해가 선행되어야한다.

• Clinics in Shoulder and Elbow
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• 제22권4호
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• pp.227-234
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• 2019

Lateral epicondylitis, also known as 'tennis elbow', is a degenerative rather than inflammatory tendinopathy, causing chronic recalcitrant pain in elbow joints. Although most patients with lateral epicondylitis resolve spontaneously or with standard conservative management, few refractory lateral epicondylitis are candidates for alternative non-operative and operative modalities. Other than standard conservative treatments including rest, analgesics, non-steroidal anti-inflammatory medications, orthosis and physical therapies, nonoperative treatments encompass interventional therapies include different types of injections, such as corticosteroid, lidocaine, autologous blood, platelet-rich plasma, and botulinum toxin, which are available for both short-term and long-term outcomes in pain resolution and functional improvement. In addition, newly emerging biologic enhancement products such as bone marrow aspirate concentrate and autologous tenocyte injectates are also under clinical use and investigations. Despite all non-operative therapeutic trials, persistent debilitating pain in patients with lateral epicondylitis for more than 6 months are candidates for surgical treatment, which include open, percutaneous, and arthroscopic approaches. This review addresses the current updates on emerging non-operative injection therapies as well as arthroscopic intervention in lateral epicondylitis.

• Advances in pediatric surgery
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• 제13권2호
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• pp.119-126
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• 2007

Trauma is one of the leading causes of death in children. Abdominal trauma is about 10 % of all pediatric trauma. This study describes the sex and age distribution, injury mechanism, site of intraabdominal injury, management and mortality of children aged 16 years or less who suffered abdominal trauma. The hospital records of 63 patients treated for abdominal injury between March 1997 and February 2007 at the department of surgery, Inje University Pusan Paik Hospital, were analyzed retrospectively. The peak age of incidence was between 2 and 10 years (78%) and this report showed male predominance(2.7:1). The most common mechanism of blunt abdominal trauma was pedestrian traffic accident (49%). The most common injured organ was liver. More than Grade IV injury of liver and spleen comprised of 4(12%) and 5(24%), respectively. Fourteen cases (22%) had multiple organ injuries. Forty nine cases (78%) were managed nonoperatively. Three patients (4.8%) died, who had Grade IV liver injury, Grade IV spleen injury, and liver and spleen injury with combined inferior vena cava injury, respectively. All of the three mortality cases had operative management. In conclusion, the liver or spleen injury which was more than Grade 4 might lead to mortality in spite of operation, although many cases could be improved by nonoperative management.

• 대한영상의학회지
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• 제82권4호
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• pp.851-861
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• 2021

간 외상은 복부 둔상에서 흔하다. 조영증강 전산화단층촬영을 통해 간 외상을 빠르게 진단하고 평가할 수 있다. 간 외상의 치료 전략은 수술적 방법에서 점차 비수술적 방법으로 바뀌어 왔는데, 간 외상뿐 아니라 그 합병증에 대한 보완적 치료 방법으로 인터벤션이 각광받고 있다. 이 종설에서는 간 외상에서 보일 수 있는 주요 영상 소견과, 치료에 있어서 인터벤션의 역할에 대해 알아보고자 한다.

• Hip & pelvis
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• 제36권1호
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• pp.37-46
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• 2024

Purpose: The prognosis of total hip replacement (THR) after open reduction and internal fixation (ORIF) versus THR following non-operative treatment of acetabular fractures is unclear. Few studies have been conducted in this regard. Therefore, the purpose of the current study was to perform an assessment and compare the functional outcomes for study subjects in the ORIF and non-ORIF groups during the follow-up period compared to baseline. Materials and Methods: This longitudinal comparative study, which included 40 patients who underwent THR for either posttraumatic arthritis after fixation of an acetabular fracture or arthritis following conservative management of a fracture, was conducted for 60 months. Twenty-four patients had undergone ORIF, and 16 patients had undergone nonoperative/conservative management for acetabular fractures. Following THR, the patients were followed up for monitoring of functional outcomes for the Harris hip score (HHS) and comparison between the ORIF and non-ORIF groups was performed. Results: The HHS showed significant improvement in both ORIF and non-ORIF groups. At the end of the mean follow-up period, no significant variation in scores was observed between the groups, i.e., ORIF group (91.61±6.64) compared to non-ORIF group (85.74±11.56). A significantly higher number of re-interventions were required for medial wall fractures and combined fractures compared to posterior fractures (P <0.05). Conclusion: THR resulted in improved functional outcome during follow-up in both the groups; however, the ORIF group was observed to have better functional outcome. Re-intervention was not required for any of the posterior fractures at the end of the mean follow-up period.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.161-171
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• 2005

Background: The management of hepatic injuries has changed dramatically during the past two decade after the technologic breakthroughs in radiologic imaging techniques. Recently, the non-operative management of blunt hepatic trauma has become the standard of care in hemodynamically stable patients. We reviewed our experience of the non-operative management of blunt hepatic trauma. And the purpose of this study was to examine the prognostic factors and indicators affecting the decision for treatment modality of emergent hepatic trauma. Methods: The medical records of 84 patients who were treated for blunt hepatic injury at Masan Samsung Hospital from January 2002 to December 2003. The patients were divided two groups, non-operative(Non-OP) and operative(OP), according to the treatment modality. The two groups were compares for age, sex, mechanism of injury, grade of liver injury scale, combined injury, systolic blood pressure, pulse rate, hemoglobin, hematocrit, WBC count, S-GOT, S-GPT, ALP, transfusion amount during initial 24 hours, amount of infused crystalloid fluid, length of ICU stay, length of ward care, morbidity and mortality. The grade of the liver injury were determined by using the organ injury scale(OSI). Results: Among the 84 patients, 46 cases(54.8%) were managed non-surgically, and 3 cases of Non-OP group were treated by transarterial embolization. Between the two groups, there were significant difference in age, injury grade, combined injury, hemoglobin, hematocrit, initial systolic blood pressure, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, and length of ICU care, morbidity and mortality.(p<0.05) The overall mortality rate was 8.3%, but 2.2% mortality in the non-operative group. Conclusion: Non-operative management may be considered as a first choice in hemodynamic stable patients with blunt liver trauma. The reliable indicators affecting the treatment modality of blunt hepatic trauma were systolic BP, Hb, Hct, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, liver injury grade and combined injury. Strict selection of treatment madality and aggresive monitoring with intensive care unit were more important.

• Journal of Trauma and Injury
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• 제19권1호
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• pp.21-27
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• 2006

Purpose: The liver is one of the most commonly injured organs by blunt or penetrating abdominal trauma. Patients with liver injury can be treated by using nonoperative or operative management. The aim of this study was to study patients with traumatic liver injury who were treated by using operative management. Methods: Ninety-eight patients with traumatic liver injury underwent surgical treatment from January 1995 to December 2004 at Soonchunhyang University Cheonan hospital. Medical records were reviewed retrospectively, and demographic, clinical, operative, and postoperative datas were collected and analyzed. Results: Among the patients with operative management, the peak incidence was in the third and the fourth decades. The male-to-female ratio was 1.9:1. The most frequent injury mechanism was blunt trauma (85.7%). Abdominal computed tomography was the diagnostic modality used most frequently. Severe liver injury above Grade III was seen in 80.6% of all patients, and long bone fracture was the most common combined injury. Patients were managed by using various techniques, including simple closure, liver resection, and perihepatic packing. Pulmonary complications were the most common postoperative complications (35.7%). the overall mortality rate was 17.3%. Between the survival group and the expired group, the amount of transfusion for the expired group was statistically more than that for the survival group. Conclusion: Operative management is an effective treatment modality for hemodynamically unstable patients with severe traumatic liver injury. The amount of transfusion is a significant prognostic factor for survival.