• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.46-53
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• 2020

Purpose: Scapular body fractures have generally been treated with non-surgical methods. This study reports the clinical and radiological outcomes after lateral-posterior internal fixation for treating displaced scapular body fractures. Materials and Methods: From March 2007 to May 2017, out of 40 patients who underwent internal fixation for scapular fractures, 13 cases of lateral plate fixation of a scapular body fracture were reviewed retrospectively. Preoperative and postoperative displacement, angulation and glenopolar angle (GPA) were measured. The range of shoulder motion, visual analogue scale (VAS), and disabilities of the arm, shoulder, and hand (DASH), and Constant score were assessed at the last follow-up. Results: The mean follow-up period was 17.7 months (range, 6-45 months). The mean preoperative GPA was 23.3°±3.96° (range, 17.8°-28.1°) and the postoperative GPA was 31.1°±4.75° (range, 22.5°-40.1°). Injury to the suprascapular nerve, nonunion, fracture redisplacement, metallic failure, or infection did not occur. At the last follow-up, the mean range of motion was 150.5°±19.3° in forward flexion, 146.6°±2.34° in lateral abduction, 66.6°±19.1° in external rotation, and 61.6°±18.9° in internal rotation. The VAS, DASH, and Constant scores were 1.7±1.3, 6.2±2.4, and 86±7.9 points, respectively. Conclusion: A scapular body fracture with severe displacement, angulation and marked decreased GPA can be stabilized by lateralposterior plate fixation using the appropriate surgical technique with good functional and radiological results.

• The Journal of the Korea Contents Association
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• v.12 no.12
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• pp.345-355
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• 2012

Delayed treatment of acute cardiovascular and cereb-directrovascular diseases is related to poor prognosis and sequelae. For rapid and adequate treatment, role of prehospital emergency dispatchers for adequate triage and selection of hospital is important. In several advanced countries, emergency dispatchers use standardized protocols for decision of rescuer resources or distribution of patients at each hospital. ut, there has not been developed standardized protocol for emergency dispatchers in Korea. We developed standardized protocol based on NHS-direct and CTAS system for triage of symptoms of chest pain and Stroke. Groups with standardized protocol and without protocol was compared to triage result at emergency department which patient visited. The accuracy of triage on chest pain was 70.0% in group A, 94.0% in group B(p<0.01). The accuracy of triage in stroke symptoms was 64.2% in group A, 84.6% in group B(p<0.01). Conclusion: In this study, the accuracy of telephone triage with the protocol was more accurate than without the protocol. But, more studies are needed to generalize the protocol in South korea.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.62-67
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• 1998

The gracilis muscle is well suited to small and medium-sized soft tissue defects that cannot be adequately handled by simple rotational flaps and it will conform well to irregular contours, can be split longitudinally at both ends to allow cavities and awkwardly shaped spaces and can be transferred in part or in whole. The gracilis muscle used as a free muscle or musculocutaneous flap is small with a long, narrow contour and its vascular pedicle is a terminal branch of the medial femoral circumflex artery and vein. The aims of soft tissue reconstruction are to cover soft tissue defects, to clear up infection and to prepare for further surgical procedures. Authors have performed 12 gracilis muscle flaps in the lower extremities at Chonbuk National University Hospital from June 1994 through March 1998. The results were as follows. 1. 11 cases of 12(91.7%) were sustained from the crushing injury and secondary complications from the traffic accident. 2. The microsurgical anastomosis of one artery and two veins have performed in 6 cases(50%) of 12 and 11(91.7%) cases of 12 were successful at the third postoperative week and in the final result. 3. Gracilis muscle flap is the infetion-resistant and aesthetically acceptable performed in the lower leg 1/3 and the foot.

• Laboratory Medicine Online
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• v.1 no.2
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• pp.110-114
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• 2011

There have been a few reports of hemophagocytic lymphohistiocytosis (HLH) with chromosomal abnormalities. Clonal chromosomal abnormalities in HLH patients are usually found in association with hematologic malignancies and rarely with epstein-barr virus (EBV) infection. Here, we report a fatal case of HLH with clonal karyotype abnormalities. A 75-yr-old man was admitted with persistent anorexia and high fever. Laboratory data revealed pancytopenia, hypofibrinogenemia, hyperferritinemia, prolonged prothrombin time and activated partial thromboplastin time, and marked elevated level of serum transaminases. In real time-PCR using whole blood, EBV DNA was not detected but cytomegalovirus (CMV) DNA was detected. The bone marrow aspiration smear showed hyperplasia of mature histiocytes with prominent hemophagocytosis. In chromosomal analysis of bone marrow aspirates, complex chromosomal abnormalities were found. In spite of steroid pulse therapy and antibiotic treatment, he died of disseminated intravascular coagulopathy.

• Tuberculosis and Respiratory Diseases
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• v.39 no.4
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• pp.310-317
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• 1992

Background: Angiotensin converting enzyme is a glycoprotein peptidyldipeptide hydrolase which cleaves the c-terminal dipeptides of several oligopeptides. It is a menbrane-bound protein mainly synthesized by the endothelial cells. Since the lung has the largest capillary bed of any organ in the body, it is here that ACE acts on circulating substrates like angiotensin I and bradykinin. It is well known that ACE correlates with disease activity in sarcoidosis and also there are reports that changes in serum ACE activity are found in many acute and chronic lung diseases. So we planned this study to see if serum ACE activity can act as a prognostic factor in lung cancer. Methods: Forty-one newly diagnosed lung cancer patients were included in the study group. There were 19 patients with squamous cell lung cancer, 13 with adenocarcinoma, and 9 with small cell carcinoma. Patients were excluded from the study if they had high blood pressure, heart disease, liver disease, renal disease, or other lung disease. Serum ACE activity was analyzed according to cell type, staging, mode of treatment, and clinical response to treatment. Results: 1) There was no difference in serum ACE activity between lung cancer patients and the control group. Also no difference in serum ACE activity was found according to cancer cell type or staging. 2) In patients who underwent curative resection of lung cancer, serum ACE activity was decreased significantly after the operation. 3) In patients who were diagnosed as non-small cell lung cancer and were treated with 4 cycles of anti-cancer chemotherapy without clinical improvement, changes in serum ACE activity were not seen after the treatment. 4) In patients diagnosed as small cell lung cancer treated with 4 cycles of anti-cancer chemotherapy with clinical improvement, changes in serum ACE activity were also not observed. Conclusion: Serum ACE activity was decreased after lung resection but had no relation to cell type, staging, or clinical response to treatment in lung cancer patients. Therefore, serum ACE activity is not suitable in predicting clinical outcome of lung cancer patients.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.815-820
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• 2005

Background: Pulmonary atresia with intact ventricular septum is a rare congenital cardiac disease. There have been various surgical options, but there are still controversies. Material and Method: Fourteen neonates who were operated on between 1999 and 2000 were enrolled in this study. We measured Z-value of tricuspid valve by echocardiography. We performed right ventricular outflow tract transannular patch in 9 patients. Modified Blalock-Taussig shunt was placed according to the condition of patients. Mean follow up period was 46.0 months. Result: There were 2 operative mortality and 1 late mortality. Biventricular repair was possible in 7 patients. One and a half ventricular repair were done in 3 (tricuspid valve Z-value was -2, -2.5 and -3) and single ventricular repair in 2 patients (tricuspid z-value was -4.6, -4.5) The tricuspid valve Z-value for the patients who had biventricular repair and one and a half ventricular repair were -0.8$\pm$1.50 (-3.2$\∼$1.2) and -2.5$\∼$0.5 (-3$\∼$ -2) respectively. All patients who survived had fair to good right ventricular function, good left ventricular function and good clinical states. Conclusion: Neonatal surgical management of pulmonary atresia with intact ventricular septum has a good surgical outcome, z-value of tricuspid may be helpful for the determination of surgical options.

• The Korean Journal of Pharmacology
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• v.27 no.2
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• pp.211-214
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• 1991

SJ-200 is an oral liquid preparation of acetaminophen, ibuprofen, Dl-methyleph edrine HCl, caffeine, chlorpheniramine maleate, guaifenesin and dextromethorphan HBr, which is indicated when there is a need to improve various cold symptoms such as headache, sore throat, fever, or cough etc. Thirty patients was enroled for this study fro June to July, 1991. They were given one bottle (30 ml) of SJ-200 t.i.d dy P.O for an average of one to seven days. 1) Twenty-eight patients (84.8%) were relieved from the symptoms of upper respiratory tract infection. 2) Side effects with this preparation occured in 8 patients924.2%) but in four patients, they were mild, which wee transienty by the discontinuation f the medication.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1077-1082
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• 1997

To assess the early results, risk factors and optimal timing for coronary artery bypass graft surgery(CABG) after an acute myocardial infarction(AMI), we reviewed our 19 patients who underwent CABG within 30 days after AMI, between June 1994 and October 1996. This study excluded 1 patient whose diagnosis was AMI with ventricular septal rupture. 14 of the patients were male and 5 were female. Their ages ranged from 41 to 77 years(mean age, 60.6$\pm$ 10.4 years), and the amount of time between AMI and CABG ranged from 8 hours to 24 days(mean time, 10.6$\pm$6.4 days). There were 11 anteroseptal infarctions and 8 inferior wall infarctions. 11 patients had trsnsmural infarctions and 8 had subendocardial infarctions. Indications of operations were p imary revascularization and postinfarction angina. Three patients required preoperative intra-aortic balloon pump(IABP) support, and 4 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.6 $\pm$ 0.6 vessels per patient were bypassed. The early mortality rate for these 19 patients was 5.3% and late mortality rate was 5.5%, 1-year and 2-year actuarial survival rates were 89.5% Univariate analysis of mortality showed that an ejection fraction less than 30% and intraopretative IABP supports were associated with risk factors(p value=0.018 and 0.015 respectively). Age, sex, time to CABG, emergency operations, types and locations of infarctions were not significant. Although our studies have weak p.oints in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.792-798
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• 1998

Background: There are various tracheal diseseas which cause the obstruction of the trachea: postintubation tracheal stenosis, tracheal cancer, thyroid cancer, endotracheal tuberculosis, et al. Recently surgical resection and reconstruction of the trachea has been adopted as the safe method for tracheal lesions. Materials and methods: We report our experience and results of resection and reconstruction for various obstructive tracheal lesions in 38cases from 1985 to 1996. Length of resection of the trachea was up to 6 cm. Twenty lesions were approached by cervical collar incision, 12 lesions by cervicosternal incision and 4cases needed transthoracic approach. Surgical procedures consisted of resection and tracheotracheal anastomosis in 32 cases, resection and laryngotracheal anastomosis in 6cases and in addition laryngeal release was necessary to release anastomotic tension in 3cases. Results: The complications were 4 minor wound infections, 2 mild suture line granulomas, 1 vocal cord palsy, 2 pneumonias and 1 systemic candidiasis. Two patients who had poor consciousness and pnemonia and one who developed systemic candidiasis were expired after operation. Conclusion: We suggests resection and reconstruction of trachea is optimal procedure for up to 6cm long tracheal lesions. However, for the patients with poor consciousness or poor general conditions would be the conservative treatment preferred to the tracheal reconstruction because of high serious complications and mortalities.

• Applied Microscopy
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• v.32 no.4
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• pp.385-398
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• 2002

The purpose of the present study is to investigate whether stromal cells supporting specific microenvironment for hematopoiesis of bone marrow are affected by toxicants and therapeutic drugs such as antibiotics and anticancer drugs and whether laminin-1 is associated with such effects. SD rats were intraperitoneally injected with 75 mg/kg of cyclophosphamide which is widely used to treat infant's solid tumor, leukemia and myeloma and sacrificed after 3 days, 1 week, 3 weeks or 5 weeks of injection. The bone marrow extracted and paraffin-sectioned was analyzed using immunohistochemical staining. A part of tissues was subjected to electron microscopy following reaction with rabbit anti-laminin antibody, biotinylated goat anti-rabbit IgG conjugated with 12 nm gold particles, and staining with uranyl acetate. 1. The bone marrow tissue at day 3 post injection with cyclophosphamide displayed dilated venous sinus, partial necrotic death, and decreased number of hematopoietic cells. Laminin-1 was intensively stained in the reticular and adipose tissues. 2. Up to 5 weeks post injection, laminin-1 was stained at a low level in the stromal tissue of bone marrow and the number of hematopoietic cell was increased. 3. Deposition of the gold particle which represents laminin-1 expression was observed at the highest level in the stromal cells of bone marrow obtained 3 days after injection, and decreased after 1 to 5 weeks. These results suggest that stromal cells which play a role in supporting microenvironment for bone marrow hematopoiesis augment induction of laminin-1 expression and activation upon administration of cyclophosphamide.