• Journal of Chest Surgery
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• v.37 no.9
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• pp.800-804
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• 2004

A 67-year-old male with a 6-year history of emphysema was admitted with severe dyspnea. On chest computed tomographic scan, a newly developed large bulla was detected in right lower hemithorax. This bulla was sucessfully managed by intracavitary drainage ［modified Monaldi procedure］ with symptomatic improvement. We report this case with review of the literature.

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.173-178
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• 2005

Objective: The goal of this study is to provide the clinical data of patients with brainstem cavernous hemangiomas after treatment with microsurgery or radiosurgery after conducting a retrospective analysis of 21 patients at one institution. Methods: Twenty one patients with brainstem cavernous hemangiomas were treated at the authors' institution between 1995 and 2004 and clinical analysis was performed by retrospective review of medical records and neuroimaging examinations. Thirteen patients underwent microsurgical resection and radiosurgery was performed as an initial treatment in 9 patients. Results: Radical excision was achieved in 12 among 13 patients and transitory neurological deterioration or new neurological deficit developed during the immediate postoperative period in 7 (54%). The final outcomes at 5 - 70 months after surgery were improved in 11 patients (85%) and worsened in 2 patients (15%) compared with the preoperative state. Radiosurgery was performed in 9 patients. During the follow up period from 5 to 70 months there was neurological improvement in 3 patients, no significant change in 3 and deterioration in 3 patients. Two patients developed rebleeding at 5 months, 60 months respectively after radiosurgery. Conclusion: Microsurgery for symptomatic cavernous hemangioma of brainstem can be performed with acceptable morbidity. Fatal complication is rare with careful selection of the optimal operative approach in well selected patients. Radiosurgery is an effective alternative for the lesions which are not accessible by surgical approach, however, there is still a possibility of rebleeding over a long period after radiosurgical treatment and microsurgery should be considered as a treatment with priority for the majority of cases.

• Journal of Korean Neurosurgical Society
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• v.61 no.4
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• pp.467-473
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• 2018

Objective : The aim of this study was to determine outcome of ischemic stroke patients in the anterior circulation treated with endovascular treatment (EVT) with intravenous thrombolysis (IVT) versus EVT alone group. Methods : A systemic literature review was performed using online database from January 2004 to January 2017. Primary outcomes were successful recanalization seen on finial angiography and good outcome at three months. Secondary outcomes were mortality and the development of symptomatic intracranial hemorrhage (S-ICH) after the procedure. A fixed effect model was used when heterogeneity was less than 50%. Egger's regression test was used to assess publication bias. Results : Five studies were included for final analysis. Between EVT with IVT and EVT alone group, successful recanalization (odds ratio [OR] 1.467, p=0.216), good clinical outcome at three months (OR 1.199, p=0.385), mortality (OR 0.776, p=0.371), and S-ICH (OR 1.820, p=0.280) did not differ significantly. Egger's regression intercept with 95% confidence interval (CI) was 1.99 (95% CI -2.91 to 6.89) in successful recanalization and -0.27 (95% CI -6.35 to 5.80) in good clinical outcome, respectively. Conclusion : The two treatment modalities, EVT with IVT and EVT alone, could be comparable in treating acute anterior circulation stroke. Studies to find specific beneficiary group for EVT alone, without primary IVT, are needed further.

• The Journal of Internal Korean Medicine
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• v.31 no.3
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• pp.437-447
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• 2010

Obejectives : To investigate the clinical effect of electroacupuncture and bee venom acupuncture for benign prostatic hyperplasia(BPH) symptoms. Methods : Among 39 outpatients who were treated at a BPH clinic, 8 were finally selected for analysis by charts-review, retrospectively. They were treated by electroacupuncture and bee venom acupuncture more than 3 times. We estimated the effectiveness of the treatments by using the International Prostate Symptom Score (IPSS) questionnaire and checking their nocturia frequency. On the basis of these variables, we analyzed the statistical significations of symptom improvements. Results : Among 8 patients, the IPSS and nocturia frequency showed significant improvement after the final treatment compared with baseline (P = .0078, P = .0078). The IPSS significantly decreased even after the 1st treatment and also after the 2nd treatment compared with the baseline (P = .0078, P = .0078). The IPSS at post final-treatment, post 1st- and post 2nd treatment also showed significant improvement compared with IPSS at baseline in 6 severe symptomatic patients(P = .031, P = .031, P = .031). Nocturia frequency decreased after the 1st treatment compared with baseline and showed significant improvement between baseline and post 2nd treatment (P = .0078). Conclusions : In a retrospective and cross-sectional study investigating the clinical effects of electroacupuncture and bee venom acupuncture on BPH, these treatments proved to have significant therapeutic effects, particularly for various symptoms involving frequent nocturia.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.371-380
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• 1984

Corrected transposition of the great arteries [C-TGA] is one of the rare congenital heart disease in which there is both a discordant atrioventricular relationship and transposition of the great vessels. With this arrangement, systemic venous blood passes through the right atrium into the morphologic left ventricle and out the pulmonary artery. Pulmonary venous blood returns to the left atrium, flows into the morphologic right ventricle and out the aorta. Thus, in the rare case when no additional cardiac anomaly is present, a hemodynamically normal heart exists. But more often they are symptomatic as a result of one or several of the commonly associated defects. This paper describes 13 patients who underwent repair of one or more cardiac anomalies associated with corrected transposition at SN UH, from June 1976 through June 1984. 1.8 were males and 5 females, with ages ranging from 3 years to 27 years. 2. Segmental anatomy was {S,L,L} in 12, or {I,D,D} in 1. 3.Associated anomalies were ventricular septal defect in 10, pulmonary outflow tract obstruction in 6, tricuspid insufficiency in. 4, atrial septal defect in 3, subaortic stenosis in 1, mitral insufficiency in 1, and patent ductus arteriosus in 1. 4.None had complete heart block preoperatively, and 3 developed complete heart block intraoperatively. But one of them recovered sinus rhythm on the postoperative 7th day spontaneously. 5.There were 3 cases of hospital morality. But there was no morality since Dec. 1980. 6.Patients with single ventricle, hypoplastic ventricle or those who had palliative surgery alone are not included in this review.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.121-124
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• 2010

In athletes, repetitive low-energy impacts in plantar lesion lead often to tendinitis, stress fracture, or overuse syndrome. The major cause of heel pain in athletes is plantar fasciitis. And it is most often attributable to repetitive low energy impact, but the vast majority patients with heel pain achieve symptomatic relief with conservative treatment and return to full activities. Not commonly, Nerve entrapment may be occurred from repetitive low energy trauma in athletes, and is not as easily diagnosed. The authors observed a basketball player who complained of chronic heel pain that do not respond to conservative treatment, he had the lesions both plantar fasciitis and lateral plantar nerve entrapment. The authors described an unusual mechanism of entrapment of the lateral plantar nerve combined with a chronic plantar fasciitis in a basketball player and reported with review of literature.

• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.313-320
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• 2014

Objective : The purpose of this study is to demonstrate the technical feasibility and clinical efficacy of emergent carotid angioplasty and stenting (CAS) for acute stroke due to athero-thrombotic occlusion of the cervical internal carotid artery (ICA). Methods : Review of medical records identified 17 patients who underwent emergent CAS for treatment of athero-thrombotic occlusion of the cervical ICA with acute stroke between 2009 and 2013. Eleven patients (64.7%) presented with concomitant intracranial artery occlusion, which was treated primarily by mechanical thrombectomy after CAS. Results : Successful revascularization of the cervical ICA with emergent CAS was achieved in all patients. After CAS, intracranial recanalization with Thrombolysis in Cerebral Infarction ${\geq}2b$ flow was achieved in four of the 11 patients (36.4%). The overall recanalization rate (cervical ICA and intracranial artery) was 10 of 17 patients (58.8%). Symptomatic intracranial hemorrhage occurred in two patients (11.8%), resulting in death. Ten patients (58.8%) showed improvement (decrease in NIHSS score of ${\geq}4$ points) at seven days after recanalization. Nine patients (52.9%) showed a favorable outcome ($mRS{\leq}2$) at the last follow-up. A favorable outcome ($mRS{\leq}2$) was obtained in four of the six patients with isolated cervical ICA occlusion (4/6, 66.7%) and five of 11 patients with intracranial tandem occlusion (5/11, 45.5%). Conclusion : Emergent CAS for acute stroke due to athero-thrombotic occusion of the cervical ICA showed a good technical feasibility and favorable clinical outcome.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.347-353
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• 2010

Objective : Iliac screw fixation has been used to prevent premature loosening of sacral fixation and to provide more rigid fixation of the sacropelvic unit. We describe our technique for iliac screw placement and review our experience with this technique. Methods : Thirteen consecutive patients who underwent spinopelvic fixation using iliac screws were enrolled. The indications for spinopelvic fixation included long segment fusions for spinal deformity and post-operative flat-back syndrome, symptomatic pseudoarthrosis of previous lumbosacral fusions, high-grade lumbosacral spondylolisthesis, lumbosacral tumors, and sacral fractures. Radiographic outcomes were assessed using plain radiographs, and computed tomographic scans. Clinical outcomes were assessed using the Oswestry Disability Index (ODI) and questionnaire about buttock pain. Results : The median follow-up period was 33 months (range, 13-54 months). Radiographic fusion across the lumbosacral junction was obtained in all 13 patients. The average pre- and post-operative ODI scores were 40.0 and 17.5, respectively. The questionnaire for buttock pain revealed the following : 9 patients (69%) perceived improvement; 3 patients (23%) reported no change; and 1 patient (7.6%) had aggravation of pain. Two patients complained of prominence of the iliac hardware. The complications included one violation of the greater sciatic notch and one deep wound infection. Conclusion : Iliac screw fixation is a safe and valuable technique that provides added structural support to S1 screws in long-segment spinal fusions. Iliac screw fixation is an extensive surgical procedure with potential complications, but high success rates can be achieved when it is performed systematically and in appropriately selected patients.

• Journal of The Korean Society of Clinical Toxicology
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• v.9 no.2
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• pp.95-100
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• 2011

Purpose: Ingestion of puffer fish can be poisonous due to the presence of potent neurotoxins such as tetrodotoxin (TTX) found in its tissues. There are few clinical reports related to TTX. We performed this study to evaluate the clinical characteristics of TTX poisoning. Methods: We conducted a retrospective study of the 41 patients diagnosed with TTX poisoning who visited the Seoul Asan medical center from July 2004 and December 2010. A review of patients' electronic medical records and patient telephone interviews were conducted. Diagnosis of TTX poisoning was confirmed by observing the casual link between puffer fish consumption and the development of typical TTX intoxication symptoms. Results: The mean age of the patients included in the study was 46.6 years. The highest incidence of intoxication was observed in patients in their 50s (10 patients). Seasonal distribution of intoxication events included 10 in spring, 7 in summer, 10 in fall, and 14 in winter. In most cases, symptoms occurred within 1 hour of ingestion. A wide range of symptoms were associated with puffer fish ingestion affecting multiple body systems including neuromuscular (27 patients), gastrointestinal (19 patients), and cardiopulmonary/vascular (19 patients). All patients were treated with symptomatic and supportive therapy and recovered completely, without sequelae, within 48 hours. In three cases, ventilator support was required. Conclusion: TTX poisoning is not seasonally related, and patients admitted to the emergency room were observed with a wide range of symptoms. Where TTX poisoning is diagnosed, supportive therapy should be performed. Early intubation and ventilation is important, especially is cases of respiratory failure.

• Archives of Craniofacial Surgery
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• v.9 no.1
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• pp.1-7
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• 2008

Osteomas are most often located in the femur, tibia, humerus, spine, and talus. They are rare in the skull. Osteomas in the head and neck regions are benign bone neoplasms usually found in the frontoethmoid area. The developmental theory postulates that osteomas develop at the sites of fusion of tissues different embryological origin such as occur at the junction of the embryonic cartilaginous frontal and ethmoid bones. Trauma and infection have also been implicated as causative factors, but many patients with osteoma deny any preceding history of these. Osteomas are usually produce symptoms primary to cosmetic problems and secondary to pressure on adjacent structures. The objects of this study are from a 5-year period of April of 2002 to April of 2007, consisting of 48 male patients and 52 female. There were 33 cases of frontal bone osteomas, 5 cases of madibular bone osteomas, 5 cases of occipital bone osteomas, 6 cases of symptomatic paranasal sinus osteomas, 48 cases of asymptomatic paranasal sinus osteomas, and 3 cases of mastoid osteomas. We reviewed medical records of patients to find out their presentations, diagnostic considerations, therapeutic options, and outcomes. Patients were followed up six months postoperatively on the average. The authors experienced 48 cases of osteoma in the head and neck lesion, which were removed via direct approach or endoscopic approach. The 100 cases who came to the hospital with or without symptoms after diagnosis healed completely without sequelae. During the follow-up periods, excellent functional and cosmetic results were observed with an inconspicuous scar. There was no specific complications related to this procedure. Results of surgery in most cases were satisfied. We discussed the surgical procedure and the characteristics of the osteomas, and we report several cases with the review of literatures.