• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.716-725
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• 2023

Objective : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.282-286
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• 2018

True extracranial carotid artery aneurysms (ECCAs) are uncommon. Atherosclerosis is the most common etiological factor. Neck pain, a pulsatile mass and murmur at auscultation are the most common symptoms. ECCAs may exhibit severe clinical manifestations due to complications. Cases of rupture can be fatal. There is a risk of distal embolization and stroke in thrombosed cases. We discuss two cases of enlarged ECCA treated surgically in the light of the most recent literature.

• Journal of Chest Surgery
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• v.24 no.11
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• pp.1144-1148
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• 1991

Ventricular false aneurysm is a rare complication of myocardial infarction We successfully operated on a case of left ventricular false aneurysm complicating a silent, undiagnosed myocardial infarction The patients, 64 year-old female, showed marked improvement in her congestive symptom after the operation and was discharged without any complication With its peculiar feature, i.e., propensity to rupture, in addition to the functionally harmful aspects shared with the true aneurysms, a false aneurysm must always be considered to be a surgical indication. Good results can be achieved by proper diagnosis and management with low operative risk.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.253-257
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• 1995

Forty-eight patients with significant left main coronary artery obstruction underwent coronary artery bypass graft between September,1989 and September,1993. They consisted of 29 males and 19 females with the mean age of 58 [range 33 - 78 . Seventeen patients[35% had stenosis in left main coronary artery only and twenty-nine[61% had associated lesions in other coronary artery systems as well.Two[4% had isolated left coronary ostial lesion. The operative mortality was 4.17% [2/48 which is comparable to the mortality of overall coronary artery bypass surgery cases during the same period[p >0.05 . Perioperative myocardial infarction was occurred in two patients[4.17% . And the infarction rates between the two groups also showed no difference[p >0.05 . The forty-six survivors showed significant improvement in exercise tolerance as well as symptomatology. We conclude that surgery for left main coronary artery disease can be done with no increased risk through careful anesthesia,surgery, and aggressive postoperative care in the critical period.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.247-252
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• 1995

The isolated coronary ostial stenosis is rare and a critical lesion which requires urgent surgical intervention. Recently direct angioplasty is assumed as a preferable approach to conventional bypass grafting. From Mar. 1990 to Aug. 1993, six patients underwent direct angioplasty in Sejong Heart Institute. The mean age of 6 patients was 48 years [range 37 to 63 and they consisted with 5 females and one male. All had severe angina [class III or IV of short duration [mean 5.3 months and a low incidence of risk factors. Despite the crucial location of the lesion, most patients had well preserved left ventricular function and normal wall motion. We performed direct angioplasty with autologous pericardium via anterior approach except one patient who underwent direct angioplasty and CABG. One patient died 4 hours after angioplasty probably due to acute coronary dissection. The survived 5 patients maintain normal life without symptoms during 26.2 months follow up [range 5 to 47 months .Our preliminary results suggest that angioplasty of isolated coronary ostial stenosis in highly selected patient can be carried out with good results and relatively low operative risks.

• Journal of Korean Neurosurgical Society
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• v.63 no.3
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• pp.373-379
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• 2020

Carotid endarterectomy (CEA) is the main procedure in carotid surgery, as well as the most frequent vascular procedure. Two techniques of CEA are available : eversion and conventional plus patch angioplasty. Eversion CEA is anatomic procedure that reduces ischemic and total operative time. Simultaneous correction of the joined carotid kinking and coiling is possible, easy and safe, while the usage of patch is excluded. Thanks to oblique shape of anastomosis, eversion CEA is associated with low risk of long-term restenosis. The false anastomotic aneurysms occurrence is very rare, almost impossible after eversion CEA. However, the usage of carotid shunt during eversion CEA is not always simple, while proximal or distal extension of the carotid plaque can make eversion CEA more difficult and risky. Eversion CEA should be the first choice in carotid surgery. Conventional CEA is indicated in cases when carotid plaque is extended more than usual, as well as, if the usage of carotid shunt is necessary.

• Journal of Chest Surgery
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• v.27 no.10
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• pp.858-861
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• 1994

Prosthetic valve thrombosis is rare but it is one of fatal complication after heart valve surgery. Improvements of the valve design and the material have decreased the frequency of thrombosis but have not eliminated completely. And some cases of prosthetic valve thrombosis during pregnancy were reported inspite of adequate anticoagulation therapy.Urgent surgical intervention is indicated for prosthetic valve thrombosis but it is associated with high operative risk, therefore medical thrombolytic therapy such as urokinase or streptokinase therapy is regarded as an alternative therapy. This is a case report of the successful thrombolytic therapy for valve thrombosis in a pregnant patient after mechanical mitral valve replacement.

• Journal of Korean Neurosurgical Society
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• v.38 no.2
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• pp.151-154
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• 2005

A 43-year-old woman was admitted with the chief complaint of progressive visual disturbance and her brain radiological studies disclosed well demarcated tumor at tuberculum sellae area and bilateral mirror image paraclinoid internal carotid artery saccular aneurysms. A larger left side aneurysm was pointing medialy and almost encased by the tumor. Although a brain tumor and intracranial aneurysm can be simultaneously treated by surgery, the high risk of intra-operative aneurysm rupture should be considered. Therefore, the author secondly performed tumor resection after the endovascular embolization of the aneurysm which was embedding the tumor using a Guglielmi detachable coil. After successful treatment of the patient with tuberculum sellae meningioma associated with bilateral mirror image paraclinoid aneurysms using endovascular and surgical techniques, the authors present the case with a review of the related literatures.

• Archives of Plastic Surgery
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• v.43 no.5
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• pp.457-460
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• 2016

Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1237-1247
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• 2019

Post-stroke oculomotor nerve palsy occurs more frequently than previously reported, but only a few studies of traditional Korean medicine treatments have been reported. The symptoms are severe and difficult to treat, and current treatments are high-cost, short-lasting, insufficient for shortening the therapeutic period and promoting better recovery, or involve the risk of post-operative over-correction or under-correction. Traditional Korean medicine treatments may be comparatively effective at lower cost and less harmful. Thus, we report three cases of post-stroke oculomotor nerve palsy treated with traditional Korean medicine.