• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.725-729
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• 2012

Background: The management of hepatolithiasis combined with intrahepatic cholangicarcinoma (IHHCC) remains a challenge due to poor prognosis. The aim of this study was to summarize our diagnosis and cure experience of IHHCC over the recent 10 years. Methods: From January 1996 to January 2006, 66 patients with IHHCC were reviewed retrospectively. Results: Of the 66 patients, 52 underwent surgical resection (radical resection in 38 and palliative in 14) and 8 patients abdominal exploration, while the other 6 cases received endoscopic retrograde biliary internal drainage and stent implantation. In this series, correct diagnosis of advanced stage was made during operation in 8 cases (8/60, 13.3%) and all of them (underwent unnecessary abdominal exploration, among them the positive rate of CA19-9 was 100%, and the positive rate of CEA was 87.6% (7/8), incidence rate of ascites was 100% and short-term significant weight loss was 100%, with median overall survival of only 4 months. Conclusion: Radical resection is mandatory for IHHCC patient to achieve long-term survival, the CT and MR imaging features of IHHCC being concentric enhancement. Patients with IHHCC have significant higher CA199 and significant higher CEA and short-term significant weight loss and ascites should be considered with advanced stage of IHHCC and unnecessary non-therapeutic laparotomies should be avoided.

• Journal of Korean Foot and Ankle Society
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• v.18 no.2
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• pp.76-79
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• 2014

In treatment of failure in ankle joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation, treatment of large bone defects is considerably important for ankle joint stability and union, therefore, the choice of treatment for large bone defects is use of femoral head or iliac crest bone graft and rigid internal fixation. Because first generation total ankle arthroplasty performed for the first time using a cemented fixation technique requires a large amount of bone resection during re-surgery and there is some possibility of a larger bone defect after removal of implants, in cases where prosthesis for the defect is needed, performance of palliative femoral head or iliac crest bone graft and rigid internal fixation can be difficult. We report on a case of a 48-year-old woman who had experienced ankle pain for 25 years since undergoing total ankle arthroplasty. Because the patient had little ankle motion and rigid soft tissue despite a large bone defect caused by aseptic loosening, a good outcome was obtained only for the femoral cancellous bone graft using allo femoral head without internal fixation.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.630-637
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• 2000

Backgroud: There are well-known problems in the management of low weight neonates or infants with congenital heart defects. In the past, because of a perceived high risk of operations using cardiopulmonary bypass(CPB) in these patients, there was a tendency for staged palliation without the use of CPB. However, the recent trend has been toward early reparative surgery using CPB, with acceptable mortality and good long-term survival. Therefore we reviewed our results of the operations in infants weighing less than 3kg and considered the technical aspect of conducting the CPB including myocardial protection. Material and Method: Between Jan. 1995 and Jul. 1998, 28 infants weighing less than 3kg underwent open heart surgery for many cardiac anomalies with a mean body weight of 2.7kg(range; 1.9-3.0kg) and a mean age of 41days(range; 4-110days). Preoperative management in the intensive care unit was needed in 20 infants and preoperative ventilator support therapy in 11. Total correction was performed in 23 infants and the palliative procedure in 5. Total circulatory arrest was needed in 11 infants(39%). Result: There were seven hospital deaths(25%) caused by myocardial failure(n=3), surgical failure(n=2), multiorgan failure(n=1), and sudden death(n=1). The median duration of hospital stay and intensive care unit stay were 13days(range; 6-93days) and 6days(range; 2-77days) respectively. The follow-up was achieved in 21 patients and showed three cases of late mortality(15%) and a one-year survival rate of 62%. No neurologic complications such as clinical seizure and intracranial bleeding were noticed immediately after surgery and during follow-up. Conclusion: The early and late mortality rate of open heart surgery in our infants weighing less than 3 kg stood relatively high, but the improved outcomes are expected by means of the delicate conduct of cardiopulmonary bypass including myocardial protection as well as the adequate perioperative management. Also, the longer follow-up for the neurologic development and complications are needed in infants undergoing circulatory arrest and continuous low flow CPB.

• Journal of Chest Surgery
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• v.54 no.2
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• pp.137-142
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• 2021

Background: Refractory empyemas with collapsed lung and persistent bronchopleural fistulas pose significant problems to thoracic surgeons and impose a substantial burden in terms of morbidity and mortality. The modified Eloesser flap procedure is a useful palliative option for clearing infections. Herein, we present our experiences with the modified Eloesser flap procedure in mixed suppurative lung pathologies with a new technique of irrigation for persistent infection. Methods: A retrospective review was carried out of 56 patients who underwent the modified Eloesser flap with continuous irrigation at Katurba Medical College. These patients had severe morbidities and were not suitable for major thoracic resection surgery, and electively underwent modified Eloesser flap surgery. Regular follow-up was done at 1, 3, 6, and 12 months. Patients with persistent infections were treated with our continuous irrigation technique. Results: The most important finding was that all patients with active sputum acid-fast bacilli-positive findings became sputum smear-negative during the first month of follow-up. Half (50%) of the patients had a patent stoma. Eleven patients had persistent infections, necessitating continuous irrigation. The infection was fully cleared after 1 month in 9 patients, while 2 patients required second irrigation and continued to receive follow-up. In the remaining 50% of the patients, the stoma closed completely, and the lung expanded fully. Conclusion: The modified Eloesser flap is a simple procedure. In suppurative pathologies, infections were well controlled and the general condition of the patients improved. Our continuous irrigation method showed promising results in patients with persistent purulent discharge.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.139-145
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• 2006

Purpose: Although several chemotherapy regimens used against advanced gastric cancer (AGC) have been studied extensively in an attempt to further improve the prognosis of patients, to date, no standard chemo-therapeutic regimens have been established. The aim of this study was to determine the anti-tumor efficacy and safety of TS-1 or TS-1 plus cisplatin (CDDP). Material and Methods: We treated 78 patients with AGC either with $80\;mg/m^{2}$ of TS-1 for 28 days, which was followed by a 2-week rest, or with $80\;mg/m^{2}$ of TS-1 for 21 days and $80\;mg/m^{2}$ of CDDP on day 8 every 5 weeks. Results: Tumor response rates in the neoadjuvant chemotherapy group and in the recurrent or post-palliative surgery group were 87.5% and 32.4%, respectively, and they were 28.6% and 48.4%, respectively, in the TS-1 group and the TS-1 plus CDDP group. The survival rates in the recurrent and the post-palliative surgery group were significantly different according to the degree of tumor response (P=0.0016), but the one-year survival rates according to the kinds of regimens (TS-1 or TS-1/CDDP group) were not significantly different. The incidences of grade 3 or 4 adverse effects in the TS-1 and the TS-1/CDDP groups were 14.3% and 36.8%, respectively. Conclusion: The anti-tumor efficacy and safety of TS-1 and TS-1 plus CDDP in Korean patients with AGC seemed to be high with modest adverse effects, thus suggesting the possible use of this regimen as a standard chemotherapy for gastric cancer.

• Korean Journal of Head & Neck Oncology
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• v.10 no.1
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• pp.74-79
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• 1994

A Phase II study of UFT which is a mixture of Tegafur and Uracil was conducted in two institutions during past two years. Ninty-four patients of head and neck squamous cell carcinoma entered this trial, of which sixty-eight were evaluated. Among those, thirty-six cases were previously untreated and thirty-two cases were recurrent UFT was administrated orally at a daily dose of $400mg/m^2$ for eight weeks. The results were as following: 1) Overall response was 30.88%, but for 38.36% for 36 cases of the untreated cases, 21.88% for 32 cases of recurrent cases. 2) UFT was more effective in early stage and well differentiated squamous cell carcinoma and UFT tended to reduce the tumor size maximally at fourth or fifth week 3) There was no serious side effects except mild gastrointestinal disturbances such as nausea and vomiting, which were recovered immediately after stop or reducing a daily dose. Therefore, UFT therapy is clinically effective for head and neck squamous cell carcinoma and also may be useful for combination or palliative chemotherapy because of mild side effects.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.48-52
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• 1984

Total anomalous pulmonary venous connection [TAPVC] defines a group of congenital heart disease which have in common the entire pulmonary venous drainage returning directly or indirectly to the right atrium instead of to the left atrium. Although this disorder represents only 1.3% of cases of congenital heart disease, if untreated the resultant mortality is greater than 80% in the 1st year of life. And since there is no satisfactory palliative treatment, correction of TAPVC Is high on the list of indications for open heart surgery in the 1st year of life. This paper describes 10 patients who underwent surgical correction of this disorder at SNUH between 1978 and 1983. 1. 7 were males and 3 females, with ages ranging from 5 months to 24 years. 2. 7 were supracardiac type, 2 cardiac type, and 1 mixed type TAPVC. We didnt experience infracardiac type. 3. All showed some degree of pulmonary hypertension preoperatively. 4. In 4 cases of supracardiac type, total circulatory arrest was used in brief period during anastomosis between common pulmonary venous trunk and left atrium. In the other cases, usual cardiopulmonary bypass with moderate to deep hyperthermia was used. 5. There were 2 cases of mortality; 1 died at operation, and the other at 4 months due to congestive heart failure. 6. Mortality seemed not closely related to age, body weight, or severity of pulmonary hypertension.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.16-21
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• 1990

From November 1978 through June 1989, 33 patients aged 3 months to 27 years [mean 9.7 years] underwent repair of intracardiac defects associated with corrected transposition. Five patients had had previous palliative surgery. Operation were performed in 31 for ventricular septal defect, 22 for pulmonary outflow tract obstruction, 16 for atrial septal defect, and 5 for anatomical tricuspid valve regurgitation. Pulmonary outflow tract obstruction was relieved by pulmonary valvotomy in 9, Rastelli procedure in 5, modified Fontan procedure in 3, and by REV procedure in 5 patients recently. Early mortality was 21.2%[7/33] and no late mortality during follow up period. Two had residual pulmonary outflow tract obstruction and one residual VSD. In eight patients, transient arrhythmia was found but soon returned to sinus rhythm. Five patients developed complete heart block and 2 were given permanent pacemaker insertion. There were 8 RBBB, 1 LBBB and one second degree atrioventricular block patients, but all showed no clinical significance. This report suggests that surgical repair of intracardiac defects associated with corrected transposition can be achieved with acceptable low risk. Though the mortality is still high, we can improved the result by advancing surgical technique, knowledge of the special conduction system, and by improving postoperative care.

• Journal of Chest Surgery
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• v.15 no.3
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• pp.278-284
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• 1982

As of today, the frequency of primary lung cancer is one of the improved problems in modern medicine and is increasing rapidly year by year. This study dealed with 138 cases of primary lung cancer proved by histopathologic examination in Thoracic & Card iovascular Surgery Dept. of N.M.C. from Sept. 1966 through June 1981. The majority of patients belong to 5th and 6th decade. Ratio between male and female was 3.7: 1. Initial symptoms were cough, blood tinged sputum, hemoptysis, chest pain, dyspnea and duration of symptoms before admission was within 6 months [60%] and 12 months [78%]. Histopathologically, 64 cases [61%] of them were the squamous cell carcinoma, 21 cases [15%] were the adenocarcinoma, 20 cases [14.8%] were the anaplastic carcinoma. Fifty-six cases were resectable: 43 cases were subjected to pneumonectomy and 13 cases were to lobectomy. The remaining 82 cases were nonresectable, but exploratory thoracotomy was performed in 22 cases of them. Among 56 resected cases, 33 cases were radically operated and 17 cases were subjected to palliative operation and 6 cases were subjected to extended operation. [Concomitant pericardium resection in 1 case and concomitant chest wall resection in 5 cases]. Surgical mortality was 10.7% and causes of death were aspiration of contralateral lung, respiratory insufficiency, postop. empyema with B.P.F, cardiogenic failure. This study analysed the cancer stage between preop clinical T.N.M. stage and postop. T.N.M. stage in 78 cases; resectable 56 cases and non-resectable 22 cases.

• Journal of Chest Surgery
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• v.28 no.8
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• pp.754-758
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• 1995

Between February 1987 and April 1994,30 modified Blalock- Taussing shunts[MBTS were carried out at the Department of Thoracic and Cardiovascular Surgery of the Keimyung University Dongsan Medical Center.The operation consists of interposing between the subclavian artery and the pulmonary artery a polytetrafluoroethylene graft.There were 19 boys and 11 girls.The average age at the time of shunt construction was 14 months [range 4 days to 5 years .Seventy-six percent [23/30 were less than 1 year of age.Cardiac defects treated with MBTS included tetralogy of Fallot[10 , pulmonary atresia with ventricular septal defect[8 , pulmonary atresia with intact ventricular septum[4 , uni-ventricular heart[3 , and other complex cardiac anomalies[5 .Prosthesis of 4mm were used in 13 cases, and 5mm in 17.Of the 30 operations, 21 were performed on the right side and 9 on the left side.The hemoglobin level decreased from 21.1 gm/dl preoperatively to 16.3 gm/dl postoperatively and systemic oxygen saturation level increased from 60.5 % preoperatively to 85.4 % postoperatively.In the 30 patients who recieved MBTS, there were one early [3% and three late deaths [10% .Seven patients have had an corrective operation and two patient required second palliative procedure.The remaining patients are awaiting further operation with ingestion of aspirin [5 mg/kg/day as an antiplatelet agent.These results indicate that the MBTS provide excellent palliation at a low operative mortality for most patients.