• Hip & pelvis
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• v.36 no.1
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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 Korean Neurosurgical Society
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• v.41 no.2
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• pp.77-81
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• 2007

Objective : In a variety of thoracolumbar diseases, corpectomy followed by interbody bone graft and anterior instrumentation has allowed direct neural decompression and reconstruction of the weight-bearing column by short segments fusion. In this study, we compared spinal stability of the two different anterior thoracolumbar instruments : Z-plate and Kaneda device representing plate and two-rods type, respectively. Methods : A retrospective review was performed for all the patients with thoracolumbar diseases or traumas treated with anterior corpectomy, autologous iliac bone graft, and fixation with instruments from 1996 to 2000. For the anterior instrumentation, Z-plate or Kaneda device was used for 24 [M:F=5:9, average age=37] and 12 [M:F=9:3, average age=41] patients, respectively. The plain AP and lateral flexion-extension films were taken immediately after surgery and at each follow-up. The sagittal and coronal Cobb's angles at the operation segments were used to observe the change of initial fixation status. The surgical time length and bleeding amount of the two groups were compared. Intra-operative and post-operative instrument associated complications were evaluated. Student t-test was used for statistical analysis and p-value less than 0.05 was considered to be significant. Results : Mean follow-up durations for Z-plate and Kaneda device were 24 and 21 months, respectively. The fusion rate was 91% for Z-plate and 100% for Kaneda device. Two cases of Z-plate group showed instrumentation failure during the follow up period, in which additional surgery was necessary. The mean differences of sagittal Cobb's angles among the AP images immediate after surgery and at follow-up were 7 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. The mean differences of coronal Cobb's angles were 5 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. No Intra-operative complication has occurred in both groups. There was no difference in surgery time and bleeding amount between two groups. Conclusion : We think that Kaneda device [rod type] is stronger than Z-plate [plate type] to keep the spinal stability after anterior thoracolumbar surgery.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.399-403
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• 1999

Background: Funnel chest is one of the most common anomaly of chest wall, which is manifested by depression of sternum and costal cartilage. Popular operative methods were Ravitch operation and Wada operation. Material and Method: From 1983 to 1996, 21 cases of funnel chest were corrected surgically in the department of thoracic surgery, National Medical Center. Investigated age and sex distribution, combined anomaly,clinical symptom, degree of correction and complication, postoperative satisfaction. We used 2 different surgical methods, one was Wada & its variants(17 cases), the other was Ravitch and it variants(4 cases). Most of operative indications were cosmetic problems. Result: The pre-operative Welch index was 4.188, but this index decreased to 3.46 after the operations.(p=0.046) The degree of correction was higher in Wada & it variant operation than the modified Ravitch operation.(p=0.54) Their results were satisfactory in 20 patients, while unsatisfactory in 1 patient because of a k-wire fracture. There was no recurrence of chest wall depression or postoperative death during the OPD follow up period. Conclusion: We recommend Wada operation in symmetric and small degree of depressive chest wall deformity in preand post school age.

• Journal of Korean Neurosurgical Society
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• v.39 no.4
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• pp.281-285
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• 2006

Objective : The tethered cord syndrome results in progressive neurological deficits. Although it may remain controversial, many physicians recommend definitive surgery to untether the cord as soon as this condition is identified. We retrospectively evaluate the pre-operative and post-operative course of 38 tethered cord patients with spinal dysraphism in an attempt to learn the natural history of the disease and to determine the effectiveness of the surgical treatment. Methods : The medical records, operation notes and radiographs were evaluated. The follow up period ranged from 4 months to 12 years with a mean follow-up of 28.6 months. Twenty-seven patients were younger than 15 years of age. Results : At presentation, 26 of the patients were asymptomatic. In three of 11 adult symptomatic patients, their neurological deficits worsened after trauma or exercise. Improvement of motor strength was documented in two out of 5 patients. Five of nine patients with bladder symptoms improved, however, none had a complete return of their bladder function. Conclusion : Childhood patients were less symptomatic than the adult patients. Adult patients showed progression of their symptoms that were not improved even after the operation in most of the cases. Asymptomatic tethered spinal cord can be symptomatic as time passes by and even at an old age. Future research should be focused on the operative methods to prevent the delayed deterioration after surgery, rather than on the usefulness of preventive surgery in asymptomatic patients.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.4045-4050
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• 2012

Objective: The impact of ablative oral cancer surgery was studied, with particular reference to recurrence and nodal metastasis, to assess survival probability and prognostic indicators and to elucidate if ethnicity influences the survival of patients. Methods: Patients who underwent major ablative surgery of the head and neck region with neck dissection were identified and clinical records were assessed. Inclusion criteria were stage I-IV oral and oropharyngeal malignancies necessitating resection with or without radiotherapy from 2004 to 2009. All individuals had a pre-operative assessment prior to the surgery. The post operative assessment period ranged from 1 year to 5 years. Survival distributions were analyzed using Kaplan-Meier curves. Results: 87 patients (males:38%; females:62%) were included in this study, with an age range of 21-85 years. Some 78% underwent neck dissections while 63% had surgery and radiotherapy. Nodal recurrence was detected in 5.7% while 20.5% had primary site recurrence within the study period. Kaplan-Meier survival analysis revealed that the median survival time was 57 months. One year overall survival (OS) rate was 72.7% and three year overall survival rate dropped to 61.5%. On OS analysis, the log-rank test showed a significant difference of survival between Malay and Chinese patients (Bonferroni correction p=0.033). Recurrence-free survival (RFS) analysis revealed that 25% of the patients have reached the event of recurrence at 46 months. One year RFS rate was 85.2% and the three year survival rate was 76.1%. In the RFS analysis, the log-rank test showed a significant difference in the event of recurrence and nodal metastasis (p<0.001). Conclusion: Conservative neck is effective, in conjunction with postoperative radiotherapy, for control of neck metastases. Ethnicity appears to influence the survival of the patients, but a prospective trial is required to validate this.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.247-253
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• 2001

Objective : In general, to perform posterior lumbar interbody fusion(PLIF), it has been used more invasive procedure than simple discectomy. However we try to perform PLIF with TFC with smaller invasion almost same as in simple discectomy. This study is about its procedure and clinical results. Materials and Methods : The authors retrospectively analyzed 43 cases of minimally invasive PLIF with TFC from July 1998 to May 2000. Operative procedure, operative complication, change of disc height, blood loss, ambulation time, hospitalization period, clinical success rate, and bony fusion rate were analyzed. Results : 40 patients were capable to walk on the 2nd day of the post-operation. The average hospitalization period is 5.6 days. The average blood loss was 0.19L/level with no transfusion or wound drainage. The height of disc changed from 8.84mm to 13.54mm. Clinical success rate is 95% when evaluated by the Prolo's scale. The complication was delayed wound infection(2) and transient paresthesis(1). The bony fusion was shown in 17 patients (94.4%) out of 18 patients who passed one year. Conclusion : As a result of minimally invasive PLIF, pain was decreased and early ambulation and short hospitalization was possible. Complication was similar or lower than other studies, and the bony fusion rate and clinical success rate were also similar during follow-up.

• Restorative Dentistry and Endodontics
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• v.46 no.2
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• pp.29.1-29.11
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• 2021

Objectives: This study was conducted to compare the post-fracture survival rate of endodontically treated molar endodontically treated teeth (molar ETT) restored with resin composites or crowns and to identify potential risk factors, using a retrospective cohort design. Materials and Methods: Dental records of molar ETT with crowns or composite restorations (recall period, 2015-2019) were collected based on inclusion and exclusion criteria. The incidence of unrestorable fractures was identified, and molar ETT were classified according to survival. Information on potential risk factors was collected. Survival rates and potential risk factors were analyzed using the Kaplan-Meier log-rank test and Cox regression model. Results: The overall survival rate of molar ETT was 87% (mean recall period, 31.73 ± 17.56 months). The survival rates of molar ETT restored with composites and crowns were 81.6% and 92.7%, reflecting a significant difference (p < 0.05). However, ETT restored with composites showed a 100% survival rate if only 1 surface was lost, which was comparable to the survival rate of ETT with crowns. The survival rates of ETT with composites and crowns were significantly different (97.6% vs. 83.7%) in the short-term (12-24 months), but not in the long-term (> 24 months) (87.8% vs. 79.5%). Conclusions: The survival rate from fracture was higher for molar ETT restored with crowns was higher than for ETT restored with composites, especially in the first 2 years after restoration. Molar ETT with limited tooth structure loss only on the occlusal surface could be successfully restored with composite restorations.

• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.358-365
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• 2001

Objectives : Although posterior lumbar fusion operations had been reported to accelerate spinal degeneration, there have been only a few studies for their biomechanical effects. We have studied the change of motion range at the vertebral joint one level above the fusion(UVJ) in pedicle screw fixation group(PSF)(n=13) where facet capsule was destroyed and in posterior lumbar interbody fusion group(PLIF)(n=8) where it was spared. Patients and Methods : The patients were divided into early(3 to 6 months) and late(over 12 months) according to postoperative follow-up period. The flexion, extension and flexion-extension angles(FA, EA, FEA) were measured at the UVJ with pre-operative, early and late post-operative films. Results : Mean age and male to female ratio were $52.7{\pm}9.3$ and 1 : 3.2. Mean follow-up periods were $144.1{\pm}30.0$ and $528.8{\pm}160.3$ days in early and late groups, respectively. The FEA and FA in the late PSF($11.8{\pm}3.1$, $8.5{\pm}2.9$) were significantly greater than pre-operative angles($7.8{\pm}3.9$, $5.1{\pm}3.7$)(p<0.01, p<0.05). All angles in the PLIF showed no significant changes with time. The FEA and FA in the late PSF($11.8{\pm}3.1$, $8.5{\pm}2.9$) were significantly greater than those of the late PLIF($7.6{\pm}2.3$, $3.4{\pm}2.0$)(p<0.01, p<0.001). All angles at early follow-up period were similar between PSF and PLIF. The EA showed no significant change in relation with follow-up period or fusion method. Conclusion : As a result, the facet capsule injury in pedicle screw fixation seems to be related with increased flexion angle or degeneration of the adjacent joint above the fused vertebra in the late phase.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.531-534
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• 2003

A 43-year-old woman who had had an invasive mole 5 years previously required emergent pulmonary embolectomy under cardiopulmonary bypass. Curative resection was impossible because the tumor invaded the right main pulmonary artery and left lower pulmonary artery. The pathologic diagnosis made by the tumor emboli specimens was choriocarcinoma. The patient received post-operative chemotherapy over a 6-month period and had complete remission. Although rare, choriocarcinoma should be considered in the differential diagnosis of fertile women presented with pulmonary embolism.

• Journal of Chest Surgery
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• v.25 no.9
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• pp.976-981
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• 1992

The results of the clinical observations on the 158 cases of the mitral valvular heart disease treated at the Department of Thoracic and Cardiovascular Surgery, Masan Koryo General Hospital from June, 1986 to December, 1991 were as follows; 1. There were 50 men and 108 women with sex ratio 1: 2.2. 2. The age of patient varied widely from 13 years to 65years. 3. The preoperative functional level accoridng to the NYHA classification were class II, III, IV in 18%, 67%, 15%. 4. All 158 patients were operated on under direct vision using extracorporeal circulation, mitral valve replacement in 118 cases, mitral and aortic valve replacement 40 cases. 5. The follow up period was between 2 months and 65 months postoperatively. [mean 30.1 months] 6. The early operative motality was 5.7%[9 cases], late motality was 4%[6 cases]. 7. The cardiothoracic ratio in the chest X-ray decreased at the 6th month postoperation. [pre-op: 0.60$\pm$0.07, post-op: 0.56$\pm$0.06 p<0.01]