• Clinics in Shoulder and Elbow
• /
• v.13 no.2
• /
• pp.299-303
• /
• 2010

Purpose: Management of the stiff elbow by arthroscopic procedure is an effective but technically demanding. Our purpose was to review the specific arthroscopic maneuver which can be useful for the stiff elbow. Materials and Methods: A stiff elbow that is refractory to conservative treatment can be treated surgically to remove soft tissue or bony blocks to motion. The olecranon or coronoid osteophyte and loose bodies have been removed arthroscopically with good results and rare complications. Results and Conclusion: For the successful arthroscopic management of elbow stiffness, it need to knowledge and skills for debride contracted tissue and preserve vital anatomic structure.

• Journal of Chest Surgery
• /
• v.35 no.1
• /
• pp.48-51
• /
• 2002

The conversion of failing Fontan circuit to total cavopulmonary connection(TCPC) is recommended as a therapeutic option in patients with late Fontan complications such as atrial arrhythmia, atrial enlargement, pulmonary venous obstruction, and ventricular dysfunction. Combined TCPC with extracardiac conduit and cryoablation of arrhythmia circuit is preferred for treatment of failing Fontan coulection with atrial lachyarrhythrnia. We report a case of conversion of atriopulmonary connection to extracardiac conduit Fontan and cryoablation of atrial arrhythmia circuit in a patient with tricuspid atresia, who also had ectopic atrial tachycardia, right atrial thrombi, pulmonary venous obstruction, and ventricular dysfunction. This patient and the parents were Jehovah's Witnesses; therefore, the patient underwent the procedure without blood transfusion.

• The Journal of the Korean bone and joint tumor society
• /
• v.11 no.2
• /
• pp.213-218
• /
• 2005

Dedifferentiated chondrosarcoma is a most highly malignant variant of chondrosarcoma and approximately 10% of chondrosarcomas dedifferentiated into more anaplastic lesions. In addition to the surgical treatment, adjuvant chemotherapy or radiation therapy has been used but with little success. Thus, the primary treatment remains wide excision and chemotherapy or radiation therapy can be used for palliation. This article shows the case of a dediffderentiated chondrosarcoma occuring in proximal femur after conservative surgical treatment of a low grade chondrosarcoma.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.29 no.1
• /
• pp.24-29
• /
• 2018

Background and Objectives : The purpose of this study was to evaluate the impact of surgical extent on voice using acoustic and aerodynamic measurements in a serially followed thyroidectomy patients. Materials and Method : From October 2015 to January 2017, 108 patients who had undergone thyroid surgery and voice test for preoperative, 2, 3, and 6 months postoperatively were classified into five operative types. The radiological stage preoperatively and histopathological stage postoperatively were classified according to the invasion of thyroid capsule and surrounding tissue. For each classification, the results of the voice analysis according to the period were compared and analyzed. Results : The difference of voice according to surgical extent, radiological stage, and histopathologic stage showed significant difference only with Maximal phonation time (MPT) over time. However, in the analysis of interaction between each classification and period, Phonation threshold pressure (PTP) only showed significant results. Conclusion : Differences in imaging and histopathologic stages have no significant effect on recovery of voice symptoms after thyroid surgery. As the extent of operation increases, the pressure to start vocalization is relatively higher, which also varies with time after surgery.

• Korean Journal of Head & Neck Oncology
• /
• v.19 no.2
• /
• pp.137-141
• /
• 2003

Introduction: A routine superficial parotidectomy with facial nerve dissection in parotid tumor surgery often results in facial dysfunction, Frey syndrome and defect in operation site. Formal facial nerve dissection has been a recommended procedure, because pleomorphic adenoma is a commonly recurrent tumor in case of inadequate surgical management, however it can not be always reasonable in aspect of postoperative sequelae. Patients and Methods: Through retrospective review of 245 cases parotidectomies and follow up for more than three years, clinicophathologic factors influencing to the selection of surgical procedure were considered to be age, sex, and preoperative pathology confirmed by preoperative MRI and FNA. Results: Five categories were established as follow for surgical decision in parotid tumor surgery. Category 1. Superficial lobe adenoma -- Superficial parotidectomy -- 124 Category 2. Deep lobe adenoma -- Deep parotidectomy -- 39 Category 3. Non pleomorphic adenoma -- Tumorectomy 1.5cm adenoma in young female -- Tumorectomy -- 25 Category 4. Recurrent multicentric tumor -- Parotidectomy+RT -- 9 Category 5. Parotid cancer; Parotidectomy + UND (RND) + RT -- 48 ; CORE (Composite Regional Ear Resection) -- 2 Conclusion: Surgical morbidity and recurrence rate could be minimized by individualizing the surgical procedure according to the category principle based on the clincopathologic features.

• Journal of Chest Surgery
• /
• v.35 no.6
• /
• pp.491-494
• /
• 2002

Inflammatory myofibroblastic tumor was widely known as inflammatory pseudotumor, commonly developed as a solid mass in lung. The endobronchial inflammatory myofibroblastic tumor is a very rare case where only a few cases have been reported. We report a 13-year-old girl who had coughing for 5 months. The simple chest X-ray and computued tomography of the chest revealed a mass which obstructed the right lower lobe bronchus and pneumonic consolidation. The fiberoptic bronchoscopic finding was mostly gelatinous, gray-yellowish mass that obstructed the airway of right lower lobe bronchus nearly, and was considered as a chondroid hamartoma pathologically. Right lower lobectomy of lung was performed. The mass was confirmed as a endobronchial inflammatory myofibroblastic tumor The patient was discharged without complication and with outpatient followup.

• Journal of the Korean Society of Radiology
• /
• v.81 no.3
• /
• pp.644-653
• /
• 2020

Purpose We aimed to analyze postoperative multidetector CT (MDCT) of acquired spondylolysis and spondylolisthesis after posterior lumbar laminectomy. Materials and Methods We enrolled 74 patients, from 2003 to 2017, who underwent posterior lumbar laminectomy with both pre and postoperative MDCT. The patients were categorized into the following two groups: group 1 without fusion and group 2 with fusion. We analyzed laminectomy width, level and location of spondylolysis or spondylolisthesis, facet changes, and fatty infiltration of paraspinal muscles on postoperative MDCT. Results Incidence of spondylolysis or spondylolisthesis was 4 of 20 patients in group 1 and 2 of 54 patients in group 2. The laminectomy width (%) was defined as the percentage of the width of laminectomy to total lamina length. Mean laminectomy width (%) in patients with spondylolysis or spondylolisthesis was 54.0 in group 1 and 53.2 in group 2, in contrast to that in patients without spondylolysis or spondylolisthesis, which was 35.0 in group 1. The spondylolysis was observed at the level of the laminectomy and below pars interarticularis in group 1 and below the fusion mass at isthmic region in group 2. Conclusion MDCT facilitates the diagnosis of postsurgical acquired spondylolysis and spondylolisthesis and demonstrates typical location of spondylolysis. Greater laminectomy width has been associated with occurrence of acquired spondylolysis and spondylolisthesis.

• Radiation Oncology Journal
• /
• v.27 no.3
• /
• pp.126-132
• /
• 2009

Purpose: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. Results: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage ($\geq$T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size ($\geq$5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage ($\geq$T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. Conclusion: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.

• Sleep Medicine and Psychophysiology
• /
• v.11 no.1
• /
• pp.50-54
• /
• 2004

The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.8 no.1
• /
• pp.31-40
• /
• 2005

Purpose: This study aimed to provide, as a basic material, the experiences of endoscopy in diagnosis and treatment of tumorous conditions in the upper gastrointestinal tract in children. Methods: The objects were 26 patients diagnosed as having tumorous conditions in the upper gastrointestinal tract among 1,283 patients who underwent upper gastrointestinal endoscopic examination at the Department of Pediatrics, Pusan National University Hospital, from January 1994 to July 2004 retrospectively. The characteristics of patients, the chief complaints for endoscopic examination, the sorts of tumors diagnosed, the endoscopic findings of tumors, and the treatment of tumors were analysed. Results: 1) Eleven male and fifteen female were included, whose mean age was $6.93{\pm}4.02years$. 2) The chief complaints for endoscopic examination were abdominal pain (80.7%), vomiting or nausea (30.8%), and gastrointestinal beeding (30.7%) in order. 3) Six cases of ectopic pancreas, five cases of sentinel polyp, three cases of papilloma and vallecular cyst, two cases of Brunner's gland hyperplasia and gastric submucosal tumor, one case of gastrointestinal stromal tumor, duodenal intramural hematoma, T cell lymphoma, lipoma, and Peutz-Jeghers syndrome were diagnosed by endoscopy with or without biopsy. 4) The location of tumors was in the pharynx (19.2%), esophagus (7.7%), gastro-esophageal junction (23.0%), stomach (30.7%) and duodeneum (26.9%). 5) The size of tumors was less than 10 mm in 53.8%, 10~20 mm in 26.9%, more than 20 mm 19.2%. 6) Treatments for tumors included resection by laser, surgical resection, endoscopic polypectomy with a forcep or snare, and observation 7) There was no significant complication. Conclusion: Various and not a few tumors were found in the upper gastrointestinal tract. The endoscopy was accurate, effective, and safe means for diagnosis and treatment of those lesions in children.