• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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• pp.18.3-19
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• 1983

후비공 폐쇄는 협비막의 과열부전, 협인두막의 지속적 잔존, Olfactory pit의 발생시 불완전 등의 선천성 원인과, 매독디프테리아, 수술 후 또는 외상 등으로 오는 후천성으로 나눌 수 있으며 선천성인 경우에는 두부, 심장, 소화기 계통에 여러 가지 기형이 동반되기도 한다. Johann Roedere (1755년)은 이 질환의 예를 최초로 보고하였으며 Emmert (1853년)가 골성 폐쇄를 트로카를 이용하여 처음 수술을 시도한 이래 , 비강내, 구개, 상악동, 그리고 비중격을 통한 수술 방법이 제시되어 왔으나 이중 경주개 경유법이 술후 재협착 빈도가 가장 적고 또 수술시 폐쇄부의 확인이 용이하여 가장 널리 이용되고 있다. 저자들은 선천성 양측 부분적 골부 후비공 폐쇄를 보인 11세 남아와 선친성 우측 완전 골막부 후비공 폐쇄와 좌측 부분적 골막부 후비공 폐쇄와 좌측 부분적 골막부 후비공 폐쇄를 보인 9세 여아에서 경구개 경유법으로 치험하였기에 문헌적 고찰과 함께 보고하는 바이다.

• 대한임상검사과학회지
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• 제42권3호
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• pp.149-154
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• 2010

To improve accuracy of the immunohistochemical testing and fluorescence in situ hybridization (FISH) study as well as a routine histology diagnosis in breast cancer, quality improvement for optimal tissue handling is mandatory. We evaluate fraction defective of 7107 blocks from 349 breast cancer patients, who underwent surgical treatment at Samsung Medical Center Seoul, Korea from January 1, 2009 to March 31, 2010. We decided pre-improvement period from January, 2009 to June, 2009. In the first quality improvement period (July, 2009 to September, 2009) we made improvements in protocol of gross examination. In the second quality improvement period (October, 2009 to December, 2009) we attempted more effective formalin fixation such as frequent exchange of formalin and use of separate fixation container for each case. In the third quality improvement period (January, 2010 to March, 2010) improvement of tissue processor was performed. We achieved a marked reduction of fraction defective (9-16%) through efforts to improve quality of formalin-fixed, paraffin-embedded blocks when compared to pre-improvement period.

• 대한족부족관절학회지
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• 제6권2호
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• pp.261-264
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• 2002

Purpose: To investigate the clinical features of fistulas of the ankle joints. Materials and Methods: Seven fistulas in seven patients were reviewed during Apr. 2000 to Mar. 2002, retrospectively. There are five men and two wemen. Average age was 47.7 years (range, 42-65 years). Average follow-up period was 1.4 years. There were six cystic lesions after ankle sprain and one patient with persistent discharge after excision of bursa over lateral malleolus. Results: Duration from injury to presentation was average 9.8 years. The site of preoperative swelling was mostly over the lateral malleolus in five patients. In one patient, the area of swelling was extended to the anterolateral ankle joint and in another patient there was extensive swelling from Achilles tendon to the anterolateral ankle joint. Concomitant symptoms were instability in three patients, pain and instability in three patients. Methods of surgery were simple repair in one, modified Brostrom in three, augmentation with periosteal flap in addition to modified Brostrom in two and Chrisman-Snook in addition to augmentation with periosteal flap and modified Brostrom in one. There were no recurrence of instability as well as fistula. Conclusion: We think that the fistula of the ankle joint should be included in the differential diagnosis of the cystic lesion over the lateral malleolus and the result of surgical treatment would be satisfactory in most cases.

• Journal of Gastric Cancer
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• 제16권1호
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• pp.14-20
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• 2016

Purpose: Early diagnosis of gastric cancer is still the exception in Western countries. In the East, as in Japan and Korea, this disease is an endemic disorder. More conservative surgical procedures are frequently performed in early gastric cancer cases in these countries where sentinel lymph node navigation surgery is becoming a safe option for some patients. This study aims to evaluate preliminary outcomes of patients with early gastric cancer who underwent sentinel node navigation surgeries in Brazil, a country with non-endemic gastric cancer levels. Materials and Methods: From September 2008 to March 2014, 14 out of 205 gastric cancer patients underwent sentinel lymph node navigation surgeries, which were performed using intraoperative, endoscopic, and peritumoral injection of patent blue dye. Results: Antrectomies with Billroth I gastroduodenostomies were performed in seven patients with distal tumors. The other seven patients underwent wedge resections. Sentinel basin resections were performed in four patients, and lymphadenectomies were extended to stations 7, 8, and 9 in the other 10. Two patients received false-negative results from sentinel node biopsies, and one of those patients had micrometastasis. There was one postoperative death from liver failure in a cirrhotic patient. Another cirrhotic patient died after two years without recurrence of gastric cancer, also from liver failure. All other patients were followed-up for 13 to 79 months with no evidence of recurrence. Conclusions: Sentinel lymph node navigation surgery appears to be a safe procedure in a country with non-endemic levels of gastric cancer.

• Journal of Gastric Cancer
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• 제7권3호
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• pp.174-179
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• 2007

진단의 발달과 치료의 발전으로 위암의 치료 성적은 괄목한 성장이 이루어졌으나 근치적 위전절제술 후 암의 발생, 즉 문합부 재발암과 전이 그리고 이시성암이 발생되었을때 외과적 치료에 대한 보고와 결과는 많지 않으며, 특히 문합부에만 국소적으로 발생된 암은 흔치 않다. 근치적 위전절제술 후 문합부에만 국소적으로 발생된 암에 대하여 적극적인 수술을 함으로써 생존이 연장되었다는 보고가 있다. 연구자들은 위선암으로 근치적 위전절제술 후 발생한 문합부 국소재발 1예, 이시성 편평상피암 1예, 림프종 1예에 대하여 원격전이가 없음을 확인한 후 수술을 시행하여 모두 좋은 결과를 얻어 이에 문헌 고찰과 함께 보고하는 바이다.

• 대한예방한의학회지
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• 제14권3호
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• pp.77-92
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• 2010

Objectives : There has been little known about the Tibetan medicine in the society for Korean medicine. The aim of this study is to review the system of Tibetan medicine and compare with Korean medicine. Methods : The authors investigated several literatures that mentioned Tibetan medicine and organized in physiology, pathology, diagnostics, and treatment. And then, we interpreted the characteristics of Tibetan medicine as well as compared Tibetan medicine with Korean medicine. After that, we analyzed the commons and the differences, and also found out the meaning of Tibetan medicine. Results : The theory of Tibetan medicine is basically constituted of three elements of Lung, Tripa, and Peken in every parts of physiology, pathology, diagnostics, and treatment. Many organs of human body are compared to the fabrications of building. There is a detail explanation about the process of the development of fetus in Tibetan medicine. Tibetan medicine uses taking pulse in wrist, analysis of urine, watching of tongue, sperm, and menstruation, and etc. for diagnosis. In Tibetan medicine, regimen is prior to other treatments such as surgical treatment and medications. Conclusions : There is the oriental thought of '3' in Tibetan medicine, and esoteric buddhism is solved in Tibetan medicine. The anatomy and the diagnostics using urine, sperm, and menstruation have especially been developed in Tibetan medicine. Tibetan medicine emphasizes the feature of preventive medicine.

• 대한치과마취과학회지
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• 제3권1호
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• pp.34-37
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• 2003

Postoperative stroke is uncommon even in elderly patients, who have a higher incidence of all types of postoperative complications. The mechanism of postoperative stroke is not certain, but can be explained by intravascular clottings originated from thrombus or embolus or by intracranial hemorrhage. In a 66-year-old male patient with current hypertension medication, who underwent both neck dissection for malignancy metastasis under general anesthesia, the left hemiparesis and delayed emergency were found postoperatively. After transferred to intensive care unit, he got the thrombolytic therapy and then the therapies to decrease the swelling of the brain on the diagnosis of cerebral infarction in the vascular distribution of the middle cerebral artery. A brain MRI definitely showed the midline deviation to the left of the right brain hemisphere due to the progressing edematous changes. As he got worse, the emergency neurosurgical operation was proposed but rejected by his family. He died at postoperative 3 days. In this hypertensive patient. perioperative stroke could be originated from the surgical stimuli on major vessels, which were inevitable in neck dissection during the operation. We report this case of the postoperative stroke, which could be highly possible to be associated with extensive head and neck surgery.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.609-615
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• 2011

Purpose: Dermatofibrosarcoma protuberans is a relatively rare tumor that originates from the dermis and subcutaneous tissue. It is generally known that this tumor easily recurs but can be successfully treated with a wide excision. Therefore, this study was conducted to investigate postoperative outcomes and risk factors for recurrence in patients with dermatofibrosarcoma protuberans who were treated at a single institution for 20 years. Methods: We retrospectively reviewed the medical records of 35 patients who had underwent surgery between June 1992, and September 2010. The patients were assessed in terms of predilection site and size of the tumor, the incidence according to sex, discrepancy between biopsy results and histopathological diagnosis of the surgical specimen, additional treatment after recurrence, recurrence rate and the time interval to recurrence. Results: In multivariate analysis, the depth and site of the tumor were significant risk factors for tumor recurrence. The recurrence rate was significantly higher in tumors occurring in the upper extremity than those occurring in other regions ($p$=0.0348). In addition, the recurrence rate was significantly higher in tumors with involvement of the fascia and the deeper structures ($p$=0.0324, odds ratio=6, relative risk=1.588). Since dermatofibrosarcoma protuberans has strong invasiveness, its tissue involvement is difficult to evaluate accurately. Conclusion: The results of this study shows that involvement of the fascia and the deeper structures and occurrence in the upper extremity were associated with tumor recurrence. Therefore, clinicians should be aware of these risk factors to achieve better treatment outcomes.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.711-714
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• 2011

Purpose: Angiosarcoma is a rare malignant neoplasm of endothelial type cells that line vessel walls. It tends to occur in aged male and the prognosis of angiosarcoma is very poor because of frequent local recurrence and early metastasis. The treatment regimen is yet to be established from its rare occurrence but the wide excision in early stage is known to be the most effective. The authors report two cases of near totally excised angiosarcoma with more than a safety margin of 5 cm. Methods: The two subjects were aged male patients, one of the two was diagnosed with angiosarcoma from our institution confirmed by the biopsy. The other one went through the wide excision with a safety margin of 2 cm and split-thickness skin graft but local recurrence was observed. The two patients underwent near total excision with more than a safety margin of 5 cm, leaving only the periosteum. After confirming that the angiosarcoma had not infiltrated the excision margin, reconstruction with split-thickness skin graft was performed. Results: Based on 6 months and 24 months post-surgery assessment, no local recurrence or remote metastasis in the lungs, liver, bones, and lymph nodes at the neck, where remote metastasis is common, was reported by the two subjects who underwent near total excision with a safety margin of 5 cm. Conclusion: Angiosarcoma has very poor prognosis from its frequent recurrence and metastasis. To enhance the survival rate of angiosarcoma patients, early diagnosis, timely surgical treatment, and radiotherapy after surgery are critical. In addition, authors suggest that it is necessary to further study the efficacy of wide excision using a wider safety margin as much as possible, and to apply this to more cases.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.421-426
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• 2010

Purpose: Patients with serious burns are prone to chondritis due to lack of soft tissue in the auricle, which can cause severe defects in the auricular morphology. In addition, skin damage occurs frequently in the vicinity of post-burn wounds, presenting difficulties in reconstruction surgery. An auricular reconstruction has functional and cosmetic significance. The aim of this study is to develop appropriate reconstruction methods for auricular defects. Methods: Thirty seven patients, who were treated for auricular defects from 2005 to 2009, were enrolled in this study. A local flap, multiple regional flaps and cartilage framework with or without a temporal fascial flap were applied in reconstruction surgery according to the location of the auricular defect. Results: The age of the subjects ranged from 11 to 56. Some subjects had defects that cover more than half of the helical rim with most exhibiting post-burn scars in the vicinity, for whom a multiple regional flap was used. A single use of a tubed flap was sufficient for subjects with defects that covered less than half of the helical rim. A regional flap was also used for reconstruction in subjects with defects covering both the helical rim and antehelix. Conclusion: Achieving satisfactory results from the skin flaps and skin grafts for post-burn auricular defects in both functional and cosmetic aspects is a difficult task. Therefore, selecting an appropriate surgical method through proper diagnosis of the auricular defect and the state of the available skin in the vicinity is essential.