• Journal of Chest Surgery
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• 제39권2호
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• pp.171-175
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• 2006

최소 침습성 흉부수술은 최근에 가장 발전되어온 중요한 수술의 한 분야이다. 선천성 낭종성 선종양 기형은 비교적 드물게 발생하는 폐질환으로 누두흉, 선천성 심장 및 폐혈관 질환 같은 여러 가지 선천성 기형 등이 동반될 수 있다. 저자들은 우하엽 폐에 선천성 낭종성 선종양 기형이 있으며 누두흉이 동반된 5세 된 남아 환자를 최소 침습적인 방법으로 치료 경험하였다. 저자들은 흉강경을 이용하여 우하엽 폐절제술을 실시하였고, 동시에 누두흉에 대해서는 흉골 하 금속막대를 이용한 너스 술식으로 교정하였다. 이와 같이 이러한 질환에 대한 최소 침습적인 수술방법은 유용하고 미용적으로 우수하다.

• Journal of Oral Medicine and Pain
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• 제47권4호
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• pp.212-216
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• 2022

Osteomyelitis in the oral and maxillofacial area is a relatively uncommon inflammatory disease that occurs due to odontogenic causes such as endodontic infection, facial trauma, insufficient blood supply caused by some medical conditions, and iatrogenic postoperative infections. Among them, the incidence rate of candida osteomyelitis in this area is minimal; therefore, no consensus on the diagnosis, treatment, and prognosis has not been established yet. With the increasing number of immunocompromised elderly patients, candida osteomyelitis of the jaw is expected to become more prevalent. In this case report, we present an 81-year-old male patient with candida osteomyelitis of the jaw, including the maxillary and ethmoid sinuses.

• 대한두경부종양학회지
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• 제14권2호
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• pp.191-198
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• 1998

Objectives: We performed an immunohistochemical study to examine the place of neovascularization in the tumorigenic process of follicular thyroid carcinoma and to determine whether tumor angiogenic activity in follicular carcinoma plays a role in tumor aggression. Materials & Methods: We studied 63 follicular thyroid carcinomas and compared with 22 follicular adenomas. The areas of capsular invasion, vascular invasion and cellular atypism of the tumor were confimed on H & E stains. The paraffin embedded tissues were stained by the use of monoclonal antibodies against Ag CD34. Microvesseles were counted in the area of highest vascular density at 200 times magnification. The microvessel densities(MVD) were analized in relation to histologic type and location of the tumors. Results: There were 59 minimal invasive types and 4 widely invasive types of carcinoma. In the histologic specimens of carcinomas, capsular invasion was identified in all the cases, vascular invasion in 46 and cellular atypism in 24. Mean values of the MVDs of the minimal invasive carcinomas, the widely invasive carcinomas and the adenomas were $263.8{\pm}69.2,\;256.l{\pm}49.3\;and\;241.5{\pm}159.4$, respectively and there was no significant difference between each group. In follicular carcinomas, there was a regional difference of the MVDs. The areas of tumor showing cellular atypism and adjacent to or penetrating the capsule, in which represents the tumorigenic process of carcinoma, had a higher rate of vascularization, than other areas of the tumor(p<0.05). However, these features were not noted in the follicular adenomas. Conclusion: Although there was no significant difference of the MVD between follicular carcinomas and adenomas, there was a regional difference of the MVD within the carcinomas and the values were significantly higher in the more malignant areas, as indicated by cellular atypism and capsular invasion. Therefore, tumor angiogenic activity measured by MVD may play a role in tumor aggression in follicular thyroid carcinoma.

• Clinics in Shoulder and Elbow
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• 제14권1호
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• pp.73-79
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• 2011

목적: 경도 및 중등도 주관절 관절염 환자에서 최소 침습적 척골-상완 관절 성형술의 임상적 유용성에 대하여 알아보고자 한다. 대상 및 방법: 2000년 1월에서 2008년 12월까지 척골 신경 증상이 없는 경도 및 중등도의 주관절 관절염 환자에서 최소 침습적 척골-상완 관절 성형술을 시행받은 환자 29예 중 1년 이상 추시가 가능하였던 24예를 대상으로 하였다. 남자 20예, 여자 4예였으며, 평균 연령은 53세 (31~69세)였고, 평균 수술 시간, 관절 운동 범위, 술 후 관절 운동 시작까지의 시간, 술 후 1년 추시에서 Mayo elbow performance score (MEPS)를 조사하였다. 결과: 술 후 평균 1.8일 (1~4일)째 수동적 및 능동적 관절 운동을 시작하였고, 평균 수술 시간은 38분 (25~55분)이었다. 관절 운동 범위는 술 전 평균 25~104도 (신전 0~70도, 굴곡 80~130도)에서 술 후 1년 추시 상 평균 14~133도 (신전 0~45도, 굴곡 90~150도)로 평균 40도 관절운동 범위가 향상되었으며, 술 후 관절 운동 시작까지의 시간은 평균 1.6일 (1~5일)이었다. 술후 1년 추시에서 MEPS는 우수 19예, 양호 5예이었다. 술 후 합병증으로 창상 치유지연 1예, 술후 부종 7예가 있었으나 자연적으로 호전되었다. 결론: 경도 및 중등도 주관절 관절염 환자에서 최소 침습적 척골-상완 관절 성형술은 수술 시간이 짧고 조기 관절 운동이 가능하며 통증이 적으므로 임상적으로 유용한 수술이다.

• 대한족부족관절학회지
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• 제16권2호
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• pp.94-100
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• 2012

Purpose: The purpose of this study is to analyze the clinical features of distal tibia fractures and to evaluate the treatment outcomes of minimally invasive plate osteosynthesis (MIPO). Materials and Methods: From January 2004 to December 2009, 84 cases of 81 patients treated with plate fixation for distal tibia fracture were enrolled in this retrospective review. We investigated age, sex, injury mechanism, fracture patterns, and complications, and the clinical features were analyzed. To evaluate the treatment outcomes of MIPO, we divided into two groups. MIPO group consisted of 55 patients were treated with MIPO technique and conventional group consisted of 18 patients were treated with open reduction and internal fixation with conventional anterolateral plating. The results were compared between two groups by assessing bony union time, operation time, amount of blood loss, range of ankle motion, clinical score by American Orthopaedic Foot and Ankle Society (AOFAS) score, and post-operative complications. Results: The mean age of 81 patients with distal tibia fracture was 54.8 years. According to AO classification, A1:2:3 were 16, 20, 16 patients, B1:2:3 were 2, 8, 7, C1:2:3 were 1, 3, 11 patients. According to injury mechanism, slip down injury was patients, traffic accident was 26, fall from height injury was 14 patients respectively. The type A fractures were lower energy trauma and more older patients. The type C fractures were higher energy trauma and younger patients. MIPO group was better than conventional group in operative time, blood loss, bony union time, and ankle joint motion. In complications, MIPO group showed no nonunion and infection, one malunion, one skin necrosis, nine skin irritations, and one screw breakage. Conventional group showed two nonunion, four infections, two skin necrosis, and one metal failure. Conclusion: Distal tibial fractures caused by low energy trauma were on the increase. Minimal invasive plate osteosynthesis was shorter bony union time and operation time, less blood loss, and larger ankle motions than conventional open reduction and plate fixation.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5589-5594
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• 2015

Cystitis and proctitis are defined as inflammation of bladder and rectum respectively. Haemorrhagic cystitis is the most severe clinical manifestation of radiation and chemical cystitis. Radiation proctitis and cystitis are major complications following radiotherapy. Prevention of radiation-induced haemorrhagic cystitis has been investigated using various oral agents with minimal benefit. Bladder irrigation remains the most frequently adopted modality followed by intra-vesical instillation of alum or formalin. In intractable cases, surgical intervention is required in the form of diversion ureterostomy or cystectomy. Proctitis is more common in even low dose ranges but is self-limiting and improves on treatment interruption. However, treatment of radiation proctitis is broadly non-invasive or invasive. Non-invasive treatment consists of non-steroid anti-inflammatory drugs (NSAIDs), anti-oxidants, sucralfate, short chain fatty acids and hyperbaric oxygen. Invasive treatment consists of ablative procedures like formalin application, endoscopic YAG laser coagulation or argon plasma coagulation and surgery as a last resort.

• Journal of Korean Neurosurgical Society
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• 제40권4호
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• pp.296-299
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• 2006

Recently the trend of surgical procedure for treatment of lumbar benign disease is a minimally invasive surgery due to small incision, minimal blood loss, and a short hospital day. By using a microscope or an endoscope, and other surgical equipment, a delicate manipulation in a narrow space became feasible, consequently, to secure a wider view with small incision, appropriate retractors are required. But the various tubular retractor systems are expensive and have some problems. We modified Thoracoport [Auto Suture Co., Norwalk, CT] by making a window at the distal end of trocar and used it as a tubular retractor in surgical procedure for treatment of lumbar benign disease. This modified tubular retractor is docked closely on the curved lamina and provides a wider view. We used it as a tubular retractor also in lumbar bilateral decompression involving a unilateral approach. But this trocar has the limited sizes [diameter and length], and also it is difficult to fix the retractor or change the direction of retractor. And then, we propose a more modified Thoracoport with various sizes and attaching the settling holders to the head of tubular retractor to be able to fix the retractor.

• Advances in pediatric surgery
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• 제20권1호
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• pp.1-6
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• 2014

Minimal invasive surgery (MIS) has rapidly gained acceptance for the management of a wide variety of pediatric diseases. A questionnaire was sent to all members of the Korean Association of Pediatric Surgeons. Thirty one members (25.4%) took part in the survey that included data for the year 2012: demographic details, opinion regarding minimal invasive surgery and robotic surgery, spectrum of minimally invasive operations, and quantity of procedures. 48.4% of the respondents had more than 10 years experience, 35.5% less than 10 years experience, and 16.1 % had no experience. The respondents of the recommend MIS and perform MIS for surgical procedures are as follow; inguinal hernia (61.3%), simple appendicitis (87.1%), complicated appendicitis (80.6%), reduction of intussusceptions (83.9%), pyloromyotomy (90.3%), fundoplication (96.8%), biopsy and corrective surgery of Hirschsprung's disease (93.5%/90.3%), imperforate anus (77.4%), congenital diaphragmatic hernia (80.6%), and esophageal atresia (74.2%). The MIS procedures with more than 70% were lung resection (100%), cholecystectomy (100%), appendectomy (96.2%), ovarian torsion (86.7%), fundoplication (86.8%), hiatal hernia repair (82.6%), and splenectomy (71.4%). The MIS procedures with less than 30% were congenial diaphragmatic hernia reapir (29.6%), esophageal atresia (26.2%), correction of malroatation (24.4%), inguinal hernia repair (11.4%), anorectal malformation (6.8%), Kasai operation (3.6%).

• Journal of Chest Surgery
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• 제47권2호
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• pp.106-110
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• 2014

Background: There are several modalities of coronary artery revascularization for multivessel coronary artery disease. Hybrid coronary revascularization (HCR) with minimally invasive direct coronary artery bypass grafting was introduced for high-risk patients, and recently, many centers have been using it. Limited incisional full sternotomy coronary artery bypass (LIFCAB) involves left internal thoracic artery (LITA)-to-left anterior descending coronary artery (LAD) anastomosis through a sternotomy with a minimal skin incision; it could be considered another technique for minimally invasive LITA-to-LAD anastomosis. Our center has performed HCR using LIFCAB, and in this paper, we report our short-term results, obtained in the past 3 years. Methods: The medical records of 38 patients from May 2010 to June 2013 were analyzed retrospectively. The observation period after HCR was 1 to 37 months (average, $18.3{\pm}10.3$ months). The patency of revascularization was confirmed with postoperative coronary angio-computerized tomography or coronary angiography. Results: There were 3 superficial wound complications, but no mortalities. All the LITA-to-LAD anastomoses were patent in the immediate postoperative and follow-up studies, but stenosis was detected in 3 cases of percutaneous coronary intervention. Conclusion: HCR using LIFCAB is safe and yields satisfactory results from the viewpoint of revascularization for multivessel disease.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.20-26
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• 2024

The etiology and pathophysiology of delayed inflammatory reactions caused by hyaluronic acid fillers have not yet been elucidated. Previous studies have suggested that the etiology can be attributed to the hyaluronic acid filler itself, patient's immunological status, infection, and injection technique. Hyaluronic acid fillers are composed of high-molecular weight hyaluronic acids that are chemically cross-linked using substances such as 1,4-butanediol diglycidyl ether (BDDE). The mechanism by which BDDE cross-links the two hyaluronic acid disaccharides is still unclear and it may exist as a fully reacted cross-linker, pendant cross-linker, deactivated cross-linker, and residual cross-linker. The hyaluronic acid filler also contains impurities such as silicone oil and aluminum during the manufacturing process. Impurities can induce a foreign body reaction when the hyaluronic acid filler is injected into the body. Aseptic hyaluronic acid filler injections should be performed while considering the possibility of biofilm formation or delayed inflammatory reaction. Delayed inflammatory reactions tend to occur when patients experience flu-like illnesses; thus, the patient's immunological status plays an important role in delayed inflammatory reactions. Large-bolus hyaluronic acid filler injections can induce foreign body reactions and carry a relatively high risk of granuloma formation.