• The Journal of Internal Korean Medicine
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• v.41 no.3
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• pp.478-486
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• 2020

Objectives: Pressure injury is a common symptom of end-stage cancer, which impact quality of life. This case study reports on use of traditional Korean medicine in an end-stage cancer patient with pressure injury after debridement and local flap. Methods: A pressure injury with debridement and a local flap was treated using herbal medicine, a carbon arc, acupuncture, dressing, and cooperation in plastic surgery. Pressure injury was followed up with photographs. Results: On the 22^nd day of treatment (26 days after the debridement and local flap), redness, swelling, and the condition of pressure injury were all improved. Moreover, the condition of the pressure injury was good without dressing. Conclusions: These results show that traditional Korean medicine may have a positive effect on a pressure injury and improve the quality of life of cancer patients. However, further study is needed to confirm these findings.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.1
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• pp.14-21
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• 2014

Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.

• Clinics in Shoulder and Elbow
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• v.14 no.2
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• pp.248-252
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• 2011

Purpose: We report a case of chronic recurrent multifocal osteomyelitis of the shoulder. Materials and Methods: A 16 year-old male who had suffered from chronic recurrent multifocal osteomyelitis of the shoulder was diagnosed by clinical features and biopsy and was treated with arthroscopic debridement and Naproxen. Results: Symptoms was subsided without relapse during 16 months follow up. Conclusion: Chronic recurrent multifocal osteomyelitis is rare disease and it can be misdiagnosis because of its rarity and non-specific clinical presentation. This is a report of a case of chronic recurrent multifocal osteomyelitis of the shoulder in 16 years man.

• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.295-301
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• 1996

Phylloides tumor is very similar to giant fibroadenoma in that they have benign appearance in breast radiologic image. Fibroadenoma has no malignant potential, but phylloides tumor is locally recurrent, invasive and may occasionally metastasize. It thus appears that evaluation of the differential point of the two tumor groups by radiologic study is very important. We retrospectively compared sonographic findings of 6 cases of phylloides tumor with those of 4 cases of fibroadenoma, which proved pathologically in Yeungnam University Hospital from 1984 to 1986. The mean age of the patients were 31.8 years old(from 14 to 41 years old) in phylloides tumor and 28.8 years old (from 17 to 40 years old) in giant fibroadenoma, respectively. The viewpoints of this analysis were size, shape and contour of the masses, internal echo pattern, posterior enhancement, and especially the existence of peripheral cyst or septal band echo. We found that diffenentiation of these two tumors by sonography was difficult. But peripheral cyst was found only in phylloides tumor and septal band echo was found largely in giant fibroadenoma. Although the existence of peripheral cyst or septal band echo in the breast mass was not pathognomonic findings, we suggest that the existence of septal band echo is preferential finding to fibroadenoma, and peripheral cyst is preferential finding to phylloides tumor.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.213-218
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• 2007

Purpose: To analyze retrospectively the outcome of postoperative radiation therapy with or without concurrent chemotherapy for curatively resected stage II pancreatic cancer with T3 or N1 disease. Materials and Methods: Between January 1996 and December 2005, twenty-eight patients completed adjuvant radiation therapy at Ajou University Hospital. The patients had either pathologic T3 stage or N1 stage. The radiation target volume encompassed the initial tumor bed identified preoperatively, resection margin area and celiac nodal area. In the case of N1 patients, the radiation field extended to the lower margin of the L3 vertebra for covering both para-aortic lymph nodes bearing area. The median total radiation dose was 50 Gy. Ten patients received concurrent chemotherapy. Results: Thirteen patients (46%) showed loco-regional recurrences. The celiac axis nodal area was the most frequent site (4 patients). Five patients showed both loco-regional recurrence and a distant metastasis. Patients with positive lymph nodes had a relatively high probability of a distant metastasis (57.1%). Patients that had a positive resection margin showed a relatively high local failure rate (57.1%). The median disease-free survival period of all patients was 6 months and the 1-and 2-year disease free survival rates were 27.4% and 8.2%, respectively. The median overall survival period was 9 months. The 2-and 3-year overall survival rates were 31.6% and 15.8%, respectively. Conclusion: The pancreatic cancer patients with stage II had a high risk of local failure and a high risk of a distant metastasis. We suggest the concurrent use of an effective radiation-sensitizing chemotherapeutic drug and adjuvant chemotherapy after postoperative radiation therapy for the treatment of patients with stage II pancreatic cancer.

• Journal of Gastric Cancer
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• v.5 no.4 s.20
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• pp.288-294
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• 2005

Purpose: Superficially spreading (SS) early gastric cancer (EGC) is characterized by wide horizontal extension without deep vertical invasion. It is a relatively rare form of EGC, and it's clinicopathological (C-P) characteristics are not evident. This study aimed to clarify their C-P characteristics. Materials and Methods: We defined SS EGC as invading less than the submucosal layer that measured more than 60 mm in diameter or wider than $5{\times}5cm \;(25cm^2)$ in width. The C-P characteristics and prognosis were compared between 69 patients with SS EGC and 319 patients with the common type EGC (EGC except SS type). Results: For SS EGC lymph node metastases, Lauren's diffuse type, lymphatic invasion were significantly higher than in common type EGC. In patients with SS EGC, all of the metastatic lymph nodes were anatomically distributed within the paragastric region, with fewer along the left gastric artery and common hepatic artery. In 6 cases of SS EGC with resection marqins less than 10 mm, there was no death during the follow-up period (4 to 13 years after operation) if margins were not involved. Age (>58 yrs), tumor site (upper 1/3), lymph node metastasis, submucosal invasion were statistically significant poor prognostic factor in univariate survival analysis. In multivariate survival analysis, age and lymph node metastasis were independent prognostic factors. However, tumor diameter or width was not a significant prognostic factor. Conclusion: Although SS EGC has histologically distinct properties, gastrectomy with free surgical margins and appropriate lymph node dissection $(D1+{\beta})$ could be a suitable treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.206-216
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• 2000

Predictional study for lateral change between pre- and post-orthognathic surgery has been emphasized mainly on anterior area of lateral profile; upper lip, lower lip and chin et al. So interest for lateral profile change has been less in posterior area of lateral profile and literature analyzing gonial angle change is rare. The purpose of this study is to make prediction for gonial angle change possible and to offer somewhat treatment guidance for gonial angle to be improved by investigating overall gonial angle change between pre- and post-orthognathic surgery and inquiring into factors influencing on pattern of genial angle change. For this study 35 patients were selected retrospectively. Lateral cephalometric radiographs were taken in just pre-op time, pod 1 day, pod 1 year. They were analyzed and genial angles were measured. The results were as follows : 1. Gonial angle at pod 1 day was decreased about $9.3^{\circ}$ than pre-op and gonial angle at pod 1 year was increased about $4.0^{\circ}$ than pod 1 day. So genial angle at pod 1 year was decreased about $5.3^{\circ}$ than pre-op genial angle(p<0.01). 2. Mean pre-op gonial angle was $129.4^{\circ}$, showing significantly high value than normal and mean gonial angle at pod 1 year was $124.1^{\circ}$, showing value near to normal. 3. Mean gonial angle change between pre-op and pod 1 year was decreased about $5.4^{\circ}$ in female and $5.3^{\circ}$ in male. There was no statistically significant difference between male and female(p>0.05). 4. Principal factor influencing on decreased gonial angle in gonial angle change between pre-op and pod 1 year was amount of mandibular setback. 5. Principal factor influencing on increased gonial angle in gonial angle change between pod 1 day and pod 1 year was % horizontal relapse, and it was thought that resorption and bone remodelling on posterior area in mandibular distal segment also were related to increased gonial angle. 6. It is thought that sagittal split ramus osteotomy in mandibular prognathic patients with high value of gonial angle is effective to improvement of gonial angle, and In patients who have normal range of gonial angle and are required with excessive mandibular setback, short lingual cut method, additional resection of posterior margin of distal segment, Obwegeser II method will be considerd. 7. More prudent operation and careful post-op management will be responsible for maintenance of postoperative stable gonial angle.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.130-138
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• 1996

Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as deforming to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites & bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication. There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, serum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.253-260
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• 2020

Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm² and the mean size of the donor sites was 51.9 cm². The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.15-20
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• 2002

Purpose: The purpose of this study is to evaluate diagnosis and treatment of acetabular labral tears in sports injuries. Materials and Methods: From March 1995 to January 2000, We treated 15 patients with acetabular labral tear by sports injuries. There were 6 men and 9 women. Mean age was 41 years old. Running injuries are 5 cases, fighting 3, aerobic exercise 3, swimming 2, climbing 1, bicycle 1. For conservative treatment, we performed medication and observation at least for 1 year. For the patients with arthroscopic surgery, we performed Harris Hip Score (pain and function) preoperatively and postoperatively at 6, 12 months, and evaluated patient’s pain by JOA pain scoring system and postoperative subjective satisfaction. Results: The mean score of HHS improved 15 points with conservative treatments and 32 points with hip arthroscopy. In 4 cases of conservative treatment, there was 1 scale improvement of JOA pain scoring system. In arthroscopic partial labrectomy, all cases were improved to more than 2 scale. Conclusion: We considered that acetabular labral tears occurred associated with sports injuries. So it is important to be interested in enthusiastic diagnosis and appropriate treatment for hip pain caused by sports injuries, especially about acetabular labral tears.