• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.4
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• pp.260-266
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• 2023

The concept of 'Implant Supracrestal Complex (ISC)' was introduced as a way to determine the impact of implant prosthetic design form on both short-term clinical outcomes and the long-term prognosis of bone and soft tissues around the implant. Implant-prosthesis-abutment complex design forms, such as implant-abutment design, junction, and location, can have important implications for the stable and healthy long-term maintenance of the tissues around the implant. In this case, a customized concave abutment and a prosthesis with an emergence angle of about 30 degrees were restored to a patient suffering from chronic soft tissue inflammation and pain after restoration of an implant prosthesis. It was confirmed that the new prosthesis improved complications by allowing sufficient bone and soft tissue space, achieved appropriate soft tissue sealing, and maintained the long-term stability of the implant.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.493-500
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• 2001

Objective : Anterior cervical locking plates are the devices for achieving anterior cervical spinal fusion. This study was conducted to evaluate the locking plate system regarding its long-term advantages and disadvantages in the view of interbody fusion rate, hardware-related failures, vertebral change close to the fusion segment and postoperative complications. Method : Eight-six patients, operated from Jan., 1996 to Jun. 1998, were followed-up for more than two years. All of the cases were fused with iliac bone graft and ORION locking plate(Sofamor Danek USA, Inc., Memphis, TN) fixation. The patients were discharged or transferred to rehabilitation department 2-7 days after operation. A comprehensive evaluation of the interbody fusion state, instrument failure, vertebral change and postoperative complications were made by direct interview and cervical flexion-extension lateral plain films. Results : There were 55 male and 31 female with a mean age of 45 years(18-75 years). The mean follow-up period was 29 months(24-43 months). Various disorders that were operated were 40 cervical discs, 6 cervical stenosis including OPLL, 2 infections, and 38 traumas. Fusion level was single in 59 cases, two levels of each disc space in 15 cases, and two levels after one corpectomy in 12 cases. There was no instrument failure. Pseudoarthrosis was observed in two cases(2%) without radiological instability. The other patients(98%) showed complete cervical fusion with stable instrument. Mild settling of interbody graft with upward migration of screws was found in 12 cases(14%). Anterior bony growth at the upper segment was found in 5 cases(6%). Postoperative foreign body sensation or dysphagia was observed in 12 cases(4%), and disappeared within one month in 7 cases and within six months in 4 cases. One patient complained for more than six months and required reoperation to remove paraesophageal granulation tissue. Conclusion : The results show that Orion cervical locking plate has some disadvantages of upward migration of screws, anterior bony growth at the upper segment, or possibility of esophageal compression even though it has advantages of high interbody fusion rate or low instrument failure. Author believe that anterior cervical locking plate in the future should be thinner, and should have short end from the screw hole, and movable screw with adequate stability.

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.325-333
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• 2012

Objective : The indications and optimal surgical treatments for intracranial cysts are controversial. In the present study, we describe long-term clinical and neuroimaging results of surgically treated intracranial cysts in children. The goal of this study is to contribute to the discussion of the debate. Methods : This study included 110 pediatric patients that underwent surgeries to treat intracranial cysts. Endoscopic cyst fenestrations were performed in 71 cases, while craniotomies and cyst excisions (with or without fenestrations) were performed in 30 patients. Cystoperitoneal shunts were necessary for nine patients. Long-term results were retrospectively assessed with medical and neuroimaging records. Results : Clinical and radiological improvement was reported in 87.3% and 92.8% of cases, respectively, after endoscopic neurosurgery, and in 93.3% and 100% using open microsurgery whereas 88.9% and 85.7% after shunt operation. There were no statistical differences in clinical outcomes (p=0.710) or volume reductions (p=0.177) among the different surgeries. There were no mortalities or permanent morbidities, but complications such as shunt malfunctions, infections, and subdural hematomas were observed in 56% of the patients that had shunt operations. A total of 13 patients (11.8%) underwent additional surgeries due to recurrences or treatment failures. The type of surgery performed did not influence the recurrence rate (p=0.662) or the failure rate (p=0.247). Conclusion : Endoscopic neurosurgeries are less invasive than microsurgeries and are at least as effective as open surgeries. Thus, given the advantages and complications of these surgical techniques, we suggest that endoscopic fenestration should be the first treatment attempted in children with intracranial cysts.

• Journal of Gastric Cancer
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• v.12 no.1
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• pp.18-25
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• 2012

Purpose: Recently, laparoscopy-assisted gastrectomy (LAG) has been widely accepted modality for early gastric cancer in Korea. The indication of LAG may be extended in an experienced institution. In our institution, the first case of laparoscopy-assisted gastrectomy (LAG) for gastric cancer was performed in May 1998. We retrospectively reviewed the long-term oncologic outcomes over 12 years to clarify the feasibility of LAG for gastric cancer. Materials and Methods: The authors retrospectively analyzed 753 patients who underwent LAG for gastric cancer, from May 1998 to August 2010. We reviewed clinicopathological features, postoperative outcomes, mortality and morbidity, recurrence, and survival of LAG for gastric cancer. Results: During the time period, 3,039 operations for gastric cancer were performed. Among them, 753 cases were done by LAG (24.8%). There were 69 cases of total gastrectomy, 682 subtotal gastrectomies, and 2 proximal gastrectomies. According to TNM stage, 8 patients were in stage 0, 619 in stage I, 88 in stage II, and 38 in stage III. The operation-related complications occurred in 77 cases (10.2%). Median follow-up period was 56.2 months (range 0.7~165.6 months). Twenty-five patients (3.3%) developed recurrence, during the follow-up period. The overall 5-year and disease free survival rates were 97.1% and 96.3%, respectively. Conclusions: The number of postoperative complications and survival rates of our series were comparable to the results from that of other reports. The authors consider LAG to be a feasible alternative for the treatment of early gastric cancer. However, rationale for laparoscopic surgery in advanced gastric cancer has yet to be determined.

• Journal of Gastric Cancer
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• v.14 no.4
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• pp.246-251
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• 2014

Purpose: There are two surgical procedures for proximal early gastric cancer (EGC): total gastrectomy (TG) and proximal gastrectomy (PG). This study aimed to compare the long-term outcomes of PG with those of TG. Materials and Methods: Between January 2001 and December 2008, 170 patients were diagnosed with proximal EGC at Soonchunhyang University Cheonan Hospital, of which 64 patients underwent PG and 106 underwent TG. Clinicopathologic features, postoperative complications, blood chemistry data, changes in body weight, and oncological outcomes were analyzed and retrospectively compared between both groups. Results: Tumor size was smaller and the number of retrieved lymph nodes was lower in the PG group. The postoperative complication rate was 10.9% in the TG group and 16.9% in the PG group. The incidence of Los Angeles grade C and D reflux esophagitis was significantly higher in the TG group. Hemoglobin level was higher and body weight loss was greater in the TG group at 2, 3, and 5 years postoperatively. The albumin levels at 3 and 5 years were lower in the TG group. There was no significant difference in the 5-year overall survival rates between the two groups (P=0.789). Conclusions: Postoperative complications and oncologic outcomes were observed to be similar between the two groups. The PG group showed better laboratory data and weight loss than did the TG group. Moreover, severe reflux esophagitis occurred less frequently in the PG group than in the TG group. PG can be considered as an effective surgical treatment for proximal EGC.

• Journal of Chest Surgery
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• v.45 no.3
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• pp.141-147
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• 2012

Background: Although the aortic valve-sparing procedure has gained popularity in recent years, it still remains challenging in patients with advanced aortic regurgitation (AR). We compared the long-term outcomes of the aortic valve-sparing procedure with the Bentall operation in patients with advanced aortic regurgitation secondary to aortic root dilatation. Materials and Methods: A retrospective review of 120 patients who underwent surgery for aortic root dilatation with moderate to severe AR between January 1999 and June 2009 was performed. Forty-eight patients underwent valve-sparing procedures (valve-sparing group), and 72 patients underwent the Bentall procedure (Bentall group). The two groups' overall survival, valve-related complications, and aortic valve function were compared. Results: The mean follow-up duration was $4.9{\pm}3.1$ years. After adjustment, the valve-sparing group had similar risks of death (hazard ratio [HR], 0.61; p=0.45), and valve related complications (HR, 1.27; p=0.66). However, a significant number of patients developed moderate to severe AR in the valve-sparing group at a mean of $4.4{\pm}2.5$ years of echocardiographic follow-up (p<0.001). Conclusion: Both the Bentall operation and aortic valve-sparing procedure showed comparable long-term clinical results in patients with advanced aortic regurgitation with aortic root dilatation. However, recurrent advanced aortic regurgitation was more frequently observed following valve-sparing procedures.

• Journal of Chest Surgery
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• v.29 no.6
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• pp.626-631
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• 1996

The forty patients with carcirLoma of the esophagus or cardia seen at National Medical Center between November 1983 and April 1994 underwent surgical exploration. The esophagogastrectomy was carried out in 29 of 40 patients, one case through right thoracotomy, the others through left thoracotomy. Two patients underwent colon bypass surgeries due to upper esophageal cancer Transhiatal esop agectomy was performed In one case. Feeding gastrostomy or feeding jejunostomy were performed in 8 patients due to the advanced stage or malnutrition. In this report, we evaluated the long-term results in the 28 patients who underwent esophagogastrectomy for palliation through the left thoracotomy. There were 25 men(89%) and 3 women(11 %), and the mean age was 58.65$\pm$7.15 years(range, 46 to 73 years). The most frequent preoperative symptoms included dysphagia (22), weight loss (15), chest pain (6), vomiting (1), and hoarsness (1). Twenty-three patients had sqamous cell cancers of mid-and lower esophagus and five adenocarcionomas of cardia. One patient died in the hospital within 30 days of the op- eration for a hospital mortality rate of ).7%, Cause of death was sepsis due to anastomotic leakage. There were five additional complications in five patients; acute respiratory distress syndrome (1), post-op- erative bleeding (1), diaphragmatic hernia (1), acute renal failure (1) and late raft stenosis (1). The one year, 1틴o years, and three years acturial survival rate were 75.6$\pm$9.5%, 43.2$\pm$ 11.6%, 21.6: 10.5$\circledcirc$ re- spectively. The average survival was 21.8 months. The data from this study suggest that esophagogastrectomy through the left thoracotomy can achieve resonable long-term palliation for carci- noma of the esophagus. The operation can be performed with a low operative mortality and few serious postoperative complications.

• Archives of Craniofacial Surgery
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• v.12 no.2
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• pp.107-110
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• 2011

Purpose: There have been few case reports regarding treatment plans for long-term, neglected scalp defects and calvarial defects with subdural abscess. The purpose of this case report is to present our experience with a free latissimus dorsi musculocutaneous flap for scalp and calvarial defects and to discuss flap options in comparison with a literature review. Methods: A 60-year-old man who fell down from a four-story-height that resulted in a craniotomy in 1979; he visited our outpatient clinic for a chronic, purulent scalp and calvarial defects with unidentified artificial bone. The artificial bone was removed by a neurosurgeon and reconstructed with a free latissimus dorsi musculocutaneous flap. The deep temporal artery was used as a recipient artery. The postoperative flap status was excellent until the 6th day post-operation when the patient experienced a seizure, and an arterial insufficiency occurred at the flap probably due to an arterial spasm. Emergency exploration with arterial re-anastomosis was performed and the flap status was stabilized. Results: Complete wound healing was achieved after 3 weeks without infectious and systemic postoperative complications. During the 6 month follow-up period, there were no complications. Conclusion: We suggest the latissimus dorsi myocutaneous free flap as a good treatment option for a chronic, purulent, complicated scalp with calvarial defect, as a well as treatment for an acute traumatic defect.

• Journal of Korean Neurosurgical Society
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• v.40 no.2
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• pp.69-73
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• 2006

Objective : The optimal surgical treatment for symptomatic middle cranial fossa arachnoid cysts is controversial. Therapeutic options include endoscopic fenestration, excision, cyst shunting, and craniotomy for fenestration of basal cistern. We reviewed the results of surgically treated middle cranial fossa arachnoid cysts. Methods : We performed a retrospective study in 18 cases of middle cranial fossa arachnoid cysts who had been treated with microsurgical fenestration between 1995 to 2003. The analysis was based on the results of the patients' age, sex distribution, developed area, clinical symptoms, treatment method, and complications. Results : Eighteen surgical treated middle cranial fossa arachnoid cysts patients were evaluated. The age range of cyst development was between 2 years and 44 years with the average of 16.4 years. The follow-up periods averaged 31.48 months. There were 15 male and 3 female patients, with significantly more cyst development in males than females. The most common clinical symptom was headache, followed by seizure. In the entire series, 77.8% of patients demonstrated a decrease in cyst size In serial imaging studies. Of them, 67.3% demonstrated a complete cyst effacement. Overall, 100% of patients with Grade I cysts, 81.8% of patients with Grade II cysts, 60% of patients with Grade III cysts exhibited evidence of decrease in cyst size during long-term monitoring. Complications included headache, meningitis, and hydrocephalus. Conclusion : Patients who were treated with microsurgical fenestration showed good outcome with acceptable complications. We concluded that microsurgical fenestration is a safe and effective surgical method for middle cranial fossa arachnoid cysts.

• Korean Journal of Radiology
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• v.2 no.3
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• pp.164-170
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• 2001

Objective: To evaluate the technical feasibility and the clinical effectiveness of sclerotherapy for the treatment of peritoneal inclusion cysts (PICs). Materials and Methods: Between June 1996 and February 2001, eight PICs in seven female patients aged 28-43 (mean, 36) years were instilled with sclerosant (povidone-iodine in three, ethanol in three, both povidone-iodine and ethanol in one). All seven patients subsequently experienced less abdominal pain. After drainage via an 8.5-Fr pigtail catheter inserted in the PICs (transabdominally in six cases, transvaginally in one), sclerosant equivalent in volume to about one-third that of drained fluid was introduced daily until the drained volume was less than 5ml. Follow-up by means of clinical procedures and ultrasound was performed every three months, at which time the success rate, possible complications and recurrence were determined. Results: Sclerotherapy was technically successful in all seven patients, though immediately after the procedure, minor complications were noted in three patients (mild pain in two, mild fever in one). During the follow-up of 4-60 (mean, 24.7) months, sclerotherapy proved successful and without long-term complications in all seven patients: lower abdominal pain disappeared and the diameter of the cysts decreased more than 50%, with complete regression in four cases. During the follow-up period there was no recurrence. Conclusion: Sclerotherapy following catheter insertion is technically feasible and effective for the treatment of PICs.