• Advances in pediatric surgery
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• v.5 no.1
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• pp.26-32
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• 1999

We analyzed our experience with orchidopexy for undescended testicle performed during recent 10 years in order to evaluate our results and to determine the most effective treatment of undecended testes. Between 1988 and 1997, we treated 420 undescended tested (314 palpable and 106 nonpalpable) in 356 boys. Medical records were reviewed with respect to age at presentation, the surgical approach, testicular location, testicular volume and the final outcome. The average patient age at presentation was 4.1 years with 40.2 % presenting before age 2 years. Of 106 nonpalpable testes, 23 testes were intra-abdominal, 32 were preperitoneal and 51 were absent. During the first 5 years, we performed orchidopexy through 31 inguinal and 13 midline transabdominal incisions for 44 paitents with nonpalpable testes. In the next 5 years, all 47 patients with nonpalpable were treated through inguinal incisions. For the nonpalpable testes, the inguinal approach with or without intraperitoneal extension was successful in defining the location of testes and blind-ending vessels in all patients. Laparoscopy did not help to avoid surgical exploration in all our patients with nonpalpable tests. Of 339 inguinal and midline tranabdominal orchidopexies without spermatic vessels ligations, 324 testes were placed in the scrotum, 4 in the upper scrotum and 3 in the inguinal area. Eight testes underwent atrophy. Of 13 Fowler-Stephens orchidopexies, 7 were placed in the scrotum and 6 became atrophied. Testicular growths were noticed in most patients who underwent orchidopexies and the colume of pexed testes became as large as the contralateral normal testes by the mean duration of 43.3 months postoperatively. In conclusion, orchidopexies were successful in most cases of cryptochidism in terms of testicular position and growth. However, there were more testicular atrophies in cases where spermatic vessels were ligated. In cases of nonpalpable undescended testes, the inguinal approach with or without intraperitoneal extesion would be recommended.

• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.707-715
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• 2018

Objective : To investigate the potential risk of approach-related complications at different access angles in minimally invasive lateral lumbar interbody fusion. Methods : Eighty-six axial magnetic resonance images were obtained to analyze the risk of approach-related complications. The access corridor were simulated at different access angles and the potential risk of neurovascular structure injury was evaluated when the access corridor touching or overlapping the corresponding structures at each angle. Furthermore, the safe corridor length was measured when the corridor width was 18 and 22 mm. Results : When access angle was $0^{\circ}$, the potential risk of ipsilateral nerve roots injury was 54.7% at L4-L5. When access angle was $45^{\circ}$, the potential risk of abdominal aorta, contralateral nerve roots or central canal injury at L4-L5 was 79.1%, 74.4%, and 30.2%, respectively. The length of the 18 mm-wide access corridor was largest at $0^{\circ}$ and it could reach 44.5 mm at L3-L4 and 46.4 mm at L4-L5. While the length of the 22 mm-wide access corridor was 42.3 mm at L3-L4 and 44.1 mm at L4-L5 at $0^{\circ}$. Conclusion : Changes in the access angle would not only affect the ipsilateral neurovascular structures, but also might adversely influence the contralateral neural elements. It should be also noted to surgeons that alteration of the access angle changed the corridor length.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.150-156
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• 1984

Paraesophageal hiatus hernia represents a rare hiatal hernia that are treated surgically. The completely asymptomatic paraesophageal hernia often does not reach the clinician or surgeon. But the presence of a symptomatic paraesophageal hernia is sufficient indication for surgery. The paraesophageal hernia may be approached either transthoracically or transabdominally. The general technique is essentially the same, whichever route is used. From either transthoracic or transabdominal approach, following reduction of the viscus and elimination of the sac, the diaphragmatic opening is then closed with interrupted heavy dacron or silk sutures in paraesophageal hiatus hernia. But if the phrenoesophageal membrane often is destroyed when the esophagogastric junction and the distal esophagus have been mobilized, it becomes important to fix the esophagogastric junction below the diaphragm, so that it does not slide through the hiatus and produce a sliding-type hiatus hernia in future. We have experienced one case of paraesophageal hiatus hernia which was accompanied with severe anemia in child. We preferred to approach through left thoracotomy incision and then pushed down the stomach into the abdominal cavity with complete excision of the hernial sac. We employed Belsey Mark V procedure using of Teflon felt pledgets with the mattress sutures against development of sliding-type hiatus hernia in postoperative period. postoperative course has been uneventful and good for about 3 months to this time.

• Parasites, Hosts and Diseases
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• v.50 no.2
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• pp.147-150
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• 2012

Cystic disease of the spleen is an uncommon entity in general population. Most cases result from parasitic infection by Echinococcus granulosus, a form called splenic hydatid disease (SHD), with a reported frequency of 0.5-6.0% within abdominal hydatidosis. On the contrary, an isolated splenic involvement of hydatid disease is very uncommon even in endemic regions. Two cases of primary SHD managed with open and laparoscopic radical surgery in our department are reported herein. Primary SHD is a rare entity with non-specific symptoms underlying clinical suspicion by the physician for prompt diagnosis. Surgical treatment is the mainstay therapy, while laparoscopic approach when feasible is safe, offering the advantages of laparoscopic surgery.

• Journal of Preventive Medicine and Public Health
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• v.43 no.5
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• pp.445-450
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• 2010

Objectives: Emotional support and a stress management program should be simultaneously provided to clients as effective preventive services for healthy behavioral change. This study was conducted to review various relaxation and meditation intervention methods and their applicability for a preventive service program. Methods and results: The author of this paper tried to find various relaxation and meditation programs through a literature review and program searching and to introduce them. The 'Relaxation Response' and 'Mindfulness Based Stress Reduction (MBSR)' are the most the widely used meditative programs in mainstream medical systems. Abdominal breathing, Progressive Musclular Relaxation (PMR), Relaxative Imagery, Autogenic Training (AT) and Biofeedback are other well-known techniques for relaxation and stress management. I have developed and implemented some programs using these methods. Relaxation and meditation classes for cancer patients and a meditation based stress coping workshop are examples of this program. Conclusions: Relaxation and meditation seem to be good and effective methods for primary, secondary and tertiary preventive service programs. Program development and standardization and further study are needed for more and wider use of the mindbody approach in the preventive service area of medicine.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.536-541
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• 1996

Between June 1988 and June 1994, twenty five patients with locAlly advanced esophageal carcinoma received preoperative chemotherapy (Cisplatln, 5-Fluorouracil with or without Etoposide) and followed by resection. All patients had clinical evidence of airway involvement or distant Iymphnode involve- ment (M 1 Iymphnode) on bronchoscopy or computed tomographic scans. The major response rate to chemotherapy decided by the postoperative stage was 48% (12125). The resection rate was 92% (23/25) with overall complete resection rate of 72% (18125). Two patients had exploratory laparotomy (thorn- cotomy) only. Thirteen patients had esophagogastrostomy with a combined abdominl and Rt. thoracic approach (Ivor Lewis operation), slx pAtients had transhiatal esophagectomy, four patients had esophagogastrostomy with a combined Rt. thoracotonly & abdominal, cervical approach. There were three postoperative deaths (12%). Follow-up duration was between 3.3 months to 65 months. Median survival ime of resected patients except hospital death was 14.8 months. Actuarial survival at 12, 24 months was 72.9%, 26.2%. Signifi- cant better survival was associated with responder group (postoperative stage less than lIB) (P=0.029). These results demonstrate that 1) Preoperative Cisplatin based combined chemotherapy Produce high response rate, 2) High complete resection rate with acceptable mortality rate occur after preoperative chemotherapy, 3) Better surviL dl can be anticipated if complete resection performed after major re- sponse to preoperative chemotherapy.

• Journal of Veterinary Clinics
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• v.36 no.3
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• pp.176-179
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• 2019

A giant prostatic urethral calculus has not been previously reported in dogs and should be distinguished from prostatic calculus. A 7-year-old castrated male Maltese dog with a 2-month history of relapsing hematuria and urinary incontinence with slowly progressing paraphimosis was referred. On abdominal radiography and ultrasonography, there was a giant calculus in the region of prostate or urethra, one left ureteral calculus, one urinary bladder calculus, and two penile urethral calculi. On computed tomography for evaluating the accurate location and planning the surgical approach, the giant calculus was located at the prostatic urethra. The calculi in urinary bladder, prostatic and penile urethra were surgically removed. These calculi were mixed-type of calcium oxalate monohydrate, struvite and calcium phosphate carbonate. On the basis of the urolith analysis and urine bacterial culture results, antibiotics and prescription diet were adjusted. At the 3-month follow-up, there were no clinical sings but paraphimosis was still remained, and ultrasonography revealed newly-formed, small urethral calculi at the prostatic urethra. This is the first report to describe the case of a canine giant prostatic urethral calculus and its clinical signs, diagnostic imaging findings, treatment, and outcome. CT may be useful to assess the accurate location and surgical approach for such calculi.

• Journal of Chest Surgery
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• v.35 no.4
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• pp.296-302
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• 2002

The classic approach for esophagectomy is via the combined thoracic and abdominal approach. Controversy exists whether patients with esophageal carcinoma are best managed with Ivor-Lewis esophagectomy(ILO) as combined thoracic and abdominal approach or transhiatal esophagectomy(THO). The THO approach is known to be superior with respect to operative time, severity of leak, morbidity/mortality, and length of stay, but may represent an inferior cancer operation as a result of survival disadvantage due to inadequate mediastinal clearance compared with ILO. Accordingly, we reviewed the results of our esophageal resections to compare these outcome parameters for each operative approach. Material and Method: From January 1993 to July 2001, We performed a retrospective review of all esophagectomies performed at Keimyung University Dongsan ·Medical Center; 27 underwent THO, and 45 underwent ILO Result: The two groups were comparable in terms of age, sex, and stage of the disease. Mean tumor length and mean operative time were 3.81cm and 354 minutes for THO versus 5.31cm and 453 minutes for ILO, respectively (p<0.01 and p<0.001). Respiratory complications were 11.1% for THO versus 35.6% for ILO(p<0.05). Hospital mortality was 11.1% for THO versus 22.2% for ILO. There were no significant differences between THO and ILO with respect to other types of complications, amount of blood transfusion, leak and stricture rates, and hospital stay. Overall long-term survival at 5 years was 37%, respectively. Conclustion: There was no significant difference in long-term survival of patients of both operative approach. ILO had significant difference in respiratory complications associated with hospital mortality. Hence, THO is a valid alternative to ILO for well selected patients. And either approach appears to be acceptable depending on the surgeons, preferences and experiences.

• Asian-Australasian Journal of Animal Sciences
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• v.20 no.11
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• pp.1777-1782
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• 2007

Beef producers are trying to produce not only better quality but also greater quantity of beef in order to meet the preferences of some consumers at a lower cost. This can be accomplished if we understand the factors regulating lipid deposition in intramuscular adipose tissue and the tenderness of meat. Propylene glycol (PG) might be used as a precursor of intramuscular fat synthesis especially in the late period of fattening because adipose tissue in ruminants is thought to mature sequentially in abdominal, intermuscular, subcutaneous and intramuscular depots. The action of cholecalciferol supplementation has been verified in producing more tender meat through the enhancement of calpain activity over the postmortem ageing period. A synergistic effect can be expected if the dietary cation and anion difference (DCAD) technique is used in combination with dietary supplementation of cholecalciferol. In another approach, the optimization of hormonal implant use also may provide similarly marbled beef at a much lower cost.

• Journal of Trauma and Injury
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• v.30 no.2
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• pp.51-54
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• 2017

We here report a case of long-term fistula formation due to bullet retention for 30 years in the lumbar spine after a gunshot injury, and describe its treatment. A 62-year-old male visited our hospital due to pus-like discharge from his left flank. The discharge had been present for 30 years, since his recovery from an abdominal gunshot injury. A spine radiography showed radiopaque material in the body of the third lumbar vertebra. Foreign body was removed using an anterolateral retroperitoneal approach. The postoperative course was uneventful. The patient was discharged 7 days after the operation and was followed-up for 8 months, during which time, the fistula did not reoccur. A bullet retained long term in the vertebral body may cause obstinate osteomyelitis and fistula formation. A fistula caused by a foreign body in the spine can be effectively treated by surgical removal.