• Title/Summary/Keyword: General Surgery

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Biventricular Repair of Double Outlet Right Ventricle with Non-Committed Ventricular Septal Defect by Arterial Switch -Report of 1 case - (비상관성 심실중격결손증을 동반한 양대혈관우심실기시증 환자에서의 동맥전환술을 이용한 양심실성 교정 - 1예 보고 -)

  • Kim, Jae-Hyun;Kim, Woong-Han;Chang, Yun-Hee;Na, Chan-Young;Oh, Sam-Se;Baek, Man-Jong;Whang, Sung-Wook;Lee, Cheol;Kang, Chang-Hyun;Jo, Won-Min;Seo, Hong-Ju;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.687-690
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    • 2003
  • Although surgical options for double outlet right ventricle (DORV) with non-committed ventricular septal defect (VSD) are vary in accordance to the morphological characteristics, it is very difficult to use biventricular repair technique when there is tricuspid chordae originating from conal septum or when the distance between the tricuspid valve and the pulmonic valve is too short. We report our clinical experience of biventricular repair of DORV with non-committed VSD by VSD rerouting to the pulmonary artery and arterial switch in case of a presence of conal tricuspid chordae and short distance between the tricuspid valve and the pulmonic valve.

Pacemaker Lead Endocarditis Combined with Rupture of Sinus Valsalva after Redo Aortic Valve Replacement (대동맥판막재치환술 후 발생한 발살바동 파열을 동반한 심박조율도관 심내막염)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Kang, Chang-Hyun;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.780-783
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    • 2003
  • Pacemaker lead-related infective endocarditis is an uncommon, but serious complication. We report a case of a 45-year-old man who had symptom of intermittent high fever and rupture of sinus Valsalva that developed after a redo aortic valve replacement and transvenous permanent pacemaker implantation. Positive blood cultures of streptococcus viridans and transesophageal echocardiography showing a large mobile vegetation on pacemaker lead and tricuspid valve lead to the diagnosis of pacemaker lead-related infective endocarditis. Initial antibiotic therapy followed by surgical extraction of the pacemaker lead and wide debridement of infective tissues including multiple vegetations was required. Postoperative antibiotic therapy was continued for 4 weeks. The postoperative course has been uneventful. The patient is totally asymptomatic and is doing well up to now.

Dynamic Reconstruction of Anal Sphincter with Camera Shutter Style Double-Opposing Gracilis Flaps

  • Allen Wei-Jiat Wong;Grace Hui-Min Tan;Frederick Hong-Xiang Koh;Min Hoe Chew
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.496-500
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    • 2023
  • Fournier's gangrene is a life-threatening infection which requires prompt recognition, early surgical debridement of unhealthy tissue, and initiation of broad-spectrum antibiotics. Relook debridement are usually performed until all the devitalized tissue has been removed. Involvement of the anal sphincter may result in significant morbidity such as permanent incontinence. Dynamic reconstruction of the anal sphincter has always been one of the holy grails in the field of pelvic reconstruction. We demonstrate a new method of camera shutter style double-opposing gracilis muscle flaps that allows dynamic sphincteric function without the need for electrostimulation. The bilateral gracilis muscles are inset in a fashion that allows orthograde contraction of the muscle to narrow and collapse the neoanal opening. With biofeedback training, the patient is able to regain dynamic continence and return to function without a stoma. There was also no need for neurotization or microsurgery techniques to restore sphincteric function to the anus. The patient was able to reverse his stoma 14 months after the initial insult and reconstruction with biofeedback training without the use of electrostimulation.

Low-cost model for pancreatojejunostomy simulation in minimally invasive pancreatoduodenectomy

  • Hiang Jin Tan;Adrian Kah Heng Chiow;Lip Seng Lee;Suyue Liao;Ying Feng;Nita Thiruchelvam
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.428-432
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    • 2023
  • Minimally invasive pancreatoduodenectomy (MIS PD) is a well reported technique with several advantages over conventional open pancreatoduodenectomy. In comparison to distal pancreatectomy, the adoption of MIS PD has been slow due to the technical challenges involved, particularly in the reconstruction phase of the pancreatojejunostomy (PJ) anastomosis. Hence, we introduce a lowcost model for PJ anastomosis simulation in MIS PD. We fashioned a model of a cut pancreas and limb of jejunum using economical and easily accessible materials comprising felt fabric and the modelling compound, Play-Doh. Surgeons can practice MIS PJ suturing using this model to help mount their individual learning curve for PJ creation. Our video demonstrates that this model can be utilized in simulation practice mimicking steps during live surgery. Our model is a cost-effective and easily replicable tool for surgeons looking to simulate MIS PJ creation in preparation for MIS PD.

Long-term outcomes of nail bed reconstruction

  • Koh, Sung Hoon;You, Youngkee;Kim, Yong Woo;Kim, Jin Soo;Lee, Dong Chul;Roh, Si Young;Lee, Kyung Jin;Hong, Min Ki
    • Archives of Plastic Surgery
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    • v.46 no.6
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    • pp.580-588
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    • 2019
  • Background There are various reconstructive options for nail bed defects. However, it is challenging not to leave a deformity. In this study, we investigated differences in outcomes depending on the reconstruction method, attempted to determine which method was better, and analyzed other factors that may affect outcomes. Methods The long-term outcomes of nail bed reconstruction were reviewed retrospectively. We performed three types of reconstruction depending on the defect type: composite grafts of severed segments, nail bed grafts from the big toe, and two-stage surgery (flap coverage first, followed by a nail bed graft). Subsequent nail growth was evaluated during follow-up, and each outcome was graded based on Zook's criteria. The reconstruction methods were statistically analyzed. Other factors that could contribute to the outcomes, including age, the timing of surgery, germinal matrix involvement, defect size, and the presence of bone injuries, were also compared. Results Twenty-one patients (22 digits) who underwent nail bed reconstruction were evaluated. The type of reconstruction method did not show a significant relationship with the outcomes. However, patients who sustained injuries in the germinal matrix and patients with a defect larger than half the size of the nail bed had significantly worse outcomes than the comparison groups. Conclusions The results suggest that no operative method was superior to another in terms of the outcomes of nail bed reconstruction. Nevertheless, involvement of the germinal matrix and defect size affected the outcomes.

RHINOCEREBRAL MUCORMYCOSIS ON MAXILLA : A CASE REPORT (상악골에 발생한 비뇌감염형 Mucormycosis 1례)

  • Huh, Won-Shil;Lee, Min-Jeong;Kang, Seung-Woo;Oh, Sang Yoon;Back, Gyung Sik;Choeh, Kyu-Chul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.1
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    • pp.21-25
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    • 1993
  • We experienced a case of rhinocerebral form of mucormycosis in a 9-year-old male suffered from acute lymphocytic leukemia (FAB $L_2$). On 15th day of induction chemotherapy (Hospital day 23) pain, tenderness and swelling on left maxillary area of face were noticed. We confirmed mucormycosis by biopsy of mass in left maxillary sinus. He expired on Hospital day 47.

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Treatment of Extraarticular Synovial Chondromatosis of the Ankle - A Case Report - (족근 관절외에 발생한 활액막 연골종증의 치료 - 1예 보고 -)

  • Lee, Won-Yong;Park, Byung-Moon;Song, Kyung-Sub;Lim, Dae-Eu;Kim, Hyung-Kyu;Kang, Yung-Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.111-116
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    • 2002
  • Synovial chondromatosis is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue, usually intraarticular, commonly affects the knee, hip and elbow. An extraarticular lesion is rare, most often seen in a synovial sheath and bursa of the hand or foot. We present a case of extraarticular synovial chondromatosis in the left ankle, originated from the FHL tendon sheath of a 31 year-old-female diagnosed by a radiography, MRI confirmed histopathologically.

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Could Tumor Size Be A Predictor for Papillary Thyroid Microcarcinoma: a Retrospective Cohort Study

  • Wang, Min;Wu, Wei-Dong;Chen, Gui-Ming;Chou, Sheng-Long;Dai, Xue-Ming;Xu, Jun-Ming;Peng, Zhi-Hai
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8625-8628
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    • 2016
  • Background: Central lymph node metastasis(CLNM) is common in papillary thyroid microcarcinoma (PTMC). The aim of this study was to define the pathohistologic risk grading based on surgical outcomes. Materials and Methods: Statistical analysis was performed to figure out the optimal cut-off values of size in preoperative ultrasound images for defining the risk of CLNM in papillary thyroid microcarcinoma. Receiver operating characteristic curves (ROC) studies were carried out to determine the cutoff value(s) for the predictor(s). All the patients were divided into two groups according to the above size and the clinic-pathological and immunohistochemical parameters were compared to determine the significance of findings. Results: The optimal cut-off value of tumor size to predict the risk of CLNM in papillary thyroid microcarcinoma was 0.575 cm (area under the curve 0.721) according to the ROC curves. Significant differences were observed on the multifocality, extrathyroidal extension and central lymph node metastasis between two groups which were divided according to the tumor size by the cutoff values. Patients in two groups showed different positive rate and intensity of Ki67. Conclusions: The size of PTMC in ultrasound images are helpful to predict the aggressiveness of the tumors, it could be an easy predictor for PTMC prognosis and assist us to choose treatment.