• 제목/요약/키워드: Evaluation of surgical outcome

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만성 불응성 외 상과염에서 시행한 관절경적 단 요 수근 신건 유리술 (Arthroscopic Release of the Extensor Carpi Radialis Brevis Tendon for Chronic Recalcitrant Lateral Epicondylitis)

  • 구정회;황태혁;이정수;조형래;김정우
    • 대한관절경학회지
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    • 제16권2호
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    • pp.140-146
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    • 2012
  • 목적: 보존적 치료에 반응하지 않는 만성 불응성 주관절 외 상과염에 대한 관절경적 단 요 수근 신건 유리술의 임상적 결과를 알아보고 예후에 영향을 주는 인자를 분석하고자 한다. 대상 및 방법: 주관절 외 상과염으로 관절경적 단 요 수근 신건 유리술을 시행 받은 환자 24명을 후향적으로 분석하여 술 후 환자 자신의 평가, visual analog scale (VAS) 점수, Quick-disabilities of the arm, shoulder and hand (DASH) 점수와 결과에 영향을 줄 수 있는 술 전 인자를 평가하였다. 결과: 21예(88%)에서 술 후 결과에 만족 하였고 평균 VAS 점수와 Quick-DASH 점수는 최종 추시 상 의미 있는 호전을 보였다. 나이, 성별, 우세수 여부, 증상 이환 기간, 관절낭 파열이나 석회 침착유무는 임상적 결과와 상당한 인과 관계가 없었다. 술 전 자기 공명 영상 T2강조 영상 상 단 요 수근 신건 기시부에 고강도 신호부가 없는 4예 중 3예에서 보다 높은 Quick-DASH 점수를 보였다. 결론: 보존적 치료에 반응하지 않는 만성 불응성 주관절 외 상과염에 대한 관절경적 단 요 수근 신건 유리술은 유용한 치료법 중 하나이며 술 전 자기공명영상 T2강조 영상에서 고강도 신호부가 없는 경우는 술 후 불량한 결과를 유발할 수 있으므로 수술 적응 시 고려해야 할 요소로 사료된다.

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Second Primary Malignant Neoplasms: A Clinicopathological Analysis from a Cancer Centre in India

  • Hulikal, Narendra;Ray, Satadru;Thomas, Joseph;Fernandes, Donald J.
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권12호
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    • pp.6087-6091
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    • 2012
  • Context: Patients diagnosed with a cancer have a life time risk of developing another de novo malignancy depending on various inherited, environmental and iatrogenic risk factors. Of late the detection of new primary has increased mainly due to refinement in both diagnostic and treatment modalities. Cancer victims are surviving longer and thus are more likely to develop a new metachronous malignancy. Aims: To report our observed trend of increase in prevalence of both synchronous and metachronous second malignant neoplasms among cancer victims and to review the relevant literature. Settings and Design: A hospital based retrospective collection of prospective data of patients diagnosed with second denovo malignancy. Materials and Method: The study was conducted over a 5 year period from July 2008 to June 2012. All patients diagnosed with a histologically proven second malignancy as per Warren Gate's criteria were included. Various details regarding sex, age at presentation, synchronous or metachronous, treatment and outcome were recorded. Conclusions: The occurrence of multiple primary malignancies is not rare. Awareness of the possibility alerts the clinician in evaluation of patients with a known malignancy presenting with unusual sites of metastasis. Individualizing the treatment according to the stages of the primaries will result in durable cancer control particularly in synchronous double malignancy.

Multiple, Sequential, Remote Intracranial Hematomas Following Cranioplasty

  • Moon, Hong-Joo;Park, Ju-No;Kim, Sang-Dae;Lim, Dong-Jun;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • 제42권3호
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    • pp.228-231
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    • 2007
  • The intracranial hemorrhage in regions remote from the site of initial operations is unusual but may present as fatal surgical complication. We report a rare case of multiple, sequential, remote intracranial hematomas after cranioplasty in a patient who did not have any prior risk factors. A 51-years-old man was transferred to the hospital after a head trauma. The brain computed tomography (CT) revealed acute subdural hemorrhage on the right hemisphere with prominent midline shifting. After performing decompressive craniectomy and hematoma removal, the patient recovered without any complications. However, the patient showed neurological deterioration immediately after cranioplasty, which was done three months after the first surgery. There was extensive hemorrhage in the posterior fossa remote from the site of the initial operation site. The brain CT taken soon after removing this hematoma evacuation displayed large epidural hematoma on the left hemisphere. This case represents posterior fossa hemorrhage after supratentorial procedure and sequential delayed hematoma on the contralateral supratentorial region thus seems very rare surgical complications. Despite several possible pathogenetic mechanisms for such remote hematomas, there are usually no clear cut relationships with each case as in our patient. However, for the successful outcome, prompt evaluation and intensive management seem mandatory.

원위 대퇴골 골절에 대한 고령 환자군의 치료 결과 비교 -임상적, 방사선학적 비교- (Clinical and Radiological Outcome of Distal Femoral Fracture in Elderly Patient Group)

  • 박희곤;김연준;장호성
    • Journal of Trauma and Injury
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    • 제26권4호
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    • pp.286-290
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    • 2013
  • Purpose: To report the postoperative Clinical and Radiological outcomes following distal femoral fractures in elderly patients compared with young patients. Methods: From March, 1996 to March, 2012, 83 patients who received surgical treatment for fractures of the distal femur were enrolled in this retrospective study. Ages more than 65 was named group A. Group A was 49 cases and mean age is 72.5 year(65~91year). Group B was 49 cases and mean age is 45.7 year(16~61 year). Surgical methods are retrograde IM nail, locking compression plate, cannulated screw and postoperative rehabilitation is no difference between two groups. Clinical results were evaluated using Neer scores, radiographic results and the presence of clinical complications. Results: The mean union period was 18.4(12-40) weeks in group A and 17(10-24) weeks in group B. Neer functional scores are no significant statistical difference between two groups. There are 5 cases metal breakage in group A and 1case in group B. There are 3 cases nonunion in group A and 1 case in group B. Conclusion: In the case of fractures of the distal femur in elderly patients, locking plate using minimally invasive percutaneous periosteal osteosynthesis (MIPPO) technique may be one of the most effective methods and preoperative bone stock evaluation in important.

Unusual Bilateral Impalement Injury with Rusted Iron Bars on Face and Neck

  • Suh, Hyun Suk;Pak, Ji Hyun;Hong, Seung-Eun;Kang, So Ra
    • 대한두개안면성형외과학회지
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    • 제16권3호
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    • pp.147-150
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    • 2015
  • Impalement injury is the subset of penetrating trauma, defined as fixed, elongated objects penetrate and remain in the human body cavity or region by relatively low velocity. We report an unusual case of facial and neck impalement where two dirty rusted iron bars penetrated forehead bilaterally and exited neck and ear respectively without causing major organ injuries. After thorough radiologic and physical evaluation, the patient got medical and surgical treatment. The patient was discharged without complication after four day of delayed wound closure. There have been no complications and sequelaes related with trauma, wound infection and scar contracture at 3-year follow-up. According to affected organs and pattern of impalement, individualized and multidisciplinary surgical approach should be considered. Following these guidelines as in this case, it was possible to achieve excellent clinical outcome in impalement injury.

COVID-19와 두경부암 (Head and Neck Oncologic Care During the COVID-19 Pandemic)

  • 장재원
    • 대한두경부종양학회지
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    • 제36권1호
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    • pp.1-8
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    • 2020
  • It is well established that cancer patients are more susceptible to infection because of the immunosuppressive status caused by both disease itself and anticancer treatment, including surgery and chemoradiation. Head and neck cancer (HNC) patients are generally at high-risk for coronavirus disease 2019 (COVID-19) infection and serious adverse outcomes. Although there is an urgent need for guidance in the delivery of safe, quality oncologic care, no international consented recommendation addressed the management of HNC patients in COVID-19 due to limited data. In this review, we summarized the consideration for head and neck oncologic care in the context of the COVID-19 pandemic, based on the data and the very recent recommendations from the Korean Cancer Association and National Cancer Center. COVID-19 should be taken into consideration in the comprehensive management of HNC patients, and multidisciplinary evaluation of multilevel surgical-risks, discussion of optimized strategy, and shared-decision-making with the patient are needed to maximize both the safety from infectious pandemic and outcome of surgical and oncologic care.

Scapulothoracic Arthrodesis for Refractory Shoulder Dysfunction: A Retrospective Study of Indications and Functional Outcome

  • Chung, Soo-Tai;Warner, Jon J.P.
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2009년도 제17차 학술대회
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    • pp.208-208
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    • 2009
  • Eleven shoulders (9 patients) with refractory scapulothoracic dysfunction were treated with scapulothoracic arthrodesis between 2000 and 2006. Refractory shoulder dysfunction included facioscapulohumeral muscular dystrophy in five shoulders (3 patients), refractory scapular winging with long thoracic nerve palsy in one shoulder, scapular winging caused by serratus anterior palsy with trapezius dysfunction in one shoulder, post-surgical thoracic outlet syndrome due to medial clavicle resection in two shoulders, refractory scapular winging with spinal accessory nerve injury in one shoulder, and chronic trapezius rupture caused by cervical spine surgery in one shoulder. The mean active flexion was improved from 82 degrees preoperatively to 112 degrees postoperatively. The mean Constant score was improved from 27.2 points to 68.0 points. Two shoulders (1 patient) that had facioscapulohumeral muscular dystrophy had broken wires due to nonunion, and one patient had a reactive pulmonary effusion. In ten of the eleven shoulders, the patients were satisfied with their results. The scapulothoracic arthrodesis can cause significant pain relief and functional improvement in refractory scapulothoracic and/or shoulder dysfunction. By selecting patients that present with appropriate indications, and using experienced surgical technique through complete preoperative evaluation, we can diminish the complication rate and make good clinical outcomes.

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갑상연골과 설골 골절을 동반한 후두외상 1례 (Laryngeal trauma with thyroid cartilage and hyoid bone frachture)

  • 강선묵;최환;정광윤;백승국
    • 대한기관식도과학회지
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    • 제13권1호
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    • pp.51-54
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    • 2007
  • Laryngeal trauma is an uncommon injury but can be life-threatening event. So, early diagnosis is important for appropriate surgical management and better outcome. Because there have been some controversies about Initial airway management, appropriate diagnostic evaluation, operative indication and timing, operative technique, it is difficult to make a common management pathway in laryngeal trauma. A case of laryngeal trauma with thyroid cartilage and hyoid bone fracture is presented with a brief review of literature.

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우측 소매 전폐 적출술 후 발생한 기관 협착증의 체외 순환을 이용한 수술치험 1례 (Tracheal Reconstruction Using Femoro-Femoral Bypass -A Case Report-)

  • 최필조
    • Journal of Chest Surgery
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    • 제27권4호
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    • pp.324-327
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    • 1994
  • Resection and reconstruction of distal trachea or carina have posed tremendous technical challenges for surgeons. Successful outcome depends on thorough preoperative evaluation, careful anesthetic management,strict attention of surgical technique and postoperative care. We report a successful case of revision of tracheal stenosis using femoro-femoral bypass on a 13~year-old boy. The patient complained severe dyspnea about I month following right sleeve pneumonectomy. Preoperative CT scan and intraoperative bronchoscopy showed pin-point tracheal stenosis at a tracheo-bronchial anastomosis site about 1.2cm in length.At operation the lesion was severely adhesed and the lumen was nearly obstructed. The stenotic segment was resected and direct end-to-end anastomosis was done under femoro-femoral bypass for adequate oxygenation. The patient was discharged at postop. 16 days without specific complications and has continued to do well.

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미니 임플란트 시스템의 적용에 대한 다기관 후향적 임상연구 (Multicentric retrospective clinical study on the clinical application of mini implant system)

  • 김영균;여인성;이양진;김운규;문경남;전승준;조용석;윤필영
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권4호
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    • pp.325-330
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    • 2010
  • Introduction: Mini-implant system is applicable to areas of narrow space and area requiring temporary loading support. The purpose of this study was to evaluate the clinical outcome of a mini-implant system as well as the application of mini-implant system in the dental clinical field. Materials and Methods: The patients who had been operated from Jan 2007 to Dec 2007 in the four dental facility including Seoul National University Bundang Hospital were enrolled. To evaluate the factors associated with the clinical outcome, the patients were classified according to gender, age, area of surgery, type of implant, diameter and length of the implant, and the purpose of the mini-implant system application. Results: From 147 implants, only three implants failed, one of them was for temporary loading. There were no serious surgical or prosthetic complications in this study. Conclusion: An analysis of the preliminary data revealed a satisfactory clinical outcome. However, more long-term evaluation of narrow ridge type as well as the patient’s satisfaction on the use of a provisional type mini-implant system is needed.