• Title/Summary/Keyword: Minor Surgery

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Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery?

  • Cho, Yong-Wook;Kim, Euiseong
    • Restorative Dentistry and Endodontics
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    • v.38 no.3
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    • pp.113-118
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    • 2013
  • Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT) regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery.

Treatment of Multidisciplinary Approach of Critical Ischemic Limb with Diabetic Foot (당뇨발과 동반된 중증 허혈성 하지에서의 다각적 접근 방법의 치료)

  • Choi, Hyun-Hee;Kim, Gab-Lae;Lee, Jae-Hee;Lee, Eui-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.1
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    • pp.52-59
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    • 2013
  • Purpose: The purpose of this study is to evaluate treatment results of multidisciplinary approach of critical ischemic limb with diabetic foot. Materials and Methods: From March 2005 to March 2012, 674 diabetic foot patients were analyzed. Among them, 85 patients were neuroarthropathic type, 383 patients were infectious type, and 206 patients were ischemic type. The subjects were 206 patients who had critical ischemic limbs and major or minor amputations were done. Various single or combined treatment method before amputation was performed. We investigated their ABI, HbA1c, main occlusion lesion, limb salvage and hospitalization period by various treatment method. Results: Major amputation was 27 cases, minor amputation was 179 cases. Mean HbA1c was 8.2%, and mean ABI was 0.66. Main occlusion lesion was 6 cases at common iliac artery, 13 cases at external iliac artery, 9 cases at internal iliac artery, 11 cases at common femoral artery, 23 cases at deep femoral artery, 52 cases at superficial femoral artery, 35 cases at popliteal artery, 40 cases at posterior tibia artery, 35 cases at anterior tibial artery, 28 cases at peroneal artery, and 13 cases at dorsalis pedis artery. Major amputations were decreased, minor amputations were increased, and hospitalization period was reduced by treatment of multidisciplinary approach. Conclusion: Treatment of multidisciplinary approach, which include preoperation percutaneus transluminal angioplasty, vascular surgery, and amputation, of critical ischemic limb with diabetic foot had advantages of limb salvage and hospitalization period reduction.

Voice Changes after Thyroidectomy Without Recurrent Laryngeal Nerve Injury (반회후두신경 손상을 동반하지 않은 갑상선 절제술 후 음성 변화)

  • Choi, Jee-Sun;Jeong, Jong-In;Jang, Min-Seok;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.1
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    • pp.37-41
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    • 2010
  • Background and Objectives : Transient minor voice changes after thyroidectomy are not infrequent complaints even in cases without any evidence of recurrent laryngeal nerve damage. However, clinical course, diagnosis and management of such voice changes are not fully understood. This study aimed to evaluate the clinical characteristics of minor voice changes after thyroidectomy. We also tried to assess the significance and feasibility of superior laryngeal nerve monitoring and to find out the optimal evaluation tools for such voice changes after thyroidectomy. Materials and Method : Nine adult patients who received total thyroidectomy without evidence of recurrent laryngeal nerve injury were enrolled for this prospective study. Voice evaluations were performed preoperatively and 3 months postoperatively ; acoustic analyses including voice range profile, aerodynamic study, stroboscopic evaluation and subjective voice assessment with questionnaires. The external branch of superior laryngeal nerve was monitored by nerve stimulator after ligation of superior thyroidal vessels. Results: Four of nine patients complained their voice change at 3 months after the surgery. Three of them reported complete recovery of their voice at 6 months after the surgery. Acoustic analysis revealed significant decrease in their phonatory range especially with high tone loss. Questionnaires related to singing was more sensitive than previously well-known "voice handicap index". Stimulation of the superior laryngeal nerve was feasible in most of the cases (94.4%), but it failed to show any correlation with minor voice changes after thyroidectomy. Conclusion : Minor voice changes were not rare events during the first 6 month after thyroidectomy. Decrease in phonatory range with high tone loss and therefore, discomfort in singing was the most common finding. Superior laryngeal monitoring was feasible but it was not a sensitive tool for the prediction of minor voice change after thyroidectomy.

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Comprehensive Analysis for Risk Factors of Lower Extremity Amputation as a Treatment of Complicated Diabetic Foot (당뇨 합병증으로 인한 하지 절단술의 위험 인자의 포괄적 분석)

  • Chung, Hyung-Jin;Bae, Su-Young;Min, Byoung-Kwon;Park, Jae-Gu;Kam, Min-Cheol;Choi, Ji-Won
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.4
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    • pp.257-264
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    • 2012
  • Purpose: The diabetic foot lesions are intractable, and aggravation often leads to amputation. None or minor amputation group was treated debridement or toe amputation and major amputation group was treated Ray, Lisfranc, Chopart, Below Knee and Above Knee amputation. We investigate the risk factors for major limb amputations among patients with diabetic foot lesion. Materials and Methods: The subjects were 73 diabetic foot lesion patients (83 diabetic foot lesions) treated at our department from January 2006 to December 2010. Non or Minor amputation group of 44 cases were treated with debridement or toe amputation. Major amputation group of 39 cases were treated with Ray, Lisfranc, Chopart, below or above Knee amputation. We investigated socioeconomic factors, diabetes mellitus related factors and wound related factors and laboratory factors. Statistical analysis was done by Students t-test, Chi-square test, Mann-Whitney's U test. Results: In our analysis, wound size, wound classification (Wagner classification, Brodsky classification), white blood cell counts, polymorphoneuclear neutrophil percentage, hemoglobin, C-reactive protein and albumin were risk factors for major amputation (p<0.05). Conclusion: Low education level, nutritional condition, premorbid activity level and progressed wound condition were observed in major amputation group compared with non or minor amputation group. In the major amputation group, higher white blood cell count, C-reactive protein level and lower albumin level were observed. Together with maintenance of adequate nutritional condition, early detection of lesions and foot care for early treatment is important. Therefore, active investigation with full risk evaluation of vascular complication is also important.

BASAL CELL ADENOCARCINOMA OF THE MINOR SALIVARY GLAND - A CASE REPORT (소타액선에 발생한 기저세포선암의 치험례)

  • Koo, Myoung-Sook;Kwon, Tae-Geon;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.5
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    • pp.390-394
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    • 2002
  • Basal cell adenocarcinoma is an epithelial neoplasm which is cytologically and histomorphologically similar to basal cell adenoma but is different because of the infilitrative growth. This tumor, a rare salivary gland tumor newly classified as basal cell adenocarcinoma by the WHO in 1991, is infiltrative, locally destructive and tends to recur but metastasis is less common. The differential diagnosis includes basal cell adenoma, adenoid cystic carcinoma, and basaloid squamous carcinoma. Nearly 90 percent of these tumors occurr in the parotid gland and can be classified into low grade carcinomas with a relative good prognosis. Basal cell adenocarcinoma of minor salivary gland is very rare and has a less favorable clinical course compared with that of the major salivary glands. This is a case of basal cell adenocarcinoma occurring at the minor salivary gland of the soft palate. We treated this patient with block excision and adjunctive radiation therapy.

Multiple bilateral malar mucinous cystadenomas in the minor salivary glands

  • Choi, Jun Ho;Kim, Seung Hyun;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.21 no.5
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    • pp.329-333
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    • 2020
  • Mucinous cystadenoma, one of the subtypes of cystadenomas, is a rare benign salivary gland tumor. Most of the cases reported tumors presenting as asymptomatic, slow growing, single masses, primarily occurring in the parotid glands, buccal mucosa, and hard palate. This report describes a case of multiple mucinous cystadenomas that presented as subcutaneous swellings in both cheeks, which were mistaken for a benign subcutaneous tumor. A complete surgical excision was performed through an intraoral incision. There were no recurrences or complications. A diagnosis of mucinous cystadenoma was made by histopathological examination. Mucinous cystadenomas are differentiated from other salivary gland tumors based on the pathological findings. A malignant transformation is also possible. Preoperative imaging cannot identify mucinous cystadenomas because of their small size and atypical features, and needle biopsy has its limitations in such salivary gland tumors. Therefore, accurate diagnosis and treatment through surgical excision become important.

Pseudoaneurysm of the Anterior Tibial Artery (A Case Report) (전방 경골 동맥에 발생한 가성 동맥류 (1예 보고))

  • Baek, Jong-Ryoon;Park, Hong-Ki;Yang, Sang-Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.104-106
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    • 2007
  • Pseudoaneurysm of the anterior tibial artery is a rare cause of pain and swelling of the lower leg and the foot following minor sports injuries. When there is no definite musculoskeletal cause of pain, it is important to consider pseudoaneurysm. Early diagnosis and management are essential for the successful outcome. MRI and angiogram are useful for early diagnosis. We report a case of pseudoaneurysm of the anterior tibial artery following minor sports injury. The patient experienced complete relief of the symptoms after resection of the pseudoaneurysm.

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PLEOMORPHIC ADENOMA OF THE CHEEK IN THE YOUNG PATIENT : REPORT OF A CASE (젊은 환자에서 협부다형선종의 치험례)

  • Kim, Bok-Joo;Choi, Yeon-Sik;Kim, Cheol-Hun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.2
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    • pp.128-130
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    • 2003
  • Pleomorphic adenoma is the most common intraoral salivary gland tumor and characteristically presents as slow painless growth. The cheek are rarely affected site of all pleomorphic adenoma arising from minor salivary glands. In this report, we present the case of a patient with pleomorphic adenoma that affects the cheek. The purpose of this paper is to report this case and review the features of the pleomorphic adenoma occuring in this site.

Reconstruction of partial maxillectomy defect with a buccal fat pad flap and application of 4-hexylresorcinol: a case report

  • Seok, Hyun;Kim, Min-Keun;Kim, Seong-Gon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.6
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    • pp.370-374
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    • 2016
  • Mucoepidermoid carcinoma (MEC) is the most common type of malignant neoplasm in the minor salivary gland. The hard palate is a frequently involved site of MEC. The treatment of low-grade MEC on the hard palate is wide local resection with a tumor-free margin. In the present case, the maxillary defect was reconstructed using a buccal fat pad (BFP) flap, followed by application of 4-hexylresorcinol (4HR) ointment for 2 weeks. The grafted BFP successfully covered the tumor resection defect without tension and demonstrated complete re-epithelialization without any complications.

Mucoepidermoid Carcinoma of the Soft Palate in a Child (소아에서 발생한 연구개 점액표피양 종양 1례)

  • Jung, Hoon;Eun, Young-Gyu;Kwon, Kee-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.2
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    • pp.207-210
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    • 2008
  • The purpose of this paper is to review our experience with mucoepidermoid carcinoma(MEC), a rare tumour in minor salivary glands, in a paediatric patients. 15-year-old boy was noted to have a irregular round mass appearing atthe soft palate just to the right of the mid-line. A computed tomographic(CT) scan showed a palatal mass limited to soft palate with no bony erosion. The lesion was curetted and debulked. Pathology was reported as an intermediate-grade mucoepidermoid carcinoma, and the patient was considered to radiation therapy institution for further treatment. To date, patients remain free of disease. Wide local excision is the treatment of choice for low to intermediate grade MEC of the minor salivary glands in paediatric patients.