• Journal of Korean Neurosurgical Society
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• 제52권1호
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• pp.14-20
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• 2012

Objective : Intracranial meningiomas are primarily benign tumors with a good prognosis. Although WHO grade II meningiomas are rare (2-10%), WHO grade II meningiomas have higher recurrence and mortality rates than benign. We evaluated the patient recurrence rate and investigated the prognostic factors of WHO grade II meningiomas. Methods : Between 1993 and 2005, 55 patients were diagnosed with WHO grade II meningiomas in our hospital. WHO grade II meningiomas (n=55) were compared with other WHO grades meningiomas (I, n=373; and III, n=20). The patients had a median age of 48.4 years (range, 14-17 years), a male-to-female ratio of 26 : 29, and a mean follow-up time of 45 months (range, 3-175 months). Results : In WHO grade II meningiomas, only the extent of resection was a significant prognostic factor. Post-operative radiotherapy had no significant influence on tumor recurrence (p=0.053). The relative risk of recurrence was significantly higher in WHO grade II meningiomas with incomplete resection (10/27, RR=37%) than in WHO grade II meningiomas with complete resection (4/28, RR=14%) regardless of post-operative radiotherapy. In the incomplete resection group, Simpson grade III or IV had a significantly high risk of recurrence regardless of post-operative RT (n=3, RR=100%) However, if the degree of resection was Simpson grade II, the recurrence rate was similar to the complete resection group even though post-operative RT was not performed. Conclusion : Complete resection was the most powerful independent predictive factor of the recurrence rate in WHO grade II meningiomas. Post-operative adjuvant RT was not a significant factor in this study.

• Journal of Korean Neurosurgical Society
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• 제57권4호
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• pp.258-265
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• 2015

Objective : The purposes of this article are to present 5 cases of intracranial meningioma with leptomeningeal dissemination (LD) and investigate the characteristics of this disease. Methods : We present a retrospective case series of 5 females at our institutions (age ranged 21-72 years, mean 54.6 years) diagnosed with LD of an intracranial meningioma after surgery between 1998 and 2013. A database search revealed 45 cases with LD of meningioma in the English literature. Characteristic features were analyzed and compared. Results : The incidence rate at our institutions of LD of meningioma was 0.9% (5/534). World Health Organization (WHO) grade was distributed as follows: I : 2, II : 2, and III : 1. Time to LD ranged from 2.5 months to 6.9 years; the patient with WHO grade III had the shortest interval to LD. The patient with an intraventricular meningioma (WHO grade II) had the second shortest interval to LD (1.7 years), and simultaneously revealed both LD and extraneuronal metastases. Four of 5 patients showed a disease progression, with the survival ranging from 1 month to 3.8 years after LD. Based on the literature, the initial tumor was an intraventricular meningioma in 9 patients, and their time to LD was shorter on average (mean 1.9 years). Histologically, 26 of 45 (58%) were initially diagnosed with a WHO grade II or III meningioma, and 6 of 19 patients (32%) with WHO grade I revealed malignant transformation. Conclusion : This study shows that intraventricular location and histologically aggressive features seem to increase the chance of LD of meningioma.

• Journal of Korean Neurosurgical Society
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• 제37권6호
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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.

• Advances in pediatric surgery
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• 제19권2호
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• pp.98-107
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• 2013

Debates exist about the appropriate treatment for pancreatic trauma in children. We intended to examine the safety of the operation of pancreatic trauma in children. This is a retrospective study of 13 patients, younger than 15, who underwent surgery for pancreatic trauma, between 1993 and 2011 in Seoul National University Children's Hospital. Medical records were reviewed for mechanism of trauma, clinical characteristics, radiological findings, operation and outcomes. Organ injury scaling from the AAST (American Association for Surgery of Trauma) was used. All injuries were caused by blunt trauma. Patients with grade III, IV, and those who were difficult to distinguish grade II from IV, underwent surgery due to severe peritonitis. Three patients with grade II were operated for reasons of mesenteric bleeding, tumor rupture of the pancreas, and progression of peritonitis. Distal pancreatectomy was performed in 10 patients and subtotal pancreatectomy and pylorus preserving pancreaticoduodenectomy in 1 patient each. The remaining one underwent surgical debridement because of severe adhesions. The location of injury, before and after operation, coincided in 83.3%. The degree of injury, before and after the operation, was identical in all the patients except for those who were difficult to tell apart grade II from grade IV, and those cannot be graded due to severe adhesion. Postoperative complications occurred in 23.1%, which improved with conservative treatment. Patients were discharged at mean postoperative 12(range 8~42) days. Even though patients with complications took longer in time from diagnosis to operation, time of trauma to operation and hospital stay, this difference was not significant. In conclusion, When pancreatic duct injury is present, or patient shows deterioration of clinical manifestation without evidence of definite duct injury, or trauma is accompanied by other organ injury or tumor rupture, operative management is advisable, and we believe it is a safe and feasible method of treatment.

• 대한두경부종양학회지
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• 제7권2호
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• pp.129-136
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• 1991

This is a clinical, retrospective review of 66 cases of the Adenoid cystic carcinoma who were treated at the Department of Surgery, Presbyterian Medical Center, Chonju during the past 20 years from January, 1971 to December, 1990. The results were obtained as follows; 1) The most common malignant tumor in the minor salivary gland was adenoid cystic carcinoma and it's incidence was 57.6% (38 cases). 2) The most common site of adenoid cystic carcinoma in the major salivary gland was parotid gland with the incidence of 22.7% (15 cases). 3) The peak age of patients with adenoid cystic carcinoma was 5th decade(30.3%) and others' peak age except adenoid cystic carcinoma was 6th decade(35.9%). 4) The duration of symptoms of adenoid cystic carcinoma patient was less than one year in the minor salivary gland, comprising 21 cases(55.3 %) and more than one year in 18 cases(64.9 %) of the major salivary gland carcinoma. 5) According to histologic grades of 66 cases of adenoid cystic carcinoma, Grade I was 15 cases and Grade II 19 cases, Grade III 5 cases. Other 27 cases were undetermined. 6) The incidence of cervical lymphnode metastasis of 39 cases of adenoid cystic carcinoma classified into histologic grades was 0% in Grade I, 10.5% in Grade II and 20% in Grade III. 7) The incidence of nerve invasion confirmed histologically was 20% in Grade I, 63.2% in Grade II and 100% in Grade III. It was significant(p<0.01). 8) The local recurrence rate was 26.7% in Grade I, 47.4% in Grade II and 60% in Grade III. The lung was the commonest site for distant metastasis comprising 14 cases among 19 cases in which distant spread occurred. 9) 5 year determinate disease-free survival rate according to the histologic grade was 57.1% in Grade I, 27.3% in Grade II and 25.0% in Grade III. 10) The determinate 5-year survial rate of adenoid cystic carcinoma was 71.4% in the only curative surgery group, 70.6% in the combined treatment group of surgery and postoperative irradiation, 66.7% in the combined treatment group of surgery with postoperative irradiation and chemotherapy, and 33.3 % in the non-curative treatment group. 11) The average size of tumor was 3.6cm in Grade I, 4.8cm in Grade II and 4.5cm in Grade III.

• Childhood Kidney Diseases
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• 제7권2호
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• pp.150-156
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• 2003

목적 : IgA 신병증의 임상 및 병리학적 소견의 비교를 통해서 IgA 신병증의 신조직 소견을 예측할 수 있는 인자를 찾아봄으로써 신생검 시기를 결정하는데 도움이 될 수 있는 지표를 찾아본다. 방법 : 원주기독병원에서 신생검상 IgA 신병증으로 확인된 40례를 대상으로 후향적 연구를 시행하였다. 결과 : 40명의 환자 중 크레아티닌이 1.5 mg/dL 이상을 보인 1명은 추적 관찰이 안되었고 나머지 39명 중 2명에서는 혈중크레아티닌이 1.5mg/dL 이상으로 진행하였으며 그 중의 한명은 진단 후 2년 7개월만에 말기신부전으로 진행하였다. WHO 분류에 따르면 class I이 15명, class II가 14명, class III가 7명, classs IV가 3명, class V 0명이었다. 육안적 혈뇨군에서 현미경적 혈뇨군보다 class I과 class II의 비율이 의미있게 높았다(P<0.02). 세뇨관간질 소견만을 분류해 보았을 때 grade 1은 24명, grade 2는 4명, grade 3는 8명, grade 4는 3명이었다. 세뇨관간질의 변화가 심해질수록 24시간 요단백/알부민 비율이 증가하였다(r=-0.32, P<0.05) 혈청 크레아티닌치가 0.79 mg/dL 이하인 경우 세뇨관간질소견이 경하였으며, 크레아티닌치가 1.13 mg/dL 보다 큰 경우 세뇨관간질병변이 심하였다. 육안적 혈뇨군에서 혈청 크레아티닌치는 현미경적 혈뇨군에 비해 낮았고(0.78 vs 1.09 mg/dL)(P=0.027), 혈청 IgA 치가 높았으며(316.3 vs 198.8mg/dL)(P=0.027), class I과 II의 낮은 WHO 분류 class를 보였다(23 vs 4)(P=0.029). 결론 : IgA 신병증 환자에서 혈청크레아티닌이 0.79 mg/dL 이하, 육안적 혈뇨, 높은 24시간 urine protein/albumin 비율을 보이는 경우 경한 신조직 소견을 보임으로 이런 소견을 보이는 경우 신조직 생검 시기를 미룰 수 있을 것으로 사료된다.

• Radiation Oncology Journal
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• 제6권2호
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• pp.163-168
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• 1988

성상세포종과 교아세포종으로 1979년부터 1985년까지 7년 간 서울대학교병원 치료방사선과에서 수술후 방사선치료를 시행한 49명의 환자에 대해 후향적 분석을 시행하여 다음과 같은 결과를 얻었다. 1. 3년 전체 생존율은 grade I, II, III 성상세포종에 대해 각각 $85.7\%,\;44.0\%,\;23.1\%$였으며, 교아세포종의 1년 및 2년 전체 생존율은 각각 $54.5\%,\;27.3\%$였다. 2. 종양의 분화도, 환자의 나이, 병소의 위치, 절제정도 등이 예후에 영향을 미치는 인자로 나타났다

• Archives of Plastic Surgery
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• 제44권1호
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• pp.59-64
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• 2017

Background Silicone implants are frequently used in augmentation rhinoplasty in Asians. A common complication of silicone augmentation rhinoplasty is capsular contracture. This is similar to the capsular contracture after augmentation mammoplasty, but a classification for secondary contracture after augmentation rhinoplasty with silicone implants has not yet been established, and treatment algorithms by grade or severity have yet to be developed. Methods Photographs of 695 patients who underwent augmentation rhinoplasty with a silicone implant from May 2001 to May 2015 were analyzed. The mean observation period was 11.4 months. Of the patients, 81 were male and 614 were female, with a mean age of 35.9 years. Grades were assigned according to postoperative appearance. Grade I was a natural appearance, as if an implant had not been inserted. Grade II was an unnatural lateral margin of the implant. Clearly identifiable implant deviation was classified as grade III, and short nose deformation was grade IV. Results Grade I outcomes were found in 498 patients (71.7%), grade II outcomes in 101 (14.5%), grade III outcomes in 75 (10.8%), and grade IV outcomes in 21 patients (3.0%). Revision surgery was indicated for the 13.8% of all patients who had grade III or IV outcomes. Conclusions It is important to clinically classify the deformations due to secondary contracture after surgery and to establish treatment algorithms to improve scientific communication among rhinoplasty surgeons. In this study, we suggest guidelines for the clinical classification of secondary capsular contracture after augmentation rhinoplasty, and also propose a treatment algorithm.

• 대한한의학회지
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• 제17권2호
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• pp.418-426
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• 1996

Clinical studies were done 23 peoples who were treated with the auricular acupuncture therapy to the hypertension in the Dept. of the Acupuncture and Moxibution Hospital of Oriental Medicine in Won Kwang University. The following results have obtained. 1. Distribution of sex: male (52.0%), female (48.0%), 2. Distribution of age: 50s age group (30.0%), 70s(26.0%), 40s or 60s(22.0%). 3. Distribution of occupation: housewife (26.0%), farmer or commerce(22.0%), unemployed(13.0%), 4. Causes of illness: unknown origin(61.0%), stress(17.0%), drinking (13.0%), 5. Distribution according to symptom: headache(57.0%), non-symptom(17.0%), dizziness(9.0%). 6. Duration of onset: 3-5 years(26,0%), unknown(17.0%), 6 months, 5-10 years or 10 years (13.0%). 7. Cure rate of auricular acupuncture treatment according to differentiation symptoms: HLY(43.0%), DLK(30.0%), DYY(13.0%), HYD(9.0%). 8. Result grade on $pr{\`{e}}-freatment$ of auricular acupuncture: Grade I(4.0%), GradeII(52.0%), Grade III(43.0%). Result grade on post-treaftment auricular acupuncture: Grade O(48.0%), Grade I(26.0%), Grade II(26.0%).

• Journal of Nutrition and Health
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• 제20권6호
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• pp.405-410
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• 1987

전보$^{23)}$에서 조사된 전국의 5학년생 10,751명의 BMI를 기준으로 하위 10%(1군)와 상위 10%(5군) 두군 간의 요인들을 비교 분석하였다. 1) 일본의 기준을 적용할 때 전국 5학년생의 5.8%, 도시지역의 7.8%가 비만에 해당하였다. 2) 거의 매일 아침을 먹지 않는 아동이 5.9%였으며 5군에서는는 8.4%로 매우 높았다. 1군에서는 29.4%, 5군에서는 22.5%가 건강을 위한 약제를 복용하였다. 3)5학년 때 BMI가 높은 군은 1학년 때 부터 연간키 성장폭이 컸으며 몸무게는 이런 경행이 더욱 두드러졌다. 5군은 학년이 올라가면서 BMI 값이 상당히 증가하였으나 1군은 변화가 거의 없었다. 4) 체력장 성적은 평균 집단인 3군에서 가장 좋았으며 5군에서 매우 낮았다.