• Journal of Chest Surgery
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• v.34 no.5
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• pp.426-429
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• 2001

Superior sulcus or pancoase tumor refers to any primarty lung cancer locating in thoracic inlet and causing pain in the periscapular region or aim. These originate inperipheral, and involve th extrapulmonary structures more than parenchyma of the lung. We experienced l case of superior sulcus tumor radically resected via anterior transcervical approach, which provide more safe exposure of cervical structures of thoracic inlet than classis posterolateral thoracotomy. Therefore were report this case with review of literature.

• Journal of Chest Surgery
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• v.26 no.7
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• pp.571-574
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• 1993

We present a rare case of malignant lymphoma developing from the wall of chronic empyema thoracis. A 54-year old man with a 35 year history of tuberculosis empyema was admitted due to right chest pain and general weakness for 2 months. Under the impression of chronic empyema thoracis with destroyed right lung and tumor on posterior costophrenic sulcus, pleuropneumonectomy including tumor was performed as a single procedure through a right thoracotomy. The tumor arose from the thickened pleura, and it was histologically and immunologically diffuse large cell[non-cleaved] B-cell non-Hodgkin`s lymphoma [NHL]

• Journal of Chest Surgery
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• v.28 no.4
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• pp.426-430
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• 1995

Pancoast tumor was specific lung carcinoma that has been symptoms and signs according to locations. It was located in peripheral,and involved the extrathoracic structures more than parenchyme of the lung. At 1838, Hare reported it, and at 1932 Pancoast was first described it. Prior to 1950,superior sulcus tumor was considered uniformly fatal, but at 1961 Paulson and Shaw advocated the use of preoperative irradiation therapy and followed by an extended en bloc resection. Recently we were experienced 2 cases of pancoast tumor managed with same method. One was 60-years old man that has been recommended preoperative radiation therapy with dose of 3000 cGy to 20 fractions and followed resection after 4 weeks, the other was 53-years old man that has been recommended a dose of 4000 cGy to 20 fractions and followed resection after 4 weeks. On tumor histology first case was large cell carcinoma and second case was squamous cell carcinoma. all patients was complicated atelectasis. First patient was expired with brain metastasis after 17 months, second was expired after 6 months.

• Korean Journal of Clinical Laboratory Science
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• v.45 no.4
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• pp.170-179
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• 2013

There is a correct way to avoid any sequale in the central motor area during neurosurgery procedures. A clear way to find the circumference of the central sulcus, central motor, and sensory areas by giving cortical electrical stimulation to the central motor area immediate after surgery is proposed. Looking at patients who underwent brain surgery September 2009 to July 2013, the central sulcus and speech areas around the central area of the brain was investigated, using the practices of either a localized brain map check or a direct cortical electrical stimulation test. Brain maps localized around the surgical site through functional movement or speech areas were identified. Accurate tests done during surgery without damage to motor neurons or after surgery were conducted smoothly. Although successful brain map test localization can be accomplished, there are some factors that can interfere. The following phenomena can reverse the phase: (1) the first sensory / motor in the case of patients severe nerve damage; (2) placement of the electrode on top of the vessel; (3) presence of a brain tumor near the brain cortex; (4) use of anesthesia if patient cooperation is difficult; and (5) location of the electrode position and stimulus is inappropriate.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1396-1401
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• 2000

Although direct surgical treatment of the lesion in the pons may cause severe neurologic morbidity, safe route to minimize injuries of the important structures in the pons should be considered. The authors operated four cases of intrapontine lesions via safe approach route without causing severe neurologic complications. Two cases were intrapontine tumors and other two were intrapontine hematoma. An anaplastic astrocytoma($3{\times}3{\times}3cm$) located bilaterally in the pons was approached via midline of the median sulcus, and a metastatic tumor($1.5{\times}1.5{\times}1.5cm$) located at the left posterolateral aspect in the upper pons was approached via suprafacial space. Two cases of hematoma were evacuated via median sulcus, and supra- and infrafacial spaces. Preoperatively, quadriplegia, swallowing difficulty, diplopia, speech disturbance, and nystagmus were noted in a patient with an anaplastic astrocytoma. A patient with metastatic tumor showed mild right hemiparesis, right hemisensory disturbance, diplopia, and dizziness. Two patients with hematoma in the pons were comatous, and had contracted, fixed pupils. Postoperatively, a patient with an anaplastic astrocytoma recovered and a patient with a metastatic tumor showed temporary hemifacial palsy. Mental status was fully recovered normal even though facial palsy, diplopia, severe ataxia, dizziness, and tremor persisted in both patients with pontine hematoma. Careful operation based on the anatomical knowledge of the floor of the 4th ventricle is of prime importance in appraoching to the intrapontine lesion with minimal injuries of the eloquent structures during surgery.

• Tuberculosis and Respiratory Diseases
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• v.40 no.4
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• pp.345-352
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• 1993

The role of magnetic resonance(MR) imaging in the evaluation of thoracic disease has been limited Nontheless, MR has inherent properties of better contrast resolution than CT allowing tissue-specific diagnosis. MR has capability of direct imaging in sagittal, coronal, and oblique planes which provide better anatomic information than axial images of CT such as lesions in the pulmonary apex, aorticopulmonary window, peridiaphragmatic region, and subcarinal region. MR is sensitive to blood flow making it an ideal imaging modality for the evaluation of cardiovascular system of the thorax without the need for intravenous contrast media. Technical developments and better control of motion artifacts have resulted in improved image quality, and clinical applications of MR imaging in thoracic diseases have been expanded. Although MR imaging is considered as a problem-solving tool in patients with equivocal CT findings, MR should be used as the primary imaging modality in the following situations: 1) Evaluation of the cardiovascular abnormalities of the thorax 2) Evaluation of the superior sulcus tumors 3) Evaluation of the chest wall invasion or mediastinal invasion by tumor 4) Evaluation of the posterior mediastinal mass, especially neurogenic tumor 5) Differentiation of fibrosis and residual or recurrent tumor, especially in lymphoma 6) Evaluation of brachial plexopathy With technical developments and fast scan capabilities, clinical indications for MR imaging in thorax will increase in the area of pulmonary parenchymal and pulmonary vascular imaging.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.2
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• pp.130-136
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• 1995

Vestibuloplasty are following categories : Mucosal advancement(submucous), secondary epithlization(reepithelization) and grafting vestibuloplasty. Although certain procedures are indicated for alveolar bone loss and sulcus shortening, relapse can occur. Every efforts to minimize or compensate for it is controversy. O'Steen(1970) reported the mucous graft methods that none of vestibular shrinkage and graft contracture. 15patients in mucous graft vestibuloplasty with fibrin adhesive system(Beriplast) were taken in cases of alveolar bone resorption and mucosal shortening due to traumatized alveolar bone defects, senile atrophic alveolar bone, postoperative cyst or tumor resection, edentulous alveolar bone loss, and others. A technique in the use of small piece of palatal mucosa$(1{\times}20mm)$ from the lateral aspect of the palate with adhesive system provided to secure the skin grafts, avoid stent fixation, postoperative patient's comfort and less time-consuming than the standard technique, especially excellent bleeding control.

• Journal of Korean Neurosurgical Society
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• v.50 no.6
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• pp.538-541
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• 2011

Objective : We evaluated a modified trans-middle temporal gyrus (MTG) approach with good postoperative visual preservation for patients with trigonal tumors. Methods : Three patients with a trigonal tumor were treated via the modified trans-MTG approach guided by a neuro-navigator. Modified trans-MTG approach involve the incision at the MTG within 5 mm to the superior temporal sulcus. This approach makes a proper trajectory to the trigone but also reduces the retraction injury of MTG as little as possible to prevent postoperative visual field defect. Preoperative and postoperative visual field examination using perimetry was performed to evaluate the visual field. Results : Three patients underwent surgery for lymphoma in the right trigone, meningioma in the left trigone, and focal enhancing nodule in the right paratrigonal area, respectively. In case of lymphoma, preoperative examination showed a left homonymous hemianopsia : one week later after surgery, a visual field examination was performed and revealed improvement of the visual field defect. In case of the meningioma, the preoperative examination showed no visual field defect : one month later, the visual field had no defect. In case of the enhancing nodule, preoperative visual field testing revealed a partial left homonymous hemianopsia. Visual examination within one month after surgery showed no visual field defect. All three patients treated with the modified trans-MTG approach showed no visual deterioration after surgery. Conclusion : The modified trans-MTG approach provides a safe and useful technique for trigonal tumors without postoperative visual field deterioration and affords adequate exposure of the trigonal tumor with a short trajectory.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.25-29
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• 2001

Objective : Intracranial metastasis is responsible for nearly 50% of mortalities of systemic cancers. Although its frequency is increasing and there is little doubt that improving the quality and expectancy of life is the final goal, the mode of treatment is still disputed. The authors report the postoperative motor function after surgery in patients with metastatic tumors around the motor cortex. Materials and Methods : We studied 24 patients with metastatic tumors around the central sulcus during the last 22 months. Motor function was assessed pre- and post-operatively as well as its response to corticosteroids. MRI, neuronavigation system and intraoperative ultrasonography were used for tumor localization and functional MRI and cortical stimulator were used to define the motor cortex. Results : Single metastasis was found in 13 cases(54%) and 11 cases(44%) had multiple foci. Thirteen cases were located in precentral, 7 in postcentral, and 4 in superior or middle-frontal lobe. The most common primary focus was the lung(16 cases). There was no difference in postoperative motor function improvement between the steroid responsive group and non-responsive group(92% versus 90%). Ninty-two percent of the patients showed significant improvement of motor function and lived independently but there was worsening in the upper extremity in one and in another no improvement. Whole brain radiation of 3000cGy was given in all cases and 4 patients died of recurrence in primary or intracranial focus during mean follow-up periods of 14 monthes. Conclusion : Surgery may provide substantial improvement of the motor function and quality of life of the patients with metastatic tumors around the motor cortex.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.10.1-10
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• 1982

The use of phonosurgery in the recent development of laryngomicrosurgery has enabled the restoration of a normal voice in respect to functional laryngeal surgery which in Korea in the past limited to simple removal of benign laryngeal tumor such as laryngeal polyp or nodules and cordal injection of $Teflon^{{\circledR}}$ for the treatment of recurrent nerve paralysis under the vision of suspension laryngoscopy. Performance of phonosurgery for the treatment of cord paralysis, mutational dysphonia, vocal cord atrophy, hyperkinetic dysphonia and sulcus vocalis is a happy event in the view point of development of phonosurgery in Korea. In this aspect thyroplasty to change the position and physical characteristics of the cord outside the glottis instead of the direct handling of the vocal cord through direct endoscopy is popular. Among the 4 types of thyroplasty, classified by Insshiki(1974), type I thyroplasty(1ateral compression of vocal cord) and type IV thyroplasty(lengthening of vocal cord) were effective in the treatment of unilateral vocal cord paralysis. Advantages of this operation are the fine adjustment of the degree of lateral compression under local anesthesia according to the phonation of the patient during operation and avoidance of dyspnea and intralaryngeal hemorrhage due to the manipulation outside the internal perichondrium of the thyroid cartilage. We did 7 cases of thyroplasty for the treatment of unilateral vocal cord paralysis in the 7 months from September 1981 to March 1982. Before the operation aerodynamic study, psychoacoustical evaluation, stroboscopy and sound spectrographic analysis were done. Two months after the operation the above procedures were performed again. Results of preoperative and postoperative examination were compared and the following results were obtained. 1) In the aerodynamic study, maximum phonation time increased to 158% of the preoperative value and the phonation quotient and the mean flow rate decreased to 58% and 54% of preoperative values. 2) The degree of hoarseness improved in the psychoacoustical evaluation and the glottic chink during phonation was decreased in the stroboscopic examiantion. 3) In the sound spectrographic analysis, periodicity was much restored and noise distribution decreased especially in the high frequency area.