• Korean Journal of Head & Neck Oncology
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• v.23 no.1
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• pp.37-40
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• 2007

Objectives：Cutaneous angiosarcoma is an infrequent but aggressive neoplasm involving the skin of the face and scalp. Unfamiliarity with the clinical manifestations of cutaneous angiosarcoma frequently leads to misdiagnosis and delay in treatment. Complete surgical resection requires the performance of preoperative staging biopsies to determine the true extent of the neoplasm. Intraoperative frozen section analysis to determine the adequacy of the surgical resection is unreliable due to the high false negative rate. Material and Methods：In five scalp angiosarcoma cases, mapping biopsies were performed at far from the suspected edge of the neoplasm. On permanent pathology, we obtained tumor free margin with occasional focal involvement of the tumor. Results：Frozen-section analysis of the resected margins is inconclusive, for the subtle diagnostic features of angiosarcoma are distorted by the tissue processing required for frozen-section analysis. The characteristic dermal vessels lined by their malignant cells are collapsed by the freezing process. This results in a high rate of false-negative reports and possibly leads to incomplete resection of the neoplasm. Conclusion：Our recommendation is to establish the margins of the tumor by performing preoperative evaluations by mapping biopsies.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.192-197
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• 2007

Purpose: The purpose of this study is to present our clinical results after surgical treatment in tarsal tunnel syndrome due to space occupying lesions. Material and Methods: We performed surgical decompression for tarsal tunnel syndrome in 20 patients from July 2004 to February 2007. Out of them, thirteen cases were due to space occupying lesions around the tarsal tunnel. The average age at operation was 51.3 years old and the duration from symptom onset to surgery was 16.5 months. The operation included removal of space occupying lesions and tarsal tunnel decompression. The clinical parameters were pain visual analogue scale (VAS), AOFAS scale, and subjective satisfaction. Results: The ganglion cysts were the most frequent causes (ten cases) and synovial chondromatosis in 1 case, neurofibroma in 1 case, talocalcaneal coalition in 1 case. The average follow-up duration was 14.5 months. The AOFAS scale showed significant improvement from 77.8 to 92.7. The average VAS decreased from 6.4 to 2.2. Seven out of thirteen patients were satisfied with the results. The excellent results were shown in six patients, the good results in one patient, the fair result in three patients and the unsatisfactory results in three patients. Conclusion: Favorable results could be obtained in patients with known etiology. But not all cases with surgical decompression of space occupying lesions showed satisfactory results. We assume that the clinical results were related to the multiple factors, not only well performed surgery but also age, size lesions and duration of symptoms, ect.

• Journal of Trauma and Injury
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• v.32 no.4
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• pp.195-201
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• 2019

Purpose: This study was conducted to investigate the usefulness of a polyester urethane dural substitute (Neuro-Patch^®, B. Braun, Boulogne, France) as an anti-adhesion agent in subsequent cranioplasty by analyzing the use of Neuro-Patch^® during decompressive craniectomy in traumatic brain injury patients. Methods: We retrospectively analyzed patients with traumatic brain injury who underwent decompressive craniectomy followed by cranioplasty from January 2015 to December 2018. Patients were analyzed according to whether they received treatment with Neuro-Patch^® or not (Neuro-Patch^® group, n=71; control group, n=55). Patients' baseline characteristics were analyzed to identify factors that could affect cranioplasty results, including age, sex, hypertension, diabetes mellitus, use of antiplatelet agents or anticoagulant medication, the interval between craniectomy and cranioplasty, and the type of bone used in cranioplasty. The cranioplasty results were analyzed according to the following factors: operation time, blood loss, postoperative hospitalization period, surgical site infection, and revision surgery due to extra-axial hematoma. Results: No significant difference was found between the two groups regarding patients' baseline characteristics. For the cranioplasty procedures, the operation time (155 vs. 190 minutes, p=0.003), intraoperative blood loss (350 vs. 450 mL, p=0.012), and number of surgical site infections (4 vs. 11 cases, p=0.024) were significantly lower in the Neuro-Patch^® group than in the control group. Conclusions: The use of Neuro-Patch^® was associated with a shorter operation time, less blood loss, and a lower number of surgical site infections in subsequent cranioplasties. These results may provide a rationale for prospective studies investigating the efficacy of Neuro-Patch^®.

• Journal of Korean Neurosurgical Society
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• v.29 no.5
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• pp.628-634
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• 2000

Objective : The introduction of MRI makes it easy to detect multiple lumbar disc herniation. However, MRI is not a physiologic test for detecting the symptomatic level. For the surgical plan, it is very important to determine the symtomatic level among the multiple lumbar disc herniation. In this regard, we studied diagnostic significance of discography on multiple lumbar disc herniation in determining the symptomatic level. Method and Material : We retrospectvely analyzed the discographic and clinical findings of 121 patients with multiple lumbar disc herniation for investigating the diagnostic availability of discography. All were surgically treated from January 1995 through May 1998. Result : Discography provocated the same pain as usual symptom in 99 out of 121 patients(81.8%). Compared with surgical findings, the diagnostic accuracy of the discography in multiple lumbar disc herniation was 75.6%, sensitivity was 64.6%, and specificity 87.2%. There was no correlation between the pain provocation of discography and the extent of annular degeneration on CT/discogram. The pain provocation showed good correlation with the extent of annular disruption on CT/discogram. The rate of same result(correlation rate) between the discography and D.I.T.I was 81.4% in multiple lumbar disc herniation patients with unilateral leg pain. Conclusion : These results indicate that in multiple lumbar disc herniation, the discography is considered useful diagnostic tool to determine the symptomatic level and to decide the surgical plan.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.158-163
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• 1999

Background: The author studied to define the current indications for surgical management of chest tuberculosis and to analyze the results of the operative procedures. Material and Method: The records of 87 patients among 107 patients operated on between January 1992 and May 1995 were reviewed. These patients were divided into 4 groups. Group I patients (n=45) underwent decortication with or without wedge resection of the lesion. Group II patients(n=23) underwent radical curettages of chest wall involving rib caries with or without thoracotomy. Group III patients(n=12) underwent standard pneumonectomy or pleuropneumonectomy. Group IV patients(n=7) underwent exploratory thoracotomy or wedge resection of tuberculous lung lesion. Result: Statistical analysis revealed an inverse correlation between AIs and intratumoral microvessel densities in squamous cell lung carcinoma(Spearman rank correlation coefficient r=- 0.229, p=0.047). Conclusion: The author concludes that surgery for chest tuberculosis is the definite management for therapeutic indications and surgical radication of tuberculous carriers for management of chest tuberculosis is safe and has satisfactory results.

• Journal of Chest Surgery
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• v.33 no.1
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• pp.68-72
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• 2000

Background: The resection of recurrent non-small cell lung cancer can be performed very rarely. There has been many arguments for longterm result and therapeutic role in surgical management of recurrent non-small cell lung cancer(NSCLC). We analyze our result of surgical re-resection of recurrent NSCLC for 10 years retrospectively. Material and Method: In the period from 1987 to 1997, 702 patients who had been confirmed for NSCLC had undergone complete resection in Seoul National University Hospital. As December 1997, 22 of these patients have been operated on the diagnosis of recurrent lung cancer. In these patients one has revealed for benign nodule at postoperative pathologic pathologic was unresectable. and two had revealed other cell type on postoperative pathologic examination. Analysis about postoperative survival rate and the factors that influence postoperative survival rate - sex, age, pathologic stage, cell type, operation adjuvant therapy after first and second operation location of recurrence disease free survival-was 59.1$\pm$10.9 year. There were 14 men and 3 women. Four patients was received radiation therpy after first opration and two patients was received postoperative chemotherapy. At first operation 2 patients was stage Ia, 8 was stage Ib, 1 was stage IIa 6 was stage IIb. Eleven patients had squamous. cell carcinoma at postoperatrive pathologic examination five had adenocarcinoma and one had bronchioalveolar carcinoma. In second operation 8 patients were received limited resection. 9 were received lobectomy or pneumonectomy. One-year survival rate was 82.4% and five-year survival rate was 58.2% Non-adjuvant therapy group after initial operation was more survived than adjuvant therapy group statistically. Conclusion: operation was more survived than adjuvant therapy group statistically. Conclusion : Operation was feasible treatment modality for re-resectable non-small cell lung cancer. But we cannot rule out possibility of double primary lung cancer for them. Postoperative prognostic factor was adjuvant therapy or nor after first oepration but further study of large scale is needed for stastically more valuable result.

• Archives of Plastic Surgery
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• v.40 no.6
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• pp.735-741
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• 2013

Background The prosthetic dura is an essential element in the protection of the cranial parenchyma and prevention of cerebrospinal fluid leakage. Although prosthetic dura are widely used in neurosurgery, they occasionally provoke infection, which can be a major concern after neurosurgical treatment. However, removal of the prosthetic dura carries a risk of brain parenchyma injury and cerebrospinal fluid leakage. The salvage of infected prosthetic dural material has not been adequately addressed in the literature. In this study, we demonstrate the value of the combination of a meticulous surgical debridement of necrotic tissue and simultaneous muscle free flap for intractable postoperative epidural abscess without removal of the infected prosthetic dura. Methods Between 2010 and 2012, we reviewed the data of 11 patients with persistent infection on the prosthetic dura. The epidural infections each occurred after a neurosurgical procedure, and there was soft tissue necrosis with the disclosure of the underlying prosthetic dura and dead bone around the scalp wound. To salvage the infected prosthetic dura, meticulous debridement and a muscle free flap were performed. Results All 11 patients experienced complete recovery from the complicated wound problem without the need for further surgical intervention. No signs of prosthetic dural infection were observed during the mean follow-up period of 11 months. Conclusions The combination of a meticulous surgical debridement and coverage with a muscle free flap is an effective treatment for salvage of infected prosthetic dura.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3031-3035
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• 2012

Background: Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. Methods: The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Results: Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. Conclusion: FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.40-45
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• 1999

Objectives: Maxillary cancer is notorious for its poor prognosis because it is usually detected lately and the majority of patients have advanced disease. Especially when the cancer extended to infratemporal fossa or pterygopalatine fossa it is very difficult to remove all the involved structure by conventional maxillectomy. In these cases we have used radical maxillectomy through lateral approach. We tried to figure out the clinical significance of this procedure. Material and Methods: This study retrospectively analyzed 23 patients with squamous cell carcinoma of the maxillary sinus who underwent surgical treatment for cure. Among them 17 patients(group A) were treated with initial surgery and 6 patients(group B) underwent salvage surgery after radiotherpy. Radical maxillectomy was performed in 12 patients and conventional total maxillectomy in 11 patients. Results: In group A, 3 out of 9 total maxillectomy case and none of 8 radical maxillectomy case were recurred. In group B one patient died of postoperative complication and among the other 5 patients only one out of 3 radical maxillectomy was salvaged and 2 total maxillectomy cases were died of intercurrent disease. Conclusion: Wide surgical dissection of pterygopalatine fossa and infratemporal fossa may improve the survival rate in patients with posterior wall invasion of maxillary sinus.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.623-629
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• 2000

Background: There has been controversy over the prevalence of recoarctation in infants treated by subclavian flap aortoplasty(SFA) for coarctation of the aorta. To assess the rate of recurrence of coarctation after SFA, we reviewed the surgical results of SFA in infants with coarctation of the aorta. Material and method: Between 1986 and 1998, a total of 25 patients less than 1 year of age(12 neonates and 13 infants) underwent SFA for aortic coarctation. Age at operation was 3.0$\pm$3.0 months(mean $\pm$ standard deviation); mean weight was 5.0$\pm$1.4kg. Classic SFA was performed in 20 patients, reversed SFA in 2 patients, subclavian artery reimplantation in 2 patients and the combined resection-flap aortoplasty in one. Result: The aortic clamping time ranged from 20 to 88 minutes(mean 35.8 minutes). There were one operative death and two late deaths. There was no case of paraplegia or left arm ischemia in complications. Twenty-one(84%) of 24 hospital survivors were followed for 26.0$\pm$24.0 months. The risk of recoarctation in neonates(33.3%) was a little greater than infants(25.0%) without statistical significance. Conclusion: This study revealed that SFA resulted a relatively high incidence of recarctation in infants. It is desirable to select other methods of surgical treatment(combined resection-flap aortoplasty, extended end-to-end repair etc.) for severe isthmic coarctation or hypoplasia of the distal aortic arch in infants, instead of choosing SFA indiscriminately.