1.Closed Intramedumary Nailing for Fracture of the Femoral Shaft
Bong Gun KIM ; Kang Ill LEE ; Duke Whan CHUNG
The Journal of the Korean Orthopaedic Association 1983;18(5):930-936
No abstract available in English.
2.Practical Incidence and Risk Factors of Terson's Syndrome: A Retrospective Analysis in 322 Consecutive Patients with Aneurysmal Subarachnoid Hemorrhage.
Gun Ill LEE ; Kyu Sun CHOI ; Myung Hoon HAN ; Hyoung Soo BYOUN ; Hyeong Joong YI ; Byung Ro LEE
Journal of Cerebrovascular and Endovascular Neurosurgery 2015;17(3):203-208
OBJECTIVE: Terson's syndrome, a complication of visual function, has occasionally been reported in patients with aneurysmal subarachnoid hemorrhage (SAH), however the factors responsible for Terson's syndrome in aneurysmal SAH patients have not yet been fully clarified. In this study, we report on potential risk factors for prediction and diagnosis of Terson's syndrome in the earlier stage of the disease course in patients with aneurysmal SAH. MATERIALS AND METHODS: The authors retrospectively analyzed the data of 322 consecutive patients who suffered from aneurysmal SAH in a single institution between Jan. 2007 and Dec. 2013. Medical records including demographics, neurologic examination, and radiologic images were collected to clarify the risk factors of Terson's syndrome. Patients with visual problem were consulted to the Department of Ophthalmology. RESULTS: Among 332 patients with aneurysmal SAH, 34 patients were diagnosed as Terson's syndrome. Four individual factors, including World Federation of Neurosurgical Societies (WFNS) grade at admission, aneurysm size, method of operation, and Glasgow outcome scale showed statistically significant association with occurrence of Terson's syndrome. Of these, WFNS grade at admission, aneurysm size, and method of operation showed strong association with Terson's syndrome in multivariate analysis. Terson's syndrome accompanied by papilledema due to increased intracranial pressure led to permanent visual complication. CONCLUSION: In patients with aneurysmal SAH, the patients' WFNS grade at admission, the size of the aneurysms, particularly the diameter of the aneurysm dome, and the method of operation might influence development of Terson's syndrome.
Aneurysm*
;
Demography
;
Diagnosis
;
Glasgow Outcome Scale
;
Humans
;
Incidence*
;
Intracranial Pressure
;
Medical Records
;
Multivariate Analysis
;
Neurologic Examination
;
Ophthalmology
;
Papilledema
;
Retrospective Studies*
;
Risk Factors*
;
Subarachnoid Hemorrhage*
;
Vitreous Hemorrhage
3.Practical Incidence and Risk Factors of Terson's Syndrome: A Retrospective Analysis in 322 Consecutive Patients with Aneurysmal Subarachnoid Hemorrhage.
Gun Ill LEE ; Kyu Sun CHOI ; Myung Hoon HAN ; Hyoung Soo BYOUN ; Hyeong Joong YI ; Byung Ro LEE
Journal of Cerebrovascular and Endovascular Neurosurgery 2015;17(3):203-208
OBJECTIVE: Terson's syndrome, a complication of visual function, has occasionally been reported in patients with aneurysmal subarachnoid hemorrhage (SAH), however the factors responsible for Terson's syndrome in aneurysmal SAH patients have not yet been fully clarified. In this study, we report on potential risk factors for prediction and diagnosis of Terson's syndrome in the earlier stage of the disease course in patients with aneurysmal SAH. MATERIALS AND METHODS: The authors retrospectively analyzed the data of 322 consecutive patients who suffered from aneurysmal SAH in a single institution between Jan. 2007 and Dec. 2013. Medical records including demographics, neurologic examination, and radiologic images were collected to clarify the risk factors of Terson's syndrome. Patients with visual problem were consulted to the Department of Ophthalmology. RESULTS: Among 332 patients with aneurysmal SAH, 34 patients were diagnosed as Terson's syndrome. Four individual factors, including World Federation of Neurosurgical Societies (WFNS) grade at admission, aneurysm size, method of operation, and Glasgow outcome scale showed statistically significant association with occurrence of Terson's syndrome. Of these, WFNS grade at admission, aneurysm size, and method of operation showed strong association with Terson's syndrome in multivariate analysis. Terson's syndrome accompanied by papilledema due to increased intracranial pressure led to permanent visual complication. CONCLUSION: In patients with aneurysmal SAH, the patients' WFNS grade at admission, the size of the aneurysms, particularly the diameter of the aneurysm dome, and the method of operation might influence development of Terson's syndrome.
Aneurysm*
;
Demography
;
Diagnosis
;
Glasgow Outcome Scale
;
Humans
;
Incidence*
;
Intracranial Pressure
;
Medical Records
;
Multivariate Analysis
;
Neurologic Examination
;
Ophthalmology
;
Papilledema
;
Retrospective Studies*
;
Risk Factors*
;
Subarachnoid Hemorrhage*
;
Vitreous Hemorrhage
4.Sporadic Hemangioblastoma in the Pituitary Stalk: A Case Report and Review of the Literature.
Gun Ill LEE ; Jae Min KIM ; Kyu Sun CHOI ; Choong Hyun KIM
Journal of Korean Neurosurgical Society 2015;57(6):465-468
Hemangioblastomas in the pituitary stalk are especially rare. Most pituitary stalk hemangioblastomas reported in the literature were associated with von Hippel-Lindau (VHL) disease. Here, we report only the 3rd case of sporadic pituitary stalk hemangioblastoma diagnosed in a 60-year-old woman. Despite the danger of potential complications due to excessive vascularity or proximity to important neural structures, the tumor in our case was successfully removed while preserving pituitary function. In this case, complete surgical excision was shown to be an effective treatment option for symptomatic pituitary stalk hemangioblastoma, and we suggest careful evaluation of any highly enhancing mass with a signal void in the pituitary stalk preoperatively, even if no VHL disease is evident.
Female
;
Hemangioblastoma*
;
Humans
;
Middle Aged
;
Pituitary Gland*
5.Effect of Using Local Intrawound Vancomycin Powder in Addition to Intravenous Antibiotics in Posterior Lumbar Surgery: Midterm Result in a Single-Center Study.
Gun Ill LEE ; Koang Hum BAK ; Hyoung Joon CHUN ; Kyu Sun CHOI
Korean Journal of Spine 2016;13(2):47-52
OBJECTIVE: We conducted this study to report the efficacy of local application of vancomycin powder in the setting of surgical site infection (SSI) of posterior lumbar surgical procedures and to figure out risk factors of SSIs. METHODS: From February 2013 to December 2013, SSI rates following 275 posterior lumbar surgeries of which intrawound vancomycin powder was used in combination with intravenous antibiotics (Vanco group) were assessed. Compared with 296 posterior lumbar procedures with intravenous antibiotic only group from February 2012 to December 2012 (non-Vanco group), various infection rates were assessed. Univariate and multivariate analysis to figure out risk factors of infection among Vanco group were done. RESULTS: Statistically significant reduction of SSI in Vanco group (5.5%) from non-Vanco group (10.5%) was confirmed (p=0.028). Mean follow-up period was 8 months. Rate of acute staphylococcal SSIs reduced statistically significantly to 4% compared to 7.4% of non-Vanco group (p=0.041). Deep staphylococcal infection decreased to 2 compared to 8 and deep methicillin-resistant Staphylococcus aureus infection also decreased to 1 compared to 5 in non-Vanco group. No systemic complication was observed. Statistically significant risk factors associated with SSI were diabetes mellitus, history of cardiovascular disease, length of hospital stay, number of instrumented level and history of previous surgery. CONCLUSION: In this series of 571 patients, intrawound vancomycin powder usage resulted in significant decrease in SSI rates in our posterior lumbar surgical procedures. Patients at high risk of infection are highly recommended as a candidate for this technique.
Administration, Topical
;
Anti-Bacterial Agents*
;
Cardiovascular Diseases
;
Diabetes Mellitus
;
Follow-Up Studies
;
Humans
;
Length of Stay
;
Methicillin-Resistant Staphylococcus aureus
;
Multivariate Analysis
;
Risk Factors
;
Staphylococcal Infections
;
Surgical Wound Infection
;
Vancomycin*
6.Genetic Alteration of p16INKA4A Promoter Region in Endometrial Carcinoma.
Se Jin KIM ; Gun Oh CHONG ; Ah Young KIM ; Chul Min PARK ; Hyun Jung LEE ; Young Lae CHO ; Ill Soo PARK ; Yoon Soon LEE
Korean Journal of Gynecologic Oncology 2005;16(1):8-20
OBJECTIVE: This study was performed to evaluate the status of p16 tumor suppressor gene in 25 endometrial carcinomas (ECs) and to correlate the loss of heterozygosity (LOH) at p16 locus, the presence of inactivating mutations, the methylation status of the promotor, and the expression of p16 protein with clinicopathological parameters. METHODS: Methylation-specific PCR (MSP) distinguishes unmethylated from methylated alleles in a given gene on sequence changes produced after bisulfite treatment of DNA. Allelic losses were determined at two polymorphic dinucleotide repeat microsatellite markers of the p16 gene on chromosome 9p21 that included D9S974 and D9S1748 at CDKN2A. Mutations were analyzed by exons 1 and 2 of p16 PCR-SSCP. Immunohistochemical staining for p16 protein was performed. The associations between genetic alterations of the p16 and the clinicopathological parameters of ECs were evaluated by chi-squared or Fisher's extraction tests. RESULTS: The median age of the 25 cases was 52 years, ranging from 32 to 72. The median tumor size was 3.6 cm, ranging from 0.8 to 9.5 cm. Histologically, the ECs were 21 endometrioid, 2 adenosquamous, 1 secretory and 1 papillary serous types. Nine cases of p16 protein staining were negative or minimal positive in 25 ECs (36%). Allelic losses were found in 6 loci (66.7%) of 5 ECs without p16 protein expression (Fisher's extraction test, p=0.0029), In this study, only 2 of 25 ECs (8%) disclosed mutations. Non-endometrioid (secretory and adenosquamous) carcinomas showed more frequent mutation and methylation than endometrioid carcinomas (p=0.043) and high grades (G3, p=0.018) showed more frequent mutation and methylation than low grade ECs. CONCLUSION: This study suggests that methylation of p16 promoter region seems not to be common (only 9.5% in our present series) and not to be associated with loss of nuclear p16 protein expression. Loss of p16 protein indicates a higher frequency of LOH, which contributes to the development of high grade or aggressive ECs. The mechanism of p16 inactivation is not clear, so other genetic or nongenetic mechanisms for inactivation should be further studied.
Alleles
;
Carcinoma, Endometrioid
;
Dinucleotide Repeats
;
DNA
;
Endometrial Neoplasms*
;
Exons
;
Female
;
Genes, p16
;
Genes, Tumor Suppressor
;
Loss of Heterozygosity
;
Methylation
;
Microsatellite Repeats
;
Polymerase Chain Reaction
;
Promoter Regions, Genetic*
7.Incidence of Acute Appendicitis: Agespecific and Sex-specific Analysis.
Jeong Han LEE ; Tas Ill MOON ; Chi Young LIM ; Yong Sik CHU ; Tae I KO ; Seong Taek KIM ; Jin Gun BAE ; Ok Jun KIM ; Sung Wook CHOI ; Suk Woo SOHN
Journal of the Korean Society of Emergency Medicine 2004;15(5):388-392
PURPOSE: This retrospective study was performed to investigate epidemiological characteristics in terms of the ageand the sex-specific incidences in patients with perforated or nonperforated appendicitis. METHOD: The study population comprised 314 patients who underwent appendectomies for suspected acute appendicitis between March 2002 and August 2003. This study used the student t-test, the coefficient of correlation, and the Cochran-Mantel-Haenszel Chi-square statistics. RESULTS: The incidence of nonperforated appendicitis was higher. Perforated appendicitis occurred at almost the same incidence in both sexes. However, the incidence of perforated appendicitis was high in small children and the elderly. The statistics of this study proved that the incidence of perforated appendicitis of the elderly was considerable. CONCLUSIONS: We suggest that the elderly need careful examination and rapid evaluation. Also, we suggest that since perforated appendicitis has a long duration of treatment, diagnostic accuracy is needed.
Aged
;
Appendectomy
;
Appendicitis*
;
Child
;
Humans
;
Incidence*
;
Retrospective Studies