• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.166-177
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• 1991

Uterine cervical cancer is the most common malignancy in korean women. In spite of recent development of early diagnostic and therapeutic modalities, about 40% of treated patient will develop relapse. So more aggressive local treatment such as more extensive surgery and higher radiation dose and administration of systemic chemotherapy will promote the curability but treatment related complications can not be avoidable. We used 22 cases of early cervical cancer, treated with surgery and post-operative radiotherapy, clinical data of these patients were analized to determine relationship between clinical parameters and final outcome. Three out of 22 cases revealed relapse and one patient showed rectovaginal fistula and another patient showed small bowel obstruction and the other patient showed rectal obstruction. Two out of three recurrence were stage IIa and the other one case was stage Ib adenocarcinoma with lymphovascular involvement. Nineteen out of 22 cases were followed without remarkable side effect or treatment related complication or sequelae. We concluded that our treatment policy was safe and effective to eradicate high risk postoperative cervical cancer with acceptable side effects or complication.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.748-752
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• 2007

Purpose: The goal of palatoplasty is focused on two points. One is to close the palatal defect completely, and the other to create a velopharyngeal system for normal speech. While established methods such as pushback palatoplasty or double opposing Z palatoplasty are used in wide cleft palate repair, sequelae such as maxillary hypoplasia or oronasal fistula may result. Therefore, when palatoplasty with buccinator myomucosal flap is used in the case of wide cleft palates, maxillary hypoplasia and oronasal fistula is reduced and optimal results are obtained. Methods: From October 2005 to December 2006, four children with wide complete cleft palate underwent unilateral buccinator myomucosal flap and intravelar veloplaty. Mean age at cleft repair was 15 months, and mean cleft size was 2.15 cm. The patients underwent intravelar veloplasty and palatoplasty was done using unilateral buccinator myomucosal flap. Results: The patients, after mean 10 months of follow-up observation, showed no signs of oronasal fistula resulting from flap tension. The shape and color similar to normal oral mucosa was obtained, and velopharyngeal function was acquired. Conclusion: When intravelar veloplasty and palatoplasty with unilateral buccinator myomucosal flap is done on wide cleft palates, postoperative speech function is optimal, velopharyngeal incompetence is effectively corrected, and sequelae resulting from pushback palatoplasty and double opposing Z-plasty, such as maxillary hypoplasia and oronasal fistula, is reduced.

• Journal of Chest Surgery
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• v.35 no.7
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• pp.535-541
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• 2002

Background: The prevalence of pulmonary tuberculosis remains high in several areas of the world, and pneumonectomy is often necessary to treat the sequelae of the disease. We retrospectively analyzed the morbidities, mortalities, and long-term outcomes after pneumonectomy for the treatment of tuberculous sequelae. Material and Method: Between 1981 and 2001, 94 patients underwent either pneumonectomy or extrapleural pneumonectomy for the treatment of tuberculous sequelae. There were 44 males and 50 females. The mean age was 40(16~68) years. The pathology included destroyed lung in 80, main bronchus stenosis in 10, and both lesions in 4. Surgical procedures were pneumonectomy in 47, extrapleural pneumonectomy in 43, and completion pneumonectomy in 4. Results: One patient died postoperatively due to empyema. Twenty-three complications occurred in 20 patients; empyema in 15(including 7 bronchopleural fistulas), wound infection in 5, and others in 3. Univariate analysis revealed presence of empyema, extrapleural pneumonectomy, prolonged operation time, and old age as risk factors of postpneumonectomy empyema. In multivariate analysis, old age and low preoperative FEV1 were risk factors of empyema. Low preoperative FEV1 was the risk factor of bronchopleural fistula(BPF) in univariate analysis. Low preoperative FEV1, positive sputum AFB, and presence of aspergilloma were risk factors of BPF in multivariate analysis. There were twelve late deaths. Actuarial 5-and 10-year survival rates were 94$\pm$3% and 87$\pm$4%, respectively. Conclusion: Pneumonectomy could be performed with acceptable mortality and morbidity, and could achieve good long-term survival for the treatment of tuberculous sequelae. In patients with risk factors, special care is recommended to prevent postoperative empyema or bronchopleural fistula.

• Journal of Trauma and Injury
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• v.29 no.4
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• pp.105-115
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• 2016

Purpose: While all midshaft clavicle fractures have traditionally been treated with conservative measures, recent operative treatment of displaced, communited midshaft clavicle fractures has become more common. Though a recent increase in operative treatment for midshaft clavicle fractures, we have done the operative methods in limited cases. The aim of this study is to present indications, operative techniques and outcomes of the experienced cases that have applied to this limited group over the previous 10 years. Methods: This study consists of a retrospective review of radiological and clinical data from January of 2005 to July of 2015. Operative criteria for midshaft clavicle fractures having considerable risk of bone healing process were 4 groups - a floating shoulder, an open fracture, an associated neurovascular injury, and a nonunion case after previous treatment. Results: The study consisted of 18 patients who had operative treatment for midshaft clavicle fractures in adults. The most common surgical indication was a floating shoulder (10 cases, 55.6%), followed by nonunion (5 cases, 27.8%), an associated neurovascular injury (4 cases, 22.2%), and open fracture (3 cases, 16.7%). All cases were treated by open reduction and internal fixation in anterosuperior position with reconstruction plate or locking compression plate. Bone union was achieved in all cases except 1 case which was done bone resection due to infected nonunion. Mean bone union period was 19.5 weeks. There were no postoperative complications, but still sequelae in 4 cases of brachial plexus injury. Conclusion: We have conducted an open reduction and internal fixation by anterosuperior position for midshaft clavicle fractures in very limited surgical indications for last 10 years. Our treatment strategy for midshaft clavicle fractures showed favorable radiological results and low postoperative complications.

• Journal of Korean Neurosurgical Society
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• v.43 no.6
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• pp.259-264
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• 2008

Objective : Total laminectomy (TL) is an effective surgical technique for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) along multiple levels. However, kyphosis and probable neurological deterioration have been frequently reported after laminectomy. We analyzed the changes in the cervical curvature after TL and subsequent changes in neurological status. Methods : We retrospectively reviewed the records of 14 patients who underwent TL for the treatment of cervical OPLL between Jan. 1998 and Dec. 2003. TL was selected according to the previously determined criteria. The curvature of the cervical spine was visualized on a lateral cervical spine X-ray and measured using Ishihara's Curvature Index (CI) before the operation and at the last follow-up examination. Perioperative neurological status was estimated using the modified Japanese Orthopedic Association score and the Improvement Rate (IR) at the same time as the images were evaluated. Results : The mean age of the patients was 57 years, the male/female ratio was 10:4, and the mean follow-up period was 41 months. The mean number of OPLL was 4.9, and the mean number of operated levels was also 4.9. The CI decreased after TL (p=0002), which was indicative of a kyphotic change. However, this kyphotic change showed no correlation with the length of the follow-up period, number of operated levels and preoperative CI. Neurological examination at the last follow-up showed an improved neurological status in all patients (p=0.001). There was no neurological deterioration in any case during the follow-up period. Moreover, there was no correlation between IR and the degree of kyphotic change. Postoperative complications, such as C5 radiculopathy and epidural bleeding, resolved spontaneously without neurological sequelae. Conclusion : Kyphotic change was observed in all but one patient who underwent TL for the treatment of cervical OPLL. However, we did not find any contributing factors to kyphosis or evidence of postoperative neurological deterioration.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.6
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• pp.275-281
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• 2018

Objectives: Isolated mandibular fractures contribute to approximately 45% of maxillofacial traumas. Improper management of mandibular fractures can cause myriad potential complications and can lead to serious functional and aesthetic sequelae. The objective of the study is to design a stepwise approach for managing isolated mandibular fractures using open reduction and internal fixation (ORIF) with regional anesthesia on outpatient basis. Materials and Methods: Patients with isolated mandibular fractures presenting to the department of maxillofacial surgery were selected for ORIF under regional anesthesia based on occlusion, age, socioeconomic status, general condition, habits, and allied medical ailments. Standard preoperative, intraoperative, and postoperative protocols were followed. All patients were followed up for a minimum of 4 weeks up to a maximum of 1 year. Results: Of 23 patients who received regional anesthesia, all but one had good postoperative functional occlusion. One patient was hypersensitive and had difficulty tolerating the procedure. Two patients developed an extraoral draining sinus, one of whom was managed with local curettage, while the other required hardware removal. One patient, who was a chronic alcoholic, returned 1 week after treatment with deranged fracture segments after he fell while intoxicated. Conclusion: With proper case selection following a stepwise protocol, the majority of mandibular fractures requiring ORIF can be managed with regional anesthesia and yield minimal to no complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.2
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• pp.135-142
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• 1997

Despite the current accomplishments with the repair of cleft lips, the surgical management of the nasal deformity remains a functional and aesthetic dilemma for patients, their families, and reconstructive surgeons. Recent improvements in the understanding and technical execution of te primary cleft lip repair have significantly reduced secondary sequelae and the consequent need for secondary surgical correction. But, secondary surgical corrections are necessary according to numerous factors. Such factors include the secondary surgical corrections are necessary according to numerous factors. Such factors include the severity of the initial deformity, the surgical plan, precision of execution of the primary repair, and success of the postoperative management. We preformed the secondary correction of cleft lip and palate in 11 patients via various methods. In conclusion, primary repair of cleft lip and palate patients is the most important to prevent the secondary deformities, and most of cleft lip and palate with secondary deformities must be treated with combined cheiloplasty and rhinoplasty.

• Journal of Korean Foot and Ankle Society
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• v.4 no.2
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• pp.83-86
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• 2000

A vascular necrosis of the talus has frequently been reported following trauma because talus has no muscle insertions, sixty percent of the surface of the talus is covered by hyaline cartilage, takes only a small area for entrance of a blood supply. Osteonecrosis is also associated with a variety of nontraumatic disorders. There are many indications for steroid usage, patient with rheumatoid arthritis, systemic lupus erythematosus, chronic obstructive pulmonary disease, and status- post renal or cardiac transplantation may be on long- term steroid usage, osteonecrosis may develop. A vascular necrosis of the talus secondary to chronic steroid usage is an unusual case. Delay in detection of osteonecrosis may lead to fragmentation and collapse of the talar body. When pain on range of motion is present and conservative treatment have been exhausted, surgical treatment is indicated, that is, fusion of the ankle joint. However it is important that conservative treatment may prevent its various sequelae with early diagnosis because steroid - treated patients have a more operative risk and increased risk for postoperative infection. We report a rare case of corticosteroid induced avascular necrosis of talus after cardiac transplantation.

• Journal of Korean Foot and Ankle Society
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• v.18 no.2
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• pp.83-86
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• 2014

Postpoliomyelitis syndrome is a common neurological disorder that occurs in patients who have experienced paralytic poliomyelitis. Recently, as a result of vaccination against poliovirus, incidence of poliomyelitis is exceedingly low. However, many patients with postpolio syndrome may encounter anesthesia when undergoing surgery, such as for correction of foot deformity and other operations. We report on a 45-year-old woman who experienced paralysis of her contralateral limb after operation on the left foot under spinal anesthesia. Postoperative electromyography/nerve conduction study (EMG/NCS) was performed in order to determine the cause of paralysis. Motor power of the sequelae involved leg showed improvement with time and recovered fully to the preoperative level at six months after the index operation. A precise evaluation, including a physical examination and EMG/NCS, should be performed preoperatively when spinal anesthesia is planned for postpolio syndrome patients.

• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.384-388
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• 2001

A 51-year-old woman presented with sudden severe headache, vomiting, and right hemiparesis at first admission. Computed tomography(CT) scans revealed an hemorrhagic density at left basal ganglia. Preoperative cerebral angiography showed no vascular lesion. Under the diagnosis of hypertensive intracerebral hemorrhage(ICH), total extirpation of hematoma was done. The postoperative neurological condition improved gradually and discharged without any neurological sequelae. Two months later, she revisited with headache, vomiting and progressive right hemiparesis. CT scans at second admission showed an irregular rim enhanced mass with central low density with surrounding edema at the initial bleeding area. Repeated craniotomy was performed and the mass was partially removed. The histopathological diagnosis of the specimen was confirmed as glioblastoma. The authors report a glioblastoma, which occurred at initial ICH site and regarded as a brain abscess with literature review.