• Journal of Chest Surgery
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• v.48 no.2
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• pp.105-111
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• 2015

Background: The aim of this study was to establish whether pulmonary lobectomy using video-assisted thoracic surgery (VATS) can be safely performed by trainees with limited experience with open lobectomy. Methods: Data were retrospectively collected from 251 patients who underwent VATS lobectomy at a single institution between October 2007 and April 2011. The surgical outcomes of the procedures that were performed by three trainee surgeons were compared to the outcomes of procedures performed by a surgeon who had performed more than 150 VATS lobectomies. The cumulative failure graph of each trainee was used for quality assessment and learning curve analysis. Results: The surgery time, estimated blood loss, final pathologic stage, thoracotomy conversion rate, chest tube duration, duration of hospital stay, complication rate, and mortality rate were comparable between the expert surgeon and each trainee. Cumulative failure graphs showed that the performance of each trainee was acceptable and that all trainees reached proficiency in performing VATS lobectomy after 40 cases. Conclusion: This study shows that trainees with limited experience with open lobectomy can safely learn to perform VATS lobectomy for the treatment of lung cancer under expert supervision without compromising outcomes.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.225-230
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• 1973

Five cases of esophageal cancer developed at the site of esophageal lye stricture were reported. Duration of lye stricture was between 13 and 40years, and all 5 cases had taken normal diet without appreciable troubles after recovery from the acute stage of burn till the suspected onset of esophageal malignaney. Outstanding symptoms of this grave condition were rather acute progressive dysphagia and frequent episodes of esophageal foreign bodies, Diagnosis could be confirmed easily by endoscopic biopsy in suspected eases, and all were epidermoid carcinoma histopathologically. Curative resection of this condition was made in neither of the cases, and their prognoses were more grave than other esophageal malignancies in our experience. The development of esophageal carcinoma at the site of corrosive esophagitis with resulting benign stricture has now been suspected as a cause and effect relationship between these two conditions, and Kiviranta: stated that the incidence of esophageal cancer in patients with lye stricture of longer duration is a thousand times higher than normal population. During last one decade the authors experienced 5 cases of esophageal carcinoma developed at the site of lye stricture of the esophagus among about 350 cases of lye burned esophagus at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seoul, Korea. In Korea they still use lye as a detergent in rural area, and there are still many persons ingesting lye for suicidal attempt or on accident. Lye stricture of the esophagus is, therefore, the most common esophageal disease needing surgical procedures, and the authors believe that there will be much more eases of lye stricture complicated by esophageal eareinoma repoted in near future in this Country.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.1
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• pp.44-50
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• 1999

Neurilemmoma is a benign encapsulated nerve sheath tumor originated from peripheral nerve. Previously its preoperative diagnosis had mainly depended on the history, physical examination, electrodiagnostic test, ultrasonography, bone scan. But only with these diagnostic modalities, exact preoperative diagnosis was nearly impossible. Therefore operation was performed under the impression of lipoma or just simple soft tissue tumor. Recently, the advent of magnetic resonance imaging(MRI) has made it easier to diagnose neurilemoma before surgery. MRI also helps to determine the extent of lesion and operative procedures. We performed marginal excision in 24 cases, evaluated those cases with respect to the sex, age, location, chief complaint, duration of illness, preoperative diagnosis, involved nerve, imaging studies, size of mass, complication, duration of follow-up and report with review of the literature.

• The Journal of the Korean dental association
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• v.49 no.4
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• pp.211-218
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• 2011

Purpose: An impacted tooth is defined as a tooth that shows delayed eruption and is expected to erupt incompletely by clinical and radiograph examination despite it reaching its expected time of eruption. The aims of this study were to investigate the clinical and radiological characteristics and treatment duration and method of impacted teeth in Korean patients. Materials and Methods: For this study we used clinical records, study models, panoramic radiographs and intraoral photographs of patients who attended Gachon University Gil Hospital Orthodontic Department between 2005 and 2008. There were 164 patients with a total number of 202 impacted teeth. Results: Male patients shows a little more prevalence than female patients (1.13:1). The under 12 age group had the highest prevalence of tooth impaction, and the over 19 age group showed the least prevalence of tooth impaction. The ratio of tooth impaction between the left to right ratio was 1.73:1 and maxilla and mandible was 1.84:1. The impacted teeth were most commonly positioned buccally (76 cases, 41.5%). Full nap closure technique (108 cases, 81.2%)was most frequently used for attachment of surgical traction hooks. Maxillary canine impaction was most commonly encountered both in male and female patients. The mean treatment period was 12.2 months and the success rate of treatment was 90.3%. The canine tooth shows the longest treatment time and highest failure rate. The ankylosis was the major cause of failure. Conclusion: Impacted teeth most commonly show in left side maxilla in the under 12 age group. And it is most commonly positioned buccally. The mean treatment period was 12.2 months, and the success rate of treatment was 90.3%.

• Journal of Korean Neurosurgical Society
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• v.29 no.11
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• pp.1451-1455
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• 2000

Objective : The goal of this study is to present whether endoscopic release(ER) is superior to open release(OR) for the treatment of carpal tunnel syndrome(CTS). Method and Material : Fifty-nine wrists in 43 patients who had clnical signs and symptoms consistent with CTS, not responded to non-operative management, were entered into the study. Authors retrospectively compared 27 wrists treated with ER(February 1999-June 1999) with 32 wrists treated with OR(October 1997-March 1999). We performed conventional open surgery in 25 patients(mean age ; 46 years) and Brown's two-portal technique in 18 patients(mean age ; 53 years) under intravenous regional block or general anesthesia. Results : Sixteen patients had CTS on both hands and left hands were affected more frequently than right hand, 34 and 25 respectively. Successful and poor results of ER were similar to those of OR. For patients in OR group, mean duration of symptoms was 5 years(range 1 month-30 years), and postoperative outcome was good in 27(84.4%) of wrists and poor in 5(15.6%). For patients in ER group, mean duration of symptoms was 7 months (range 2 months-25 years), outcome was good in 23(85.2%) of wrists and poor in 4(14.8%). The average time for complete relief of pain was 1.3 weeks and 7.6 weeks, respectively for OR and ER groups. No complication was noted in either group. Conclusion : This preliminary analysis suggests that faster relief of pain was achieved when the endoscopic method was used, although there were no significant differences in their efficacies regarding the improvement of symptoms.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.1010-1014
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• 1997

Judet's rib struts which are designed for osteosynthesis are made of stainless steel This report describes clinical analysis of our experiences of 30 cases with the operative stabilization of multiple rib fractures with Judet's rib struts from December, 1995, to December, 1996 in Chungmoo Hospital, Chounan. Our indications for operative stabilization were as follows: 14 cases in flail chest, 8 cases in severe displacement of rib including segmental fractures, 7 cases in additional procedures during intrathoracic operation, and 1 case in other cause. Postoperative artificial ventilation is needed in only 1 case for 5 days and postoperative complications were few: 2 cases of hemopneumothorax, 2 cases of alcohol withdrawal delirium, and 1 case of postoperative hepatitis. Average duration of hospital admission who have limited thoracic injuries was 10.5 days. Though more comparative studies is necessary, we find this technique to be better than previously published m thods, since it provides better stabilization and immobilization of the ribs and shortening the duration of hospital admission.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.176-180
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• 2006

Purpose: Although surgical arthroscopic repair of rotator cuff has become much more common as surgeons have developed proficient techniques, it is still technically difficult. The purpose of this study was to evaluate the clinical results and the usefulness of mini-open repair in large and massive size tears. Materials & Methods: From January 2000 to December 2004, sixteen patients were treated with mini-open repair. There were 10 male and 6 female patients with the average age of 62.5 years. The size of tear was massive in 4 cases and large in 12 cases. All tears were repaired with metal anchor sutures. The mean duration of follow-up period was 23 months. Postoperative results were evaluated based on American Shoulder and Elbow Society scoring system. Results: Five patients showed excellent results, five good, and two fair in large tears while one patient showed excellent result, one good, and two fair in massive tears. Poor outcome was not seen during the follow-up period. There was no significant relationship between the patient's age and the size of tear, and postoperative results. However, the relationship between the duration of symptomatic period in preoperation and postoperative results showed significant correlation. Conclusion: Mini-open repair combined with the preservation of deltoid and early rehabilitation is clinically useful in large and massive size rotator cuff tear patients treatment.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.359-362
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• 2012

Objective : To investigate the effect of surgery time on prognosis of newborns with meningomyelocele. Methods : The records of neonates with meningomyelocele were retrospectively analyzed. Demographic and clinical characteristics as well as information, timing of surgery, and durations of hospital stay and antibiotic therapy were recorded. Results : The records of 30 babies were included in the final analysis. Overall, the mean gestational age was $37.7{\pm}2.7$ weeks, with a mean birth weight of $2967{\pm}755$ g and head circumference of $35.8{\pm}3.8$ cm. In terms of localization, 46.6% of the meningomyeloceles were lumbosacral, 40% were lumbar, 10% were thoracolumbar and 3.3% were thoracal. The mean size of the meningomyelocele sacs was $4.33{\pm}1.2$ cm. Newborns underwent surgery on average of $8.2{\pm}5.9$ days after birth, with an overall mean duration of hospital stay of $30{\pm}25.1$ days. Patients were divided into two groups based on timing of surgery (group 1, ${\leq}5$ days; group 2, >5 days), and comparisons between groups revealed that earlier surgery was associated with significantly shorter durations of hospital stay (p<0.001) and antibiotic therapy (p<0.05). Conclusion : Early surgical intervention (${\leq}5$ days) was associated with a shorter duration of hospital stay and antibiotic therapy as well as a lower complication rate. We recommend that corrective surgery be undertaken as soon as reasonably possible.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7409-7414
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• 2013

Background: Delay in diagnosis of breast cancer is associated with a poorer survival and a pivotal contribution to this delayed diagnosis comes from patient delay in presenting at a clinic. Reasons involved must be evaluated in order to decrease this reducible delay. Objectives: i) To evaluate the reasons for patient delay in diagnosis of breast cancer; ii) to investigate any association with other variables. Materials and Methods: A 6 month cross sectional study (from July 2012 to Dec 2012), was carried out in Surgical and Oncology Units of Civil Hospital, Karachi. A total of 100 females diagnosed with breast cancer of any histological type were interviewed after informed consent and relevant data were collected. Due ethical clearance was obtained. Results: Mean age was $47.5{\pm}12.1$ years with a range from 25-77 years. Mean duration of delay was $5.13{\pm}4.8$ months, from shortest 1 month to longest 36 months. Duration of delay was observed to be no delay (<1 month) in 28%, short delay (1-3 months) in 30% and long delay (>3 months) in 42% of patients. Considering the symptoms as "harmless" (39%) was the most frequent reason of delay followed by "temporary" (20%) and the "use of traditional methods" (12%). Most common reason for later approaches was an increase in the size of the lump (41%). Statistically significant association (p-value <0.05) of longer patient delay was obtained with being single, being illiterate, painless breast lump as the first symptom, negative family history of breast cancer and vague attribution of the symptoms. Conclusions: Significant delay in approach to health care facility was observed in our study due to variable reasons given by women. Sufficient awareness regarding breast cancer, its symptoms and favorable effects of a timely diagnosis on prognosis must be imparted to our general population.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.640-648
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• 2020

Objective : This study aimed to assess the relationship between increased intracranial pressure (ICP) and mastoid effusions (ME). Methods : Between January 2015 and October 2018, patients who underwent intracranial surgery and had ICP monitoring catheters placed were enrolled. ICP was recorded hourly for at least 3 days. ME was determined by the emergence of opacification in mastoid air cells on follow-up brain imaging. C-reactive protein (CRP) levels, presence of endotracheal tube (ETT) and nasogastric tube (NGT), duration of intensive care unit (ICU) stay, duration of mechanical ventilator application, diagnosis, surgical modalities, and presence of sinusitis were recorded. Each factor's effect on the occurrence of ME was analyzed by binary logistic regression analyses. To analyze the independent effects of ICP as a predictor of ME a multivariable logistic regression analysis was performed. Results : Total of 61 (53%) out of 115 patients had ME. Among the patients who had unilateral brain lesions, 94% of subject (43/50) revealed the ipsilateral development of ME. ME developed at a mean of 11.1±6.2 days. The variables including mean ICP, peak ICP, age, trauma, CRP, ICU stays, application of mechanical ventilators and presence of ETT and NGT showed statistically significant difference between ME groups and non-ME groups in univariate analysis. Sex and the occurrence of sinusitis did not differ between two groups. Adding the ICP variables significantly improved the prediction of ME in multivariable logistic regression analysis. Conclusion : While multiple factors affect ME, this study demonstrates that ICP and ME are probably related. Further studies are needed to determine the mechanistic relationship between ICP and middle ear pressure.