• Journal of International Society for Simulation Surgery
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• v.1 no.2
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• pp.87-89
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• 2014

An aberrant left hepatic artery is one of the most common variants of hepatic arteries, and its prevalence has been reported 6.5-30%. During D2 lymph node dissection for gastric cancer, an aberrant left hepatic artery arising from left gastric artery is ligated which may lead to hepatic damage. In this case report, a 66-year-old male patient underwent total gastrectomy with D2 lymph node dissection during which the aberrant left hepatic artery was ligated. Post-operative liver function tests revealed elevated liver enzymes, and ischemic changes in the left lateral hepatic section was seen on the CT scan. On retrospective review of preoperative CT images, a replaced left hepatic artery from left gastric artery could have been identified. The information on the presence of aberrant LHA and its supplying area is clinically important when planning curative gastrectomy for gastric cancer, because extended lymph node dissection requires division of the left gastric artery and this may lead to severe liver damage. By using preoperative CT scan, detection of aberrant left hepatic artery could be done.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.119-123
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• 2018

Background: Since the first report of a rapidly resolved subdural hemorrhage (SDH) in 1986, few additional case reports have been presented in the literature. Case Report: An 82-year-old female patient presented with a SDH over the left convexity. The SDH was removed via catheter drainage through a burr hole trephination. Post-operative computed tomography (CT) following 300 mL drainage from the chronic SDH demonstrated a newly developed SDH along the right convexity. A follow-up CT performed 2 hours later revealed an unexpected significant resolution of the acute SDH. Conclusion: The spontaneous resolution of acute SDH is believed to result from redistribution by washout of the hematoma by cerebrospinal fluid dilution. However, its exact pathophysiology is not well understood. When surgical evacuation is considered in acute SDH, conservative management should also be considered because spontaneous resolution of hemorrhage remains a possibility.

• Journal of Korean Neurosurgical Society
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• v.48 no.6
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• pp.496-500
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• 2010

Objective : Surgical treatment of lumbosacral foraminal stenosis requires an understanding of the anatomy of the lumbosacral area in individual patients. Unilateral facetectomy has been used to completely decompress entrapment of the L5 nerve root, followed in some patients by posterior lumbar interbody fusion (PLIF) with stand-alone cages Methods : We assessed 34 patients with lumbosacral foraminal stenosis who were treated with unilateral facetectomy and PLIF using stand-alone cages in our center from January 2004 to September 2007. All the patients underwent follow-up X-rays, including a dynamic view, at 3, 6, 12, 24 months, and computed tomography (CT) at 24 months postoperatively. Clinical outcomes were analyzed with the mean numeric rating scale (NRS), Oswestry Disability Index (ODI) and Odom's criteria. Radiological outcomes were assessed with change of disc height, defined as the average of anterior, middle, and posterior height in plain X-rays. In addition, lumbosacral fusion was also assessed with dynamic X-ray and CT. Results : Mean NRS score, which was 9.29 prior to surgery, was 1.5 at 18 months after surgery. The decrease in NRS was statistically significant. Excellent and good groups with regard to Odom's criteria were 31 cases (91%) and three cases (9%) were fair. Pre-operative mean ODI of 28.4 decreased to 14.2 at post-operative 24 months. In 30 patients, a bone bridge on CT scan was identified. The change in disc height was 8.11 mm, 10.02 mm and 9.63 mm preoperatively, immediate postoperatively and at 24 months after surgery, respectively. Conclusion : In the treatment of lumbosacral foraminal stenosis, unilateral facetectomy and interbody fusion using expandable stand-alone cages may be considered as one treatment option to maintain post-operative alignment and to obtain satisfactory clinical outcomes.

• The Korean Journal of Nuclear Medicine
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• v.34 no.4
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• pp.366-369
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• 2000

We report a case of a patient with cystic subdural hygroma who underwent pre-operative Tc-99m DTPA cistrenoscintigraphy to determine the course of operation. A 68-year-old female was admitted to the department of neurosurgery because of acute subarachnoid hemorrhage. After emergency ventricular drainage, the hydrocephalus and cystic subdural hygroma in the right fronto-temporal area developed. She underwent Tc-99m DTPA cisternoscintigraphy to evaluate the type of hydrocephalus, which revealed obstructive communicating hydrocephalus and the communication between the subdural hygroma and the subarachnoid space. As a result of these findings, she underwent the ventriculo-peritoneal shunt operation without removal of the subdural hygroma. Post-operative brain CT showed nearly normalized shape and size of the right ventricle and disappearance of subdural hygroma. We recommend the pre-operative cisternoscintigraphy in patients with complex hygroma to evaluate the communication between subdural hygroma and the subarachnoid space.

• Korean Journal of Radiology
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• v.1 no.3
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• pp.135-141
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• 2000

Objective: To compare the clinical utility of the different imaging techniques used for the evaluation of tracheobronchial diseases. Materials and Methods: Forty-one patients with tracheobronchial diseases [tuberculosis (n = 18), bronchogenic carcinoma (n = 10), congenital abnormality (n = 3), post-operative stenosis (n = 2), and others (n = 8)] underwent chest radiography and spiral CT. Two sets of scan data were obtained: one from routine thick-section axial images and the other from thin-section axial images. Multiplanar reconstruction (MPR) and shaded surface display (SSD) images were obtained from thin-section data. Applying a 5-point scale, two observers compared chest radiography, routine CT, thin-section spiral CT, MPR and SSD imaging with regard to the detection, localization, extent, and characterization of a lesion, information on its relationship with adjacent structures, and overall information. Results: SSD images were the most informative with regard to the detection (3.95±0.31), localization (3.95±0.22) and extent of a lesion (3.85±0.42), and overall information (3.83±0.44), while thin-section spiral CT scans provided most information regarding its relationship with adjacent structures (3.56±0.50) and characterization of the lesion (3.51±0.61). Conclusion: SSD images and thin-section spiral CT scans can provide valuable information for the evaluation of tracheobronchial disease.

• Radiation Oncology Journal
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• v.2 no.1
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• pp.81-86
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• 1984

The preliminary analysis has been made of 63 Patients who were treated in the Department of Radiation Therapy at Korea University Hospital for the lung cancer from April 1981 to December 1983. The patients were treated via Co-60 teletherapy unit and the doses were 5,400 rad/ 6 week for the curative, $3,600\~4,500\;rad/2\;1/2\;\~3$ week for the Palliative treatment. Thirty two $(32/63=51\%)$ patients have been for curative, $25/63 (40\%)$ were for Palliative, and $6/63 (9\%)$ were for post-operative radiation. A post-radiation treatment, $28/63 (53\%)$ were able to follow from 2 months to 3 yrs. During the follow up, chest X-rays and/or CT scans were taken and $22/27 (81.4\%)$ of patients were responded more than $50\%$ of tumor regression one month following completion of radiation.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.588-593
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• 1990

The rupture of tracheobronchial tree caused by non penetrating blunt trauma is being increased in incidence though it is still rarely occurred on now Because this type of injury is uncommon, a high index of suspicion should be maintained in all crush injuries involving the chest. Early diagnosis and primary repair not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. We experienced a case of tracheobronchial rupture caused by non penetrating blunt chest trauma without rib fracture. The patient was a 16 year old male who was a high school student. He was compressed on anterior chest by hand ball goal post being failed down on the morning of admission day. After this accident, he was suffered from progressively developing dyspnea and subcutaneous emphysema on face, neck and anterior chest. The diagnosis, tracheal rupture, was made by chest CT and bronchoscopy. After right thoracotomy, the ruptured site was directly closed by using interrupted suture. Post-operative course was uneventful. Thus we report this case of traumatic tracheal rupture with review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.232-240
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• 2008

Purpose: This study was performed to evaluate transverse changes of proximal segment after bilateral sagittal split ramus osteotomy (BSSRO) using 3-D CT in mandibular prognathism. Patients and methods: Twenty-two patients who underwent BSSRO for mandibular set-back in class III malocclusion without facial asymmetry were examined. Miniplates were used for the fixation after BSSRO. Facial CT was taken before and after BSSRO within 3 months. Frontal-ramal inclination (FRI), inter-gonial width (IGW) and intercondylar width (ICW) were measured in 3-D CT images using V-works $4.0^{TM}$ program. Student t-test was used to compare the changes between pre- and post-operative measurements using SPSS 10.0 program. Results: 1. Mean peroperative FRI value ($12.87{\pm}3.43^{\circ}$) was slightly increased to postoperative value ($14.13{\pm}3.72^{\circ}$) (p < 0.05). The average FRI increased 10.42% and the range was from $-2.46^{\circ}$ to $3.34^{\circ}$. 2. Mean peroperative IGW ($99.01{\pm}5.36$) was slightly decreased to postoperative IGW ($96.51{\pm}5.88mm$) (p < 0.05). The average IGW decreased 2.52 % and the range was from $-6.61^{\circ}$ to 0.91 mm. 3. Mean preoperative ICW ($125.01{\pm}5.30mm$) was slightly decreased to postoperative ICW ($125.40{\pm}5.45mm$) (p < 0.05). There is no significant difference between pre- and post-operative ICW. 4. There was significant correlationship between FRI difference and IGW difference (p < 0.05). Conclusions: These results indicate that the lower ramus of the proximal segment is moved inward after BSSRO procedure for mandibular set-back.

• Journal of Korean Neurosurgical Society
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• v.58 no.1
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• pp.76-78
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• 2015

This report details a case of unexpected, severe post-operative cerebral edema following cranioplasty. We discuss the possible pathological mechanisms of this complication. A 50-year-old female was admitted to our department with sudden onset of stuporous consciousness. A brain computed tomography (CT) revealed a subarachnoid hemorrhage with intracranial hemorrhage and subdural hematoma. Emergency decompressive craniectomy and aneurysmal neck clipping were performed. Following recovery, the decision was made to proceed with an autologous cranioplasty. The cranioplasty procedure was free of complications. An epidural drain was placed and connected to a suction system during skin closure to avoid epidural blood accumulation. However, following the procedure, the patient had a seizure in the recovery room. An emergency brain CT scan revealed widespread cerebral edema, and the catheter drain was clamped. The increased intracranial pressure and cerebral edema were controlled with osmotic diuretics, corticosteroids, and antiepileptic drugs. The edema slowly subsided, but new low-density areas were noted in the brain on follow-up CT 1 week later. We speculated that placing the epidural drain on active suction may have caused an acute decrease in intracranial pressure and subsequent rapid expansion of the brain, which impaired autoregulation and led to reperfusion injury.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.6
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• pp.467-477
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• 2011

Purpose: The objective of this study was to examine the affected period and the amount of bone formation during osteogenesis of intramembranous bone using low-intensity pulsed ultrasound (LPUS) $in$ $vivo$. Methods: Xeno-bone (Bio-oss) and autogenous bone were grafted bilaterally into mini-pig mandibles. The left mandible served as the control and the other mandible was treated with 3 MHz, 160 mW (output, 0.8 mW) ultrasound stimulation for 7 days 15 minutes per day. The mini-pigs were sacrificed at 1, 2, 4, and 8 weeks, and micro computed tomography (${\mu}CT$), a microscopic examination, and a statistical analysis were performed on the specimens. Results: Based on a computerized image analysis of the ${\mu}CT$ scans, the experimental group had an average 150% more new bone formation than that in the control group. The effect of LPUS continued during the post operative 2 weeks. The histomorphological microscopic examination showed similar results. Conclusion: Our results suggest the LPUS had an effect on early intramembranous bone formation in vivo.