1.A Study of Anastomotic Stricture after EEA Stapled.
Do Hwan JEON ; Sung Rae CHO ; Soo Bong CHUN
The Korean Journal of Thoracic and Cardiovascular Surgery 1998;31(12):1217-1221
BACKGROUND: The advent of EEA stapler has lowered the leakage rate of esophagogastric anastomoses and thereby contributed to a decrease in the operative mortality of the easophageal resection. Recent surgical reports, however, have documented 10% to 20% prevalence of benign anastomotic stricture formation after the use of EEA stapler to construct an esophagogastric anastomosis. We analyzed the cases of anastomotic strictures to reduce the incidence of anastomotic strictures with EEA stapled esophagogastrostomy. MATERIAL AND METHOD: EEA stapled esophagogastrostomy was performed in 195 parients during the period of over 11 years from Jan. 1986 to Dec. 1996 in Kosin Medical Center. Ten patients of them died in the early postoperative days. In the remaining 185 patients, we studied the incidence and the onset time of anastomotic strictures, relationship between the patients' ages, the anastomotic sites, and the size of the cartridges with incidence of anastomotic stricture. We also studied the method of treatment and its effect in the anastomotic strictures. RESULT: Benign anastomotic strictures occurred in 39 cases among 185 patients (21%), 25 cases (64.1%) of the 39 cases developed in one to three months postoperatively. The patients' ages and the anastomotic sites did not effect with the incidence of anastomotic stricture, but high incidence of anastomotic stricture in EEA stapled esophagogastrostomy (p=0.04)was observed in small cartridge sizes. One or two balloon dilatation (89%) relieved the anastomotic strictures. CONCLUSION: We conclude that a larger size cartridge is recommended in EEA stapled esophagogastrostomy to reduce the incidence of anastomotic stricture if possible, and one or two balloon dilatation would seem to be a safe and reliable method in treating anastomotic stricture when the anastomotic stricture was occurrs.
Constriction, Pathologic*
;
Dilatation
;
Humans
;
Incidence
;
Mortality
;
Prevalence
2.The Treatment of Recurrent Anterior Dislocation of the Shoulder by Modified Bristow Operation
Yong Girl LEE ; Tae Hwan CHO ; Sang Soo DO ; Hyung Joo KIM ; Dong Kyuen LEE ; Jin Ho CHUN
The Journal of the Korean Orthopaedic Association 1990;25(4):1143-1149
A review of sixteen cases of the modified Bristow operation for recurrent anterior dislocation of the shoulder from Feb. 1987 to Feb. 1989 was presented and the following results were obtained. 1. The age of initial dislocation varied from 12 years to 27 years of age with the average of 17.3 years. 2. The age at operation varied from 21 years to 30 years of age with the average of 23.3 years. 3. The times of dislocation vaaried form 7 to 40 times with the average 23.8 times. 4. The average loss of abduction and external rotation were 5.9 and 12.5 degree respectively. 5. The complications and recurrence were not observed in this period
Dislocations
;
Recurrence
;
Shoulder
3.Left External Iliac and Common Femoral Artery Occlusion Following Blunt Abdominal Trauma without Associated Bone Injury.
Chun Sung BYUN ; Il Hwan PARK ; Hye jin DO ; Keum Seok BAE ; Joong Hwan OH
The Korean Journal of Thoracic and Cardiovascular Surgery 2015;48(3):214-216
Blunt abdominal trauma may cause peripheral vascular injuries. However, blunt abdominal trauma rarely results in injuries to the external iliac and common femoral arteries, which often stem from regional bone fractures. Here, we present the case of a patient who had experienced trauma in the lower abdominal and groin area three months before presenting to the hospital, but these injuries did not involve bone fractures and had been managed conservatively. The patient came to the hospital because of left lower leg claudication that gradually became severe. Computed tomography angiography confirmed total occlusion of the external iliac and common femoral arteries. The patient underwent femorofemoral bypass grafting and was discharged uneventfully.
Angiography
;
Femoral Artery*
;
Fractures, Bone
;
Groin
;
Humans
;
Leg
;
Transplants
;
Vascular System Injuries
4.Prognostic Value of Normal Exercise (99m)Te-MIBI Myocardial Perfusion SPECT: Comparison with Exercise Electrocardiography and Coronary Angiography.
Sang Woo LEE ; Jae Tae LEE ; Kyung Ah CHUN ; Do Young KANG ; Dong Hwan KIM ; Yong Keun CHO ; Shung Chull CHAE ; Kyu Bo LEE
Korean Journal of Nuclear Medicine 2000;34(3):199-206
PURPOSE: Myocardial perfusion scintigraphy is a useful technique to diagnose and to predict prognosis in patients with suspected or known coronary artery disease. The purpose of the present study is to evaluate the prognostic value of normal exercise (99m)Tc-MIRI myocardial perfusion single photon emission computed tomography (SPECT) an(l to analyze results with regard to those of exercise. electrocardiography or coronary angiography. MATERIALS AND METHODS: We evaluated 30) patients (mean age S2+/-10 years, 166 males and 135 females) with normal exercise (99m)Tc-MIBI myocardial perfusion SPECT performed for suspected coronary artery disease. Subjects were evaluated for cardiac events and followed for 8-55 months (mean 19+/-10 months) after imaging. RESULTS: During the follow-up period, there was no cardiac death but only one non-fatal myocardial infarction (event rate 0,21%: per year). In addition, only one patient underwent coronary revascularization. There was no significant difference in cardiac event rate between patients with positive (n=27) and negative (n-235) exercise electrocardiography (p:NS), There was no cardiac event in ]7 patients who underwent coronary angiography (4 patients with >50% luminal narrowing, 2 patients with vasospasm and 11 patients with no significant lesion). CONCLUSION: Patients with normal exercise (99m)Tc-MIBI myocardial perfusion SPECT has a very low risk for cardiac events regardless of exercise electrocardiographic and coronary angiographic findings.
Coronary Angiography*
;
Coronary Artery Disease
;
Death
;
Electrocardiography*
;
Follow-Up Studies
;
Humans
;
Male
;
Myocardial Infarction
;
Perfusion Imaging
;
Perfusion*
;
Phenobarbital
;
Prognosis
;
Tomography, Emission-Computed, Single-Photon*
5.The effects of performance status, clinical symptoms and laboratoy data on length of survival of advanced cancer patients.
Do Haeng LEE ; Soo Hyun KIM ; Youn Seon CHOI ; Byung Chul CHUN ; Myung Ho HONG ; Kyung Hwan CHO ; Jeong A KIM
Journal of the Korean Academy of Family Medicine 2001;22(12):1794-1805
BACKGROUND: Patients diagnosed as an advanced cancer and families need accurate information about the length of survival in order to plan for and to make the best use of the time that remains. The health care of that patient can then be redirected toward palliation and mobilizing resources to ensure a comfortable life. The purposes of this study were to evaluate the prognostic value of performance status plus some physical symptoms and some biological indices and there fore to assist in planning appropriate palliative care. METHODS: This study was performed on 161 patients, who had been diagnosed as advanced cancer in Korea University Guro Hospital from July 1999 to July 2000. : We requested Karnofsky performance status scale, mental status, jaundice, severity of pain, anorexia, voiding difficulty, dyspnea and dry mouth We assessed the biological indices by leukocyte count, plasma albumin, proteinuria. RESULTS: We could confirm 82 patients' death(54.37) of 151 patients. Univariate analysis showed that Karnofsky performance status scale, mental status, jaundice, severity of pain, anorexia, voiding difficulty, dyspnea, dry mouth, leukocyte count, albumin and proteinuria demonstrated a statistically significant predictive prognosis. Multivariate analysis using Cox's proportional hazard model showed that age, performance status, albumin, proteinuria were independent predictors of survival and severity of pain had the borderline value. CONCLUSION: Age, performance status, albumin and proteinuria were the independent prognostic factors for patients with advanced cancer.
Anorexia
;
Delivery of Health Care
;
Dyspnea
;
Humans
;
Jaundice
;
Karnofsky Performance Status
;
Korea
;
Leukocyte Count
;
Mouth
;
Multivariate Analysis
;
Palliative Care
;
Prognosis
;
Proportional Hazards Models
;
Proteinuria
;
Serum Albumin
6.Treatment of Complete Spinal Cord Injury Patients Receiving Autologous Bone Marrow Cell Transplantation and Bone Marrow Stimulation with Granulocyte Macrophage-Colony Stimulating Factor: Report of Three Cases.
Yoon HA ; Seung Hwan YOON ; So Ra PARK ; Yong Eun CHO ; Do Heum YOON ; Hyung Chun PARK
Journal of Korean Neurosurgical Society 2004;35(5):459-464
OBJECTIVE: The transplantation of bone marrow cells into the injured spinal cord improves neurologic functions in experimental animals. However, it is unclear whether bone marrow cells can similarly improve the neurologic functions of complete spinal cord injury patients. To study their therapeutic effects in human spinal cord injury (SCI), we transplante autologous bone marrow cells into the SCI sites and administer granulocyte macrophage-colony stimulating factor (GM-CSF) in three complete SCI patients. METHODS: Bone marrow cell transplantation with GM-CSF administration was performed on two patients (patients1 and 2), wherein concentrated bone marrow cell pastes were injected into the injury area using a sterile 21 gauge fine needle. The total volume of bone marrow cells injected was 1.8ml (cell concentration 1.1X106/ul). Patient 3 was administered GM-CSF only. The follow up periods were 5 months (patient 1), 4 months (patient 2) and 6 months (patient 3). RESULTS: Sensory improvements were followed immediately after the operations. Sensory recovery in the sacral segment was noticed at 3 weeks (patient 1), 13 days (patient 2) and at 2 months (patient 3) postoperatively. Significant motor improvements were noticed at 3 months in patients 1 and 2, and at 4 months in patient 3. All three patients showed neurologic improvements at the last follow up 5, 4 and 6months respectively (Frankel grade C, AIS grade C). CONCLUSION: Treatment of SCI patients with autologous bone marrow cell transplantation and GM-CSF administration shows some beneficial effects during the early postoperative periods. However, long-term and more comprehensive clinical studies are required.
Animals
;
Bone Marrow Cells*
;
Bone Marrow Transplantation*
;
Bone Marrow*
;
Follow-Up Studies
;
Granulocyte-Macrophage Colony-Stimulating Factor
;
Granulocytes*
;
Humans
;
Needles
;
Ointments
;
Postoperative Period
;
Spinal Cord Injuries*
;
Spinal Cord*
;
Stem Cells
;
Transplantation
7.Expression of Mutant p53 and MAGE-3 Gene Products in Esophageal Squamous Cell Carcinoma.
Sung Rae CHO ; Il Chong YANG ; Chung Seok LEE ; Do Hwan CHUN ; Hee Kyung CHANG
The Korean Journal of Thoracic and Cardiovascular Surgery 2001;34(1):64-71
BACKGROUND: Despite recent advances in multimodality therapy, the prognosis for invasive esophageal cancer is poor, with five years survival rate generally below 10%. Therefore, immunotherapy is considered as one of the new therapeutic modality in esophageal cancer. However, expression of tumor specific antigen in tumor tissue should be necessary for immunotherapy of tumor. This study is to clarify that mutant p53 protein and MAGE-3 gene product is expressed in esophageal cancer specifically and they can be played a role of prognostic factors in esophageal cancer. MATERIAL AND METHOD: Expression of mutant p53 protein and MAGE-3 gene products in formalin fixed, paraffin embedded samples of 79 patients with primary squamous cell carcinoma of the esophagus, who undewent esophageal resection, were analyzed immunohistochemically with DO-7 monoclonal antibody and anti- MAGE-3 antibody. Twenty cases of esophageal normal mucosa and 20 cases of leiomyoma which is a benign tumor of esophagus, were used as control groups. Immunoreactivities of mutant p53 and MAGE-3 gene product in esophageal cancer tissues were analyzed and the relationships between immunoreactivity of mutant p53 protein, MAGE-3 gene product and AJCC stage of esophageal cancer were determined by the Chi-square test. RESULT: Positive immunoreactivity of mutant p53 and MAGE-3 gene product were each of 41/79(51.9%), 48/79(60.8%) in esophageal cancer tissue, but 0% in normal mucosa and leiomyoma of esophagus(p<0.001). Both immunoreactivity of mutant p53 and MAGE-3 gene products were not related to AJCC stage of esophageal cancer(p=0.193, p=0.452). There was not correlation between expression of mutant p53 protein and MAGE-3 gene product in esophageal cancer(p=0.697). CONCLUSION: Mutant p53 and MAGE-gene product cannot be a prognostic factor in squamous cell carcinoma of esophagus, but mutant p53 and MAGE-3 gene product is expressed in squamous cell carcinoma of the esophagus specifically, so esophageal cancer can be target for cytotoxic T lymphocyte in anticancer immunotherapy.
Carcinoma, Squamous Cell*
;
Esophageal Neoplasms
;
Esophagus
;
Formaldehyde
;
Humans
;
Immunotherapy
;
Leiomyoma
;
Lymphocytes
;
Mucous Membrane
;
Paraffin
;
Prognosis
;
Survival Rate
8.A Case of Artificial Testis Implantation Using Tissue Expander in Anorchidism with Scrotal Hypoplasia.
Dong Chan CHUN ; Su Hyung LEE ; Tack LEE ; Do Hwan SUNG ; Sang Won HAN ; Seung Kang CHOI ; Chung Jae LEE
Korean Journal of Urology 1997;38(2):215-218
A hypoplastic empty scrotum is a critical factor in the success of implantation of artificial testis. A hypoplastic scrotum increases the postoperative complication, such as wound dehiscence and prosthesis extrusion. Any technique cannot overcome this problem satisfactorily. Furthermore previous operative scars and inflammatory disease as epididymo-orchitis have often added to the difficulties. Enlarging the scrotum by gradual distention of a tissue expander implanted in the contracted scrotum has been successful in overcoming this problem. We report a case of successful artificial testes implantation after gradually enlarging scrotum by tissue expander in a 6 year old boy, who was diagnosed anorchidism with scrotal hypoplasia.
Child
;
Cicatrix
;
Humans
;
Male
;
Postoperative Complications
;
Prostheses and Implants
;
Scrotum
;
Testis*
;
Tissue Expansion Devices*
;
Wounds and Injuries
9.Prevalence and Insight of Scoliosis among Korean Male Adolescents by Chest Radiographs.
Do Keun KIM ; Seung Hwan YOON ; Chang Hyun OH ; Hyung Chun PARK ; Chong Oon PARK ; Dong Keun HYUN
Korean Journal of Spine 2011;8(3):148-153
OBJECTIVE: We applied chest radiographs to scoliosis screening for conscription. Prevalence, types of scoliosis, and insight of examinees with scoliosis were investigated. METHODS: In this study, chest radiographs of 2417 males, who had been given an examination for conscription at the Seoul Regional Military Manpower Administration from April 2009 to May 2009, were analyzed. The prevalence of scoliosis more than a 10 degrees Cobb angle was calculated. The insight of scoliosis was investigated in every examinee and thoracolumbar radiographs were checked in those examinees with more than a 20 degree Cobb angle. RESULTS: Among 1904 males, 477 (19.7%) exhibited scoliosis involving more than a 5 degrees Cobb angle were and 131 (5.4%) exhibitedmore than a 10 degree Cobb angle. In those 131 cases, 18 (13.7%) had a known history of problems with scoliosis. Among the group measuring less than a 10 degree Cobb angle, 1.7% of them misunderstood scoliosis. Insight of scoliosis increased according to the severity of spinal curvature; however, nearly half of the cases with a 20 degree or greater Cobb angle had no insight with respect to their scoliosis. CONCLUSION: In male adolescents, the prevalence of scoliosis with a greater than 10 degree Cobb angle was 5.4% and there was a low insight with respect to scoliosis.
Adolescent
;
Benzeneacetamides
;
Humans
;
Male
;
Mass Screening
;
Military Personnel
;
Piperidones
;
Prevalence
;
Scoliosis
;
Thorax
10.Celiac Artery Dissection after Abdominal Blunt Trauma.
Yun Suhk SUH ; Seong Chun KIM ; Hwan Do RA ; Ho Seong HAN
Journal of the Korean Society of Traumatology 2006;19(2):196-200
We report a case of celiac artery dissection after abdominal blunt trauma. A 29-year-old man visited the emergency room for acute left periumbilical pain after abdominal blunt trauma from his child. Computed tomography showed a wedge-shaped splenic infarction with splenic artery thrombus. He was hospitalized for careful observation, and after two days, follow-up computed tomographic angiography showed a progressed celiac artery dissection that involved common hepatic artery and an increased extent of splenic infarction. He underwent conventional angiography, and a self-expandable stent was placed between the celiac axis and the common hepatic artery. After two days, follow-up computed tomographic angiography showed good hepatic arterial blood flow via the stent and no progression of splenic infarction. After ten days, he was discharged without complications.
Adult
;
Angiography
;
Axis, Cervical Vertebra
;
Celiac Artery*
;
Child
;
Emergency Service, Hospital
;
Follow-Up Studies
;
Hepatic Artery
;
Humans
;
Splenic Artery
;
Splenic Infarction
;
Stents
;
Thrombosis