• 대한두개안면성형외과학회지
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• 제17권4호
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• pp.211-217
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• 2016

Background: Nonsyndromic craniosynostosis is a relatively common craniofacial anomaly and various techniques were introduced to achieve its operative goals. Authors found that by using smaller bone fragments than that used in conventional cranioplasty, sufficiently rigid bone union and effective regeneration capacity could be achieved with better postoperative outcome, only if their stable fixation was ensured. Methods: Through bicoronal incisional approach, involved synostotic cranial bone together with its surrounding areas were removed. The resected bone flap was split into as many pieces as possible. The extent of this 'multi-split osteotomy' depends on the degree of dysmorphology, expectative volume increment after surgery and probable dead space caused by bony gap between bone segments. Rigid interosseous fixation was performed with variable types of absorbable plate and screw. In all cases, the pre-operational three-dimensional computed tomography (3D CT) was checked and brain CT was taken immediately after the surgery. Also about 12 months after the operation, 3D CT was checked again to see postoperative morphology improvement, bone union, regeneration and intracranial volume change. Results: The bony gaps seen in the immediate postoperative brain CT were all improved as seen in the 3D CT after 12 months from the surgery. No small bone fragment resorption was observed. Brain volume increase was found to be made gradually, leaving no case of remaining epidural dead space. Conclusion: We conclude that it is meaningful in presenting a new possibility to be applied to not only nonsyndromic craniosynostosis but also other reconstructive cranial vault surgeries.

• Journal of Chest Surgery
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• 제26권1호
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• pp.47-53
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• 1993

The high relapse rate after curative surgery of lung cancer suggests that tumor cells are remained at the site of resection and in the distant organs. Postoperative radiochemoimmunotherapy including protein-bound polysaccharide PS-K[Copolang] and/or chemotherapy to improve the prognosis in lung cancer has been adopted. The patients with lung cancer who were treated with a combined modality therapy after surgery were reviewed to determine the effects of adjuvant immunotherapy[PS-K] and the relationship between midterm survival and clinicopathologic variables. During the past 5 years, 95 patients with lung cancer underwent resective operation. Of them, 30 cases were curative surgery, 29 were relative curative surgery, and the remainders were non-curative surgery. Postoperative combination therapies consisted of three types of therapies: postoperative BRM[biological response modifiers] with PS-K [Copolang] 50 mg/kg for 24 weeks[Group 1], chemoimmunotherapy with chemotherapy[a combination of cisplatin, etoposide, vindesine] and PS-K [Group 2], radioimmunotherapy with postoperative prophylactic irradiation to the mediastinum at total dose of 54 Gy-60 Gy and PS-K [Group 3] and surgery without adjuvant therapy[Group 4]. Twenty months survival rates of localized disease [Stages I and II] treated with PS-K, with radioimmunotherapy and no therapy were 73 %, 60 %, and 50 %, respectively [p [0.05]. Three-year survival rates of regionally advanced cases [stage Ilia and IIIb] were 23 % in Group 1.57 % in Group 2.20 % in Group 3, and 0 % in Group 4, respectively.According to above results, we suggest that postoperative combination therapy including PS-K might improve the prognosis of lung cancer. The similar survival pattern of patients with squamous cell carcinoma and adenocarcinoma treated with BRM, chemoimmunotherapy or radioimmunotherapy need to evaluate the role of postoperative immunotherapy[PS-K] in randomized studies.

• Journal of Chest Surgery
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• 제57권2호
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• pp.169-177
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• 2024

Background: Pericardial effusion (PE) is a serious condition in cancer patients, primarily arising from malignant dissemination. Pericardial window formation is a surgical intervention for refractory PE. However, the long-term outcomes and factors associated with postoperative survival remain unclear. Methods: We retrospectively analyzed data from 166 oncology patients who underwent pericardial window formation at Samsung Medical Center between 2011 and 2023. We analyzed survival and PE recurrence regarding surgical approach, cancer type, and cytopathological findings. To identify factors associated with survival, we utilized Cox proportional-hazards regression. Results: All patients had tumors documented in accordance with the American Joint Committee on Cancer staging manual, including lung (61.4%), breast (9.6%), gastrointestinal (9.0%), hematologic (3.6%), and other cancers (16.4%). Surgical approaches included mini-thoracotomy (67.5%) and thoracoscopy (32.5%). Postsurgical cytopathology confirmed malignancy in 94 cases (56.6%). Over a median follow-up duration of 50.0 months, 142 deaths and 16 PE recurrences occurred. The 1-year overall and PE recurrence-free survival rates were 31.4% and 28.6%, respectively. One-year survival rates were significantly higher for thoracoscopy recipients (43.7% vs. 25.6%, p=0.031) and patients with negative cytopathology results (45.1% vs. 20.6%, p<0.001). No significant survival difference was observed between lung cancer and other types (p=0.129). Multivariate analysis identified New York Heart Association class, cancer stage, and cytopathology as independent prognostic factors. Conclusion: This series is the largest to date concerning window formation among cancer patients with PE. Patients' long-term survival after surgery was generally unfavorable. However, cases with negative cytopathology or earlier tumor stage demonstrated comparatively high survival rates.

• Medical Lasers
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• 제8권1호
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• pp.35-38
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• 2019

Thread-lifting is a minimally invasive procedure that shows good results and fewer complications as compared with those results and complications of standard surgery. Many procedures and techniques have been developed to create a younger appearance of facial/neck skin for aging people, and the demand for an improved aesthetic appearance is increasing. Since the incidence of side effects is much less than that of non-absorbable threads, which can lead to complications such as foreign body reactions, polydioxanone (PDO) threads are predominantly used for face lift procedures. A 66-year-old woman presented to our clinic with inflamed palpable masses. She had undergone a face lift with absorbable threads in our clinic 5 months previously. Excisional biopsy was performed with the patient under local anesthesia. During the operation, any threads were not detected and there was both fibrotic scar tissue and granulomatous tissue. For effectively promoting healing and managing the scars, treatment with LDM^®-MED was performed on the day after surgery. The treatment was performed according to the author's protocol. Although foreign body granuloma as a complication after using non-absorbable thread types have been previously reported, it is relatively rare to find this type of complication after using absorbable thread. In this report, we present a case in which a 66-year-old female with foreign body granuloma after undergoing a face lift using absorbable threads was treated with the application of dual-frequency ultrasound, which promoted wound healing.

• Journal of Gastric Cancer
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• 제1권3호
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• pp.150-154
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• 2001

Purpose: Multiple early gastric cancers were found in $6.9\∼11.7\%$ of patients with early gastric cancer. The goal of this study was to clarify the clinicopathologic features of and to investigate treatment strategy for multiple early gastric cancer. Materials and Methods: Of 967 patients with an gastric adenocarcinoma who were treated by surgical resection during the period of $1993\∼1998$ at the Department of Surgery, Korea University College of Medicine, 267 patients had early gastric cancer. A retrospective analysis of the clinicopathologic differences between the main and the accessory lesions in multiple early gastric cancer was carried out. A comparative analysis was also conducted between solitary early gastric cancer and multiple early gastric cancer. Results: Of 267 patients with early gastric cancer, multiple early gastric cancers were found in 12 patients ($4.5\%$), including 10 men and 2 women. Eleven patients with multiple early gastric cancer had one accessory lesion and 1 patient had 2 accessory lesions. Of the 13 accessory lesions, 7 ($53.8\%$) were located in the same region as the main lesion. The most frequent combination of macroscopic types for the main lesion and the accessory lesion were depressed and depressed types (6 cases, $46.1\%$). The most frequent histologic type of main lesion was a well differentiated adenocarcinoma in 7 ($58.3\%$) of the 12 cases; the accessory lesion was also well differentiated in 4 of those 7 cases. Of the 13 accessory lesions, 4 ($30.8\%$) had been overlooked preoperatively; most of them were located in the lower third of the stomach and were IIb or IIc type and measured less than 1 cm in diameter. Lymph node metastasis was detected in 1 patient ($8.3\%$). The clinicopathologic features of multiple early gastric cancer were not different from those of solitary early gastric cancer. Conclusion: In multiple early gastric cancer, the main and the accessory lesions showed similar differentiation, and lymph node metastasis was less frequent than in solitary early gastric cancer. Therefore, limited procedures, including endoscopic mucosal resection, may be indicated if each lesion of the multiple early gastric cancer fits the criteria for treatment strategy.

• Journal of Chest Surgery
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• 제24권7호
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• pp.674-684
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• 1991

The surgical treatment of tetralogy of Fallot [TOF] was initiated by Blalock and Taussig in 1945 with the establishment of the subclavian artery to pulmonary artery anastomosis. In an imaginative and daring effort, in 1954, Lillehei and collaborators [1955] using controlled cross-circulation, carried out the first intracardiac repair of TOF by closing the ventricular septal defect [VSD] and relieving the pulmonary stenosis under direct vision. Nowadays, total correction is the ideal operation for treatment of TOF and is accomplished with extracorporeal circulation. And the results of surgery for TOF have steadily improved over the years, thanks to important contributions of many surgeons. Nevertheless because of its protean physiologic and anatomic presentation, TOF continues to offer challenges to cardiologist and cardiac surgeons. Thirty two cases of TOF have undergone total corrective surgery using extracorporeal circulation in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, Inje University, from Oct. 1985 to Feb. 1990. Clinical considerations were applied to these cases and the results were obtained as follows. 1. The heart lung machine used for extracorporeal circulation was SarnsO 7000, 5-head roller pump, and the number and type of oxygenators were 10 of bubble type and 22 of membrane type. The mean bypass time was 148.9 minutes and the mean aortic cross clamp time was 123.8 minutes. The GIK [glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 2. 20 cases were male and 12 were female, the mean age was 8 years old and the mean body weight was 25Kg. 3. The preoperative symptoms were cyanosis [29 cases], squatting [27 cases] and etc. The mean values of preoperative Hb., Hct., and SaO2 were 16.5 gm /dl, 50.3%, and 78.5%. 4. Combined anomalies were noticed in 16 cases [50%]. Among them 10 cases were PFO and 6 cases were ASD. 5. The degree of aorta overriding were 25% in 5 cases, 25 ~ 50% in 22 cases and above 50% in 5 cases. The dPA/Ao [ratio of diameter of pulmonary artery trunk to ascending aorta] were below 25% in 5 cases, 25 ~ 50% in 10 cases, 50 ~ 70% in 6 cases and above 75% in 11 cases. 6. The types of RVOT [right ventricular outflow tract] stenosis were valvular and infundibular in 14 cases [43.6%], diffuse hypoplastic type in 12 cases [37.5%], infundibular in 5 cases, and valvular and supravalvular in 1 case. 7. One stage radical corrective surgery was applied to the all cases. In widening of the RVOT, 3 types of patches were used: MVOP [monocusp ventricular outflow patch, Polystan BioprosthesesO] in 3 cases, knitted Dacron vessel patches in 2 cases, and double layer with bovine pericardium and woven Dacron prosthesis in 26 cases. 8. Postoperative complications were occurred in 15 cases. Among them, low output syndrome were occurred in 10 cases [31.3%] and 2 of them were expired postoperatively.

• 대한두경부종양학회지
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• 제22권1호
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• pp.47-50
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• 2006

Angiosarcoma is a rare and high aggressive malignant tumor originated from endothelial cell. Angiosarcoma has four clinical types that are in the scalp and face of old age, in chronic lymphedema, in previously irradiated sites, and malignant angioendothlioma. We report one case of angiosarcoma of the scalp in a 74-year-old male patient. The patient had $4.0{\times}4.5cm,\;4.0{\times}3.5cm$ sized, localized, asymmetric several dome-shaped nodule and plaque with crust and ulcer on the parieto-frontal area of the scalp. We performed wide excision and subsequently covered with split-thickness skin graft. Postoperatively the patient underwent radiotherapy for prevention of recurrence and he had been followed up for 1 year without evidence of recurrence.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권5호
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• pp.238-241
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• 2013

Lateral and superior-lateral dislocations of the intact condyle are a rare complication, following traumatic insult to the mandible. We report an unusual case of a 54-year-old male patient who experienced both types of dislocations of the intact condyles with symphysis fracture following a road-traffic accident. Under general anesthesia, conventional manipulation was unsuccessful in relocating the condyles into the glenoid fossa. After applying a percutaneous traction force, using a bone traction hook placed at the sigmoid notch, the displaced intact mandibular condyles were repositioned, and the symphyseal fracture was finally reduced and fixed. The mouth opening was within normal limits, and favorable occlusion was confirmed one month postoperatively. To our knowledge, this is the first case of dislocation of both intact condyles--associated with symphysis fracture--being reduced with bone traction hook.

• 대한치과교정학회지
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• 제45권6호
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• pp.333-340
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• 2015

Condylar hyperplasia (CH) is a rare disorder characterized by excessive bone growth that almost always presents unilaterally, resulting in facial asymmetry. Classification of the different types of CH can differ depending on the authors. Correct diagnosis is critical in determining the proper treatments and timing. This paper is a review of the recent literature on the epidemiology, etiology, diagnosis, classification, and surgical treatments of CH.

• 대한족부족관절학회지
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• 제23권2호
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• pp.43-51
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• 2019

Despite the increasing number of osteochondral lesions of the talus, there are a lack of definite evidence-based treatment protocols. Several types of treatments are available, each having their advantages and disadvantages. First-line therapy consists of well-conducted conservative treatment. Surgical treatment is the second choice. Treatments are chosen based on the size of the lesion, location, chronicity, and the condition of the neighboring cartilage. This article reviews the current updates in the treatment of osteochondral lesions of the talus to help clinicians use the available treatment strategies more efficiently.