• Journal of Yeungnam Medical Science
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• v.9 no.2
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• pp.321-326
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• 1992

The study consisted of all patients over 35years old undergoing surgical repair of atrial septal defect for the period from June 1985, to August 1992. The following results were observed. 1. ASD was closed with patch in 11(73%) patients. 2. The relationship of pulmonary artery systolic pressure to Qp/Qs ratio was not significant. 3. Before operation 6 patients were in NYHA functional class II, 8 were in class III, After operation 8 patients were in class I, 6 were in class II. 4. Atrial fibrillation has persisted in 3 patients and returned regular rhythm in 1 patient after surgery. 5. There was no operative mortality and we had good surgical results regardless of patient's age.

• Journal of Korean Neurosurgical Society
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• v.58 no.6
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• pp.571-577
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• 2015

Direct removal of beak-type ossification of posterior longitudinal ligament at thoracic spine (T-OPLL) is a challenging surgical technique due to the potential risk of neural injury. Slipping off the cutting surface of a high-speed drill may result in entrapment in neural structures, leading to serious complications. Removal of T-OPLL with an ultrasonic osteotome, utilizing back and forth micro-motion of a blade rather than rotatory-motion of drill, may reduce such complications. We have applied the ultrasonic osteotome for posterior circumferential decompression of T-OPLL for three consecutive patients with beak-type OPLL and have described the surgical techniques and patient outcomes. The preoperative chief complaint was gait disturbance in all patients. Japanese orthopedic association scores (JOA) was used for functional assessment. Scores measured 2/11, 5/11, 2/11, and 4/11 for each patient. The ventral T-OPLL mass was exposed after posterior midline approach, laminotomy and transeversectomy. The T-OPLL mass was directly removed with an ultrasonic osteotome and instrumented segmental fixation was performed. The surgeries were uneventful. Detailed surgical techniques were presented. Gait disturbance was improved in all patients. Dural tear occurred in one patient without squeal. Postoperative JOA was 6/11, 10/11, 8/11, and 8/11 (recovery rate; 44%, 83%, 67%, and 43%) respectively at 18, 18, 10, and 1 months postoperative. T-OPLL was completely removed in all patients as confirmed with computed tomography scan. We hope that surgical difficulties in direct removal of T-OPLL might be reduced by utilizing ultrasonic osteotome.

• Journal of Korean Neurosurgical Society
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• v.37 no.6
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• pp.405-409
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• 2005

Objective: The purpose of this study is to assess the factors related to the outcome of 84 patients who underwent surgery for anterior communicating Artery(ACoA) aneurysms. Methods: The authors review 84 patients who were undertaken from January 1998 to May 2004. In the management of ACoA aneurysms, the outcome was based on several factors: Clinical condition, Distribution of hemorrhage, Time between aneurysmal rupture and surgery, Direction and shape of the aneurysm. Results: The incidence rate of the ACoA aneurysm was 35%. Seventy four patients were classified as those having a good recovery, but 5 patients suffered from some morbidity and 5 patients died. The rate of good outcome for the patients with Hunt and Hess grade was as follows 100% in grade I, 95% in grade II, 80% in grade III, IV and V. The rate of good outcome for the patients with Fisher grade was as follows 98% in grade I, II and 81% in grade III, IV. Nineteen of 22 patients who underwent early surgery were rated as good, while twenty six of 30 patients for whom surgery was delayed showed a favorable result. The unfavorable outcomes were also attributed by vasospasm or other medical problems. Conclusion: For further improvement of the overall surgical outcome: First, early surgical intervention is recommended for good grade patients. Second, active management of poor grade patients should be scrutinized with early surgery. Third, it is also important to step up the effort to minimize the risk of medical complications to enhance surgical results on top of the mainstay of prevention efforts for vasospasm and rebleeding.

• Convergence Security Journal
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• v.19 no.5
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• pp.75-84
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• 2019

Recently, the value of video as an important data of medical information technology is increasing due to the feature of rich clinical information. On the other hand, video is also required to be de-identified as a medical image, but the existing methods are mainly specialized in the stereotyped data and still images, which makes it difficult to apply the existing methods to the video data. In this paper, we propose an automated system to index candidate elements of personal identification information on a frame basis to solve this problem. The proposed system performs indexing process using text and person detection after preprocessing by scene segmentation and color knowledge based method. The generated index information is provided as metadata according to the purpose of use. In order to verify the effectiveness of the proposed system, the indexing speed was measured using prototype implementation and real surgical video. As a result, the work speed was more than twice as fast as the playing time of the input video, and it was confirmed that the decision making was possible through the case of the production of surgical education contents.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.3
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• pp.204-209
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• 2012

Surgical extrusion, immediate extrusion following tooth luxation, is a method to preserve one's natural tooth and achieve esthetic restoration without additional periodontal surgery when subgingival dental caries or crown fracture occurs. A 16-year-old male was referred to the clinic from the department of operative dentistry for the esthetic restoration of maxillary left lateral incisor. Due to the crown to root fracture, the tooth was endodontically treated with a buccal crown length of 4 mm. When the palatal flap was elevated, the mesiopalatal cervical fracture area was situated 3-4 mm subgingivally. Crown lengthening was achieved through surgical extrusion. After 3 months of clinical observation and provisional restoration, the maxillary left central incisor was restored with all ceramic crown and obtained a satisfactory clinical result.

• Journal of Chest Surgery
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• v.33 no.4
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• pp.301-305
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• 2000

Background: The surgical indications of stage IV non-small cell lung cancer(NSCLC) are extremely limited with its controversial results. We analyzed the surgical results and survival in selected patients with resectable stage IV NSCLC. Material and Method: We reviewed the medical records of 21 patients who underwent operation for stage IV NSCLC from Jan. 1992 to Sep. 1999. Result: The mean age of patients was 55.6 years(range: 35 to 78). Sixteen were men and 5 were women. Tissue types were squamous cell carcinoma in 10(45.5%), adenocarcinoma in 9(40.9%), large cell carcinoma in 1 and carcinosarcoma in 1. Distant metastatic lesions were ipsilateral other lobe of lung in 18, brain in 2 and adrenal gland in 1. Pneumonectomy was performed in 16 patients, bilobectomy in 3, and lobectomy in 2 who underwent previous operatin for brain metastasis. Mean follow-up duration was 21.2$\pm$17.7 months. During follow-up period, 13 patients died. Three-and 5-year survival of patients were 38.0% and 19.0%, the median survival time was 19.1$\pm$7.8 months. In the group with ipsilateral pulonary metastasis(PM, n=18), 3- and 5-year survival of patients with N0 and N1(n=9) disease were 64.8% and 32.4%, median survival time was 55.3$\pm$27.2 months. Three-year survival of patients with N2(n=9) disease was 11.1%, median survival time was 10.6$\pm$0.3 months. The survival of N0 and N1 disease group was significantly better than that of N2 disease group(p=0.042). Also the disease free survival of N0 and N1 was significantly better than that of N2 disease in overall group(53.3 months vs 12.1 months, p=0.036) and ipsilateral PM group(63.4 months vs 8.8 months, p=0.001). Conclusion: We suggest that surgical treatment is worthful modality in well selected patients with stage IV NHSCLC especially with ipsilateral PM and N0 or N1 disease,. Nevertheless our study indicate questions that will need to be experienced further in larger studies.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1175-1183
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• 1997

Background. Infective endocarditis s an uncommon but serious disease in children. Optimal treatment strategy, especially surgical indications, continues to evolve. Method. In this report, we retrospectively reviewed 19 patients who underwent operations in Seoul National University Children's Hospital for infective endocarditis between September 1986 and February 1996. There were 8 male and 11 female patients(mean age 70.6 months) and their main symptoms were fever and dyspnea. Preoperative echocardiography detected vegetation in 14 cases out of 19. Congenital anomalies were in 15 cases and acquired forms were in 4 cases. Causative organisms were identified in 12 cases and Gram-positive cocci were in 7 cases. Adequate preoperative antibiotic management was done. Result. With cardiopulmonary bypass in all cases, surgical corrections including vegetation removal were performed. 4 patients died after operations(21.1%). All the mortality cases were having underlying complex cardiac anomalies. There were no late deaths. Act arial survival rate was 79.0% at 1 year and 79.0% at 5 year and reoperationfree survival rate was 73.7% at 1 year and 73.7% at 5 year. Collclusion. Despite advances in antibiotic therapy, early surgical treatment is imperative in a significant subset, and concurrent intracardiac repair should be appropriate.

• Journal of Chest Surgery
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• v.48 no.3
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• pp.193-198
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• 2015

Background: Patients on dialysis undergoing surgery belong to a high-risk group. Only a few studies have evaluated the outcome of major thoracic surgical procedures in dialysis patients. We evaluated the outcomes of pulmonary resection for non-small cell lung cancer (NSCLC) in patients on hemodialysis (HD). Methods: Between 2008 and 2013, seven patients on HD underwent pulmonary resection for NSCLC at our institution. We retrospectively reviewed their surgical outcomes and prognoses. Results: The median duration of HD before surgery was 55.0 months. Five patients underwent lobectomy and two patients underwent wedge resection. Postoperative morbidity occurred in three patients, including pulmonary edema combined with pneumonia, cerebral infarction, and delirium. There were no instances of in-hospital mortality, although one patient died of intracranial bleeding 15 days after discharge. During follow-up, three patients (one patient with pathologic stage IIB NSCLC and two patients with pathologic stage IIIA NSCLC) experienced recurrence and died as a result of the progression of the cancer, while the remaining three patients (with pathologic stage I NSCLC) are alive with no evidence of disease. Conclusion: Surgery for NSCLC in HD patients can be performed with acceptable perioperative morbidity. Good medium-term survival in patients with pathologic stage I NSCLC can also be expected. Pulmonary resection seems to be the proper treatment option for dialysis patients with stage I NSCLC.

• Journal of Chest Surgery
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• v.32 no.1
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• pp.27-31
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• 1999

Background: In spite of the development of chemotherapy, prognosis of metastatic lung cancer was poor. On the other hand, surgical intervention has proven itself to bring out superior results, therefore more operations are being praticed based on this superiority against chemotherapy and other modalities on metastatic lung cancer. Material and Method : We analyzed the surgical cases performed from 1983 to 1997 on 17 cases and estimated 5 year survival rate using Kaplan-Meier method. Result: Average age was 42.8, ratio between male and female was 10:7. We had 8 single lobe resections,3 pneumonectomies,1 wedge resection,2 bilobectomy and 3 cases of lobar resection with wedge resection. 5 deaths have occured and among the 5, 3 patients were caused by recurrence of ca. The remaining 12 patients are being followed up in OPD basis among these, 3 recurrence were observed and 9 are still free of cancer. The average survival time was 40.5 months and 5 year survival rate obtained through the Kaplan-Meier method was 60.4%. Conclusion: Even though we are a bit short of cases, we recommend that a thoracic surgeon approach this disease through a surgical method as possibly as he could.

• Korea Journal of Hospital Management
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• v.5 no.2
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• pp.22-39
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• 2000

The purpose of this study was to determine the difference between estimated profit and utilization of medical equipment upon purchasing and actual results at one teaching hospital in Seoul, Korea Medical equipments over $100,000 from 1992 to 1997 were selected and results were as follows: 1. Twenty equipments out of thirty exceeded estimated profits and the difference was 3.98 billion won and ten equipments did not reach the estimated profits and 5.5 billion won was the difference. Diagnostic equipment exceeded the estimated profit which surgical equipment didn't. 2. Eleven equipments exceeded estimated utilization, which showed 100%. In the mean time, eighteen equipments didn't reach the estimated utilization, which was 71%. Diagnostic equipment showed the less estimated utilization than surgical equipment 3. Twenty-one equipments showed the 6.83 billion won profits and nine equipments showed the 1.6 billion won deficits. Diagnostic equipment was more profitable than surgical equipment. Finally. diagnostic equipment helped improving hospital management than surgical equipment. 4. Main factors which showed the big difference from the initial plan were lacking reasonable estimated method, no evaluation system for purchase, emphasis in medical treatment, excessive expenditure in maintenance, duplicated investment for medical equipment and leadership commitment. As a result. Substantial planning is required from the requesting department in consideration of estimated profit and utilization and systematic quality control is needed to confirm. Also, One-sided decision making should be avoided to purchase a high cost medical equipment and efforts should be made in examining carefully and developing a reasonable analytic method.