• Journal of Korean Neurosurgical Society
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• 제41권1호
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• pp.22-26
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• 2007

Objective : Cerebral palsy may induce harmful spastic hip adduction. We report the result of microsurgical selective obturator neurotomy, performed on 12 spastic hip adductions of 6 patients, followed clinically for at least 26 months postoperatively. Methods : Microsurgical selective obturator neurotomies, involving microsurgical resection of the anterior obturator nerve branches were performed on 6 patients from January 2000 through June 2003. All patients presented with the inability to sit and 2 patients complained of persistent, intractable pain. We used intraoperative bipolar stimulation to identify selected motor branches. Results : The procedure was performed bilaterally in all patients. In the 3 patients in whom contractures were present, microsurgical selective obturator neurotomies were accompanied by an additional tenotomy of the adductor muscles. Selective tibial neurotomy was performed on three of six patients who originally presented with a spastic ankle. Postoperatively, all spastic hip adductions were corrected more than 60 degrees in passive abduction-adduction amplitude. However, one patient who did not receive active postoperative physiotherapy demonstrated a decreased passive abduction-adduction amplitude upon follow-up. There were no surgical complications. Conclusion : We think microsurgical selective obturator neurotomy may be an effective procedure in the treatment of localized, harmful spastic hip adduction after failure of well conducted conservative treatment. As muscular contractions are often associated with spasticity of the hip adductors, an adjunctive tenotomy may be an option. Comprehensive postoperative physiotherapy is essential to improve long-term results.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.755-762
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• 2017

Objective : The purpose of this study is to describe the detailed surgical technique and short-term clinical and radiological outcomes of lateral lumbar interbody fusion (LLIF) and in situ lateral screw fixation using a conventional minimally invasive screw fixation system (MISF) for revision surgery to treat rostral lumbar adjacent segment disease. Methods : The medical and radiological records were retrospectively reviewed. The surgery was indicated in 10 consecutive patients with rostral adjacent segment stenosis and instability. After the insertion of the interbody cage, lateral screws were inserted into the cranial and caudal vertebra using the MISF through the same LLIF trajectory. The radiological and clinical outcomes were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. Results : The median follow-up period was 13 months (range, 3-48 months). Transient sensory changes in the left anterior thigh occurred in 3 patients, and 1 patient experienced subjective weakness; however, these symptoms normalized within 1 week. Back and leg pain were significantly improved (p<0.05). In the radiological analysis, both the segmental angle at the operated segment and anterior disc height were significantly increased. At 6 months postoperatively, solid bony fusion was confirmed in 7 patients. Subsidence and mechanical failure did not occur in any patients. Conclusion : This study demonstrates that LLIF and in situ lateral screw fixation may be an alternative surgical option for rostral lumbar adjacent segment disease.

• Radiation Oncology Journal
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• 제27권1호
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• pp.1-9
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• 2009

방사선치료후 발생할 수 있는 골 손상은 골반 부전골절, 방사선 골 괴사, 무혈성 괴사, 골 육종 등이다, 특히 최근 방사선치료후의 골탄성도의 변화로 발생하는 골반 부전골절에 관하여 많은 보고가 있었다. 과거 방사선치료 후의 골 손상 특히 골절의 빈도는 선형가속기를 이용한 메가볼트 방사선치료 바뀌면서 현저히 줄어 들어서 매우 낮은 것으로 보고 되었으나 최근에는 $8{\sim}20%$로 보고가 되고 있다. 따라서 골반 부전골절의 임상적 의미와 중요성과 예방 및 치료에 대하여 관심이 증가되고 있다. 저자는 자궁경부암 치료 후 관찰한 골반 부전골절, 골 괴사, 무혈성 괴사, 및 2차성 골육종등 골반골 변화와 손상에 관하여 저자의 경험과 문헌고찰을 통하여 보고 하고자 한다.

• Radiation Oncology Journal
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• 제30권4호
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• pp.153-157
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• 2012

Purpose: There has been no definite consensus on standard treatment, either local or systemic, for the Kaposi's sarcoma (KS). Radiotherapy (RT) can be a good local therapeutic choice especially in non-AIDS associated KS (NAKS) for its indolent behavior. Materials and Methods: Medical records of 17 KS patients treated with RT at the Seoul National University Hospital from February 1998 to January 2012 were retrospectively reviewed. One human immunodeficiency virus (HIV)+ patient with 3 lesions was excluded. The total number of the lesion was 23 among the 16 patients. The median follow-up period was 27.9 months. Correlation between response and variables was analyzed using the logistic regression model. Median age of the patients was 75 years. All the 23 lesions were located at the extremities. Fourteen (61%) of those had pain or local swelling as the initial presentation. Ten patients had possible causes of immunodeficiency and were regarded as iatrogenic, and other 6 were classic KS. Median dose of RT was 36 Gy. Results: No KS-related death was observed. Excluding 2 with short-term follow-up only, complete response and partial response were obtained in 2 (9%) and 19 (73%) lesions, respectively. Of those, 3 lesions underwent local progression. Six had out-of-field recurrence after RT. Symptom improvement was achieved in 13 (93%) of 14 patients. Grade 2 skin toxicities were found in 9 lesions but all got improvement after treatment. When divided into responsive and progressive group, free from progression was not related to any of the possible variables. Conclusion: RT is effective in local control of NAKS resulting great response rate.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.363-369
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• 2011

Objective : We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. Methods : We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. Results : In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. Conclusion : Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.

• Journal of Acupuncture Research
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• 제33권1호
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• pp.79-93
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• 2016

Objectives : The purpose of this study is to explore research trends in gold implantation therapy performed on the animal and human body, through a review of clinical studies focused on gold thread, gold needle and gold bead. Methods : Medical databases, including Pubmed, CENTRAL, MEDLINE, EMBASE, RISS4u, KISTI, OASIS and KTKP, were searched for relevant articles published from their launch to December 31, 2015 using the key word 'gold' with '$thread^*$', '$needle^*$', '$acupuncture^*$', '$wire^*$', '$bead^*$', '$embed^*$', '$implant^*$', or '$insert^*$'. The results were classified into in vivo studies, clinical trials and clinical reports. Analysis of the results was conducted in several research areas, from the identity of studies such as nationality and published year, to the gold preparations-features and implanted locations and to the outcomes that reflect the clinically favorable or adverse effect of gold implantation therapy. Results : A total of 30 studies including 11 in vivo studies, 4 clinical trials and 15 case reports, were found in the search. We observed certain research trends according to the research time, nationality and target indication of the studies. The studies primarily revealed a chronic local inflammatory response which could be a useful mechanism for pain-relief in musculoskeletal diseases and facial rejuvenation. Researches concerning long-term reactions or adverse effects were rare. Conclusion : The results show that the efforts to discover the level of clinical efficacy of gold implantation therapy were steady and worldwide. However, further researches on the longterm effect, and more importantly, the safety of gold implantation therapy are required.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8383-8386
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• 2016

Background: To evaluate the safety, convenience and effectiveness of 940nm diode laser for treatment of homogenous leukoplakia. Materials and Methods: Ten patients having homogenous leukoplakia which were diagnosed clinically were selected from an Indian dental educational institution for the study. Toludine blue staining was applied locally over the lesion. The area where there was increased uptake of stain was excised using a 940 nm EZLASE TM diode laser (BIOLASE-USA). Results: Although various treatment modalities have been tried and the search continues for novel treatment modalities for complete removal of homogenous leukoplakia, from results of our preliminary pilot study it is clear that the use of 940 nm diode laser as a treatment modality for homogenous leukoplakia is a good substitute. Healing was perfect without any complication within a duration of 1 month. Pain intensity was also mild and absolutely zero on the VAS scale after 1 month follow up. Conclusions: 940 nm diode lasers are safe and can be effectively used as a treatment modality of homogenous leukoplakia, without any complication and without compromising health and oral function of patients. Considering recurrence factor, long term follow up for patients is a must.

• 대한족부족관절학회지
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• 제9권1호
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• pp.31-37
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• 2005

Purpose: To report our opinions of management about avascular necrosis following operative treatment of talar fracture and dislocation. Materials and Methods: We followed up 5 patients who were diagnosed as talar avascular necrosis after operation of talar fracture and dislocation. Clinical and radiological analysis were performed. The mean age of patients was 36 years. There were 4 males and 1 females. The average follow up was 51 months. Hawkins scoring system was used as clinical evaluation. Results: Regardless of radiological sclerotic finding, all patients showed satisfactory clinical result. Despite arthritic change in one patient, there were no further radiological and clinical deterioration to require salvage procedure. Conclusion: Most avascular necrosis after operative treatment of talar fracture and dislocation showed satisfactory result with conservative treatment. Thus, salvage operation such as talectomy or ankle fusion should be reserved in cases of intractable ankle pain and claudication.

• 대한소아치과학회지
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• 제32권1호
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• pp.126-131
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• 2005

본 연구는 항생제를 복합 투여하여 유치의 근관 및 치근단 주위 감염에 대한 효과를 임상적으로 관찰하고자 하였다. 근관 및 치근단 주위 병소의 멸균을 목적으로 metronidazole, ciprofloxacin 및 minocyclin을 증류수 및 근관시멘트와 혼합하여 적용하였다. 유치의 근관 입구로부터 하방에 $Fissurotomy^{(R)}$ bur(SS White, USA)를 이용하여 약제 공간을 형성하였고 약제는 치수실 바닥까지 채웠다. 본 증례들에서 단회 적용으로 임상 증상이 개선되었다. 치은종창, 동통, 누공 등 모든 증상이 술 후 1주일 내에 소실되었다. 임상적으로 활용하기 위해서는 보다 많은 수의 증례와 장기간의 임상적 평가가 필요하며 아직까지 근관내 항생제 사용에 따른 부작용에 대한 보고가 없지만 항생제에 민감한 환아에 대해서는 사용에 주의가 필요할 것으로 사료된다. 저자는 행동조절이 곤란한 소아에서 생리적 치근흡수가 진행 중인 감염된 유치를 가진 환아들을 대상으로 항생제를 복합 사용한 바 증상의 개선을 관찰하였기에 보고하는 바이다.

• Journal of Gastric Cancer
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• 제6권3호
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• pp.193-197
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• 2006

흑색종은 피부나 점막에 존재하는 멜라닌 세포에서 기원하는 악성 종양으로 피부에 가장 흔하게 발생한다. 위장관계 점막에서도 흑색종이 발생할 수 있는데 원발성은 매우 드물고 대부분은 피부의 원발성 흑색종으로부터 전이되어 나타난다. 위에 발생한 원발성 흑색종은 매우 드물고 치료 성적이 나쁘고 전이 속도가 빨라서 예후가 매우 나쁘다. 저자들은 혈변, 복통과 체중 감소를 주소로 내원한 75세 남자로 수술 전 진행성 위암으로 진단되어 위전절제술을 시행하였으나 수술 후 위 분문부의 원발성 흑색종으로 식도-위 접합부까지 침범한 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. 흑색종 치료에서 수술은 가장 표준적인 치료법이다. 수술 후 보조 요법으로 항암화학요법, 방사선 치료, 면역 치료 등을 시도해 보았지만 생존율 증가가 입증된 치료 방법은 아직 없는 실정이다. 장기간 생존율을 향상시키기 위해서는 조기 진단과 수술적 치료가 가장 중요하다.