1.Short Term Results of Endovenous Laser Treatment with Ultrasound Guided Ligation of the Sapheno-femoral Junction or Sapheno-popliteal Junction in Patients with Varicose Vein.
Journal of the Korean Society for Vascular Surgery 2008;24(2):125-129
PURPOSE: The main cause of recurrence of varicosity after endovenous laser treatment (EVLT) is incomplete occlusion of the sapheno-femoral junction (SFJ) or the sapheno-popliteal junction (SPJ). To reduce the recurrence and complications of EVLT, we have tried to ligate the SFJ or SPJ under ultrasonic guidance. METHOD: Two separate parallel punctures were made under ultrasonic guidance 1 cm inferior to and alongside the SFJ or SPJ with using a 16 gauge needle. A hook was passed through beneath the saphenous vein and it was pulled out through the puncture holes. A black silk thread was passed through backward with the hook and then the thread was tied. Low energy EVLT was then performed in a continuous fashion with using a 980 nm multidiode laser. RESULT: Between December, 2007 and February, 2008, 21 patients (males: 14, females: 7, 28 legs, mean age: 45 years old) with including 20 great saphenous veins (GSV) and 8 small saphenous veins (SSV) were managed using our protocol. The mean energy density (ED) was 9.8J/cm for the GSV and 9.5J/cm for the SSV. The pullback speed on the fiber was 69.5 sec at the GSV and 28sec at the SSV. No recurrence was noted. The complications were bruise (7 limbs/24%), fibrotic cord (4 limbs/14%), pain (8 limbs/31%), inguinal pain and paresthesia (1 limb/3%) and hematoma (4 limbs/14%). These complications were well controlled without any further problems. CONCLUSION: During EVLT, ultrasound (US) guided ligation of the SFJ is cosmetically satisfactory and effective in reducing the amount of required endovenous laser energy. The complication rate and severity were not reduced, but they under control.
Contusions
;
Hematoma
;
Humans
;
Leg
;
Ligation
;
Needles
;
Paresthesia
;
Punctures
;
Recurrence
;
Saphenous Vein
;
Silk
;
Ultrasonics
;
Varicose Veins
2.Physeal Injuries in Association with Severe Osteoporosis.
Seok Hyun LEE ; Kyung Wook RHA ; Dong PARK ; Joon Gyu MOON
The Journal of the Korean Orthopaedic Association 1998;33(4):1178-1183
The physeal injuries in children occur result of trauma, infection, metabolic or ischemic disease, and these conditions cause significant problems, such as growth disturbance, deformity and premature closure of physis. The authors experienced 7 cases of children who had angular deformity of knee and limb shortenings, but no history of obvious causes of physeal injury. All of these cases had severe osteoporosis and underlying disease, which were osteogenesis imperfecta, fibrous dyplasia and long term steroid therapy. The purpose of this study are evaluation of pathomechanism of physeal injuries in severe osteoporotic children. Patients were range of age from 4 to 9 years and had common clinical features, which were angular deformities of knee, limb shortening. Also they had common radiographic findings, that were severe porosis, metaphyseal sclerosis and in some cases, pop corn like calcification around physis. At this, we supposed that chronic mechanical stress in osteoporotic bone make physis be damaged due to loss of capillary circulation and this event appear to result from collapse of bone plate, through which epiphyseal vessel penetrate. In conclusion, the children with severe osteoporosis should be observed carefully about physeal injuries, which pathomechanism are perhaps deprivation of capillary circulation through bone plate. Therefore, We should try to protect bone plate by being conscious of its existence.
Bone Plates
;
Capillaries
;
Child
;
Congenital Abnormalities
;
Extremities
;
Humans
;
Knee
;
Osteogenesis Imperfecta
;
Osteoporosis*
;
Sclerosis
;
Stress, Mechanical
;
Zea mays
3.Spontaneous Correction of the Angular Deformity after Femoral Shaft Fractures in Children: Preliminery Report
Yung Khee CHUNG ; Jung Han YOO ; Baek Yong SONG ; Yong Wook PARK ; Gyu Cheol ROH
The Journal of the Korean Orthopaedic Association 1995;30(5):1382-1388
We reviewed 14 children with unilateral fractures of femoral shaft who had an angular deformity after union of 10° to 25°. At an average follow-up of 32 months(15 to 65), we measured remodelling of the proximal physis, the distal physis and the femoral shaft. The average correction was 83% of the initial deformity and there was no relation between the remodelling rate and degrees of malunion. Of the correction of angulation, only 27% had occurred at the fracture site and 73% at physis. The ability of physis to remodel better than that of fracture site. In children under 13 years of age, malunion as much as 25° in flexion deformity will remodel enough to get normal alignment of the joint surfaces.
Child
;
Congenital Abnormalities
;
Follow-Up Studies
;
Humans
;
Joints
4.Neurilemmoma of the tongue: Report of two cases.
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2007;33(3):260-262
Nearly 45% of all neurilemmoma occur in the head and neck area, but only 1% have an intraoral origin. The authors report two cases of uncommon neurilemmoma of the tongue. Both of them presented with a mass on the lateral border of the tongue, which was noted several days before. The lesions of tongue appeared as smooth-surfaced, well-circumscribed mass. They were excised under general anesthesia and diagnosed as neurilemmoma on histopathologic examination.
Anesthesia, General
;
Head
;
Neck
;
Neurilemmoma*
;
Tongue*
5.Analysis of Risk Factors in Poststernotomy Sternal Wound Infection and Mediastinitis after Open-heart Surgery.
Wonho CHANG ; Han Gyu PARK ; Hyunjo KIM ; Wook YOUM
The Korean Journal of Thoracic and Cardiovascular Surgery 2003;36(8):583-589
BACKGROUND: With the purpose of identifying significant risk factors in poststernotomy sternal wound infection and mediastinitis, we underwent a retrospective analysis of the whole patients operated on at the our department of cardiovascular surgery for the two years. MATERIAL AND METHOD: From March 2001 to March 2003 at the department of cardiovascular surgery, medical school of Soonchunhyang University, major sternal wound infections had been developed in 12 (9.76%) of 123 consecutive patients. These patients underwent open-heart procedure through a midline sternotomy and survived long enough for infection to appear. For this group of patients, we evaluated possible risk factors such as age, sex, diabetes mellitus, chronic obstructive pulmonary disease, obesity, interval between hospital admission and operation, type of surgical procedure, elective or emergency surgical procedure, reoperation, duration of surgical procedures, duration of cardiopulmonary bypass, amount of blood transfused, postoperative blood loss, chest reexploration, rewiring of a sterile sternal dehiscence, duration of mechanical ventilation, and days of stay in the intensive care unit and analyzed these factors. RESULT: Analysis represented that age, sex, diabetes mellitus, type and mode of surgical procedure, reoperation, duration of operation, duration of cardiopulmonary bypass, and interval between hospital admission and operation were not significantly associated with wound infection. For all other predisposing factors, p-values of less than .05 were demonstrated. Eight emerged as significant: early chest reexploration (p=0.001), sternal rewiring (p<0.0001), chronic obstructive pulmonary disease (p<0.0001), blood transfusions (p<0.05), postoperative bleeding (p=0.008), days of stay in the intensive care unit (p<0.0001), duration of mechanical ventilation (p=0.001), and obesity (p=.003). CONCLUSION: Contamination of patients may occur before, during, and after the operation, and any kind of reintervention may predispose the patient to wound infection.
Blood Transfusion
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Cardiopulmonary Bypass
;
Causality
;
Diabetes Mellitus
;
Emergencies
;
Hemorrhage
;
Humans
;
Intensive Care Units
;
Mediastinitis*
;
Obesity
;
Postoperative Hemorrhage
;
Pulmonary Disease, Chronic Obstructive
;
Reoperation
;
Respiration, Artificial
;
Retrospective Studies
;
Risk Factors*
;
Schools, Medical
;
Sternotomy
;
Surgical Procedures, Elective
;
Thorax
;
Wound Infection*
;
Wounds and Injuries*
6.A Case of Gastric Actinomycosia after Gastrectomy for Early Gastric Cancer.
Gyeng Hyen PARK ; Sung Ook CHOO ; Jae Wook LEE ; Jang Gyu LEE ; Chung HUR ; Jin Kwan LEE
Korean Journal of Gastrointestinal Endoscopy 1996;16(5):757-760
Primary gastric actinomycosis is an extremely rare disease and less than 20 cases are reported in literature. We experienced a case of gastric actinomycosis in the 63-year-old woman who had subtotal gastrectomy for early gastric cancer(type IIc) 7 month ago. Endoscopic biopsy from elevated lesion on stoma was found to show the neutrophilic infiltration and sulfur granule. She placed on tetracycline for 30 days. Follow up endoscopy showed no abnormality. We report this case with literature review. (Koresn J Gastrointest Endosc 18: 757~ 760, 1996)
Actinomycosis
;
Biopsy
;
Endoscopy
;
Female
;
Follow-Up Studies
;
Gastrectomy*
;
Humans
;
Middle Aged
;
Neutrophils
;
Rare Diseases
;
Stomach Neoplasms*
;
Sulfur
;
Tetracycline
7.Treatment of Multiple Thoracolumbar and Lumbar Spine Fractures: Comparison of Contiguous and Non-Contiguous Fractures in Non-Osteoporotic Patients
Yi Gyu PARK ; Sin Wook KANG ; Hong Moon SOHN
Journal of Korean Society of Spine Surgery 2018;25(1):9-17
OBJECTIVES:
To evaluate the outcomes of multiple thoracolumbar and lumbar fractures depending on whether the fractures were contiguous.SUMMARY OF THE LITERATURE REVIEW: The treatment of multiple spine fractures in patients without osteoporosis has rarely been reported.
MATERIALS AND METHODS:
From February 2004 to January 2016, 81 patients without osteoporosis who had acute thoracolumbar and lumbar fractures and underwent posterior fusion surgery were evaluated. Patients were divided into 2 groups (group A: contiguous, group B: non-contiguous). We investigated the causes of the injuries, the locations of the injuries within the spine, the range of fusion levels, and functional outcomes based on the patients' general characteristics.
RESULTS:
Group A comprised 37 patients and group B comprised 44 patients. In most patients, the fusion included 3 segments (group A: 12, group B: 14) or 4 segments (group A: 9, group B: 10). Group A scored 21.2 and group B scored 19.0 on the Korean Oswestry Disability Index. In both groups, longer fusion was associated with poorer clinical results. In the clinical evaluation of the fusion rate, there was no statistically significant difference between the 2 groups (p=0.446).
CONCLUSIONS
In this study, patients with multiple vertebral fractures showed more fusion segments and poor clinical outcomes in contiguous fractures. In the patients with non-contiguous fractures, the clinical results were better when a minimal number of segments was fused. Therefore, the authors recommend conservative treatment to minimize the number of segments that are fused in non-contiguous multiple thoracolumbar and lumbar fractures when decompression is not necessary.
8.Family Function and Children of Alcoholics Screening Test Score in High School Students .
In Wook JUNG ; Jong Sung KIM ; Jin Gyu JUNG ; Keun Bae KIM ; Chan Il PARK ; Won Ki HONG ; Sung Soo KIM
Journal of the Korean Academy of Family Medicine 2007;28(6):436-441
BACKGROUND: Parent's alcohol drinking not only influences their health but also their children. This research was designed to assess the family function of children who were affected by parent's alcohol drinking. METHODS: Questionnaire survey was performed on 208 high school students (129 males and 79 females) in Daejeon from March to April, 2005. We defined the students whose CAST (Children of Alcoholics Screening Test) score was 6 or more as children of alcoholics (COA) group. Then, we evaluated the family function by family APGAR score between the COA group and the control group. RESULTS: Among the total, 36 (27.9%) male and 27 (34.1%) female students were in COA group. There was a significant (P<0.01) negative correlation between the CAST score and the family APGAR score in all students. In boys, there was no significant correlation between the CAST score and the family APGAR score, but in girls, there was significant negative correlation (P<0.01). Mean family APGAR score of the COA group was significantly (P<0.05) lower than that of the control group in all students. In boys, there was no significant difference, but in girls, the COA group's family APGAR score was significantly lower than the control group's score (P<0.05). CONCLUSION: The high school students, especially girl students, who were affected by parent's alcohol drinking showed a lower family APGAR score. Therefore, family physicians need to evaluate the family function when encountering students similar to COA group.
Alcohol Drinking
;
Alcoholics*
;
Apgar Score
;
Child*
;
Female
;
Humans
;
Male
;
Mass Screening*
;
Physicians, Family
;
Surveys and Questionnaires
9.Treatment of Multiple Thoracolumbar and Lumbar Spine Fractures: Comparison of Contiguous and Non-Contiguous Fractures in Non-Osteoporotic Patients
Yi Gyu PARK ; Sin Wook KANG ; Hong Moon SOHN
Journal of Korean Society of Spine Surgery 2018;25(1):9-17
STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate the outcomes of multiple thoracolumbar and lumbar fractures depending on whether the fractures were contiguous. SUMMARY OF THE LITERATURE REVIEW: The treatment of multiple spine fractures in patients without osteoporosis has rarely been reported. MATERIALS AND METHODS: From February 2004 to January 2016, 81 patients without osteoporosis who had acute thoracolumbar and lumbar fractures and underwent posterior fusion surgery were evaluated. Patients were divided into 2 groups (group A: contiguous, group B: non-contiguous). We investigated the causes of the injuries, the locations of the injuries within the spine, the range of fusion levels, and functional outcomes based on the patients' general characteristics. RESULTS: Group A comprised 37 patients and group B comprised 44 patients. In most patients, the fusion included 3 segments (group A: 12, group B: 14) or 4 segments (group A: 9, group B: 10). Group A scored 21.2 and group B scored 19.0 on the Korean Oswestry Disability Index. In both groups, longer fusion was associated with poorer clinical results. In the clinical evaluation of the fusion rate, there was no statistically significant difference between the 2 groups (p=0.446). CONCLUSIONS: In this study, patients with multiple vertebral fractures showed more fusion segments and poor clinical outcomes in contiguous fractures. In the patients with non-contiguous fractures, the clinical results were better when a minimal number of segments was fused. Therefore, the authors recommend conservative treatment to minimize the number of segments that are fused in non-contiguous multiple thoracolumbar and lumbar fractures when decompression is not necessary.
Decompression
;
Humans
;
Osteoporosis
;
Retrospective Studies
;
Spine
10.Safety of 'Isolated IVb (Inferior) Resection of the Liver' by Cadaver Dissection.
In Gyu KIM ; Jung Wook PARK ; Bong Wan KIM ; Hee Jung WANG ; Bong Hwa LEE ; Myung Wook KIM
Korean Journal of Hepato-Biliary-Pancreatic Surgery 2005;9(1):1-5
PURPOSE: Healey divided segment IV of the live as the 'superior portion (IVa) ' and the 'inferior portion (IVb) '. On the contrary, Couinaud suggested that there was no useful purpose in dividing segment IV because of several reasons. Our goal is to evaluate the safety of the 'isolated IVb (inferior) resection of the liver' via performing the dissection of cadavers. METHODS: There were ten total cadavers. Cadaver dissection proceeded with respect to the Glissonian pedicle, the portal vein and the bile duct, respectively. The total number of Glissonian pedicles at segment IV was measured. The distance between the origins of the IVa and IVb branches was measured. Additional pedicles that were known to exist at segment IVa were also evaluated. RESULTS: The mean number of Glissonian pedicles in segment IV, IVa, and IVb was 5 (+/-1.3), 1.6 (+/-7), and 3.4 (+/-0.9), respectively. The mean distance between the origins of the IVa and IVb branches was 5.6 mm (+/-3.9 mm). Two of 10 cases had a very short distance between the origins that were considered as having common origin. Additional pedicles were identified at the Lt. main Glissonian pedicle in all the cases (8 cases: 1 each, 2 cases: 2 each). CONCLUSION: Considering the possible existence of a common origin of segment IVa and IVb Glissonian pedicles, there is the risk that the segment IVa will be injured during 'iso lated IVb resection'. Inevitable ligation of the additional pedicle of segment IVa from the Lt. main Glissonian pedicle can be made during the 'isolated IVb resection'. Therefore, we think that 'isolated IVb resection of the liver' can be safe only when the surgeon divides the branches of segment IVb with meticulous preservation of the IVa branches.
Bile Ducts
;
Cadaver*
;
Hepatectomy
;
Ligation
;
Portal Vein