• Journal of Chest Surgery
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• v.37 no.5
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• pp.401-409
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• 2004

Background: As the rupture of chordae and/or papillary muscle became the main cause of mitral valve regurgitation, mitral reconstructive surgery has a very important role. In this regard, we analyzed the clinical result and postoperative early result of operative treatment performed in our hospital, Material and Method: For this analysis, forty nine patients (male 26, female 23, mean age 49.0$\pm$16.5) who underwent mitral valve operation caused by the rupture of chordae and/or papillary muscle from August 1991 to April 2002 were reviewed. Among forty nine patients, twenty two (44.9%) received mital valve reconstruction and twenty seven (59.2%) received mitral valve replacement. Result: As to the pathological etiology of rupture of mitral and papillary muscle, twenty five cases (51.0%) were nonspecific degeneration, eleven cases (22.4%) were myxomatous degeneration, seven cases (14.3%) were subacute bacterial endocarditis. Three patients suffered mortality after operation (6.1%) and valve replacement was performed again on one patient because of remnant mitral insufficiency after valve reconstruction. The 5-year survival rate after operation for the entire mitral valve regurgitation patients was 81 .4%. We have also compared and analyzed the operation results of a group of patients who underwent valve reconstruction and the other group of patients who underwent valve replacement from thirty six patients who had suffered from mitral valve regurgitation caused by degenerative disease. The mortalities were 0% and 14.3%, respectively and the 5-year survival rates were 90.2% and 64.3%, respectively, but there were no statistical significance. Conclusion: The most common pathological etiology of mitral valve regurgitation caused by rupture of chordae and/or papillary muscle was nonspecific degeneration, In case of degenerative disease is the cause of mitral valve regurgitation, valve reconstruction showed better long-term effects in many respects and better operation results compared to valve replacement.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.2
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• pp.117-122
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• 2006

Purpose: The purpose of this study is to investigate the relationship between rotator cuff tear and nerve injury, and prevalence of nerve injury using electromyographic study. Materials and Methods: From May 2004 to Feb. 2005, 19 cases, who underwent surgery for full-thickness rotator cuff tear, were evaluated for nerve injury using electomyogram instruments preoperatively. Rotator cuff tears caused by acute high energy trauma were excluded in this study. Mean age was 59 (range, 45-87) years and mean duration of symptoms was 45 (range, 1-360) month. Results: There were six nerve injuries (31.6%). All of them were incomplete brachial plexus injuries, and mainly postganglionic lesions. Four cases among them had minor trauma history. There were no significant differences in terms of cuff tear size, range of motion, pain score and functional score between groups with and without nerve injury. Conclusion: This study showed high prevalence (31.6%) of nerve injury in full-thickness rotator cuff tear. So careful physical examination and evaluation for nerve injury are needed in rotator cuff tear.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.24-31
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• 2008

Purpose: We purposed to analyze the incidence and the patterns of the injuries associated with anterior cruciate ligament(ACL) tears. Materials and Methods: We retrospectively reviewed 547 knees that had undergone ACL reconstructions and compared the associated injuries according to the time of injury(acute vs. chronic), the cause of injury(sports vs. non-sports) and the type of sports. Results: Medial collateral ligament(MCL) injury and bone contusion were more in acute injury group less than 3 months after trauma(p=0.001, 0.019) and the injuries of medial or lateral meniscus were more in chronic injury group more than 3 months after trauma(p=0.014, 0.029). The trochlea in acute injury group(p=0.027) and the medial femoral condyle in chronic injury group(p=0.011) had higher incidence of chondral injury. Grade I, II chondral injury was frequent in acute injury group(p=0.016) and grade III, IV chondral injury was frequent in chronic injury group(p=0.017). Lateral meniscus injury was frequent in sports injury group(P=0.035). Medial collateral ligament injury was frequent in ski(P=0.005), and chondral injury was in gymnastics(P=0.017). Conclusions: The incidences of medial and lateral meniscus tears and grade III, IV chondral defects were high in chronic injury group. According to the causes of the tears and the types of sports, some differences in the incidence and pattern of associated injuries were found.

• Journal of Yeungnam Medical Science
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• v.22 no.1
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• pp.90-95
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• 2005

A coronary artery perforation is a rare but often fatal complication of angioplasty. We experienced a coronary artery perforation and cardiac tamponade during balloon angioplasty. A polytetrafluorethylene (PTFE)-covered stent was used to successfully close the perforation.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.599-604
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• 2002

Acute or chronic aortic dissection may lead to the rupture, which is the major cause of death. A dissecting aneurysm of ascending aorta(Stanford type A dissection) can rupture into the superior vena cava producing a aortocaval fistula, which is rare, but has been reported mostly in the cases of abdominal aortic aneurysm. We report a case of 67-year-old man with type A chronic dissection and aortocaval fistula, presenting symptoms of superior vena syndrome. The preoperative diagnosis was composed of radiologic examinations, including computed tomography, magnetic resonance imaging angiography and aortography. The dissecting aneurysm was resected and replaced, and the aortocaval fistula was repaired under deep hypothermic circulatory arrest. The details are described here.

• Journal of Chest Surgery
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• v.40 no.10
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• pp.704-707
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• 2007

Penetrating atherosclerotic ulcer involving the aortic arch has rarely been reported on in the literature. Acute rupture of a penetrating atherosclerotic ulcer involving the distal arch and the proximal descending thoracic aorta was found in a 78-year-old male, and he originally presented with acute-onset shoulder pain and hoarseness. Patch repair of the perforated arch and the proximal descending thoracic aorta was successfully done under total circulatory arrest.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.265-271
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• 1999

Patients with mediastinal teratoma are usually asymptomatic, but may develop symptoms by rupture into adjacent structures which result in pneumonia, hemoptysis, pleural effusion, pericardial effusion, or pneumothorax. Rarely, life-threatening acute respiratory distress require a emergency surgery. Rupture into pleural cavity may result in pleuritis and pleural effusion with severe anterior chest or back pain. The symptom must be differentiated from other common intrathoracic distress diseases. Clinical, cytologic and radiologic examinations of pleural effusion, and moreover, measurement of enzymes such as amylase or insulin, which is secreted from pancreatic tissues, in pleural effusion and cystic fluid enabled us to make the diagnosis of rupture of mediastinal teratoma preoperatively.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.112-115
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• 1997

While the cruciate ligament has a profuse vascular response following injury, spontaneous repair does not occur. This may result from the fact that synovial fluid dilution of the hematoma following injury prevents the formation of a fibrin clot and thus the initiation of the healing mechanism. Another theory suggests that the dynamic nature of the fascicles of the anterior cruciate ligament(ACL) through even small ranges of motion prohibits spontaneous union to these fibers. But we experienced two cases of spontaneous healing of partially injured ACL. Initially they showed more than grade II anterior instability. 6 mm difference by stress roentgenographs(pull view) and difference of 8 mm by KT 1000TM arthrometer between the ACL injured knee and normal side knee. Lax, nearly complete tear of ACL and synovial bleeding were noted during arthroscopic examination but the continuity of synovial membrane was seemed to be intact. These cases were treated by conservative management rather than reconstructive procedure. Postoperatively they showed excellent clinical results, no anterior instability and unlimited athletic activity. Based on our clinical experience. we think that cruciate ligament has the spontaneous healing potential in acute stage and middle aged patient. We consider the microfracture technique and initial immobilization for accelleration of healing response of the ACL.

• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.37-42
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• 2002

Purpose : The purpose of this study was to evaluate the results of arthroscopic meniscal repair according to joint stability. Materials and Methods : Twenty cases were reviewed, which had underwent arthroscopic meniscal repair. The mean age was 32.3 years old. The mean follow-up period was 59.7 months. Menisci that had underwent complete repair of associated ligament injuries (8cases, Sa) and menisci that had no associated ligament injury (9 cases, Sb) were classified as stable group (S), and the others (3 cases) as unstable group (U). Also stable group was divided into acute and chronic group. The result was evaluated with Lysholm score and IKDC method. The statistical analysis was done using Wilcoxon rank sum test and Fisher's exact test (p<0.05). Results : Group Sa had $87.5\%$ satisfactory and Lysholm score was 90.9. Group U had $66.7\%$ satisfactory, and Lysholm score was 77.7. Group Sb had $89.9\%$, satisfactory and Lysholm store was 91.4. In acute group $91.7\%$ was satisfactory, Lysholm score 92.5, in chronic group $80\%$ was satisfactory, Lysholm score 88.6. Conclusion : Joint stability was important factor for the outcome of meniscal repairs. So, it is desirable to repair meniscus injury early and the repair of associated ligament injuries should be performed together.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.141-147
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• 2013

A 57-year-old man who simultaneously underwent an operation for repair of rotator cuff and a revision operation for nonunion of a Pilon fracture presented with osteomyelitis of the humeral head on the $19^{th}$ day after surgery due to MRSA (Methicillin-resistant Staphylococcus aureus) infection. Infection was controlled after administration of appropriate intravenous antibiotic therapy and performance of several surgical procedures. However, devastating defects at the humeral head and the rotator cuff remained. No case of short term MRSA induced osteomyelitis has been reported.