• Clinics in Shoulder and Elbow
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• v.16 no.1
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• pp.27-32
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• 2013

Purpose: The purpose of this study is to evaluate the clinical and radiological outcomes of treatment of humerus shaft simple fracture by minimally invasive percutaneous osteosynthesis (MIPO) technique using locking compression plate (LCP). Materials and Methods: Six patients who were operated for humerus shaft simple fracture from August 2010 to May 2011 were enrolled for this study. We checked the cause of injury and the accompanying injuries and evaluated the operation time, the clinical and radiological period of union, postoperative range of motion of the shoulder and elbow joint, pain, activities in daily living, radiologic alignment, and other complications. Results: The clinical period of bone union was 7.2 weeks on average, and the radiologic period of bone union was 8 weeks on average. Follow-up period was more than 12 months in all cases. The angulation through postoperative alignment was 2.8 degrees in AP view and 2 degrees in lateral view. The postoperative range of motion was 167 degrees in forward flexion, 50 degrees in external rotation, and thoracic vertebra 12 level in internal rotation. The average value of visual analogue scale (VAS) was 1.2 and that of KSS was 91.3. The American Shoulder and Elbow Surgeons' score (ASES) was 26.5 and the UCLA score was 31.5. Conclusion: MIPO technique for the humerus shaft simple fracture showed good functional and radiological outcomes and may be considered as one of the treatment options for humerus shaft simple fracture.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.53-60
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• 2009

Purpose: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. Materials and Methods: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. Results: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. Conclusion: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.299-304
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• 2009

Background: Although the results of the surgical management for complete atrioventricular septal defect (c-AVSD) have improved, the optimal surgical strategy is still controversial. The aims of this study are to evaluate the outcome of c-AVSD repair and to define the risk factors related to reoperation. Material and Method: We retrospectively reviewed the medical records of 35 patients (8 males and 27 females) who underwent the total correction of c-AVSD from August 1996 to March 2008. The median age at repair was 5.2 months (range: 3 days$\sim$82 months). Sixteen patients (45.7%) were associated with Down syndrome. Prior palliative operations were performed in 4 patients. The one-patch techniques were performed in 3 patients, and the two-patch techniques were done in 32 patients. Result: There was 1 early death (2.9%). The median follow-up period was 68 months (range: $2\sim134$ months) for 34 survivors. There was no late death. Reoperations were performed in 5 patients (14.3%) for severe left atrioventricular valvular regurgitation (AVVR). Nine patients (25.7%) showed left an AVVR of more than grade III. Associated major cardiac anomalies and the use of Gore-Tex patch for ventricular septal closure were the risk factors for postoperative left atrioventricular valve failure and reoperation. Conclusion: In this study, we found that surgical repair of c-AVSD was safe and effective. However, the high reoperation rate after repair remains a problem to be solved.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.75-80
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• 2007

Purpose: To investigate the quality of training hospital based treatment, we evaluated the soft tissue sarcoma treatments afforded by general orthopedic surgeon rather than orthopedic oncologist. Materials and Methods: We reviewed the details of 25 patients with pathologically confirmed soft tissue sarcoma who registered in our hospital between July 1997 and 2006 September. We evaluated initial diagnoses, the surgical treatment (including adjuvant therapy) and the follow up method used and related these to the principles of soft tissue sarcoma treatment. Results: The study cohort comprised 16 men and 9 women of mean age of 50.2 years. A diagnostic biopsy was performed in 9(36%) cases before definitive surgical treatment. Wide excision was performed in 13(52%) cases. For the 12 cases in which the grade of sarcoma was estimated, adequate surgical treatment with adjuvant therapy was performed only in 4(33.3%) cases. In addition, an adequate follow up schedule was adopted in only 4(16%) of the 25 study subjects. Conclusion: Unexpectedly, many cases of soft tissue sarcoma were treated inadequately even in a training hospital. An intensive education program on the treatment of soft tissue sarcoma is necessary for all orthopedic surgeons.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.381-386
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• 2002

Background: Bronchial carcinoids account for approximately 2% of all pulmonary tumor and consist of typical carcinoids and atypical carcinoids. An atypical carcinoids is considered to be an intermediate form of tumor between a low-grade malignant typical carcinoid and a high-grade malignant small cell lung carcinoma. There is still controversy with regard to the extent of resection and the value of systemic adjuvant therapy in atypical carcinoids. We performed a retrospective review of our experiences at Severance Hospital. Material and Method: Between 1990 and 2000, 15 patients with bronchial carcioids were operated, and 5 of these had atypical carcinoids. Histologic diagnosis was established un the criteria of WHO/IASLC(1999). Result: There were 3 pneumonectomies, 11 lobectomies, and 1 segmentectomy. In typical carcinoids, one patient had regional lymph node metastasis, and 3 patients in atypical carcinoids had mediastinal lymph node metastases. Distant metastases developed in one patient of typical carcinoid, but developed in 4 patients of atypical carcinoids(p=0.0017). The 5-year survival rate in patients with atypical carcinoids was 20%, versus the 100% 5-year survival rate observed in patients with topical carcinoids(p=0.0039). Conclusion: In atypical carcincids, because of many lymph node metastases on diagnosis and a low long-term survival rate, lobectomy constitutes a mininal procedure. Adjuvant systemic therapy is recommended fur patients with lymph node and distant metastasis.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.286-290
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• 1998

The pectus excavatum is the most common deformity of chest wall. The most common cause of surgical correction is cosmetic problem. From January 1981 to July 1996, 24 patients had undergone surgery for pectus excavatum and they were corrected by Ravitch operation(n=4) or modified Wada operation(n=20) respectively. We analyzed each surgical cases according to age, sex, chief complaint, degree of deformity, EKG findings, complications and satisfaction degree of patient. In some cases, we measured Welch index preoperatively and postoperatively. The postoperative complications were wound infection in two, pneumothorax in two and reccurrence in one. The average value of Welch index was significantly improved from 5.86$\pm$0.51 preoperatively to 4.10$\pm$0.51 postoperatively(P<0.05). The results by Humphreys' criteria were satisfiable in 88%(excellent 71%, good 17%). The findings of this study suggest that surgical correction of pectus excavatum with modified Wada rocedure and submammary s in incision is effective method in physical and psychiatric aspect.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.88-95
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• 2004

Purpose: Current treatment for osteoid osteomas is usually surgical excision of the nidus. Various minimal invasive techniques have been reported to overcome the invasiveness of the surgical excision. We treated 22 patients with osteoid osteoma by percutaneous thermoablation of the nidus under computed-tomography guidance. Materials and Methods: Twenty two consecutive patients underwent CT-guided percutaneous radio-frequency thermoablation between April 1999 and May 2004. The mean age was 26.5(7~55) years. In three cases, the diagnosis was confirmed pathologically before the prodedure while the others clinically and radiologically. Computed tomography (CT)-guided percutaneous RF ablation was performed with general or spinal anesthesia. With an RF electrode, the lesion was heated to 80 or 90 degrees C for 6(3~8) minutes. Clinical success was assessed at a mean of 30(4~62) months after the procedure at out patient clinic or by telephone interview. Results: The procedure was technically successful in all cases except a complication. Patients were discharged on 1.9 days after the procedure and resumed normal activities immediately. All patients but three (86%) remained pain free during follow-up (range 4~62 months). A second thermoablation treatment relieved the recurrent symptoms in 2 patients and the remained had persistent pain without a second prodedure. Conclusion: Percutaneous thermoablation appears to be safe and effective for osteoid osteomas, and is a minimally invasive procedure alternative to surgical resection.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.201-205
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• 2007

Purpose: This retrospective study was conducted to assess outcome and to determine the prognostic factors in patients with a desmoid tumor treated with postoperative radiotherapy. Materials and Methods: Twenty-seven patients with a desmoid tumor who were treated with postoperative radiotherapy between June 1984 and October 2005 were analyzed. There were 13 male and 14 female patients. The age of the patients ranged from 3 to 79 years (median age, 28 years). Tumors were located in an extra-abdominal area (21 cases), and in the abdominal walls (6 cases). The tumor size ranged from 2.5 to 25 cm (median size, 7.5 cm) in the largest linear dimension. Thirteen cases received radiotherapy after initial surgery, and 14 recurrent cases received radiotherapy after additional surgery. The total radiation dose given was $45{\sim}66$ Gy (median dose, 59.4 Gy), and the fraction size was $1.8{\sim}2.0$ Gy. Results: The median follow-up period was 61 months (range, $12{\sim}203$ months). Two patients developed local progression and six patients experienced local recurrence. The 5-year disease-free survival rate and the 5-year progression-free survival rate were 61 % and 70%, respectively. Wide local excision was associated with better disease free survival with statistical significance (p=0.028). Radiotherapy after initial surgery (p=0.046) and a higher radiation dose of more than 60 Gy (p=0.049) were associated with better progression free survival with statistical significance. At the time of the last follow-up, the number of additional surgeries was higher in patients that received radiotherapy after reoperation (p<0.001). Conclusion: Radiotherapy after the initial operation improved local control and decreased the number of subsequent operations. Thus, postoperative radiotherapy after an initial operation is recommended in patients with a high risk of recurrence for a desmoid tumor.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.2
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• pp.186-190
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• 1995

타석증을 동반한 만성 악하선 타액선염의 경우 악하선 적출은 일반적인 치료 방법이다. 일반적으로 악하선 적출술은 수술의 용이성, 수술시야의 확보 등의 장점으로 구강외접근에 의해서 시행되어져 왔다. 그러나 시대적으로 심미적인 요구가 증대되고 있는 요즈음 구외 접근으로 인한 술후 반흔은 구외접근법의 가장 결정적인 단점이라 할 수 있다. 또한 설하선과 함께 적출하여야 할 경우 구내접근과 구외접근을 동시에 실시할 경우 술후 치유과정상의 후유증을 유발할 수도 있다. 반면에 구강내 접근에 의한 악하선의 적출은 수술상의 고도의 난이도로 수술자체의 어려움은 있으나 구강의 반흔을 남기지 않아 심미적으로 만족할 만한 결과를 얻을 수 있다. 이에 본 저자 등은 타석증을 동반한 악하선 타액선염의 환자에 있어 구내 접근으로 악하선 및 설하선 적출술을 시행하여 좋은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.8-12
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• 2006

회전근 개 파열이 왜 통증을 일으키며 어떤 경우 통증을 일으키는가에 대해 아직도 모르는 부분이 많다. 그러나 생 역학적으로 회전근 개 질환을 이해하고 접근하면 순리적으로 풀어져 나가는 부분도 많다. 회전근 개가 파열되었어도 통증이 미약하다면 수술보다는 적극적인 보존적 치료가 원칙이다. 만약 수술을 하는 경우 고식적인 방법으로 충분한 경험을 쌓은 후 관절경술을 시도하여야 한다. 물론 최근 관절경술로 파열된 회전근 개를 봉합하여 주는 것이 선호되고 있으며 치료 결과 역시 관절경술이 더 좋을 수는 있으나 불안정성과 마찬가지로 전례에서 가능한 것도 아니고 만족한 결과를 모든 정형외과 의사가 공히 얻는 것은 아니다. 특히 회전근 개 봉합술은 고도의 관절경술 수기가 요구되는 것이므로 충분한 연마가 요구된다.