• The Korean Journal of Cytopathology
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• v.14 no.1
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• pp.36-41
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• 2003

Epithelioid hemangioendothelioma is a rare vascular tumor of borderline malignancy which is characterized by the presence of "epithelioid" or "histiocytoid" endothelial cells. Superficial and deep tumors have been recognized in the extremities, head, neck, chest, and mediastinum of adult patients. It may also occur as a primary tumor of liver, bone, and other visceral organs. Few effusion cytologic findings of epithelioid hemangioendothelioma have been reported. We report a case of composite epithelioid hemangioendothelioma with focal epithelioid angiosarcomatous areas of the iliac bone and adjacent soft tissue in a 38-year-old female, which, during its metastatic course, was presented as a pleural effusion. The effusion was cellular with epithelioid cells presenting both singly and in clusters. The tumor cells were round to ovoid shewing cytoplasmic vacuolization, variability in cell size, and prominent nucleoli. The effusion smears and cell block sections revealed strong positive staining for CD31 and vimentin, weak positive for CD34 and Factor VIII-related antigen, and negative for cytokeratin, CEA, and calretinin. The cytologic findings in this case were similar to that of metastatic adenocarcinoma or malignant mesothelioma. Therefore, immunocytochemical staining in smear and cell block is a helpful tool to differentiate malignant 'epithelioid' cells in effusion.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.332-334
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• 1995

Two hypertensive men with DeBakey type III dissection were admitted due to acute onset of leg ischemia.One patient had ischemia of both legs,The other patient had ischemia of the right leg.Angiograms showed occlusion of aortic bifurcation in one patient and occlusion of right common iliac artery and right renal artery in the other patient.The first patient who had ischemia of both legs was relieved by axillo-bifemoral bypass operation and the second patient with right leg ischemia by femoro-femoral bypass.The dissection of the aorta was successfully managed by conservative measures including hypotensive medication.The bypass grafts was functioning well one year later.The aortic dissection should not be overlooked as an etiology of acute onset of ischemia of the lower extremities.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.44-48
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• 2011

Maxillary defects are inherently complex because they generally involve more than one midfacial component. In addition, most maxillary defects are composite in nature, and often require bony support, as well as a mucosal lining for reconstruction. Therefore, midfacial bone and soft tissue defects present a unique challenge because they require a complex arrangement of tissues in a relatively limited space. This might be difficult to achieve only with free osteocutaneous flaps. The use of bone grafts allows greater flexibility in a reconstruction but is limited by graft resorption. We report a case of a patient reconstructed with a lateral arm free flap, iliac bone graft, sagital split ramus osteotomy for the reconstruction of a right maxillary defect zygomatico-maxillary defect caused by a zygomatico-maxillary malignant tumor resection.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.1-15
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• 1996

From Fabuary 1982 to May 1995, 396 patients had undergone reconstructive surgery of the upper and lower limb with microsurgical technique at department of orthopaedic surgery, Yonsei University of Medicine. The results were as follows; 1. Average age at the time of operation was 23.4years(2-64 years), and there were 277 male and 119 female patients. 2. Among 324 patients of soft tissue flap(87 inguinal flap, 132 scapular flap, 38 latissimus dorsi flap, 11 latissimus dorsi and scapular combind flap, 6 gracilis flap, 12 deltoid flap, 3 tensor facia lata flap, 11 dorsalis pedis flap, 6 lateral thigh flap, 12 wrap around flap, 1 lateral arm flap, 5 musculocutaneous flap), 274 cases(85.5%) were succeed. 3. Among 37 patients of vascularized bone graft(18 fibular bone graft, 11 iliac bone graft, 7 toe to finger transplantation,1 vascular pedicle rib graft), 30 cases(80.1%) were succeed. 4. In 26 cases of segmental resection and rotationplasty at lower extremity, 23 cases were succeed. 5. In 7 cases of Tikhoff-Linberg procedure and in 2 case of segmental resection and replantation, all case was succeed. Overall success rate of microscopic reconstructive surgery was 85.6%. In conclusion, microsurgical technigue is valuable for reconstruction of tissue defect or function loss of the limb.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.89-92
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• 1997

Neurolytic splanchnic nerve block is effective for treatment of intractable upper abdominal cancer pain. Conventional approach for splanchnic nerve block is conducted in the prone position to ensure proper orientation and to allow insertion of needles on each side of the vertebral body. However, the prone position has some technical disadvantages as this position is frequently poorly tolerated by a majority of patients with advanced cancer due to severe abdominal pain, ascites and so on. Male patient, 53-year old with transverse colon cancer, carcinomatosis peritonei and $L_1,\;L_2$ vertebral body metastasis, was admitted for treatment of severe right upper quadrant and right iliac crest pain. We performed neurolytic splanchnic nerve block with transdiscal technique in the lateral decubitus position under fluoroscopic guidance, and well noted the usefulness and the advantage of this technique. The benefits of this technique are safe, simple and effective because the lateral position is better tolerated by patients and makes bony landmarks more accessible during fluoroscopy.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1074-1079
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• 2000

We report a case of pyogenic spondylitis on L2 and L3 with diffuse epidural abscess up to T4 to L3 and large psoas abscess. A forty-nine-year old male was presented with progressive back pain, left flank pain and ab-dominal distention, weakness of the both legs and voiding and defecation difficulty during last 2 months. Initially multiple coronal hemilaminectomies from T4 to T12 were done for the treatment of diffuse thoracic epidural ab-scess. Then second operation via left retroperitoneal approach was performed for lumbar spondylitis and psoas abscess on third day after initial operation. After removal and curettage of pyogenic psoas and epidural abscess and spondylitis (L2-L3), iliac bone grafting with Keneda instrumentation from L1 to L4 was done simultaneously. Postoperative course has been unevenful without recurrent infection. The literature on diffuse epidural and large psoas abscess with pyogenic spondylitis are reviewed and instrumentation for stabilization of pyogenic spondylitis is also discussed.

• Journal of Korean Neurosurgical Society
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• v.50 no.6
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• pp.528-531
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• 2011

Although posterior segmental fixation technique is becoming increasingly popular, surgical treatment of craniovertebral junctional disorders is still challenging because of its complex anatomy and surrounding critical neurovascular structures. Basilar invagination is major pathology of craniovertebral junction that has been a subject of clinical interest because of its various clinical presentations and difficulty of treatment. Most authors recommend a posterior occipitocervical fixation following transoral decompression or posterior decompression and occipitocervical fixation. However, both surgical modalities inadvertently sacrifice C0-1 and C1-2 joint motion. We report two cases of basilar invagination reduced by the vertical distraction between C1-2 facet joint. We reduced the C1-2 joint in an anatomical position and fused the joint with iliac bone graft and C1-2 segmental fixation using the polyaxial screws and rods C-1 lateral mass and the C-2 pedicle.

• Journal of radiological science and technology
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• v.2 no.1
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• pp.59-69
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• 1979

For the clearer visualization of the lung apices in the routine chest P-A view, we have analysed the films at the different positions and different directions of the central X-ray beams. The brief results are as the follows. 1. Best visualization of the lung apices are made with the following position of the patient and central ray. Central ray is directed to the median sagittal plane at the level of the 5th thoracic vertebra with the palms of the hands placing at the greater trochanteric area of the both femurs. 2. The position of the sterno-clavicular joint shows no alteration between the radiographs with the central beam to the film center and to the 5th thoracic vertebra, and position of the hands at the greater trochanters or iliac crests. 3. No relationship exists between the center of the film and the position of the hand. The central beam is projected more inferiorly when the beam is centered to the film center than to the 5th thoracic vertebra. 4. The scapulae are rotated sufficiently anteriorly and more inferiorly, with placing the palms at the greater trochanters, directing central ray to the 5th thoracic vertebra, and with close contact the lung apices to the cassette.

• Journal of Chest Surgery
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• v.34 no.2
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• pp.133-137
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• 2001

배경: 하지에 영향을 미치는 죽상경화증은 복부대동맥과 이에 중요분지인 총장골동맥을 침범할 수 있다. 또한 국소분절을 침범할 수 있으나 다중분절은 침범할 수도 있다. 대상 및 방법: 을지의과대학교 흉부외과학 교실에서는 1995년 1월부터 1999년 12월까지 대동맥총장골동맥의 죽상경화증을 주소로 우회술을 시행받은 23례의 환자들을 후향적으로 조사하였다. 결과: 모든 환자는 남자였고 평균연령은 60.15$\pm$8.7세였다. 전 예에서 흡연의 과거력이 있었으며 동반질환으로 당뇨병 8례, 고혈합 7례, 관상동맥질환 6례, 그리고 판막질환 1례였다. 대동맥장골동맥 죽상경화증에 대한 수술방법으로는 대동맥양측대퇴동맥 우회술(7례), 대동맥양측동맥 우회술 및 대퇴동맥슬와동맥 우회술(8례), 대동맥양측대퇴동맥 우회술(2례), 액와대퇴동맥 및 고고동맥 우회술(3례), 고고동맥 우회술(3례)였다. 훌후 합병증으로 후복막상 출혈 3례, 마비성 장폐색 3례, 폐렴3례, 뇌졸중 1례, 급성신부전 2례, 창상감염 2례였다. 해부학적 우회술을 받은 환자중 3례에서 수술 사망이 발생하였다. 결론: 해부학적 우회술은 대동맥장골동맥의 폐쇄성질환에 표준적인 수술방법이지만 또한 해부학적 우회술 역시 술후 유병률 및 사망률이 낮은 좋은 수술법으로 사료된다.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.393-396
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• 1996

During the past eight years, we have encountered 9 patients, aged between 2 and 61 years, with renovascular hypertension. The renovascular hypertension In this series included Takayasu's disease with renal artery stenosis, arteriosclerosis of renal artery, fibromuscular dysplas a of renal artery Aortd-renal bypass was performed In 8 patients, iliac-to-renal bypass in 1 patient. 9 patients have been followed form 2 months to 5.1 years. Postoperatively, all patients'hypertension was improved. Only 2 patients need to take small dose of antihypertensive medication after discharge. These data indicated the good results of renovascular reconstruction for the patients with renovascular hypertension.