• 제목/요약/키워드: Essential Surgery

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One Stage Repair of Traumatic Ventricular Septal Defect and Mitral Regurgitation (외상성 심실중격결손 및 승모판막 역류증의 일차 완전정복)

  • 이재원;송태승;제형곤;송명근
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1131-1134
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    • 1999
  • After a penetrating thoracic injury early detection of intracardiac injury and early surgical repair when indicated are essential. A case presenting severe respiratory distress two weeks after a penetrating thoracic injury is reported. Transesophageal echocardiography showed massive pericardial effusion ventricular septal defect and mirtal regurgitation, The infundibular ventricular septal perforation was repaired using a Dacron patch the anterior mitral leaflet by interrupted sutures and the ruptured chordae of the posterior leaflet by a new chordae formation.

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Acquired Simulated Brown Syndrome Combined with Blepharoptosis after Upper Blepharoplasty (상안검성형술 후 발생한 후천성 유사 브라운증후군과 안검하수의 치험례)

  • Do, Eon Rok;Ha, Won Ho;Park, Dae Hwan
    • Archives of Craniofacial Surgery
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    • v.13 no.2
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    • pp.130-134
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    • 2012
  • Purpose: Brown syndrome is motility disorder of the eyeball which shows limited elevation in adduction and occurs very rarely after eye surgery. The authors have experienced a case of strabismus-like Brown syndrome combined with blepharoptosis and report this case with the review of literatures. Methods: A 28-year-old female suffered from hypotropia in the primary gaze and severe blepharoptosis with diplopia of the right eye after upper blepharoplasty. Rotation showed an inability to elevate the adducted right eye. She underwent extraocular muscle surgery about the 7 mm tucking of the right superior rectus muscle and 6 mm recession of right inferior rectus muscle. Intraoperatively, injury of the superior rectus muscle and foreign body were observed. Seven months after the extraocular surgery, the patient underwent frontalis muscle transfer on the right upper eyelid for the correction of blepharoptosis. Results: Postoperatively, the patient was orthophoric in the primary gaze, and she had improvements in the correction of blepharoptosis and eyeball movement. Conclusion: Repeated eyelid surgeries increase the risk of ocular motility disorder. Careful approach is essential for the proper treatment and successful outcome in secondary surgeries.

Polymorphous Low-grade Adenocarcinoma of the Palate: Case Report (구개부에 발생한 다형성 저등급 선암종: 증례보고)

  • Ryu, Hye-In;Jee, Yu-Jin;Lee, Deok-Won;Kim, Tae-Hee;Hong, Sung-Ok;Ryu, Dong-Mok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.1
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    • pp.65-70
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    • 2012
  • Polymorphous low-grade adenocarcinoma (PLGA) is a neoplasm that is regarded as the second most common malignant salivary gland tumor after mucoepidermoid carcinoma. After the diagnosis of PLGA it is important to make a treatment decision and consider the prognosis. A histopathologic examination is necessary for diagnosis. Treatment is primarily surgical excision and long-term follow up is essential to evaluate local recurrences. This report describes 2 cases of PLGA located in the soft palate without any evidence of metastasis. The first case was PLGA with bony infiltration and an irregular margin lesion. The second case was PLGA localized in palatal soft tissue. We present diagnoses, histopathologic features, treatments and prognosis of PLGA.

Perioperative Hypertension Management during Facelift under Local Anesthesia with Intravenous Hypnotics

  • Chung, Ki Ho;Cho, Myeong Soo;Jin, Hoon
    • Archives of Plastic Surgery
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    • v.44 no.4
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    • pp.276-282
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    • 2017
  • Perioperative hypertension is a phenomenon in which a surgical patient's blood pressure temporarily increases throughout the preoperative and postoperative periods and remains high until the patient's condition stabilizes. This phenomenon requires immediate treatment not only because it is observed in a majority of patients who are not diagnosed with high blood pressure, but also because occurs in patients with underlying essential hypertension who show a sharp increase in their blood pressure. The most common complication following facelift surgery is hematoma, and the most critical risk factor that causes hematoma is elevated systolic blood pressure. In general, a systolic blood pressure goal of <150 mm Hg and a diastolic blood pressure goal of >65 mm Hg are recommended. This article discusses the causes of increased blood pressure and the treatment methods for perioperative hypertension during the preoperative, intraoperative, and postoperative periods, in order to find ways to maintain normal blood pressure in patients during surgery. Further, in this paper, we review the causes of perioperative hypertension, such as anxiety, epinephrine, pain, and postoperative nausea and vomiting. The treatment methods for perioperative hypertension are analyzed according to the following 3 operative periods, with a review of the characteristics and interactions of each drug: preoperative antihypertensive medicine (atenolol, clonidine, and nifedipine), intraoperative intravenous (IV) hypnotics (propofol, midazolam, ketamine, and dexmedetomidine), and postoperative antiemetic medicine (metoclopramide and ondansetron). This article focuses on the knowledge necessary to safely apply local anesthesia with IV hypnotics during facelift surgery without the assistance of an anesthesiologist.

Venous Anastomosis with Dorsal Veins Using Additional Incisions after Wound Closure in Metacarpophalangeal Joint Level Replantation

  • Cho, Sang Hyun;Bahar-Moni, Ahmed Suparno;Whang, Jong Ick;Seo, Hyeung Gyo;Park, Hyun Sik;Kim, Ji Sup;Park, Hyun Chul
    • Archives of Reconstructive Microsurgery
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    • v.25 no.1
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    • pp.12-14
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    • 2016
  • In cases of replantation, accurate closure of all structures, including bone, tendons, arteries, nerves, and veins is essential. Among these, the vein is a weaker structure and is damaged severely in most amputation cases. After fixation of bone, repair of tendons, nerves, and arteries, surgeons often experience difficulty in performing venous anastomoses. We found that in such cases, venous anastomosis is easy to perform using an additional incision after closure of the original wound. In a 33-year-old male patient with amputation of all four fingers at the metacarpophalangeal joint level, venous anastomoses were performed with dorsal veins using additional incisions after completion of the fixation of bones and repair of all other structures and closure of the skin due to surgical site tension.

RECONSTRUCTION OF THE CORNERS OF THE MOUTH IN BURN-INDUCED MICROSTOMIA - A CASE REPORT - (화상에 의한 소구증 환자의 구각부 재건 - 증례보고 -)

  • Choi, Young-Dal;Byun, Sung-Soo;Jung, Hwui-Dong;Nam, Woong;Kim, Hyung-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.6
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    • pp.543-547
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    • 2007
  • The lips and corners of the mouth are not only important for appearance but are also essential for facial expression, speech, and nutrition. Defects in these areas can be caused by congenital clefts of the lip and face, trauma, infection, cysts, and excision of benign or malignant tumors. Numerous techniques have been introduced for reconstruction of the lips and corners of the mouth, and in particular, techniques such as the Kazanjian Roopenian I and II, Converse method, Zisser method, Platz and Wepner method. Gillies and Millard method are commonly utilized for elongation and reconstruction of the mouth corner. Few reports exist in the oral and maxillofacial surgery literature regarding correction of microsomia and reconstruction of the corners of the mouth. As such, the authors report a case of the corners of the mouth elongation in a patient with burn-induced microstomia using the Converse flap which yielded a satisfactory outcome.

Acute Osteomyelitis of the Mandible by Extended-Spectrum β-Lactamase Producing Klebsiella Pneumoniae: A Case Report

  • Jung, Gyeo-Woon;Moon, Seong-Yong;Oh, Ji-Su;Choi, Hae-In;You, Jae-Seek
    • Journal of Oral Medicine and Pain
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    • v.46 no.3
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    • pp.88-92
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    • 2021
  • Acute osteomyelitis caused by Klebsiella pneumoniae is rare in the oral and maxillofacial region. Klebsiella pneumoniae is a Gram-negative bacillus and the normal flora of the human body, but it can cause pneumonia, urinary tract infection, meningitis, and osteomyelitis in patient with compromised immune systems. These infections are mainly caused by nosocomial infection. Microbacterial osteomyelitis was developed by clinical cause such as tooth extraction, fracture, and surgical history, which requires long-term antibiotic administration and surgical treatment. This report describes that a 56-year-old male patient with acute osteomyelitis caused by Klebsiella pneumoniae infection after implant placement was treated with intravenous administration of ertapenem without open surgery treatment. Through this case, we report that antibiotic susceptibility test is essential for the treatment of acute osteomyelitis caused by a bacterial infection resistant to empirical antibiotics, and early administration of appropriate antibiotics can reduce the possibility of extensive bone destruction or additional open surgery.

Plan for plastic surgeons to participate in trauma teams at regional trauma and emergency centers (권역외상 및 응급센터에서 성형외과의 참여방안)

  • Lim, Nam Kyu;Kang, Dong Hee
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.710-714
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    • 2018
  • A law revised in May 2012 provided support to regional and emergency centers for reducing the risk of preventable deaths. In particular, regional trauma centers have been established throughout the nation, with the goal of ensuring that any trauma patient can reach a trauma center within an hour. As a multidisciplinary approach is particularly important in treating severe trauma patients, activation teams are currently organized at each center to perform multiple simultaneous treatments. Under the present system, only 7 departments can participate in these trauma teams; emergency medicine, cardiothoracic surgery, general surgery, orthopedic surgery, neurosurgery, radiology, and anesthesiology. Plastic surgeons also play an essential role in treating trauma patients, and in fact currently treat many such cases. Especially in reconstruction procedures in patients with head and neck trauma and wide tissue defects, plastic surgeons possess unique expertise. However, since plastic surgeons are excluded from the trauma response teams due to institutional limitations, we describe the role and necessity of plastic surgery for trauma and emergency patients, and urge that the system be improved.

Serious Complications of the Percutaneous A1 Pulley Release: Case Reports and Literature Review

  • Dong Chul Lee;Kyung Jin Lee;Hohyung Lee;Sung Hoon Koh;Jin Soo Kim;Si Young Roh
    • Archives of Plastic Surgery
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    • v.51 no.1
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    • pp.110-117
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    • 2024
  • Percutaneous first annular pulley (A1 pulley) release, which has been increasingly used to treat trigger fingers, has been widely established as a safe and simple procedure. Multiple studies have reported positive results of percutaneous A1 pulley release. In this study, however, we report cases of patients who developed complications after undergoing percutaneous A1 pulley release at local clinics. A total of six patients visited our hospital for infectious complications after percutaneous A1 pulley release. Various sequelae such as damage to normal structures, insufficient procedure, and tissue necrosis were observed during the exploration. A retrospective study was conducted to identify the cause and trend of the observed complications by instruments (HAKI knife or needle). In the HAKI knife group, there was a tendency for damage to normal structures, while in the needle group, an insufficient release or serious soft tissue necrosis was observed. Based on these cases, our findings confirm the existence and characteristics of infectious complications following the percutaneous A1 pulley release. We further identify that the type of instrument used predicts the nature of complications. Thus, reliable and skilled performance of the procedure by experts is essential for safe treatment.

Fracture and Dislocation of the Midtarsal Joint: A Case Report (중족근 관절의 탈구 및 골절: 증례 보고)

  • Choi, Jun Cheol;Jung, Yu-Hun;Park, Sang Jun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.3
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    • pp.108-112
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    • 2017
  • The midtarsal joint is composed of the talonavicular and calcaneocuboid joints. It is also known as the Chopart joint. Midtarsal joint fracture and dislocation are relatively rare and frequently missed or misdiagnosed. A proper understanding about the anatomy of the midtarsal joint is an essential part in comprehending the mechanism of injury and rationale for treatment. Anatomical reduction of midtarsal joint with correction of the column in length and shape are important; however, it is technically challenging and may require open procedure. Herein, we described a case of initial open reduction and internal fixation for midtarsal joint fracture and dislocation with a brief literature review.