1.Optimal timing of surgery after neoadjuvant chemoradiation therapy in locally advanced rectal cancer.
Duck Hyoun JEONG ; Han Beom LEE ; Hyuk HUR ; Byung Soh MIN ; Seung Hyuk BAIK ; Nam Kyu KIM
Journal of the Korean Surgical Society 2013;84(6):338-345
PURPOSE: The optimal time between neoadjuvant chemoradiotherapy (CRT) and surgery for rectal cancer has been debated. This study evaluated the influence of this interval on oncological outcomes. METHODS: We compared postoperative complications, pathological downstaging, disease recurrence, and survival in patients with locally advanced rectal cancer who underwent surgical resection <8 weeks (group A, n = 105) to those who had surgery > or =8 weeks (group B, n = 48) after neoadjuvant CRT. RESULTS: Of 153 patients, 117 (76.5%) were male and 36 (23.5%) were female. Mean age was 57.8 years (range, 28 to 79 years). There was no difference in the rate of sphincter preserving surgery between the two groups (group A, 82.7% vs. group B, 77.6%; P = 0.509). The longer interval group had decreased postoperative complications, although statistical significance was not reached (group A, 28.8% vs. group B, 14.3%; P = 0.068). A total of 111 (group A, 75 [71.4%] and group B, 36 [75%]) patients were downstaged and 26 (group A, 17 [16.2%] and group B, 9 [18%]) achieved pathological complete response (pCR). There was no significant difference in the pCR rate (P = 0.817). The longer interval group experienced significant improvement in the nodal (N) downstaging rate (group A, 46.7% vs. group B, 66.7%; P = 0.024). The local recurrence (P = 0.279), distant recurrence (P = 0.427), disease-free survival (P = 0.967), and overall survival (P = 0.825) rates were not significantly different. CONCLUSION: It is worth delaying surgical resection for 8 weeks or more after completion of CRT as it is safe and is associated with higher nodal downstaging rates.
Chemoradiotherapy
;
Disease-Free Survival
;
Female
;
Humans
;
Male
;
Neoadjuvant Therapy
;
Polymerase Chain Reaction
;
Postoperative Complications
;
Preoperative Period
;
Rectal Neoplasms
;
Recurrence
2.Augmentation with Bone Marrow Aspirate Harvested from the Iliac Crest for Horizontal or Radial Meniscal Tears Yields Favorable Healing Rates in Magnetic Resonance Imaging and Clinical Outcomes
Byung Sun CHOI ; Juneseok WON ; Hyuk-Soo HAN
Clinics in Orthopedic Surgery 2024;16(6):897-905
Background:
As the importance of meniscus in joint function becomes more apparent, there is a growing interest in meniscus repair techniques. Notably, biological augmentation methods have shown promising results for meniscus healing, despite their challenges in practical implementation. The purpose of this study was to evaluate meniscus healing and clinical outcomes of meniscus repair with bone marrow aspirate for horizontal or radial tears.
Methods:
This study retrospectively reviewed patients who underwent arthroscopic meniscal repair with bone marrow aspirate from the iliac crest. A total of 30 patients with horizontal or radial meniscus tears confirmed by magnetic resonance imaging (MRI) were included, excluding those with insufficient data or concurrent surgeries. Patient demographic characteristics, operative data, and clinical outcomes including pain numeric rating scale, International Knee Documentation Committee score, Lysholm score, and Tegner activity scale were evaluated. For radiographic evaluation, knee x-rays, preoperative MRIs, and postoperative 3-month MRIs were evaluated.
Results:
Thirty patients (15 women and 15 men) with a mean age of 46.8 ± 15.2 years were followed up for a mean of 25.1 ± 3.4 months. Of these patients, 22 (73%) had horizontal meniscal tears, while 8 (27%) had radial tears. Clinical outcomes were significantly improved over the time from the initial to 2 years after surgery. Meniscus healing was 60% on MRI at 3 months after surgery. There was no correlation between changes in clinical scores and healing rate. Furthermore, there was no statistically significant difference in the healing rate or changes in clinical scores according to tear patterns. Retears were observed in 2 patients, who were non-compliant with rehabilitation and were managed conservatively.
Conclusions
Augmentation with bone marrow aspirate harvested from the iliac crest for meniscal repair of horizontal or radial tears yields favorable healing rates in MRI and clinical outcomes, highlighting its potential for addressing challenging meniscal repair.
3.Augmentation with Bone Marrow Aspirate Harvested from the Iliac Crest for Horizontal or Radial Meniscal Tears Yields Favorable Healing Rates in Magnetic Resonance Imaging and Clinical Outcomes
Byung Sun CHOI ; Juneseok WON ; Hyuk-Soo HAN
Clinics in Orthopedic Surgery 2024;16(6):897-905
Background:
As the importance of meniscus in joint function becomes more apparent, there is a growing interest in meniscus repair techniques. Notably, biological augmentation methods have shown promising results for meniscus healing, despite their challenges in practical implementation. The purpose of this study was to evaluate meniscus healing and clinical outcomes of meniscus repair with bone marrow aspirate for horizontal or radial tears.
Methods:
This study retrospectively reviewed patients who underwent arthroscopic meniscal repair with bone marrow aspirate from the iliac crest. A total of 30 patients with horizontal or radial meniscus tears confirmed by magnetic resonance imaging (MRI) were included, excluding those with insufficient data or concurrent surgeries. Patient demographic characteristics, operative data, and clinical outcomes including pain numeric rating scale, International Knee Documentation Committee score, Lysholm score, and Tegner activity scale were evaluated. For radiographic evaluation, knee x-rays, preoperative MRIs, and postoperative 3-month MRIs were evaluated.
Results:
Thirty patients (15 women and 15 men) with a mean age of 46.8 ± 15.2 years were followed up for a mean of 25.1 ± 3.4 months. Of these patients, 22 (73%) had horizontal meniscal tears, while 8 (27%) had radial tears. Clinical outcomes were significantly improved over the time from the initial to 2 years after surgery. Meniscus healing was 60% on MRI at 3 months after surgery. There was no correlation between changes in clinical scores and healing rate. Furthermore, there was no statistically significant difference in the healing rate or changes in clinical scores according to tear patterns. Retears were observed in 2 patients, who were non-compliant with rehabilitation and were managed conservatively.
Conclusions
Augmentation with bone marrow aspirate harvested from the iliac crest for meniscal repair of horizontal or radial tears yields favorable healing rates in MRI and clinical outcomes, highlighting its potential for addressing challenging meniscal repair.
4.Augmentation with Bone Marrow Aspirate Harvested from the Iliac Crest for Horizontal or Radial Meniscal Tears Yields Favorable Healing Rates in Magnetic Resonance Imaging and Clinical Outcomes
Byung Sun CHOI ; Juneseok WON ; Hyuk-Soo HAN
Clinics in Orthopedic Surgery 2024;16(6):897-905
Background:
As the importance of meniscus in joint function becomes more apparent, there is a growing interest in meniscus repair techniques. Notably, biological augmentation methods have shown promising results for meniscus healing, despite their challenges in practical implementation. The purpose of this study was to evaluate meniscus healing and clinical outcomes of meniscus repair with bone marrow aspirate for horizontal or radial tears.
Methods:
This study retrospectively reviewed patients who underwent arthroscopic meniscal repair with bone marrow aspirate from the iliac crest. A total of 30 patients with horizontal or radial meniscus tears confirmed by magnetic resonance imaging (MRI) were included, excluding those with insufficient data or concurrent surgeries. Patient demographic characteristics, operative data, and clinical outcomes including pain numeric rating scale, International Knee Documentation Committee score, Lysholm score, and Tegner activity scale were evaluated. For radiographic evaluation, knee x-rays, preoperative MRIs, and postoperative 3-month MRIs were evaluated.
Results:
Thirty patients (15 women and 15 men) with a mean age of 46.8 ± 15.2 years were followed up for a mean of 25.1 ± 3.4 months. Of these patients, 22 (73%) had horizontal meniscal tears, while 8 (27%) had radial tears. Clinical outcomes were significantly improved over the time from the initial to 2 years after surgery. Meniscus healing was 60% on MRI at 3 months after surgery. There was no correlation between changes in clinical scores and healing rate. Furthermore, there was no statistically significant difference in the healing rate or changes in clinical scores according to tear patterns. Retears were observed in 2 patients, who were non-compliant with rehabilitation and were managed conservatively.
Conclusions
Augmentation with bone marrow aspirate harvested from the iliac crest for meniscal repair of horizontal or radial tears yields favorable healing rates in MRI and clinical outcomes, highlighting its potential for addressing challenging meniscal repair.
5.Augmentation with Bone Marrow Aspirate Harvested from the Iliac Crest for Horizontal or Radial Meniscal Tears Yields Favorable Healing Rates in Magnetic Resonance Imaging and Clinical Outcomes
Byung Sun CHOI ; Juneseok WON ; Hyuk-Soo HAN
Clinics in Orthopedic Surgery 2024;16(6):897-905
Background:
As the importance of meniscus in joint function becomes more apparent, there is a growing interest in meniscus repair techniques. Notably, biological augmentation methods have shown promising results for meniscus healing, despite their challenges in practical implementation. The purpose of this study was to evaluate meniscus healing and clinical outcomes of meniscus repair with bone marrow aspirate for horizontal or radial tears.
Methods:
This study retrospectively reviewed patients who underwent arthroscopic meniscal repair with bone marrow aspirate from the iliac crest. A total of 30 patients with horizontal or radial meniscus tears confirmed by magnetic resonance imaging (MRI) were included, excluding those with insufficient data or concurrent surgeries. Patient demographic characteristics, operative data, and clinical outcomes including pain numeric rating scale, International Knee Documentation Committee score, Lysholm score, and Tegner activity scale were evaluated. For radiographic evaluation, knee x-rays, preoperative MRIs, and postoperative 3-month MRIs were evaluated.
Results:
Thirty patients (15 women and 15 men) with a mean age of 46.8 ± 15.2 years were followed up for a mean of 25.1 ± 3.4 months. Of these patients, 22 (73%) had horizontal meniscal tears, while 8 (27%) had radial tears. Clinical outcomes were significantly improved over the time from the initial to 2 years after surgery. Meniscus healing was 60% on MRI at 3 months after surgery. There was no correlation between changes in clinical scores and healing rate. Furthermore, there was no statistically significant difference in the healing rate or changes in clinical scores according to tear patterns. Retears were observed in 2 patients, who were non-compliant with rehabilitation and were managed conservatively.
Conclusions
Augmentation with bone marrow aspirate harvested from the iliac crest for meniscal repair of horizontal or radial tears yields favorable healing rates in MRI and clinical outcomes, highlighting its potential for addressing challenging meniscal repair.
6.Two Cases of Postural Orthostatic Tachycardia Syndrome.
Byung In HAN ; Ji Man HONG ; Se Ho OH ; Jae Hyuk LEE ; Oh Young BANG ; In Soo JOO ; Kyoon HUH
Journal of the Korean Neurological Association 2002;20(5):571-573
No abstract available.
Postural Orthostatic Tachycardia Syndrome*
;
Syncope
7.Factors Associated with a Decline in Activities of Daily Living in Patients with Dementia at Geriatric Hospitals: A 6 Month Prospective Study.
Hyuk GA ; Chang Won WON ; Roo Ji LEE ; Il Woo HAN ; In Soon KWON ; Byung Joo PARK
Journal of the Korean Geriatrics Society 2011;15(3):128-134
BACKGROUND: Decreased activities of daily living (ADL) in elderly people are related to decreased quality of life and death and are a clinically important issue. However, few studies have investigated the various characteristics and risk factors for a decline in ADL among elderly in-patients in geriatric hospitals in Korea. METHODS: In total, 163 elderly in-patients with dementia in three geriatric hospitals located in Incheon, Gwangju and Yongin, Korea were surveyed prospectively for associated factors of a decline in ADL after 6 months. RESULTS: On average, the subjects were 79.4+/-7.6 years old, and 67.5% were female. Approximately 63% had Alzheimer type dementia, 36.8% only attended primary school, 73.0% were widowed, and 38.7% had been admitted to hospitals for less than 1 year. The Korean version of the Mini Mental State Examination (K-MMSE) score was 14.1+/-6.5, and the clinical dementia rating was 1.9+/-0.9. In total, 8.6% were bed-ridden and 59.5% and 64.6% had never experienced fecal and urinary incontinence, respectively. Total ADL scores declined after 6 months follow-up, and significantly associated factors were low K-MMSE score, fecal incontinence, and co-existence of fecal and urinary incontinence. CONCLUSION: Low K-MMSE scores, fecal incontinence, and the co-existence of fecal and urinary incontinence were associated with ADL declines in elderly in-patients with dementia in long-term care hospitals located in three cities in Korea.
Activities of Daily Living
;
Aged
;
Alzheimer Disease
;
Dementia
;
Fecal Incontinence
;
Female
;
Follow-Up Studies
;
Humans
;
Korea
;
Long-Term Care
;
Prospective Studies
;
Quality of Life
;
Risk Factors
;
Urinary Incontinence
;
Widowhood
8.Validity and Reliability of the Korean Version of the MD Anderson Dysphagia Inventory for Head and Neck Cancer Patients.
Chan Hyuk KWON ; Yeo Hyung KIM ; Jae Hyeon PARK ; Byung Mo OH ; Tai Ryoon HAN
Annals of Rehabilitation Medicine 2013;37(4):479-487
OBJECTIVE: To translate the MD Anderson Dysphagia Inventory (MDADI) which is a self-administered questionnaire that assesses effect of dysphagia on the quality of life for patients with head and neck cancer, into Korean and to verify the validity and reliability of the Korean version of MDADI. METHODS: We performed 6 steps for the cross-cultural adaptation which consisted of translation, synthesis, back translation, review by an expert committee, cognitive debriefing, and final proof reading. A total of 34 dysphagia patients with head and neck cancers from Seoul National University Hospital answered the translated version of the questionnaire for the pre-testing. The patients answered the same questionnaire 2 weeks later to verify the test-retest reliability. RESULTS: One patient was excluded at second survey because he changed his feeding strategy. Overall, 33 patients completed the study. Linguistic validations were achieved by each step of cross-cultural adaptation. We gathered statistically strong construct validity (Spearman rho for subdomain scores to total score correlation range from 0.852 to 0.927), internal consistency for subdomains (Cronbach's alpha coefficients range from 0.785 to 0.889) and test-retest reliability (intra-class correlation coefficient range from 0.820 to 0.955) CONCLUSION: The Korean version of the MDADI achieved linguistic validations and demonstrated good construct validity and reliability. It can be a useful tool for screening and treatment planning for the dysphagia of patients with head and neck cancers.
Deglutition Disorders
;
Head
;
Head and Neck Neoplasms
;
Humans
;
Linguistics
;
Mass Screening
;
Neck
;
Quality of Life
;
Reproducibility of Results
;
Surveys and Questionnaires
9.Chronic Subdural Hematoma Secondary to Traumatic Subdural Hygroma.
Byung Ho LEE ; Pyo Nyun KIM ; Deok Hwa HONG ; Han Hyuk LIM ; Won Kyung BAE ; Il Young KIRN ; Kyeong Seok LEE
Journal of the Korean Radiological Society 1994;30(2):219-224
PURPOSE: Sometimes chronic subdural hematoma can be developed following posttraumatic subdural hygroma. The purpose of this study is to investigate its incidence, the duration required for their conversion, and characteristic CT and MR findings of subdural hygroma and chronic subdural hamatoma. MATERIALS AND METHODS: We studied 8 patients with persistent posttraumatic subdural hygroma which consquently developed chronic subdural hamatoma. The patients were examined with CT initially and foilowed-up with CT in 3 and MR in 5. We analyzed the location of the lesion, the change of the density or signal intensity, the change of the size, and the degree of enhancement and mass effect. RESULTS: The duration required for the formation of hematoma was 48-166 days (mean, 76 days). The characteristic CT findings of subdural hygroma were a crescentric lesion with CSF density along the inner table without contrast enhancement. The mass effect was minimal. The CT findings of chronic subdural hematoma were higher density than that of hygroma in all cases, increase in thickness and size in 3 cases, and contrast enhancement along the inner membrane of the hematoma in 5 cases. The signal intensities of the subdural hygroma were identical to those of CSF on both T1 and T2 weighted images, whereas, those of chronic subdural hematoma were higher. CONCLUSION: The increased signal intensity on T1 weighted MR images and increased attenuation or contrast enhancement of the lesion on CT may suggest the conversion of subdural hygroma into chronic subdural hematoma.
Hematoma
;
Hematoma, Subdural, Chronic*
;
Humans
;
Incidence
;
Lymphangioma, Cystic
;
Membranes
;
Subdural Effusion*
10.A Case of Myelopathy due to Spinal Dural Arteriovenous Fistula Supplied by Branches of the Internal Iliac Arteries.
Il Hyung LEE ; Jae Chun BAE ; Sang Moo LEE ; Jin Hyuk KIM ; Ki Han KWON ; Byung Chul LEE
Journal of the Korean Neurological Association 1999;17(3):447-451
Spinal dural arteriovenous fistulas are rare abnormal connections of artery and vein within the dura, at the level of the intervertebral foramen. A 57-year-old male developed weakness in both lower extremities and sphincteric dysfunction, which had stepwisely, progressive and fluctuating course since 6 months ago. He showed areflexia in both ankle & right knee. T-spine MRI showed high signal intensity with ill defined margin in T2WI and intensely enhanced by con-trast agent through lower thoracic and lumbosacral spinal cord. Selective spinal angiography revealed a dural arteriove-nous fistula with a nidus at thoracolumbar vertebral level, supplied by the internal iliac artery and enlarged medullary veins. Superselective angiographic embolization was done. Clinically, his symptoms has been ameliorated. We report a rare case of thoracic myelopathy due to spinal dural arteriovenous fistulas exclusively supplied by the branches of internal iliac artery.
Angiography
;
Ankle
;
Arteries
;
Central Nervous System Vascular Malformations*
;
Fistula
;
Humans
;
Iliac Artery*
;
Knee
;
Lower Extremity
;
Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Spinal Cord
;
Spinal Cord Diseases*
;
Veins