• Journal of Chest Surgery
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• v.26 no.12
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• pp.915-919
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• 1993

The management of Patent Ductus Arteriosus[PDA] with heart failure and cardiac cachexia in premature infants have been a disturbing and controversial problem in the field of pediatric cardiovascular surgery.We analysed our experiences to determine the rationale of surgical closure of PDA in infants . During a period of 7 years from January 1986 to December 1992, 12 infants under 2 months of age underwent operations for "hemodynamically significant" PDA which had caused severe heart failure.There were 6 male and 6 female patients. Their mean gestational age was 33.8 weeks and their mean body weight was 1990 g. ranged from 710 g. to 2900 g. Mean age at operation was 28.5days. Seven patients had history of Indomethacin trial. All patients were operated with double ligation technique under general anesthesia.There was no mortality and blood transfusion was not necessary in any patient during the operation.In all cases, we could confirm the complete closure of PDA after operation by follow-up echocardiography.Two patients died during their hospital stay and 1 patient died at 6 months after operation. The causes of death were sepsis with congestive heart failure, necrotizing entero colitis and pneumonia respectively.We can not detect any operation related complication which resulted in permanent sequelae as well as delayed complications related to nerve damage. These results indicate that surgical ligation of PDA in infants with severe heart failure is relatively safe and effective.effective.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.260-263
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• 2007

A 9-month-old, intact female mixed dog was referred to Veterinary Medical Teaching Hospital of Gyeongsang National University with symmetrically enlarged and protruded upper jaw. The patient was diagnosed as acute renal failure due to ethylene glycol poisoning and was treated for 1 month in a local animal hospital. In spite of treatment, the patient proceeded to chronic renal failure. Also, the patient's upper jaw begun to enlarge continuously. To evaluate this upper jaw, radiographic examination was performed. Skull radiographs revealed thickening of maxilla, decreased bone opacity, cortical thinning, loss of lamina dura and periodontal space in the maxilla. Diagnosis of rubber jaw syndrome is based on clinicial signs, radiographic findings and laboratory evidence of chronic renal failure due to ethylene glycol poisoning.

• The Journal of the Korean dental association
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• v.57 no.7
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• pp.372-378
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• 2019

The dental implants in modern dentistry brought out a new era in everyday dental practice. Increasing of dental implants usage, various failures and complications has occurred. Failures and complications of dental implant treatments that can happen in implant surgery, in mechanical or prosthetic problem and in biological aspect. The aim of this study was to assess implant failures for 6 years as well as find out how to overcome implant failure. In Jeju National University hospital, 26 dental implants in 17 patients were removed by implant failure through 2013.1.1.-2018.12.31. Each implant failure case was analyzed in report form with various informations about failure retrospectively. The present study showed 26 failed dental implants of 17 patients were removed. 13 implants(50%) of 8 patients(47.06%) were failed before functional loading and 13 implants(50%) of 9 patients(52.94%) were failed after functional loading. 11 implants(42.31%) of 7 patients(41.18%) with medical disease were extracted. 6 implants(23.08%) of 5 patients(29.41%) with additive bone graft were failed. We discuss with 26 failed dental implants of 17 patients about their causes, solutions and prevention retrospectively for 6 past years. Precise diagnosis and treatment planning are needed. Medically compromised patients and patients with implants and additive bone grafts should be cautiously treated with high failing possibilities.

• 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%.

• Radiation Oncology Journal
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• v.22 no.2
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• pp.115-123
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• 2004

Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

• Quality Improvement in Health Care
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• v.5 no.2
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• pp.190-201
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• 1998

Background : Medical equipments take a very important role in diagnosis and treatment of disease in modern medicine and effective maintenance of the equipments is a necessary to provide a good health care to the public. After developing a new QC program for effective maintenance of medical equipments and practicing it for a year, we report the results of the new program. Methods : The maintenance data of 9 equipments in 8 categories including a CT Scanner were analyzed with regard to the parts responsible for most frequent failure and cause of the failure. After learning the most frequent failure part and cause of the failure, we developed a new QC program that emphasizes preventive maintenance of the most frequent failure part. We compared the number of failure per year and active rate of each equipment before and after the adoption of the new QC program. Results : The average number of failure per year per equipment was 20.7 before and it decreased by 43% to 11.9 after adoption of the new QC program. The average active rate of the equipments was 92.6% before and it increased by 3.2% to 95.8% after adoption of the new program. Conclusions : The practice of the new QC program appears very useful as it decreased the failure rate and increased the active rate of the equipments.

• Radiation Oncology Journal
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• v.33 no.1
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• pp.29-35
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• 2015

Purpose: To analyze the prognostic factors for survivals and to evaluate the impact of postoperative whole pelvic radiotherapy (WPRT) on pelvic failure in patients with uterine sarcoma treated with radical surgery. Materials and Methods: We retrospectively analyzed 75 patients with uterine sarcoma who underwent radical surgery with (n = 22) or without (n = 53) radiotherapy between 1990 and 2010. There were 23 and 52 patients with carcinosarcoma and non-carcinosarcoma (leiomyosarcoma, 22; endometrial stromal sarcoma, 25; others, 5), respectively. The median follow-up period was 64 months (range, 17 to 269 months). Results: The 5-year overall survival (OS) and pelvic failure-free survival (PFFS) of total patients was 64.2% and 83.4%, respectively. Multivariate analysis revealed that mitotic count (p = 0.006) was a significant predictor of OS. However, factors were not found to be associated with PFFS. On analyzing each of the histologic subtypes separately, postoperative WPRT significantly reduced pelvic failure in patients with carcinosarcoma (10.0% vs. 53.7%; p = 0.046), but not in patients with non-carcinosarcoma (12.5% vs. 9.9%; p = 0.866). Among the patients with carcinosarcoma, 4 patients (17%) had recurrence within the pelvis and 3 patients (13%) had recurrence in other sites as an initial failure, whereas among the patients with non-carcinosarcoma, 3 patients (6%) experienced pelvic failure and 13 patients (25%) experienced distant failure. Conclusion: The most significant predictor of OS was mitotic count. Based on the improved PFFS after postoperative WPRT only in patients with carcinosarcoma and the difference in patterns of failure between histologic subtypes, optimal adjuvant treatment options should be offered to patients based on the risk of recurrence patterns.

• Journal of Yeungnam Medical Science
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• v.1 no.1
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• pp.13-23
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• 1984

Acute renal failure refers to a rapid reduction in renal function that usually occurs in an individual with no known previous renal disease. Development of a complication of acue renal failure in critically ill surgical patients is not unusual, and it causes high morbidity and mortality. Acute renal failure can be divided as Pre-renal (functional), Renal (organic), and Post-renal (obstructive) azotemia according to their etiologies. Early recognition and proper correction of pre-renal conditions are utter most important to prevent an organic damage of kidney. These measures include correction of dehydration, treatment of sepsis, and institution of shock therapy. Prolonged exposure to ischemia or nephrotoxin may lead a kidney to permanent parenchymal damage. A differential diagnosis between functional and organic acute renal failure may not be simple in many clinical settings. Renal functional parameters, such as $FENa^+$ or renal failure index, are may be of help in these situations for the differential diagnosis. Provocative test utilyzing mannitol, loop diuretics and renovascular dilators after restoration of renal circulation will give further benefits for diagnosis or for prevention of functional failure from leading to organic renal failure. Converting enzyme blocker, dopamine, calcium channel blocker, and propranolol are also reported to have some degree of renal protection from bioenergetic renal insults. Once diagnosis of acute tubular necrosis has been made, all measures should be utilized to maintain the patient until renal tubular regeneration occurs. Careful regulation of fluid, electrolyte, and acid-base balance is primary goal. Hyperkalemia over 6.5 mEq/l is a medical emergency and it should be corrected immediately. Various dosing schedules for medicines excreting through kidney have been suggested but none was proved safe and accurate. Therefore blood level of specific medicines better be checked before each dose, especially digoxin and Aminoglycosides. Indication for application of ultrafiltration hemofilter or dialysis may be made by individual base.

• Hip & pelvis
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• v.35 no.3
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• pp.193-199
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• 2023

Purpose: Cephalomedullary (CM) nailing is widely performed in treatment of elderly patients with femoral intertrochanteric fractures. However, in cases of fixation failure, re-operation is usually necessary, thus determining factors that may contribute to fixation failure is important. In this study, we examined factors affecting the occurrence of fixation failure, such as age or fracture stability, after CM nailing in elderly patients. Materials and Methods: This study was conducted retrospectively using registered data. From April 2011 to December 2018, CM nailing was performed in 378 cases diagnosed with femoral intertrochanteric fractures, and 201 cases were finally registered. Cases involving patients who were bed-ridden before injury, who died from causes unrelated to surgery, and those with a follow-up period less than six months were excluded. Results: Fixation failure occurred in eight cases. Comparison of the surgical success and fixation failure group showed that the mean age was significantly higher in the fixation failure group compared with the control group (81.3±6.4 vs. 86.4±6.8; P=0.034). A significantly high proportion of unstable fractures was also observed (139/54 vs. 3/5; P=0.040), with a significantly high ratio of intramedullary reduction (176/17 vs. 5/3; P=0.034). A significantly higher ratio of unstable fractures compared with that of stable fractures was observed in the intramedullary reduction group (132/49 vs. 10/10; P=0.033). Conclusion: Fixation failure of CM nailing is likely to occur in patients who are elderly or have unstable fracture patterns. Thus, care should be taken in order to avoid intramedullary reduction.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2003.10a
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• pp.63-63
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• 2003