• Journal of Chest Surgery
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• 제54권6호
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• pp.473-479
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• 2021

Background: The purpose of this study was to compare 1-year clinical outcomes between patients who underwent a Nuss operation or vacuum bell therapy and to present vacuum bell therapy as a possible alternative treatment modality for patients who prefer non-surgical correction of pectus excavatum. Methods: We conducted a retrospective review of pectus excavatum patients who had undergone vacuum bell therapy for more than 1 year and examined patients who had undergone Nuss bar removal more than 1 year previously. The treatment outcomes were evaluated by comparing changes in the Haller index before and after treatment in both patient groups. Results: We included 57 patients in this study and divided them into 2 groups according to the type of treatment received. Both groups showed no significant difference in the post-treatment Haller index after 1 year of follow-up, although the Nuss operation group showed a greater change in the Haller index than the vacuum bell group. Conclusion: Although the Nuss operation is a well-established and effective treatment of choice to correct pectus excavatum, vacuum bell therapy showed comparable outcomes and could become an alternative treatment modality for select patients who prefer non-invasive treatment.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2577-2581
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• 2014

Background: Triple negative breast cancer is associated with aggressive behavior and high risk of local and regional failure. Aggressive surgical intervention is considered suitable. This makes role of breast conserving therapy (BCT) debatable in these patients. The objective of this study was to compare outcome of BCT for triple negative versus non-triple negative breast cancer. Materials and Methods: Medical records of patients who underwent breast conserving therapy from 1999 to 2009 at Shaukat Khanum Cancer Hospital and had complete receptor status information were extracted. Patients were divided into triple negative breast cancer (TNBC) and non-TNBC. Patient characteristics, medical treatment modalities and adverse events were compared. Expected five year locoregional recurrence free, disease free and overall survival was calculated. The Cox proportional hazard model was used to identify independent predictors of outcome. Results: A total of 194 patients with TNBC and 443 with non-TNBC were compared. Significant difference was present for age at presentation (p<0.0001), family history (p=0.005), grade (p<0.0001) and use of hormonal therapy (p<0.0001). The number of locoregional failures, distant failures and mortalities were not significantly different. No significant difference was present in 5 year locoregional recurrence free (96% vs 92%, p=0.3), disease free (75% vs 74%, p=0.7) and overall survival (78% vs 83%, p=0.2). On multivariate analysis, tumor size, nodal involvement and hormonal treatment were independent predictors of negative events. Conclusions: Breast conserving therapy has comparable outcomes for triple negative and non-triple negative breast cancers.

• 대한치과의사협회지
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• 제21권4호통권167호
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• pp.305-313
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• 1983

• Journal of Korean Neurosurgical Society
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• 제61권5호
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• pp.625-632
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• 2018

Objective : Because the anatomical structure of the brachial plexus is very complex, surgical treatment of tumors in this region is challenging. Therefore, a lot of clinical and surgical experience is required for successful treatment; however, many neurosurgeons have difficulty accumulating this experience owing to the rarity of brachial plexus tumors. The purpose of this report is to share our surgical experience with brachial plexus tumor with other neurosurgeons. Methods : The records of 18 consecutive patients with brachial plexus tumors who underwent surgical treatment between January 2010 and December 2017 in a single institution were retrospectively reviewed. The surgical approach was determined according to the tumor location and size, and intraoperative neurophysiological monitoring (IONM) was used in most of cases to prevent iatrogenic nerve injury during surgery. In addition, to evaluate the differences in tumor characteristics according to pathologic diagnosis, the tumors were divided twice into two groups, based on two separate classifications, and statistical analysis was performed. Results : The 18 brachial plexus tumors comprised 15 (83.3%) benign peripheral nerve sheath tumors including schwannoma and neurofibroma, one (5.6%) malignant peripheral nerve sheath tumor, one (5.6%) benign tumor of non-neural sheath origin (neurogenic cyst), and one (5.6%) metastatic tumor (papillary carcinoma). The authors analyzed relationship between tumor size/location and tumor characteristic parameters such as age, size, right-left, and pathology. There were no statistically significant differences except a tendency of bigger tumor size in young age. Conclusion : For a successful surgical outcome, an appropriate surgical approach is essential, and the appropriate surgical approach is determined by the location and size of the tumor. Furthermore, applying IONM may prevent postoperative complications and it is favorable option for brachial plexus tumors surgery.

• 대한소아치과학회지
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• 제23권4호
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• pp.893-898
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• 1996

The occlusal disharmonies resulted from labially protruded or malpositioned teeth can damage the periodontium and induce the non-inflammatory gingival recession. For these cases, a conservative approach was performed by improving oral hygiene and correcting the axial and positional status of the gingivally recessed teeth and removing the prematurely contacted areas. In some cases, rapid remission of tooth mobility and gradual decrease of gingival recession was observed just after start of treatment. In cases of gingival recession in permanent lower incisors of the children with mixed dentition, the treatment of choice is non-surgical conservative approaches. In cases when the gingival inflammation can be controlled through reinforcing the oral hygiene, when attached gingiva have a potential to increase in width through growth (not more than 1 year after eruption or not yet arrived at adult level), and when the recession can be corrected by moving the teeth from labial cortical plate through orthodontic treatment, the conservative measures would be the first choice. On the contrary, when recession has exceeded beyond the level of CEJ, when the gingival inflammation existed with the cause of poor oral hygiene, when the attached gingiva have little potential to increase (for example, more than 8 years after eruption), and when the conservative measures yielded no benefit after 4-8 weeks of treatment, the surgical approaches should be sought.

• Journal of Chest Surgery
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• 제57권2호
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• pp.128-135
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• 2024

Background: This retrospective study aimed to determine the treatment patterns and the surgical and oncologic outcomes after completion lobectomy (CL) in patients with locoregionally recurrent stage I non-small cell lung cancer (NSCLC) who previously underwent sublobar resection. Methods: Data from 36 patients who initially underwent sublobar resection for clinical, pathological stage IA NSCLC and experienced locoregional recurrence between 2008 and 2016 were analyzed. Results: Thirty-six (3.6%) of 1,003 patients who underwent sublobar resection for NSCLC experienced locoregional recurrence. The patients' median age was 66.5 (range, 44-77) years at the initial operation, and 28 (77.8%) patients were men. Six (16.7%) patients underwent segmentectomy and 30 (83.3%) underwent wedge resection as the initial operation. The median follow-up from the initial operation was 56 (range, 9-150) months. Ten (27.8%) patients underwent CL, 22 (61.1%) underwent non-surgical treatments (chemotherapy, radiation, concurrent chemoradiation therapy), and 4 (11.1%) did not receive treatment or were lost to follow-up after recurrence. Patients who underwent CL experienced no significant complications or deaths. The median follow-up time after CL was 64.5 (range, 19-93) months. The 5-year overall survival (OS) and post-recurrence survival (PRS) were higher in the surgical group than in the non-surgical (p<0.001) and no-treatment groups (p<0.001). Conclusion: CL is a technically demanding but safe procedure for locoregionally recurrent stage I NSCLC after sublobar resection. Patients who underwent CL had better OS and PRS than patients who underwent non-surgical treatments or no treatments; however, a larger cohort study and long-term surveillance are necessary.

• 대한치과의사협회지
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• 제51권6호
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• pp.322-329
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• 2013

Among the occlusal discrepancies, maxillary transverse deficiency is quite common in several reasons. The reasons are comprised of maxillary hypoplasia, thumb sucking habits, non-syndromic palatal synostosis and syndromal patients including cleft patients. Orthodontic treatment is used routinely to correct a deficiency in young patients while it has limitations for a skeletally mature patient. Surgical treatments help provide effective maxillary expansion to correct a deficiency in adults. Surgical methods can be categorized to segmental Le Fort I osteotomy and surgically assisted rapid maxillary expansion(SARME). Both methods seem successful but each method would have its own indication. We give a review on transverse maxillary deficiency and two surgical methods.

• 대한치과의사협회지
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• 제53권12호
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• pp.926-934
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• 2015

Obstructive sleep apnea (OSA), most common respiratory disorder of sleep, is characterized by intermittent partial or complete occlusions of the upper airway due to loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxemia, which leads to poor quality of sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences. Untreated OSA may cause, or be associated with, several adverse outcomes, including daytime sleepiness, increased risk for motor vehicle accidents, cardiovascular disease, and depression. Various treatments are available, including non-surgical treatment such as medication or modification of life style, continuous positive airway pressure (CPAP) and oral appliance (OA). Skeletal surgery for obstructive sleep apnea (OSA) aims to provide more space for the soft tissue in the oropharynx to prevent airway collapse during sleep. Conventional surgical techniques include uvopalatopharyngoplasty(UPPP), genioglossus advancement (GA), and maxillomandibular advancement (MMA). Surgical techniques, efficacy and complications of skeletal surgery are introduced in this review.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권4호
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• pp.341-346
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• 2018

Gastric hemangiomas are rare benign vascular tumors that can cause severe gastrointestinal system bleeding. We presented the case of a neonate with fresh bleeding and melena from the orogastric tube and detected gastric hemangioma in esophagogastroduodenoscopic examination. Propranolol is widely used in treatment of cutaneous hemangiomas and non-gastric gastrointestinal system hemangiomas. However, the surgical approach is preferred for treating gastric hemangiomas, and there are few reports of gastric hemangiomas associated with non-surgical treatment. Gastric hemorrhage decreased with antacid and somatostatin treatment. Propranolol treatment was initiated before the surgery decision. After three weeks of treatment, we observed regression in the hemangioma with endoscopic evaluation. During the course of treatment, the patient's gastrointestinal system bleeding did not recur, and there were no side effects associated with propranolol.

• 대한후두음성언어의학회지
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• 제26권2호
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• pp.97-100
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• 2015

Benign vocal fold lesions, such as vocal nodules, polyps and Reinke's edema, usually result from chronic voice overuse. Conservative management such as voice therapy and pharmacotherapy are used as the primary treatment techniques. The main purpose of voice therapy is to identify and reduce voice misuse to achieve the optimal voice. But complete resolution may not be possible in all patients after voice therapy. Furthermore, some patients with voice-related occupations, voice rest and voice therapy are sometimes difficult, which makes it hard to carry out the treatment. When conservative therapy is ineffective, laryngeal microsurgery can be performed under general anesthesia. However, potential complications following laryngeal suspension and violation of the layered structure of the vocal fold during surgery should be considered before surgery. In recent decades, emerging literatures have demonstrated the potential usefulness of vocal fold steroid injection as an alternative treatment option for benign vocal fold lesions. The most advantageous feature of vocal fold steroid injection is the maintenance of regional anti-inflammatory effects while preventing the potential systemic adverse effects of the steroid. Many non-surgical treatment methods can be conducted using different approaches in the office setting. It can be applied as an alternative treatment modality for the management of various benign vocal fold lesions.