• Journal of Yeungnam Medical Science
• /
• 제36권3호
• /
• pp.201-207
• /
• 2019

Implant-based breast reconstruction is the most commonly used reconstruction technique after mastectomy. This is because skin-sparing mastectomy has become possible with advancements in oncology. In addition, the development of breast implants and the advent of acellular dermal matrices have reduced postoperative complications and resulted in superior cosmetic results. The most frequently performed surgical breast reconstruction procedure for the past 20 years was the insertion of an implant under the pectoralis major muscle by means of the dual plane approach. However, some patients suffered from pain and animation deformity caused by muscle manipulation. Recently, a prepectoral approach has been used to solve the above problems in select patients, and the results are similar to subpectoral results. However, this technique is not always chosen due to the number of considerations for successful surgery. In this article, we will discuss the emergence of prepectoral breast reconstruction, indications and contraindications, surgical procedures, and outcomes.

• 고신대학교 의과대학 학술지
• /
• 제33권2호
• /
• pp.141-149
• /
• 2018

Hot flush (hot flush or facial flush) is the most frequent symptom experienced by women of peri-menopausal age. It may appear on women or even men after surgery or chemotherapy. Hot flush is one of the biggest reason for women to undergo hormone replacement therapy (HRT). It also crucially affects various aspects of life quality such as occupation, social life, daily routine and health awareness. The most effective and fundamental remedy for hot flush is HRT. However, a few women is not responsive to HRT and investigation to elucidate other causes of hot flush is warranted, especially in elderly. The contraindications such as breast cancer mandates other modality of treatment. Variety of treatment for hot flush other than HRT will be discussed herein.

• Archives of Plastic Surgery
• /
• 제48권2호
• /
• pp.199-207
• /
• 2021

Traditional orthognathic surgery has long been performed after presurgical orthodontic treatment. Despite some concerns, the surgery-first orthognathic approach (SFOA) or surgery-first approach (SFA) without presurgical orthodontic treatment has gradually gained popularity. In recent years, several articles dealing with the concepts of the SFA have been published worldwide. However, the SFA has not yet been standardized, and many surgeons use slightly different protocols and concepts. This review article discusses the beginning and evolution of the SFA and its current concepts, including some opinions based on the authors' clinical experiences over the last 15 years. According to recent investigations, the SFA could be applied effectively in several situations including class III malocclusion, class II malocclusion, and facial asymmetry. However, debate on the SFA continues and many issues remain to be resolved. This review article addresses the current issues regarding the SFOA, including its advantages and disadvantages, as well as its indications and contraindications. The authors summarize various aspects of the SFA and expect that this review article will help surgeons and orthodontists better understand the current status of the SFA.

• 대한족부족관절학회지
• /
• 제26권3호
• /
• pp.111-117
• /
• 2022

Despite the lack of evidence-based standard guidelines to select the best surgical treatment option for end-stage ankle osteoarthritis, the rate of total ankle arthroplasty (TAA) is increasing rapidly relative to ankle arthrodesis (AA) with the development of implant designs and surgical techniques. Physicians and patients would benefit from a more comprehensive understanding of the differences in postoperative pain relief, functional improvement, the rates of complication or reoperation, and restoration of gait ability and sports activity. This paper overviews the current consensus on indications and contraindications for TAA and provides a literature review on a comparison of the clinical and functional results between TAA and AA.

• 대한정형외과학회지
• /
• 제56권6호
• /
• pp.504-511
• /
• 2021

목적: 양측 슬관절 퇴행성 관절염으로 동시에 시행하는 양측 인공 슬관절 전치환술(simultaneous bilateral total knee arthroplasty, SBTKA)의 정맥 투여 금기에 해당하는 환자를 포함하여 관절강 내 트라넥삼산(tranexamic acid, TXA) 투여 후 배액량, 실혈량, 수혈률, 수혈량 및 합병증 발생의 차이를 비교해 보고자 하였다. 대상 및 방법: 2016년 4월부터 2018년 12월까지 퇴행성 관절염으로 SBTKA를 시행하였던 환자 중 관절낭 봉합 후 배액관을 통해 관절강 내로 한쪽당 3 g의 TXA를 주입한 139명을 실험군(group T), 2007년 10월부터 2010년 8월까지 TXA를 주입하지 않고 수술하였던 SBTKA 환자 57명(group A)을 대조군으로 설정했다. 양 군은 나이, 성별에 따른 유의한 차이는 없었다(p=0.572, 0.474). TXA는 정맥 내 투여의 금기에 해당하는 환자들에게도 관계 없이 주입하였고 염증성 관절염으로 수술을 시행한 환자는 본 연구에서 제외시켰다. 각각 평균 배액량, 실혈량, 수혈률, 수혈량과 일 평균 혈색소의 변화 추이, 일 평균 수혈량을 비교하였다. 합병증으로 심부 정맥 혈전증, 폐색전증, 감염, 뇌경색, 심근경색 발생 여부를 조사하였다. 결과: 평균 실혈량은 group A와 group T에서 각각 2195.32±1175.63 ml, 1145.09±382.95 ml, 평균 배액량은 1178.30±484.59 ml, 774.19±310.06 ml로 group T에서 각각 유의하게 적었다(p=0.002, <0.001). 수혈률은 각각 77.2% (44/57), 0.7% (1/139), 전체 평균 수혈량은 각각 735.44±550.83 ml, 4.60±54.28 ml로 group T에서 각각 유의하게 적었다(p<0.001, <0.001). 혈색소는 group A, group T에서 각각 술 후 3, 4일째 증가하였다(p<0.001, 0.001). 합병증으로 심부 정맥 혈전증이 group T에서 2예(1.4%), 폐색전증이 3예(2.2%) 발생하였으나 group A에서는 발생하지 않았다. 감염, 뇌경색, 심근경색은 모두에서 발생하지 않았다. 결론: 동시에 시행하는 SBTKA에서 TXA의 관절강 내 주입은 TXA의 평균 배액량, 실혈량, 수혈률, 수혈량을 유의하게 감소시키며 정맥 내 투여 금기에 해당하는 환자들을 포함하여도 합병증 발생률이 높아지지 않는다.

• 대한치과의사협회지
• /
• 제48권11호
• /
• pp.829-840
• /
• 2010

In recent years, medical techniques have provided patients with various measures to improve their quality of life. For dental treatment, drug-mediated sedation techniques for relieving dental anxiety have been developed, but behavior control through drugmediation may be limited because of possible side effects, contraindications, and the additional expense to the patient. Many patients tend to avoid the treatment or are unwilling to accept it and this makes both patients and dentists feel pressured. The field of NLP application might alleviate this uncomfortableness. Recently, NLP has spread to the dental and medical field rapidly and has been used in surgical treatments as well as in direct psychotherapy. NLP techniques which could be applied to dental phobic patients are as follows. 1) anchoring, 2) dissociation, 3) submodality change, 4) time line threapy, 5) swish pattern, 6) six step reframing, 7) parts integration, 8) modeling and imagination and so on. The aim of this study is to examine the strategy of NLP psychology so that dental phobic patients can be treated efficiently and effectively by the application of behavior management. Through NLP, patients can be induced to have more positive attitudes and experiences in future dental treatment.

• 대한암한의학회지
• /
• 제17권1호
• /
• pp.27-38
• /
• 2012

Objective : To present an overview of current reports and guidelines of physical activity and exercise intervention for cancer survivors Methods : We searched Pubmed for the related studies such as randomized controlled trials and observational studies, as well as published guidelines or recommendations for exercise intervention. Results : Physical activity and exercise intervention is considered safe and effective for most cancer survivors. According to the guidelines, patients with peripheral neuropathy, musculoskeletal disorder, or those who are at risk of fracture, should undergo proper medical assessment before starting exercise intervention. Also, patients with bone metastasis, thrombocytopenia, symptomatic anemia, or acute infection may fall into one of the contraindications of exercise intervention. Conclusions : Physical activity and exercise intervention may play a major role in improving physical functioning, quality of life, or treatment-related symptoms of cancer survivors. It is necessary to recognize the benefits and precautions of exercise in caring cancer patients.

• Clinical and Experimental Reproductive Medicine
• /
• 제41권2호
• /
• pp.41-46
• /
• 2014

IVM refers to the maturation of immature oocytes in culture after their recovery from small antral follicles at the stage prior to selection and dominance. IVM requires little or no FSH in vivo and has been proposed as an alternative to conventional IVF, since it reduces the primary adverse effects caused by controlled ovarian stimulation, including the ovarian hyperstimulation syndrome. Moreover, IVM is a promising option for cases for which no standard protocol is suitable, such as FSH resistance, contraindications for ovarian stimulatory drugs, and the need for urgent fertility preservation. Recently, IVM has been used in women with regular cycles and normal ovaries. However, the pregnancy rate following IVM is suboptimal compared with that of conventional IVF, indicating that further studies to optimize the protocol and the culture conditions are warranted.

• Archives of Plastic Surgery
• /
• 제32권1호
• /
• pp.135-138
• /
• 2005

Pyoderma gangrenosum(PG) is an uncommon cutaneous vascular disease that typically presents as a painful and destructive ulceration on the anterior surface of the legs. The etiology of PG is currently unknown. But, the association with many immunologic disorders and its clinical response to immunomodulating agents suggest an immune etiology. A common feature of patients with PG is the presence of pathergy(the induction of lesion following injury of the skin). The trauma of surgery can be sufficient to induce pathergy, thus paradoxically limiting the usefulness of surgical treatment of PG. For that reason, medical treatments have been commonly used, while surgical treatments have been regarded not suitable. However, the use of the classic systemic agents is limited by their side effects and contraindications. Moreover, the large, problematic ulcers take too long to heal with medical management only. We present our experience in closing large wounds with the goal of decreasing morbidity, drug side effects and hospital stay by combination of medical and surgical therapy(split thickness skin graft). And authors advocate that surgical management is not a contraindication and may be considered as a selective modality in treatment of PG.

• 대한후두음성언어의학회지
• /
• 제20권1호
• /
• pp.11-16
• /
• 2009

OPD based laryngeal procedures offers a new avenue to the modern laryngologist, incorporating new technology in the office setting. With the development of flexible fiberoptic endoscopes, compact video system, and short acting anesthetics and sedatives allow these procedures. The success or failure of procedures are depend on excellent topical anesthesia. An inadequately anesthetized patient is apt to be uncomfortable, anxious and hyperresponsive and therefore unlikely to tolerate the procedure. On the other hand, a patient who is well informed, reassured, and thoroughly anesthetized can complete procedures. Therefore, optimal anesthesia is obligatory for excellent surgical results. The phonosurgeon should choose the anesthetic and sedative agents based on duration of action, time of onset of action, and any medical contraindications that the patient may have. And should be familiar with the properties and interaction of the agents used, as well as the signs of toxicity.