• Journal of Korean Neurosurgical Society
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• v.66 no.5
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• pp.598-604
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• 2023

Penetrating head injury is a serious open cranial injury. In civilians, it is often caused by non-missile, low velocity flying objects that penetrate the skull through a weak cranial structure, forming intracranial foreign bodies. The intracranial foreign body can be displaced due to its special quality, shape, and location. In this paper, we report a rare case of right-to-left displacement of an airgun lead bullet after transorbital entry into the skull complicated by posttraumatic epilepsy, as a reminder to colleagues that intracranial metal foreign bodies maybe displaced intraoperatively. In addition, we have found that the presence of intracranial metallic foreign bodies may be a factor for the posttraumatic epilepsy, and their timely removal appears to be beneficial for epilepsy control.

• Radiation Oncology Journal
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• v.36 no.3
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• pp.182-191
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• 2018

Purpose: To investigate the clinical outcome of proton therapy (PT) in patients with chordoma. Materials and Methods: Fifty-eight patients with chordoma treated with PT between June 2007 and December 2015 at the National Cancer Center, Korea, were retrospectively analyzed. The median total dose was 69.6 cobalt gray equivalent (CGE; range, 64.8 to 79.2 CGE). Local progression-free survival (LPFS), distant metastasis-free survival (DMFS), overall survival (OS), and disease-specific survival (DSS) rates were calculated by the Kaplan-Meier method. Results: With the median follow-up of 42.8 months (range, 4 to 174 months), the 5-year LPFS, DMFS, OS, and DSS rates were 87.9%, 86.7%, 88.3%, and 92.9%, respectively. The tumor location was associated with the patterns of failure: the LPFS rates were lower for cervical tumors (57.1%) than for non-cervical tumors (93.1%) (p = 0.02), and the DMFS rates were lower for sacral tumors (53.5%) than for non-sacral tumors (100%) (p = 0.001). The total dose was associated with both the LPFS rate and DMFS rate. The initial tumor size was associated with the DMFS rate, but was not associated with the LPFS rate. Three patients had grade 3 late toxicity with none ≥grade 4. Conclusion: PT is an effective and safe treatment in patients with chordomas. The tumor location was associated with the patterns of failure: local failure was common in cervical tumors, and distant failure was common in sacral tumors. Further refinement of PT, such as the utilization of intensity modulated PT for cervical tumors, is warranted to improve the outcome.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.2055-2060
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• 2015

Purpose: To present information about prognostic factors of gastric cancer patients treated in our Erzurum center including age, gender, tumour location, pathological grade, stage and the effect of treatment on survival. Materials and Methods: This retrospective study was performed on patients who applied to our clinic and diagnosed as gastric cancer. Age and gender of the patients, primary location, histopathological characteristics, TNM stage of the gastric cancers (GCs), treatment applied, oncological treatment modalities and survival outcomes were studied. A univariate analysis of potential prognostic factors was performed with the log-rank test for categorical factors and parameters with a p value < 0.05 at the univariate step were included in the multivariate regression. Results: A total of 228 patients with a confirmed diagnosis of gastric cancer were included in the study with a male/female ratio of 1.47. Median follow-up period was estimated as 22.3 (range, 3 to 96) months. When diagnosis of the patients at admission was analysed, stage III patients were most frequently encountered (n=147; 64.5%). One hundred and twenty-six (55.3%) underwent surgical treatment, while 117 (51.3%) were given adjuvant chemotherapy. Median overall survival time was 18.0 (${\pm}1.19$) months. Mean overall survival rates for 1, 2, 3 and 5 years were $68{\pm}0.031%$, $36{\pm}0.033%$, $24{\pm}0.031%$and $15.5{\pm}0.036%$, respectively. Univariate variables found to be significant for median OS in the multivariate analysis were evaluated with Cox regression analysis. A significant difference was found among TNM stage groups, location of the tumour and postoperative adjuvant treatment receivers (p values were 0.011, 0.025 and 0.001, respectively). Conclusions: This study revealed that it is possible to achieve long-term survival of gastric cancer with early diagnosis. Besides, in locally advanced GC patients, curative resection followed by adjuvant concomitant chemoradiotherapy based on the McDonald regimen was an independent prognostic factor for survival.

• Archives of Reconstructive Microsurgery
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• v.11 no.1
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• pp.29-35
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• 2002

Free flap reconstruction of the foot has become one of the standard procedures at the present time, but choice of a free flap for the soft tissue defect of the foot according to location and size remains controversial. We evaluated the results of free flap reconstruction for the soft tissue defects of the foot. Twenty seven free flaps to the foot were performed between May 1986 and December 2000 in the department of Orthopedic Surgery. Patient age ranged from 3 to 60 years. Male to female distribution was 20:7. Mean follow-up period was 30.5 months which ranged from 12 months to 60 months. The indications for a specific flap depended on the location and extension of the foot defect. In weight-bearing area and amputation stump, the authors chose the sensate (reinnervated) dorsalis pedis flaps (n=7) and sensate radial forearm flaps (n=2). In nonweight-bearing area including dorsum of the foot and area around Achilles tendon, we performed nonsensate (non-reinnervated) free flap reconstructions which included dorsalis pedis flaps (n=5), groin flap (n=1), radial forearm flaps (n=6), scapular flaps (n=4), latissimus dorsi flaps (n=2). Twenty-six flaps transferred successfully (96.3%). The sensate flaps which were performed in weight-bearing area and amputation stumps survived in all cases and recovered protective sensation. Mean two-point discrimination was 26 mm at the last follow up. As a conclusion, the selection of a proper flap depends on the location and extension of the foot defect and patient's age. Fasciocutaneous flap including radial forearm flaps and dorsalis pedis flaps were the best choice in nonweight-bearing area. The sensate free flaps which are performed in the weight-bearing area and amputation stumps can produce better outcome than nonsensate free flap.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.170-174
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• 2013

Purpose: A flail chest is one of most challenging problems for trauma surgeons. It is usually accompanied by significant underlying pulmonary parenchymal injuries and mayled to a life-threatening thoracic injury. In this study, we evaluated the treatment result for a flail chest to determine the effect of trauma localization on morbidity and mortality. Methods: Between 2004 and 2011, 46 patients(29 males/17 females) were treated for a flail chest. The patients were divided into two group based on the location of the trauma in the chest wall; Group I contained patients with an anterior flail chest due to a bilateral costochondral separation (n=27) and Group II contained patients with a single-side posterolateral flail chest due to a segmental rib fracture (n=19). The location of the trauma in the chest wall, other injuries, mechanical ventilation support, prognosis and ISS (injury severity score) were retrospectively examined in the two groups. Results: Mechanical ventilation support was given in 38 patients(82.6%), and 7 of these 38 patients required a subsequent tracheostomy. The mean ISS for all 46 patients was $19.08{\pm}10.57$. Between the two groups, there was a significant difference in mean ventilator time (p<0.048), but no significant difference in either trauma-related morbidity (p=0.369) or mortality (p=0.189). Conclusion: An anterior flail chest frequently affects the two underlying lung parenchyma and can cause a bilateral lung contusion, a hemopneumothorax and lung hemorrhage. Thus, it needs longer ventilator care than a lateral flail chest does and is more frequently associated with pulmonary complications with poor outcome than a lateral flail chest is. In a severe trauma patient with a flail chest, especially an anterior flail chest, we must pay more attention to the pulmonary care strategy and the bronchial toilet.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.28-32
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• 2014

Purpose: We aim to determine sciatic nerve bifurcation location and depth at the level of the popliteal fossa in Korean female. Materials and Methods: Thirty three subjects were enrolled in Korean female. M-turbo ultrasound system (SonoSite, bothell, WA, USA)with 38 mm high frequency linear array transducer, 13-6 MHz probe was used for ultrasound measurements. With subject lying prone, the location of the sciatic nerve in relation to the popliteal crease and skin to nerve distance were assessed via ultrasound. Analyses were performed with SAS version 9.3 using multiple linear regression. Results: Thirty three subjects were enrolled. Distance from the popliteal crease to the sciatic nerve was 4.5-7.5 (mean 5.7 cm), and the depth of the sciatic nerve from the skin was 1.8-3.2 (mean 2.4 cm). Multiple linear regression for the usefulness of the model has a p value of 0.036, shows between weight and depth. Conclusion: We show that variability exists for sciatic nerve bifurcation location in Korean female, The success rate is creased if consider the relations between weight and depth when performs sciatic nerve block in Korean female. In our study, a sciatic nerve block is recommend that performed 7.5 cm proximal to the crease in the popliteal fossa.

• Investigative Magnetic Resonance Imaging
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• v.21 no.2
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• pp.97-101
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• 2017

We are reporting about a case of a rheumatoid nodule, beneath the ischial tuberosity, mimicking ischiogluteal bursitis. Rheumatoid nodules are frequently seen, at the subcutaneous soft tissues of repetitive mechanical irritation points, and prominent bones. There have been no reported cases of rheumatoid nodules, extending just beneath the ischial tuberosity bone. A 68-year-old woman with a seven-year history of rheumatoid arthritis, suffered for six months, from right buttock swelling and discomfort in seating. A cystic lesion postero-inferior to the ischial tuberosity, was noted in the MRI scan, which was thought to be ischiogluteal bursitis, because of its characteristic location and appearance. Histopathologic analysis and gross findings on the operation, revealed no evidence of bursitis.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.111-116
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• 1999

Primary hemangiopericytomas of the lung are uncommon sarcomas that arise from pericytes that surround the basement membrane of capillaries and small venules within the lung parenchyma. The presenting symptoms and signs depend on the location of the tumor and radiologic features are not diagnostic. The behavior of pulmonary hemangiopericytomas is difficult to predict and all tumors should be considered potentially malignant. Wide surgical excision remains the mainstay of treatment. We report a case of primary hemangiopericytoma of the lung with a brief review of literature.

• Tuberculosis and Respiratory Diseases
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• v.51 no.4
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• pp.373-378
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• 2001

An idiopathic mediastinal fibrosis is a rare disease with an unknown etiology. It is a benign condition in which a fibrosis of the soft tissue and chronic inflammation occurs within the mediastinum. This leads to a constriction and obliteration of the adjacent mediastinal structures, particularly the great veins. This can result in a variety of clinical conditions depending on the anatomic location of the disease. Here, we report a case of an idiopathic mediastinal fibrosis with vocal cord palsy, which was confirmed by a biopsy with a thoracotomy. Postoperative medical treatment using prednisolone and tranilast was performed.

• The Korean Journal of Health Service Management
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• v.6 no.2
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• pp.101-109
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• 2012

This study purposed to analyze the differences of cost, length of stay, and number of visits between patients who referred from clinics to a general hospital and patients who directly visit a general hospital. Study sample included 402 patients (177 patients who were not referred from clinics, 225 patients who referred from clinics) who visited the Dept. of Gastroenterology in a university hospital in Daejeon from January to June in 2007. Cost and patients' information were collected from Hospital Information System and medical record. SPSS v.12.0 was used for the statistical analysis. Multiple regression analysis found that for inpatients, location variables and malignant tumors of digestive organs had a significant influence on cost variable. For outpatients, a referring hospital type and visiting month had significant influences on total cost, and sex and visiting month (February) had significant relationship with number of visit. The study results help to understand the differences of patient care depending on whether they were referred from clinics or not. Hospital managements could use the results for marketing purposes, and it could provide valuable information for increasing the competitiveness of hospital in a given market.