• Korean Journal of Radiology
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• 제1권1호
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• pp.38-42
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• 2000

Objective: The purpose of this study was to determine the utility of preoperative CT in predicting early recurrence of hepatocellular carcinoma after partial hepatic resection. Materials and Methods: Preoperative three-phase helical CT scans in 53 patients with hepatocellular carcinoma were retrospectively reviewed by two radiologists. In 27 patients (group I), HCC had recurred within six months, while 26 (group II) had remained disease free for at least two years. In each group, preoperative CT findings were evaluated in each group for the tumor size and number, the presence or absence of capsule, distinctness of tumor margin, perinodular extension, and the presence or absence of portal vein thrombosis. Results: In group I, a tumor capsule of tumor was seen in five of 27 patients (19%), and in group II, in 16 of 26 (62%) (p = .001). The tumor margin was distinct in eight patients (30%) in group I and in 20 (77%) in group II (p = .001). Multiple tumors, perinodular extension, and portal vein thrombosis were more frequently seen in group I but the differences were not statistically significant (p > .05). Tumor size was similar in each group (p > .05). Conclusion: Preoperative CT findings that may help predict the early recurrence of hepatocellular carcinoma after surgical resection are an absence of capsule of tumors and an indistinct margin. Reference to these findings during preoperative CT can guide clinicians in their choice of treatment.

• Investigative Magnetic Resonance Imaging
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• 제21권2호
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• pp.119-124
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• 2017

Chromophobe renal cell carcinoma (RCC) is an uncommon subtype of RCC having a better prognosis than clear cell RCC. Although there are several reports of seeding metastasis of RCC after biopsy, seeding metastasis of chromophobe RCC after surgical resection has seldom been reported. Here, we describe a case of multiple seeding metastases in the abdomen and pelvis 78 months after robot-assisted laparoscopic partial nephrectomy, without prior history of biopsy for chromophobe RCC in the right kidney. As magnetic resonance imaging (MRI) of the pelvic mass showed a similar appearance to the primary renal mass and displayed separate margins with the rectum and prostate gland, we were able to make a diagnosis before pathologic confirmation.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.222-230
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• 2000

Purpose : Resection of the epileptogenic zone in the parietal and occipital lobes may be relevant although only few studies have been reported. Methods : Eight patients with parietal epilepsy and nine patients with occipital epilepsy were included for this study. Preoperatively, all had video-EEG monitoring with extracranial electrodes, MRI, 3D-surface rendering of MRI using Allegro(ISG Technologies Inc., Toronto, Canada), and PET scans. Sixteen patients underwent invasive recording with subdural grid. Eight had parietal resection including the sensory cortex in two. Seven had partial occipital resection. Two underwent total unilateral occipital lobectomy. The extent of the resection was made based mainly on the data of invasive EEG recordings, MRI, and 3D-surface rendering of MRI, not on the intraoperative electrocorticographic findings as usually done. During resection, electrocortical stimulation was performed on the motor cortex and speech area. Results : Out of eight patients with parietal epilepsy, three had sensory aura, two had gustatory aura, and two had visual aura. Six of nine patients with occipital epilepsy had visual auras. All had complex partial seizures with lateralizing signs in 15 patients. Four had quadrantopsia. One had mild right hemiparesis. Abnormality in MRI was noticed in six out of eight parietal epilepsy and in eight out of nine occipital epilepsy. 3D-surface rendering of MRI visualized volumetric abnormality with geometric spatial relationships adjacent to the normal brain, in all of parietal and occipital epilepsy. Surface EEG recording was not reliable in localizing the epileptogenic zone in any patient. The subdural grid electrodes can be implanted on the core of the structural abnormality in 3D-reconstructed brain. Ictal onset zone was localized accurately by subdural grid EEGs in 16 patients. Motor cortex in nine and sensory speech area in two were identified by electrocortical stimulation. Histopathologic findings revealed cortical dysplasia in 10 patients ; tuberous sclerosis was combined in two, hamartoma and ganglioglioma in one each, and subpial gliosis in six. Eleven patients were seizure free at follow-up of 6 months to 37 months(mean 19.7 months) after surgery. Seizures recurred in two and were unchanged in one. Six produced transient sensory loss and one developed hemiparesis and tactile agnosia. One revealed transient apraxia. Two patients with preoperative quadrantopsia developed homonymous hemianopsia. Conclusion : This study suggests that surgical treatment was relevant in parietal and occipital epilepsies with good surgical outcome, without significant neurologic sequelae. Neuroimaging studies including conventional MRI, 3Dsurface rendering of MRI were necessary in identifying the epileptogenic zone. In particular, 3D-surface rendering of MRI was very helpful in presuming the epileptogenic zone in patients with unidentifiable lesion in the conventional MRI, in planning surgical approach to lesions, and also in making a decision of the extent of the epileptogenic zone in patients with identifiable lesion in conventional MRI. Invasive EEG recording with the subdural grid electrodes helped to confirm a core of the epileptogenic zone which was revealed in 3D-surface rendered brain.

• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.233-242
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• 2018

Objective : A spinal cord subependymoma is an uncommon, indolent, benign spinal cord tumor. It is radiologically similar to a spinal cord ependymoma, but surgical findings and outcomes differ. Gross total resection of the tumor is not always feasible. The present study was done to determine the clinical, radiological and pathological characteristics of spinal cord subependymomas. Methods : We retrospectively reviewed the medical records of ten spinal cord subependymoma patients (M : F=4 : 6; median 38 years; range, 21-77) from four institutions. Results : The most common symptoms were sensory changes and/or pain in eight patients, followed by motor weakness in six. The median duration of symptoms was 9.5 months. Preoperative radiological diagnosis was ependymoma in seven and astrocytoma in three. The tumors were located eccentrically in six and were not enhanced in six. Gross total resection of the tumor was achieved in five patients, whereas subtotal or partial resection was inevitable in the other five patients due to a poor dissection plane. Adjuvant radiotherapy was performed in two patients. Neurological deterioration occurred in two patients; transient weakness in one after subtotal resection and permanent weakness after gross total resection in the other. Recurrence or regrowth of the tumor was not observed during the median 31.5 months follow-up period (range, 8-89). Conclusion : Spinal cord subependymoma should be considered when the tumor is located eccentrically and is not dissected easily from the spinal cord. Considering the rather indolent nature of spinal cord subependymomas, subtotal removal without the risk of neurological deficit is another option.

• Journal of Gastric Cancer
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• 제2권2호
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• pp.96-100
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• 2002

Purpose: The proper reconstructive technique after a partial gastrectomy for an adenocarcinoma of the stomach is often debated, but few data exist to clarify the issue. The aim of this study was to compare retrospectively the early postoperative results and complications after different anastomoses used during a partial gastrectomy for a gastric adenocarcinoma. Materials and Methods: We reviewed the hospital records of 218 patients who had undergone a subtotal gastrectomy for gastric cancer at Chosun University Hospital between January 1997 and July 2000. Of the 218 subtotal gastrectomies performed with curative intent, 127 reconstructions were Billroth I gastrectomies and 91 were Billroth II gastrectomies. The following data were analyzed: age, sex, tumor size, gastric resection margin, timing of removal of the nasogastric tube, first bowel movement, resumption of oral feeding, and postoperative complications. Results: The timing of removal of the nasogastric tube was significantly earlier in the Billroth Igroup than in the Billroth II group ($27.9\pm13.9$ hours and $69.7\pm68$ hours, respectively)(P<0.05). Resumption of oral feeding was possible on day $4.6\pm1.5$ in the Billroth I group and on dsy $5.2\pm1.5$ in the Billroth II group (P<0.05). There were no anastomotic leakage, postoperative bleeding, and postoperative mortality among the patients in either group. Conclusions: the Billroth lgastrectomy should be considered for patients undergoing a partial gastric resection for gastric cancer due to its physiological benefits and acceptable rate of complication.

• Journal of Chest Surgery
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• 제23권2호
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• pp.231-235
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• 1990

Segmental resection or wedge resection of the lung and direct cutting across of bronchi frequently results in postoperative airleaks or bronchopleural fistula in some cases. Many methods have been devised to handle air leak problems by oversuturing the raw edges, the application of pleural onlay flaps, the use of cautery or tissue adhesives, but these still has not solved the problem of air leaking from raw surfaces of the lung with only partial successful we have tried the use of histoacryl to closure the raw surface of the resected lung and compared it’s results with of the closure with chromic catgut sutures in cats from May 1989 to Jan. 1990 at the department of the thoracic and cardiovascular surgery, Yonsei University, College of Medicine. Ninety lobe of the lungs were used in this study and forty nine of which have been divided segmentally and closed with histoacryl on the raw surfaces. Forty one of which have been divided segmentally and closed with sutures using chromic catgut for control. There were air leakages in twelve cases among 49 cases with applying histoacryl and airleak were in two cases among 12 cases with reapply histoacryl, But there were air leak in two cases among 41 cases with sutures using chromic catgut and airleak were in one case among with resutures using chromic catgut.

• Journal of Chest Surgery
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• 제50권4호
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• pp.308-311
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• 2017

A 71-year-old man was referred for an anterior chest wall mass. Chest computed tomography (CT) and positron emission tomography-CT suggested a malignant tumor. Surgical biopsy through a vertical subxiphoid incision revealed an extra-gastrointestinal stromal tumor (EGIST). En bloc resection of the tumor, including partial resection of the sternum, costal cartilage, pericardium, diaphragm, and peritoneum, was performed. Pathologic evaluation revealed a negative resection margin and confirmed the tumor as an EGIST. On postoperative day 17, the patient was discharged without any complications. At the 2-week follow-up, the patient was doing well and was asymptomatic.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권1호
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• pp.85-90
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• 2012

The odontogenic myxoma is a relatively rare, benign tumor that occurs on the jaw. A 41 year-old man visited Seoul National University Dental Hospital because of swelling of the mandible. Clinical and radiographic evaluation showed a huge mass invading most of the mandible. After biopsy, he was diagnosed with odontogenic myxoma. For resection of the lesion, partial mandibulectomy and reconstruction with a vascularized fibular free flap was done. The result showed successful removal of the lesion. Reconstruction resulted in satisfactory functional and esthetic outcomes. We conclude that huge benign neoplasms such as odontogenic myxomas can be successfully treated by using a wide margin of resection followed by vascularized fibular free flap reconstruction.

• Journal of Chest Surgery
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• 제18권4호
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• pp.792-799
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• 1985

Primary neoplasms of the trachea are rare, but are a very serious critical life-threatening disease. Nearly all the lesions of the trachea are presented as obstructive lesions. Bronchoscopic examination including chest C-T, tomogram and air tracheogram are essential for the further definition of these lesions. The need for removal of tracheal tumors whether complete or incomplete, is clear enough regardless of the histology of the tumor. We have experienced 9 cases from Jan. 1965 to June, 1985. One patient with tracheal hamartoma was cured with complete resection through rigid bronchoscopy and another patient with fibrous histiocytoma was treated with re-excision and laser evaporation through superior mediastinotomy due to recurrence, 1 year later. The remaining patients were treated with mass excision or segmental resection and end-to-end anastomosis through collar incision and superior mediastinal sternotomy. The remaining two patients were operated with and segmental resection and end-to-end anastomosis of trachea using partial cardiopulmonary bypass. The histologic diagnosis were adenoid cystic Ca[5], fibrous histiocytoma[1], mucoepidermoid Ca[1]. hamartoma[1], anaplastic Ca.[1]. Three patients were treated post-operatively with radiation; with adenoid cystic Ca.[2] and anaplastic Ca.[1]. Their post-operative courses were uneventful during the follow-up from 2 months to 7 years.

• Journal of Korean Neurosurgical Society
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• 제59권2호
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• pp.158-160
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• 2016

Ganglion cell tumors (GCT) are divided into two subtypes : gangliocytoma and ganglioglioma. Intramedullary gangliocytomas are extremely rare. A 20-year-old male patient with pain of neck, who also had a previously known neuroendocrine tumor of lung, was operated for mass found in the cervicomedullary junction with a presumptive diagnosis of metastases. Only partial resection could be performed. Pathological diagnosis had been reported as gangliocytoma. Only ten cases of intramedullary gangliocytoma have been reported in the literature. Although association with scoliosis and Von Recklinghausen;s disease were previously reported in the literature, no gangliocytoma case concomitant with endocrine tumor of lung have been published. Pathological study is the most important diagnostic method for gangliocytomas. Surgical excision is the primary treatment, but difficulty in total surgical tumor resection is the most important problem.