• Journal of Chest Surgery
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• 제48권2호
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• pp.105-111
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• 2015

Background: The aim of this study was to establish whether pulmonary lobectomy using video-assisted thoracic surgery (VATS) can be safely performed by trainees with limited experience with open lobectomy. Methods: Data were retrospectively collected from 251 patients who underwent VATS lobectomy at a single institution between October 2007 and April 2011. The surgical outcomes of the procedures that were performed by three trainee surgeons were compared to the outcomes of procedures performed by a surgeon who had performed more than 150 VATS lobectomies. The cumulative failure graph of each trainee was used for quality assessment and learning curve analysis. Results: The surgery time, estimated blood loss, final pathologic stage, thoracotomy conversion rate, chest tube duration, duration of hospital stay, complication rate, and mortality rate were comparable between the expert surgeon and each trainee. Cumulative failure graphs showed that the performance of each trainee was acceptable and that all trainees reached proficiency in performing VATS lobectomy after 40 cases. Conclusion: This study shows that trainees with limited experience with open lobectomy can safely learn to perform VATS lobectomy for the treatment of lung cancer under expert supervision without compromising outcomes.

• Journal of Chest Surgery
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• 제43권2호
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• pp.184-187
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• 2010

압축성 심막염은 개심술 후 드문 합병증이지만 여전히 심장 수술 후 이상적인 치료접근이 필요한 어려운 질환이다. 저자들은 심장 수술 후 우심부전증을 보이는 압축성 심막염 2예를 경험하였다. 심장 초음파 검사에서 보이는 심실중격떨림 현상으로 진단하였고, 두 환자에서 각각 개심수술 40일과 31일만에 좌측 전측방 소절개 개흉술로 심막절제술을 시행하였다. 심막절제술 후 1∼2주일에 걸쳐 심부전증은 서서히 호전되었다. 개심술 후 발생한 압축성심막염에 대해 보존적 내과적 치료방법으로 압축성 증상 및 증후가 호전되지 않는 경우 좌측 전측방 소절개 개흉술에 의한 심막절제술은 효과적인 치료 방법의 하나로 생각된다.

• 대한족부족관절학회지
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• 제10권1호
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• pp.37-41
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• 2006

Purpose: To investigate the early results of limited open repair technique of Achilles tendon ruptures, and to describe the surgical technique. Materials and Methods: From October 2004 to February 2005, a total of 10 patients with Achilles tendon rupture underwent limited open repair. The average age of the patients was 39.3 years, and the average follow-up period was 9 months. The causes of injury were sports injuries in 8 cases, and slip down in 2. The mean interval between the injury and the operation was 9 days. The clinical results were assessed by patient's satisfaction, incision length, hospitalization, the ankle-hindfoot scale of American Foot and Ankle Society (AOFAS), and complications. Results: Of 10 patients, 8 were very satisfied, and the remaining 2 were satisfied. The mean incision length was 2.0 cm, and the mean hospitalization was 2 days. The mean AOFAS score was 97 points, and there was no complications such as infection, rerupture, or nerve injury. All patients returned to work at approximately 2 months, and resumed light exercise such as jogging at approximately 3 months. Conclusion: Limited open repair technique of Achilles tendon ruptures is provided for better cosmetic results, high patient's satisfaction, and functionally successful results without postoperative complications.

• Clinics in Shoulder and Elbow
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• 제27권1호
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• pp.117-125
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• 2024

While shoulder hemiarthroplasty is still used to treat young patients with shoulder pathology, the use of this procedure has substantially declined in recent years due to its significant complication profile. Glenoid wear with arthrosis is one of the major postoperative complications following shoulder hemiarthroplasty, and efforts to prevent this complication led many scientists to explore alternative weight-bearing surfaces on arthroplasty implants to decrease joint wear and improve patient outcomes. Pyrolytic carbon, or pyrocarbon, is a material that has better biocompatibility, survivorship, strength, and wear resistance compared to the materials used in traditional shoulder hemiarthroplasty. Pyrocarbon implants have been used in orthopedics for over 50 years; recently, their utility in shoulder hemiarthroplasty has garnered much interest. The purpose behind the use of pyrocarbon in shoulder hemiarthroplasty is to decrease the risk of progressive glenoid wear, especially in young active patients in whom joint preservation is important. Promising survivorship and outcomes have been demonstrated by recent studies, including limited glenoid wear following pyrocarbon hemiarthroplasty. Nevertheless, these clinical studies have been limited to relatively small case series with limited long-term follow-up. Accordingly, additional research and comparative studies need to be conducted in order to properly assess the therapeutic efficacy and value of pyrocarbon hemiarthroplasty.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제39권
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• pp.11.1-11.6
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• 2017

Background: This case report discusses the unusual presentation of limited mouth opening as a result of bilateral coronoid process hyperplasia. Case presentation: A 14.5-year-old male patient of white Caucasian ethnicity presented with limited mouth opening, mandibular asymmetry, and dental crowding. Investigations confirmed bilateral coronoid process hyperplasia and management involved bilateral intraoral coronoidectomy surgery under general anaesthesia, followed by muscular rehabilitation. Mouth opening was restored to average maximum opening within 4 months of surgery. Conclusion: Limited mouth opening is a common presentation to medical and dental professionals. The rare but feasible diagnosis of coronoid impingement syndrome should not be overlooked.

• Journal of Trauma and Injury
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• 제34권1호
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• pp.75-78
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• 2021

A Morel-Lavallée lesion is a post-traumatic closed degloving soft tissue injury after blunt trauma. Infection and skin necrosis frequently occur if it is not treated properly in the early stages. However, there is no clearly established treatment algorithm. In the acute stage, it is mainly treated with aspiration, simple compression, and incisional drainage. In the chronic stage, sclerotherapy is usually performed. If skin necrosis develops, the necrotic tissue is resected and a skin graft is needed. We describe a case of acute Morel-Lavallée lesion in the buttock region that was treated with limited incisional drainage and negative-pressure wound therapy, and also present a review of the literature.

• Journal of Chest Surgery
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• 제30권11호
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• pp.1139-1141
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• 1997

최근 개발된 소절개를 통한 소위 최소 침습적 심장수술은 기존의 정중 흉골절개술을 통한 심장수술에 비해 수술의 난이도가 높음에도 불구하고 환자에게 가해지는 수술에 의한 손상을 최소화할 뿐 아니라 술 후 수술 반흔의 측면에서도 환자의 만족도를 높일 수 있다는 장점들로 인하여 빠르게 확산되는 추세에 있다. 본 인하병원 흉부외과에서는 흉골의 횡절개를 통한 최소 침습적 방법으로 대동맥 판막치 환술을 2례 시행하였기에 문헌고찰과 함께 보고하고자 한다.

• Journal of Trauma and Injury
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• 제35권4호
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• pp.282-286
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• 2022

Complete cricotracheal separation, which is the most severe type of laryngeal trauma, is an uncommonly seen injury that clinicians have limited experience in managing. However, it is potentially fatal. Due to limited exposure to this condition, mismanagement can occur, which may further aggravate the patient's condition. The most crucial part of managing this injury is to establish a secure airway. Tracheostomy under local anesthesia is the preferred method of airway stabilization, in order to avoid further injuries to the airway caused by endotracheal intubation. Here, we discuss the management of complete cricotracheal separation based on a case experienced in the east coast region of Malaysia, where this type of injury is rarely encountered.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.29.1-29.7
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• 2015

Facial asymmetry is found in patients with or without cosmetic facial alterations. Some patients have facial asymmetry that manifests underlying skeletal problems, while others have only limited soft-tissue facial asymmetry. Orthognathic surgery brings about a dermatic change, as soft tissue covers underlying bones. Limited soft-tissue asymmetry, meanwhile, is difficult to correct. The treatment modalities for the creation or restoration of an esthetically pleasing appearance were autogenous fat grafts, cartilage graft, and silicon injections. A young female patient had right-side facial asymmetry. The clinical assessment involved visual inspection of the face and palpation to differentiate soft tissue and bone. Although the extra-oral examination found facial asymmetry with skin atrophy, the radiographic findings revealed no mandibular atrophy or deviation. She was diagnosed as localized scleroderma with muscle spasm. In conclusion, facial asymmetry patients with skeletal asymmetry can be esthetically satisfied by orthognathic surgery; however, facial atrophy patients with skin or subdermal tissue contraction need treatment by cosmetic dermatological surgery and orthodontic correction.

• Clinical and Experimental Otorhinolaryngology
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• 제11권4호
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• pp.233-241
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• 2018

Objectives. As endoscopic instrumentation, techniques and knowledges have significantly improved recently, endoscopic ear surgery has become increasingly popular. Transcanal endoscopic ear surgery (TEES) can provide better visualization of hidden areas in the middle ear cavity during congenital cholesteatoma removal. We aimed to describe outcomes for TEES for congenital cholesteatoma in a pediatric population. Methods. Twenty-five children (age, 17 months to 9 years) with congenital cholesteatoma confined to the middle ear underwent TEES by an experienced surgeon; 13 children had been classified as Potsic stage I, seven as stage II, and five as stage III. The mean follow-up period was 24 months. Recurrence of congenital cholesteatoma and surgical complication was observed. Results. Congenital cholesteatoma can be removed successfully via transcanal endoscopic approach in all patients, and no surgical complications occurred; only one patient with a stage II cholesteatoma showed recurrence during the follow-up visit, and the patient underwent revision surgery. The other patients underwent one-stage operations and showed no cholesteatoma recurrence at their last visits. Two patients underwent second-stage ossicular reconstruction. Conclusion. Although the follow-up period and number of patients were limited, pediatric congenital cholesteatoma limited to the middle ear cavity could be safely and effectively removed using TEES.