• Title/Summary/Keyword: Conservative Surgery

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Selective embolization of the internal iliac arteries for the treatment of intractable hemorrhage in children with malignancies

  • Bae, Sul-Hee;Han, Dong-Kyun;Baek, Hee-Jo;Park, Sun-Ju;Chang, Nam-Kyu;Kook, Hoon;Hwang, Tai-Ju
    • Clinical and Experimental Pediatrics
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    • v.54 no.4
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    • pp.169-175
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    • 2011
  • Purpose: Acute internal hemorrhage is an occasionally life-threatening complication in pediatric cancer patients. Many therapeutic approaches have been used to control bleeding with various degrees of success. In this study, we evaluated the efficacy of selective internal iliac artery embolization for controlling acute intractable bleeding in children with malignancies. Methods: We retrospectively evaluated the cases of 6 children with various malignancies (acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, T-cell prolymphocytic leukemia, Langerhans cell histiocytosis, and rhabdomyosarcoma), who had undergone selective arterial embolization (SAE) of the internal iliac artery at the Chonnam National University Hwasun Hospital between January 2004 and December 2009. SAE was performed by an interventional radiologist using Gelfoam$^{(R)}$ and/or Tornado$^{(R)}$ coils. Results: The patients were 5 boys and 1 girl with median age of 6.9 years (range, 0.7-14.8 years) at the time of SAE. SAE was performed once in 4 patients and twice in 2, and the procedure was unilateral in 2 and bilateral in 4. The causes of hemorrhage were as follows: hemorrhagic cystitis (HC) in 3 patients, procedure-related internal iliac artery injuries in 2 patients, and tumor rupture in 1 patient. Initial attempt at conservative management was unsuccessful. Of the 6 patients, 5 (83.3%) showed improvement after SAE without complications. Conclusion: SAE may be a safe and effective procedure for controlling acute intractable hemorrhage in pediatric malignancy patients. This procedure may obviate the need for surgery, which carries an attendant risk of morbidity and mortality in cancer patients with critical conditions.

A Case of Focal Reexpansion Pulmonary Edema after Chest Tube Insertion (흉관 삽관 후 발생한 국소성 재팽창성 폐부종 1예)

  • Chung, Hye Kyoung;Jang, Won Ho;Kim, Yang Ki;Lee, Young Mok;Hwang, Jung Hwa;Kim, Ki-Up;Uh, Soo-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.1
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    • pp.59-62
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    • 2009
  • Reexpansion pulmonary edema is not a common phenomenon after chest tube insertion but some reports from 0% to 14%. There are various resulting complications, including acute respiratory distress syndrome. We report a case of focal reexpansion pulmonary edema after chest tube insertion. A 49-year-old male came to the hospital due to ongoing dyspnea and left chest pain for 3 days. On chest X-ray, the patient had a left pneumothrax. We planned to insert a chest tube for symptom relief. To determine whether or not the chest had expanded as a result of the chest tube insertion, the patient underwent repeated chest X-rays the following day. The patient experienced brief respiratory symptoms upon initial suction; a chest PA showed patchy consolidated infiltration at the inserted site. After 5 days of conservative management, the recovered completely.

THE PROGNOSIS OF FIXATION OF MANDIBULAR FRACTURES WITH BIODEGRADABLE PLATES AND SCREWS (생체 흡수성 고정판을 이용한 하악골 골절치료의 예후)

  • Choi, Jin-Ho;Kim, Ju-Rok;Ha, Tae-Jin;Yu, Jang-Bae;Kim, Il-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.1
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    • pp.32-38
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    • 2005
  • The efficacy of bioresorbable fixation has recently been described in the osseosynthesis of the oral & maxillofacial region. However, a liitle data exist regarding the use of biodegradable plates and screws for the internal fixation of human mandible fractures. The purpose of this study is to analyze and compare the treatment of mandibular fractures by using a bioresorbable fixation system with conventional titanium system in human mandible fractures. eighteen patients constituted the bioresorbable fixation group and twenty-five patients constituted the titanium fixation group. Both groups underwent open reduction and internal fixation by use of a bioresorbable system or a titanium fixation system. Panoramic radiograph were obtained preoperatively, immediately postoperatively after reduction, at 6 months and at 12 months postoperatively. In the bioresorbable fixation group, complication(infection) occurred in 1 patient(5.6%) and was resolved by incision & drainage, plate removal and antibiotics without untoward sequelae. 2 patients(8.0%) experienced complications in the titanium fixation group and were treated using conservative treatment. There was no statistical difference in complication rates between two groups. Our data supported the use of bioresorbale plate fixation in mandibular fractures as a means of avoiding the potential and well documented problems with rigid titanium fixation systems. In conclusion, the bioresorbable fixation system provide a reliable and sufficient alternative to conventional titanium plate system.

Development of modern dentistry in Korea (한국 현대 치의학의 발전 1946-1969년 논문, 증례보고, 종설 및 학술강연회 연제를 중심으로)

  • Shin, Yooseok;Shin, Jaeeui
    • The Journal of the Korean dental association
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    • v.53 no.11
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    • pp.817-843
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    • 2015
  • Korean dentist's new mission was extended in dental practice field since the National Liberation Day of Korea. Modern dentistry development were due to the introduction of american dentistry, the development of Military dentistry, the unified academic activities koreans dental Association and improvement of korean dentist system. Modern dentistry development factors were as follows, First, Seoul National University's professors have been sent for studying abroad since May 1954. Thanks to this advanced system, each dental department established branch academy. Researchers and academic activities were increased in Seoul National University, Second, from January 1954, the military started training program to the korean dentists in the United States, and also the korean dentists were sent to the US Army hospital in korea for practical training courses (On the Job Training) so they could get chances to learn the advanced dentistry. During the korean war, the oral surgery dentists enlarged treatments to the maxillofacial field. Third, korean Dental academy meeting, special lectures and tables clinic from 1947 were contributing to the development of modern dentistry in the transmission of knowledge and skills. Since 1955 "Dentistry(齒學)" with a focus on the translation of foreign literature also developed modern dentistry. Since 1958 the International dental conference could broaden dental knowledge, it also provided opportunities to communicate with the world dentistry. On Oct 11, 1962, revised the Articles of association in Korean Dental academy and korean dental association unified meeting and enhanced the conferences. Improvement of korean dentist system in 1964 unified the dentists as new dentist education. Articles, case reports, review articles and academic meetings of korean dental association from 1946 to 1969 analyzed to demonstrate the development of korean modern dentistry, The titles and lectures were classified according to department and they were organized by topic.

A Case of Varicose Veins of the Lower Limbs with Cerebral infarction Treated with Guibi-tang (귀비탕(歸脾湯)으로 호전된 뇌경색을 동반한 하지정맥류 환자 치험 1례)

  • Lee, Hae-Yeon;Cho, Hyun-Seok;Kim, Jung-Chul;Lee, Jae-Eun;Lee, Jae-Jun;Bae, Dong-Joo;Kong, Kyung-Hwan;Baik, Tae-Hyun;Park, Jung-Han
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.633-639
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    • 2004
  • A varicose vein of the lower limbs is dilated, tortuous and elongated vein. Western medical treatment involves conservative management, sclerotherapy, and surgery. Currently, internal medicinal treatment is inadequate. Recently a patient was diagnosed with varicose veins of the lower limbs based on clinical symptoms. In this case, Guibi-tang was administered and clinical symptoms improved. This report suggests that oriental medicinal treatment is efficacious in treating varicose veins of the lower limbs. We think that further oriental medical studies on various surgical diseases are needed.

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Recurrent acinic cell carcinoma in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy (심장 전이와 비후성 골관절증을 동반한 재발성 이하선 선방세포암)

  • Jung, Sung Yun;Lee, Dong Won;Gu, Min Geun;Kwon, Tae Hun;Ko, Sung Ae;Choi, Joon Hyuk;Sohn, Jang Won;Hyun, Myung Soo
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.33-37
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    • 2014
  • Acinic cell carcinoma (ACC) is an uncommon malignant tumor of the salivary glands that is difficult to diagnose. It grows slowly and shows distant metastasis rarely. We experienced a case of recurrent ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy. The 29-year-old man had been suffering from severe multiple bones and joints pain for 2 months. Ten years earlier, he underwent superficial parotidectomy due to a right subauricular mass. The mass was diagnosed with ACC. After surgery, the tumor recurred twice. Then the patient was diagnosed with cardiac metastasis via positron emission tomography-computed tomography and trans-thoracic echocardiography. He also had hypertrophic osteoarthropathy with multiple bone metastasis. He was given palliative radiotherapy and conservative treatment. ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy has not yet been reported in literature. From this case, it is recommended to evaluate multiple distant metastasis in the ACC of the parotid gland when joint and bone pain are present.

Strategy for Management of Giant Invasive Pituitary Adenoma

  • Yang, Hee-Seok;Kim, Oh-Lyong;Kim, Min-Soo;Kim, Sang-Woo;Chang, Chul-Hun;Cho, Soo-Ho
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.25-28
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    • 2005
  • Objective: Giant invasive pituitary adenoma looks histologically benign, but these tumors have an aggressive clinical course. The authors review 10 cases and discuss the results obtained and the strategy to use for the management of giant invasive pituitary adenoma. Methods: Out of a series of 155 pituitary adenomas treated surgically between 1994 and 2002, ten patients with giant invasive pituitary adenoma were selected and their clinical problems, radiologic findings, extent and invasiveness, hormonal and histologic findings and surgical results were analyzed retrospectively. Results: There were 4 male and 6 female patients, with an average age of 47 years and an average follow-up period of 42 months. The average size of tumor was 50.7mm. These tumors revealed severe invasions into surrounding structures. 8 patients underwent transsphenoidal approach(TSA) operations, 1 patient with transcranial operation and 1 patient with combined TSA and transcranial operation. In all cases, subtotal resection was performed. The histologic findings were 2 prolactinomas and 3 hormonal non-function adenomas. The therapies administered after surgical removal consisted of conventional fractionated radiotherapy (2 patients), treatment with dopamine agonists to control hyperprolactinemia (2 patients), and treatment with hormone replacement (2 patients). Conclusion: Giant invasive pituitary adenomas are characterized by different forms of expansion and invasiveness and variable clinical problems. Because of their aggressive expansion and invasiveness, there are many different strategies which can be considered for their management. The authors obtain good results by choosing conservative surgical removal and multidisciplinary treatments with serial radiological and hormonal follow-up.

Interferon Stimulated Gene - ISG15 is a Potential Diagnostic Biomarker in Oral Squamous Cell Carcinomas

  • Laljee, Rupesh Puthenparambil;Muddaiah, Sunil;Salagundi, Basavaraj;Cariappa, Ponappa Muckatira;Indra, Adarsh Surendran;Sanjay, Venkataram;Ramanathan, Arvind
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1147-1150
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    • 2013
  • Background: Cancer diagnostic biomarkers have a wide range of applications that include early detection of oral precancerous lesions and oral squamous cell carcinomas, and assessing the metastatic status of lesions. The interferon stimulated ISG15 gene encodes an ubiquitin-like protein, which conjugates to stabilize activation status of associated proteins. Hence a deregulated expression of ISG15 may promote carcinogenesis. Indeed overexpression of ISG15 has been observed in several cancers and hence it has been proposed as a strong candidate cancer diagnostic biomarker. Given the emerging relationship between malignant transformation and ISG15, we sought to examine the expression pattern of this gene in tumor biopsies of oral squamous cell carcinoma (OSCC) tissues collected from Indian patients. Materials and Methods: Total RNA isolated from thirty oral squamous cell carcinoma tissue biopsy samples were subjected to semi-quantitative RT-PCR with ISG15 specific primers to elucidate the expression level. Results: Of the thirty oral squamous cell carcinomas that were analyzed, ISG15 expression was found in twenty four samples (80%). Twelve samples expressed low level of ISG15, six of them expressed moderately, while the rest of them expressed very high level of ISG15. Conclusions: To the best of our knowledge, the results show for the first time an overexpression of ISG15 in up to 80% of oral squamous cell carcinoma tissues collected from Indian patients. Hence ISG15 may be explored for the possibility of use as a high confidence diagnostic biomarker in oral cancers.

Computed Tomography Fluoroscopy-Guided Selective Nerve Root Block for Acute Cervical Disc Herniation

  • Eun, Sang-Soo;Chang, Won-Sok;Bae, Sang-Jin;Lee, Sang-Ho;Lee, Dong-Yeob
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.419-422
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    • 2010
  • Objective : To analyze the clinical outcomes of computed tomography (CT) fluoroscopy-guided selective neve root block (SNRB) for severe arm pain caused by acute cervical disc herniation. Methods : The authors analyzed the data obtained from 25 consecutive patients who underwent CT fluoroscopy-guided SNRB for severe arm pain, i.e., a visual analogue scale (VAS) score of 8 points or more, caused by acute soft cervical disc herniation. Patients with chronic arm pain, motor weakness, and/or hard disc herniation were excluded. Results : The series comprised 19 men and 6 women whose mean age was 48.1 years (range 35-72 years). The mean symptom duration was 17.5 days (range 4-56 days) and the treated level was at C5-6 in 13 patients, C6-7 in 9, and both C5-6 and C6-7 in 3. Twenty-three patients underwent SNRB in 1 session and 2 underwent the procedure in 2 sessions. No complications related to the procedures occurred. At a mean follow-up duration of 11.5 months (range 6-22 months), the mean VAS score and NDI significantly improved from 9 and 58.2 to 3.4 and 28.1, respectively. Eighteen out of 25 patients (72%) showed successful clinical results. Seven patients (28%) did not improve after the procedure, and 5 of these 7 underwent subsequent anterior cervical discectomy and fusion. Conclusion : CT fluoroscopy-guided SNRB may play a role as a primary conservative treatment for severe arm pain caused by acute cervical disc herniation.

A Case of Henoch-Sch$\"{o}$nlein Purpura with Acute Pancreatitis and Hypovolemic Acute Renal Failure (급성 췌장염과 저혈량성 급성 신부전이 동반된 Henoch-Sch$\"{o}$nlein 자반증 1예)

  • Oh, Ki-Won;Park, Sang-Kyu;Kim, Joon-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.226-229
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    • 2009
  • Gastrointestinal involvement in Henoch-Sch$\"{o}$nlein purpura (HSP) is common. However, both acute pancreatitis and acute renal failure appear to be very rare complications of HSP. We describe a case of HSP with acute pancreatitis and hypovolemic acute renal failure in a 7-year-old girl who presented with a vasculitic purpuric rash involving the lower extremities, abdominal pain, hematochezia, vomiting, and oliguria. Laboratory findings showed increased serum levels of amylase, lipase, and creatinine. An abdominal CT scan revealed diffuse enlargement of the head and body of the pancreas. The patient was successfully managed with conservative treatment, including corticosteroids, and then her pancreatic enzymes and renal function returned to normal. Acute pancreatitis should be differentiated from other causes of acute abdomen in HSP to avoid unnecessary surgery.

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