• Journal of Korean Neurosurgical Society
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• v.38 no.4
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• pp.255-258
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• 2005

Objective : Lumbar lordotic curve on L4 to S1 level is important in maintaining spinal sagittal alignment. Although there has been no definite report in lordotic value, loss of lumbar lordotic curve may lead to pathologic change especially in degenerative lumbar disease. This study examines the changes of lumbar lordotic curve after posterior lumbar interbody fusion with wedge shape cage. Methods : We studied 45patients who had undergone posterior lumbar interbody fusion with wedge shape cage and screw fixation due to degenerative lumbar disease. Preoperative and postoperative lateral radiographs were taken and one independent observer measured the change of lordotic curve and height of intervertebral space where cages were placed. Segmental lordotic curve angle was measured by Cobb method. Height of intervertebral space was measured by averaging the sum of anterior, posterior, and midpoint interbody distance. Clinical outcome was assessed on Prolo scale at 1month of postoperative period. Results : Nineteen paired wedge shape cages were placed on L4-5 level and 6 paired same cages were inserted on L5-S1 level. Among them, 18patients showed increased segmental lordotic curve angle. Mean increased segmental lordotic curve angle after placing the wedge shape cages was $1.96^{\circ}$. Mean increased disc height was 3.21mm. No cases showed retropulsion of cage. The clinical success rate on Prolo's scale was 92.0%. Conclusion : Posterior lumbar interbody fusion with wedge shape cage provides increased lordotic curve, increased height of intervertebral space, and satisfactory clinical outcome in a short-term period.

• Journal of Chest Surgery
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• v.48 no.6
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• pp.387-392
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• 2015

Background: The aim of this study was to evaluate the feasibility of single-port video-assisted thoracic surgery (VATS) in the treatment of secondary spontaneous pneumothorax (SSP). Methods: Twenty-four patients who were scheduled to undergo single-port VATS for SSP were studied. The medical records of the patients were retrospectively reviewed. The mean follow-up duration was $26.1{\pm}19.8$ months. In order to evaluate the feasibility of single-port VATS for SSP, the postoperative results of single-port VATS (n=15) in patients with emphysema were compared with those of emphysematous patients who underwent three-port VATS (n=15) during the study period. Results: Single-port VATS was feasible in 19 of 24 patients (79.2%), while an additional port was needed in five patients. In the single-port VATS patients, the median operation time, duration of chest tube drainage, and hospital stay were 84.0 minutes, one day, and two days, respectively. Postoperative complications included prolonged chest tube drainage for more than five days (n=1), wound infection (n=1), and vocal fold palsy (n=1). No recurrence of pneumothorax was observed during the follow-up period. The median operation time, duration of chest tube drainage, and hospital stay of the emphysematous patients who underwent single-port VATS were shorter than those who underwent three-port VATS group (p<0.05 for all parameters). Conclusion: Single-port VATS proved to be a feasible procedure in the treatment of patients with secondary spontaneous pneumothorax.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.195-200
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• 2011

Objective : To present the profiles of spinal cord tumors that can be removed through a unilateral hemilaminectomy and to demonstrate its usefulness for benign spinal cord tumors that significantly occupy the spinal canal. Methods : From June 2004 to October 2010, 25 spinal cord tumors were approached with unilateral hemilaminectomy. We calculated the cross-sectional occupying ratio (CSOR) of tumor to spinal canal before and after the operations. Results : The locations of the tumors were intradural extramedullary in 20 cases, extradural in 2, and intramedullary in 3. The levels of the tumors were lumbar in 12, thoracic 9, and cervical 4. In all cases, the tumor was removed grossly and totally without damaging spinal cord or roots. The mean height and width of the lesions we195re 17.64 mm (3-47.5) and 12.62 mm (4-32.7), respectively. The mean CSOR was 69.40% (range, 27.8-96.9%). Postoperative neurological status showed improvement in all patients except one whose neurologic deficit remained unchanged. Postoperative spinal stability was preserved during the follow-up period (mean, 21.5 months) in all cases. Tumor recurrence did not develop during the follow-up period. Conclusion : Unilateral hemilaminectomy combined with microsurgical technique provides sufficient space for the removal of diverse spinal cord tumors. The basic profiles of the spinal cord tumors which can be removed through the unilateral hemilaminectomy demonstrate its role for the surgery of the benign spinal cord tumors in various sizes.

• Journal of Korean Dental Science
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• v.13 no.1
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• pp.11-20
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• 2020

Purpose: This study sought to identify differences in hard and soft tissue chin profile changes in skeletal Class III patients after bimaxillary surgery, with or without advancement genioplasty. Materials and Methods: The retrospective study was conducted based on cephalometric analysis of skeletal and soft tissue variables. Lateral cephalograms taken at 3 different time points were utilized: pre-operation (T0), immediately post-operation (T1), and at least 6 months (11.0±2.6 months) post-operation (T2). The 2 groups were matched for sample size (n=20 each). Data were analyzed using independent t-tests with Bonferroni correction. Result: Group N (bimaxillary surgery alone) and Group G (bimaxillary surgery with an advancement genioplasty by horizontal sliding osteotomy) did not differ significantly in terms of demographic characteristics. The soft tissue chin thickness of Group G increased more after surgery, followed by a greater decrease during the postoperative period, and was eventually not significantly different from Group N at T2. On the other hand, the mentolabial sulcus depth of Group G (5.5±1.3 mm) was significantly greater than that of Group N (4.4±0.9 mm) (P=0.006) at T2. Conclusion: Although Group G showed a statistically significantly greater decrease in soft tissue chin thickness during the postoperative period, there were no significant intergroup differences in the chin profile for at least 6 months after the surgery, except for the mentolabial sulcus depth, which was greater in Group G than in Group N.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.445-450
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• 1993

Recent studies have shown that opiods can produce potent antinociceptive effects by interacting with opioid receptors in peripheral tissues. This study sougt to compare the effects of morphine with those of bupivacaine administered intraarticularly upon pain after arthroscopic knee surgery. In a ramdomized manner, 60 healthy patients received either morphine(3 mg in 20 ml NaCl ; n=20), bupivacaine(20 ml, 0.25% ; n=20) intraarticularly at the completion of surgery, and others were not administered(n=20) under general anesthesia after 1, 2, 4, 6, 12 and 24h of postoperative day, pain was assessed by a visual analogue pain scales, time to first analgesic use were recorded. Pain scores were significantly greater in the morphine group than two groups at 1h. From 4th until the end of the study period, pain scores were significantly greater in the bupivacaine group than in the other two group. Anagesic requirements were significantly greater in the morphine group than two groups at 1h but were significantly greater in the bupivacaine group than in the other groups throughout the remainder of the study period. The results suggest that intraarticular morphine produces an analgesic effect of delayed onset but of remarkably long duration.

• Clinics in Shoulder and Elbow
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• v.18 no.3
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• pp.128-132
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• 2015

Background: We described a surgical method for osteosynthesis and reported the resultant strength after application of a PHILOS plate through the anterolateral approach for the treatment of fractures of the distal humerus. Methods: Between February 2010 and March 2012, open reduction and internal fixation operations with the PHILOS plate for treatment of fracture of the distal humerus were performed on a total of nine patients (five men, four women). The mean age was 40.8 years (range, 24-50 years), and the average follow-up period was 9.1 months (range, 6-15 months). Clinical evaluations were performed 6 months after the operation. Clinical assessment included determination of the range of motion of the elbow, the Mayo and Oxford elbow scores, and any postoperative complications. Results: Fracture union was noted in all patients, with an average period of 12.4 weeks. The average Mayo elbow and Oxford elbow scores were 87.2 (of a total of 100) and 43.3 (of a total of 48), respectively. For the postoperative range of motion of the elbow, all patients showed complete recovery to the preoperative range of motion. No other conditions, such as neurolepsis, plate breakage, or rotational deformity, were observed. Conclusions: Open reduction and internal fixation of distal humerus fractures with a PHILOS plating system via anterolateral approach can be effective. A high rate of union with good outcomes can be assumed.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2027-2030
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• 2016

Objective: To investigate the effect of peripheral blood CD4 + CD25 + regulatory T cell on postoperative immunotherapy in patients with renal carcinoma. Methods: 38 patients with renal cell carcinoma were recruited, and 20 patients from the operation group purely underwent the radical nephrectomy therapy, 18 patients from the combined group successively underwent the radical nephrectomy therapy and IFN-${\alpha}$ adjuvant immunotherapy. Additionally, 12 healthy subjects were recruited in the same period of time and regarded as the control group. Flow cytometry was used to detect CD4 +, CD8 +, CD4 + CD25+ T lymphocyte subset content and the ratio of all parts in the pre-operative period, in the first post-operative week and in the third post-operative month, compare and analyze its variation trend. Results: The CD4+CD25+ T lymphocyte subset content of individual renal carcinoma patients was significantly higher than that of the control group, also increases with the progression in the tumor stage (P<0.05). The post-operative CD4 + CD25+T lymphocytes of individual operation group and combined group patients showed different degrees of increment, but the increment of the combined group was significantly lower than that of the operation group (P<0.05). For the combined group patients with less pre-operative CD4 + CD25+T lymphocytes, their levels would increase after the immunotherapy, while the pre-operative patients with more CD4 + CD25+ T lymphocytes were the opposite situation. Conclusion: The detection of peripheral blood CD4+CD25+ regulatory T lymphocyte subset can reflect the anti-tumor immune status of renal cell carcinoma patient body. It can contribute to predict the prognosis of immunotherapy and provide reference for the choice of renal carcinoma post-operative adjuvant immunotherapy.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1577-1583
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• 2000

Objectives : Among the various types of minimally invasive spine surgeries, thoracoscopic surgery is becoming more widely accepted and increasingly utilized. This report delineates our clinical experience using thoracoscopy to resect herniated thoracic discs in 16 patients who suffered from myelopathy or intolerable radiculopathy. Patients and Methods : Between Mar. 1997 and Sep. 1999, 16 consecutive patients underwent thoracoscopic discectomy for treatment of herniated thoracic discs. There were 12 men and 4 women(mean age 43.5 years ; range 18-61 years). Eleven patients presented with myelopathic signs and symptoms from spinal cord compression and 5 patients had incapacitating thoracic radicular pain without myelopathy. The surgical level was varied between T3 and T12. The pathology of specimen were 11 hard discs and 5 soft discs herniations. Thoracoscopic techniques were performed with long narrow spine instruments and high speed drill through 3 or 4 ports under one lung ventilated general anesthesia. During the operation three patients were converted to open thoracotomy due to intolerable one lung ventilation, excessive bleeding and inadequate operation field. The mean operation time was 264min.(range : 100-420min.), and postoperative mean admission period was 11 days. Results : Clinical and neurological outcomes were good in all patients(mean follow-up period 20 months). Among the eleven myelopathic patients, 8 improved neurologically, and 3 stabilized. Among the five radiculopathic patients, 4 recovered completely and no patient had worsened. Postoperative complications were pleural effusion in one case, intercostal neuralgia in one, delayed hemopneumothorax in one, prolonged air leakage in one and pneumonia in one case. Conclusions : Thoracoscopic discectomy needs a steep learning curve to be familiar to anatomical space and handling of endoscopic instruments. However, it is technically feasible and can be effectively performed with acceptable results.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.300-304
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• 2009

Objective : This is retrospective study of clinical and radiological outcomes of anterior cervical fusion using Bongros-$HA^{TM}$ (BioAlpha, Seongnam, Korea) which is a type of synthetic hydroxyapatite (HA) spacer to evaluate the efficacy in its clinical application and usefulness as a reliable alternative to autograft bone. Methods : Twenty-nine patients were enrolled in this study and 40 segments were involved. All patients were performed anterior cervical interbody fusion using HA spacer and plating system. Indications for surgery were radiculopathy caused by soft-disc herniation or spondylosis in 18 patients, spondylotic myelopathy in 1 patient, and spinal trauma in 10 patients. Cervical spine radiographs were obtained on postoperative 1day, 1week, and then at 1, 2, 6, and 12 months in all patients to evaluate intervertebral disc height, and the degrees of lordosis. Cervical computed tomography was done at postoperative 12 month in all patients to confirm the fusion status. The mean period of clinical follow-up was 17 months. Results : Complete interbody fusion was achieved in 100% of patients. Preoperative kyphotic deformities were corrected in all cases after surgery. Intervertebral disc height was well maintained during follow up period. There were no cases of graft extrusion, graft deterioration and graft fracture. Conclusion : HA spacer is very efficient in achieving cervical fusion, maintaining intervertebral disc height, and restoring lordosis. When combined with the placement of a cervical plate, immediate stability can be achieved and graft related complication can be prevented.

• Journal of Chest Surgery
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• v.44 no.2
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• pp.142-147
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• 2011

Background: Endovascular aortic aneurysm repair (EVAR) has come into use and been widely extended because of the low complication rate and less-invasiveness. This article aimed to describe our experience in the treatment of abdominal aortic aneurysm with EVAR. Materials and Methods: A retrospective review was conducted for the 22 patients who underwent EVAR in a single hospital December 2001 to June 2009. Results: The mean age of the patients was $68.5{\pm}7.6$ years. There were several risk factors and comorbidities in 20 patients (90.9%). The mean diameter of the aortic aneurysms was $61.2{\pm}12.9$ mm. The mean length, diameter, and angle of the aneurysmal neck were $30.5{\pm}15.5$ mm, $24.0{\pm}4.5$ mm, and $43.9{\pm}16.0^{\circ}$, respectively. The mean follow-up period of the patients was $28.8{\pm}29.5$ months. The 30-day postoperative mortality was none. Seven patients (31.8%) had endoleaks during the hospital stay and three patients (13.6%) had endoleaks during the follow-up period. One patient (4.5%) died due to a ruptured aortic aneurysm. The cumulative patient survival rates were 88.2%, 88.2%, and 70.6% at 1, 3, and 5 years of follow-up, respectively. Conclusion: EVAR is currently a safe, feasible procedure for high risk patients with abdominal aortic aneurysm because of low postoperative complication and mortality if patients are selected properly and followed up carefully.