• Journal of Chest Surgery
• /
• v.17 no.4
• /
• pp.729-734
• /
• 1984

Bochdalek hernia is a type of congenital diaphragmatic defect in the posterolateral portion of the diaphragm. The defect is usually Lt. sided due to protective effect of liver on right. Sex distribution is male preponderance [2:1] and it is diagnosed during neonate, mostly first 24 hours, due to severe respiratory distress. We experienced a rare case of old aged female patient with congenital Bochdalek hernia on Rt. side which was found incidentally during treatment of spontaneous pneumothorax of Rt. side. 17 year old female patient was admitted to CS department for chest discomfort on right and mild dyspnea with duration of 20 days. Under the diagnosis of spontaneous pneumothorax, Rt. closed thoracostomy and underwater sealed drainage with continuous suction was applied. On follow-up chest x-ray, poorly defined hazy increased density with multiple air-fluid levels in Rt. lower lung field and Lt. subphrenic free air were noted. So, Barium enema was done under the impression of Rt. diaphragmatic hernia, and nearly entire colon proximal to sigmoid was demonstrated in the Rt. hemithorax. Operation was done-for surgical repair of defected diaphragm through Rt. posterolateral thoracotomy. Operative findings were as follows; 1.Hypoplastic Rt. lung, esp. RML & RLL. 2.Nearly entirely intestines were herniated. 3.Diaphragmatic defect was located on posterolateral portion of the diaphragm, about 10x3cm in size with blunt smooth margin. 4.A large bleb on apex of RUL of lung. Herniated intestines were repaired into abdominal cavity manually and defect of diaphragm was repaired with No. I black silk interrupted sutures directly, and bleb was resected. Postoperative courses were uneventful and the patient was discharged with good condition on POD 14th.

• Journal of Chest Surgery
• /
• v.17 no.4
• /
• pp.819-828
• /
• 1984

Between September 1973 and December 1983, 61 patients with carcinoma of the esophagus were treated surgically at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Among 61 patients, male patients were 51 cases, female 10 cases and the age ranged from 21 years old to 72 years old with the average of 54.6 years old. Min symptoms of esophageal cancer were dysphagia (91.5%), weight loss (40.4%), pain(27.6%), and the average symptom duration was 3.85 months. The anatomical locations of esophageal cancer in preoperative esophagogram revealed 41.7% in middle 1/3, 8.3% in esophagograstic junction or cardia. Among 61 cases, 9 cases were managed by feeding gastrostomy due to inoperability, 8 cases by exploratory thoracotomy or lapatotomy only without curative or palliative resection, and 44 cases by curative or palliative resection with reconstruction. Among 52 cases of exploration, 44 cases were managed with curative or palliative resection of cancer and the resectability revealed 84.6% in operated cases. Among palliative or curative resected group, the esophagogastrostomy was performed in 40 cases (90.9%), esophagojejunostomy in 3 cases(6.8%), esophagectomy only in 1 case(2.3%). Postoperative complications were noticed in 12 cases, such as anastomotic leakage in 7 cases(15.6%), empyema in 2 cases (4.4%), respiratory failure in 2 cases (4.4%), anastomotic stricture in 1 case (2.2%). among 7 postoperative anastomotic leakage, 2 patients died as a result of that complication and the operative mortality revealed 4.3%. During follow-up work, the mean survival period was 19.3 months in patients who discharged hospital alive, and the 2 year survival rate was 34.6%.

• The Korean Journal of Pain
• /
• v.11 no.1
• /
• pp.74-80
• /
• 1998

Background: Myprodol, a newly introduced combination analgesics with codeine, ibuprofen and paracetamol was evaluated in the dental surgery patients for its efficacy and side effects. Methods: Total 60 ASA I or II outpatients dental surgical patients were randomly assigned into three groups(n=20 each). After various oral procedures, one of three oral analgesics, myprodol, ibuprofen or codeine, was prescribed to each patients in double blind fashion for three days. Each patient was followed carefully by daily phone calls for verbal analog pain scale, side effects and patient's satisfaction level. Results: Demographic data and duration of surgery revealed no statistical differences in all three groups. Myprodol group showed better verbal analgesic scores consistently for the study period than ibuprofen or codeine group. Adverse effects were minimal. Patients' satisfaction level was high in all three groups. Conclusion: We conclude that myprodol is an excellent oral analgesic for day-surgery based dental procedure patients. This effect appears to be synergistic among different analgesics rather than additive.

• Journal of Pharmaceutical Investigation
• /
• v.40 no.1
• /
• pp.45-49
• /
• 2010

Unlike human, with some exceptions, animals do not heal with excessive scar. The lack of suitable animal model has hindered the development of effective scar therapy. We previously reported that partial thickness rabbit ear wound model resembles human wound heal process. This study was designed to prepare a hypertropic scar wound model which can be employed for testing anti-scar therapy. Four wounds were created down to the bare cartilage on the anterior side of each rabbit ear using 8-mm dermal biopsy punch and histology analysis at post operation day (POD) 5, 28 and 48 were performed. As the outcome of scar formation is largely determined by the early inflammatory response to the wounding and the degree and the duration of occlusion, cephalodin(50 mg/kg) was injected daily and medical occlusive dressings were applied. Five micro wound and scar sections were stained with hematoxylin and eosin for quantification of epidermal regeneration and scar hypertrophy. Sections were also stained using Masson's trichrome and Sirius red to evaluate collagen organization and rete ridge formation. Wound closure process was assessed to 7wks post wounding. Complete removal of the epidermis, dermis and perichondrial layer caused delayed epithelialization, which results in hypertropic scarring. The inability of the wounds to contract and the delay in epithelialization in rabbit ear was likely due to cartilage and it created scar elevation. The results suggest that full thickness surgical punch wound model in rabbit ear could be employed as a reliable and reproducible scar wound model for testing anti-scar therapy.

• Journal of Korean Neurosurgical Society
• /
• v.40 no.3
• /
• pp.175-179
• /
• 2006

Objective : The surgical outcome of anterior lumbar interbody fusion[ALlF] with pedicle screw fixation for elderly isthmic spondylolisthesis was analyzed. Methods : Consecutive nineteen elderly patients [aged 65 years or more] with isthmic spondylolisthesis [Grade I or II] who underwent single level ALIF with pedicle screw fixation in 2002 were analyzed. Using clinical chart and mailed questionnaires, preoperative and postoperative Visual Analogue Scale[VAS] of back and leg pain and postopertive Macnab criteria were evaluated. Results : The mean age at the time of operation was 68.4 years [range 65 to 78 years]. Twelve patients underwent ALIF with percutaneous pedicle screw fixation. Seven patients underwent ALIF followed by posterior decompression and pedicle screw fixation. The postoperative complication rate was 10.5% [wound dehiscence in 1 patient and incisional hernia in 1 patient]. There was no postoperative major morbidity or mortality. At a mean follow-up duration of 30.7 months [range 25 to 35 months], 93.3% [14/15] of the patients showed excellent or good outcomes in terms of Macnab criteria. The mean VAS scores of back pain and leg pain significantly decreased after surgery. Conclusion : ALIF with pedicle screw fixation yielded favorable results for elderly isthmic spondylolisthesis in selected cases.

• Journal of Korean Neurosurgical Society
• /
• v.57 no.6
• /
• pp.440-444
• /
• 2015

Quality of life is the current trend and issue for the most of human diseases. In moyamoya disease (MMD), surgical revascularization has been recognized as the possible assistance to reduce the neurological insult. However, the progressive nature of the disease has been invincible so far. To improve the quality of life of MMD patients not only the protection from the neurological insult but also the maintenance or improvement of cognitive function is inevitable. For pediatric MMD patients, younger age or longer duration of disease is the key factor among the prognostic factors for bad neurological outcomes. Hence, 'the earlier, the better' is the most precious rule for treatment. Protection from neurological insult is very critical and foremost important to improve cognitive outcome. Clinicians need to know the neuropsychological profile of MMD patients for the care of whole person and make an effort to protect the patients from neurological insults to maintain or improve it.

• Journal of Korean Neurosurgical Society
• /
• v.37 no.4
• /
• pp.300-302
• /
• 2005

The authors report a case of hyperacute, massive hemorrhage in the left basal ganglia with severe midline shift that was treated successfully by the ultrasound-monitored free hand aspiration technique. Every effort was made to shorten time until removal of considerable amount of the hematoma and minimize duration of cerebral herniation, avoiding additional irreversible neurological deficit. A burr hole aspiration technique was preferred to standard craniotomy procedure, and any time-consuming procedures such as stereotactic frame application were abandoned. A burr hole was localized on the basis of computed tomography images simply and quickly with a ruler, and safety of the aspiration procedure was augmented by real-time ultrasound monitoring. Such minimally invasive technique relieved cerebral herniation successfully while avoiding time consumption and the morbidity of major craniotomy procedure. Early resuscitation of the patient with cerebral herniation in this case resulted in excellent recovery of the patient's neurological deficit. The patient's mentality started to improve rapidly and was clear six months after the surgery.

• Journal of Chest Surgery
• /
• v.2 no.1
• /
• pp.13-18
• /
• 1969

A clinical evaluation was done on a total of 41 cases of primary bronchogenic carcinoma, which came to the department of thoracic surgery, Chonnam University Hospital for the period of 5 years from May 1964, and the various factors led the patients to an inoperable stage were searched. The incidence ratio of male to female was 5.8:1 and the age group of fifty and sixty decade occupied 78% of the total. The subjective symptoms of the patients were cough with or without sputum [83%], chest pain or chest discomfort [76%], and a few incidence of bloody sputum and hemoptysis. The histological findings were 40% of squamous cell carcinoma, 35% of adenocarcinoma and 25% of anaplastic carcinoma, including 5 cases of unclassified bronchogenie carcinoma in scalene biopsy. 12 cases [29%] of a total of 41 cases received thoracotomy, but 8 cases among them were operable and 4 cases inoperable. The rest of 29 cases [71%] could not receive thoracotomy because of the various contraindication. 23 cases [70%] out of inoperable 33 cases had wasted time over 2 months duration for an operation owing to physicians` misdiagnosis of bronchogenic carcinoma as pulmonary tuberculosis, chronic lung abscess, asthma, pleurisy, pneumonia. common cold, neuralgia in order. The delaying factors led the patients to an inoperable stage were physicians misdiagnosis of bronchogenic carcinoma due to non-specific symptoms and signs of the patients, old aged patients dependance on herb medicine, and poor economical condition of the patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.30 no.4
• /
• pp.339-344
• /
• 2004

The purpose of this study was to evaluate neurosensory disturbance associated with implant surgery performed by implant practitioner (n=47) composed of trained oral surgeon, periodontist, prosthodontist. The incidence, type and duration of sensory disorder were investigated. Anatomical factor of the patient and experience of operator were also evaluated. The result revealed high incidence of inferior alveolar nerve damage (45%) regardless of experience of implant practitioner. The sensory disturbance sustained within 6 months for 61% of cases, which revealed almost normal recovery of nerve function. Initial neurologic sign after nerve damage was not coincide with their consequence of recovery. Half of the practitioners tried surgical intervention to the implants such as removing the fixture, partial unscrewing or re-implant shorter fixture, of which trial regarded as effective measure for 53% of cases. The result indicates that the objective method of sensory nerve evaluation should be introduced to the implant practitioners and the importance of informed consent for possibility of nerve damage in mandibular implant fixation.

• Advances in pediatric surgery
• /
• v.2 no.2
• /
• pp.81-87
• /
• 1996

Although nonoperative reduction plays a major role in the management of uncomplicated intussusception in the pediatric age group, surgical treatment is still a necessary alternative when nonoperative reduction is unsuccessful. The author analyzed the clinical features of 68 patients requiring operation in order to identify factors which might influence the type of operative management. A nine-year experience at Ewha Womans University Hospital was reviewed, and the findings compared to previous reports. Barium was used for the initial reduction attempt in 33 cases, saline in 35. Manual reduction by milking at operation achieved success in 41 cases(60.3%). Fifteen cases(22.1%) required resection of bowel, and 12 patients(17.6%) were found to have spontaneous and complete reduction of the intussusception at operation. Two cases had pathologic leading points. There were no perforations due to nonoperative reduction. There were no significant differences in demographic data, clinical findings, laboratory data, and anatomic type of intussusception between barium and saline reduction groups. However, a significant number of cases with spontaneous reduction were in saline reduction group(p<0.05). There was a slight chance of spontaneous reduction in infants under 6 month of age(p<0.001). Age under 6 month. body temperature over $38^{\circ}C$, symptom over 24 hours, and ileo-colic and ileo-ileo-colic intussusception contributed significantly to the necessity for bowel resection(p<0.05-0.001). The author believes that the age, body temperature, duration of illness, and anatomic type of intussusception strongly influence operative management.