• Title/Summary/Keyword: One-incision

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A Surgical Treatment of the Esophageal Foreign Body (10 cases report) (수술적 처치가 필요했던 식도이물에 관한 임상적 고찰)

  • 황의두;황경환
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1117-1120
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    • 1997
  • Ten cases with esophageal foreign body were treated surgically from July 1980 to October 1995 at the Departme t of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. The mean age was 45.3 years, with a range from 25 to 71. Out of ten cases, 6 were female and four were male. Common symptoms were dysphagia, fever, foreign body sensation and neck pain. Three cases of foreign bodies were of fish bones, two of bubble paclcage of drugs, one case of a Eeer bottle cap, one of a piece glass, one of a bathtub plug, one of chicken and one of a bean. The diagnosis was established by esophagography using a water soluble contrast material and esophagoscopy. Among of ten cases, two had esophageal stricture due to the ingestion of Aye at a young age. One case had experienced psychological problems. All foreign bodies were removed by surgical procedures. Five cases were treated by cervical esophagostomy, one case by right thoracotomy, one case by retrograde bougienation through gastrostomy and two cases by cervical incision and drainage for cervical abscess. Three cases developed pos operative esophageal leaks which healed spontaneously and transient hoarseness developed in one case. One case developed traumatic pneumothorax and subcutaneous emphysema which was treated by closed thoracostomy. There were no operative deaths. C(ocean J Thorac Cardiovasc Surg 1997;30:1117-20)

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Clinical Results of Treatment of Distal Biceps Rupture (이두박근 원위부 파열의 임상적 치료 결과)

  • Chung, Duke-Whan;Hwang, Jung-Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.13-18
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    • 2009
  • Purpose: To report the clinical results of patients treated for a rupture of the distal tendon of biceps brachii Materials and Methods: Between February 1987 and March 2004, we treated 16 patients with a rupture of the distal tendon of biceps brachii. 9 of 16 patients underwent surgical treatment. All cases were male, median age was 26.3(range, 16-48) years. The mean interval between injury and surgery was 4.7 days (range, 1~36 days). Operative correction was performed anatomically, using the two-incision technique(3 cases) or one-incision technique(6 cases). Clinical outcomes were evaluated one year after operation by assessing the review about the physical examination finding and radiologic findings with surgical findings, range of motion, muscle strength, subjective satisfaction, activity and return to previous occupation. and via telephone interview in cases of conservative treatment. Results: In cases of surgical treatment, 85.8%, 86.3% of flexion-extension and supination-pronation motion than healthy side were measured respectively. 75% of flexion power than healthy side was measured. Eight of nine(89%) were very satisfied. Eightl of nine returned to original job. In cases of conservative treatment, 65% of flexion power than pre-injury state was reported. Four of seven were satisfied, two were dissatisfied, one was very dissatisfied. Three of seven returned to original job. Conclusion: Early anatomic reconstruction can restore more strength and endurance for supination and flexion range and power. Conservative management may be considered for partial injuries, but operative repair must be considered in complete rupture, athletes, patient with high activity.

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Surgical Repair of Single Ventricle (Type III C solitus) (단심실 -III C Solitus 형의 수술치험-)

  • naf
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.281-288
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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Surgical Repair for Ebstein's Anomaly (Ebstein 기형의 수술 -2례 보고-)

  • naf
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.289-296
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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Surgical Treatment of Achalasia : A report of 13 cases (Achalasia 의 수술요법 -13례 보고-)

  • Jo, Dae-Yun;Yang, Gi-Min;Rho, Joon-Rhyang
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.470-474
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    • 1980
  • Achalasia is a neurogenic esophageal disorder, characterized by incomplete relaxation of the gastroesophageal sphincter in response to deglutition and absence of peristalsis from the body of the esophaugs. Because there is no known method by which esophageal peristalsis can be restored, therapy is directed toward the relief of dital esophageal obstruction. During the period of June 1965 to September 1980, 13 cases of achalasia were operated at the Department of Thoracic SUrgery, Seoul Natonal University Hospital. 1. Among 13 cases, 5 were male and 8 were female. 2. Esophagomyotomy was performed in 12 cases, and 1 case was treated with transverse suture of lower esophagus after longitudinal incision. 3. There was no operative mortality, but 2 cases subsequently underwent esophagogastrostomy after esophagomyotomy. 4. One of 13 cases was combined with mongolism.

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Sacrococcygeal Abscess in Neonates (신생아 천미추부 농양)

  • Lee, Doo-Sun
    • Advances in pediatric surgery
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    • v.4 no.2
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    • pp.144-147
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    • 1998
  • The sacrococcygeal region is the frequent site for meningocele, congenital dermal sinus and pilonidal cyst. From May 1995 to July 1998, we have treated 8 neonatal patients with an abscess in the sacrococcygeal area. The mean age at onset was 8.3 days with a range from 6 to 11 days. The sex ratio was 5:3 with male preponderance. Mild fever was the only systemic symptom. Ultrasonogram revealed a slightly hypo echoic lesion in the subcutaneous tissue which became more hypoechoic with time. Pus cultures showed $Staph.$ $aureus$ in 7 patients, two of them had mixed infection with $E.$ $coli$ and other 2 had methicillin-resistant $Staph.$ $aureus.$ The remaining one patient had a mixed infection with $Klebsiella$ and $Proteus.$ Histopathological examination revealed non-specific granuloma and fibrinoid necrotic debris. All patients were easily treated by incision, drainage and proper antibiotics.

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Clinical comparison of surgical approach for orbital fracture. (안와하 골절부의 외과적 접근 방법에 관한 임상적 비교연구)

  • Lee, Sang-Chull;Kim, Hyoun-Chull
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.261-266
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    • 1989
  • This study was undertaken to compare those 4 most commonly used incisions for exposure of fractures of the infraorbital rim and the orbital floor. The patient's age ranged from 19 to 67 years, the majority being in the 2nd decade. There were 17males and 1 female. Three orbital rim, 5 lower eyelid, 7 subciliary and 3 combined conjunctival-lateral canthotomy incisions were reviewed. Following points were the summury of author's experience. 1. The average scar following any of four incisions is barely noticeable. 2. Adequate fracture exposure was achieved with lower eyelid, orbital rim, subciliary and combined conjunctival-lateral canthotomy incisions. 3. One transient ectropion following subciliary incision occurred in 29-years old man with prolonged postoperative eyelid edema.

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Giant Dermoid Cyst in Mouth Floor (구강저에 발생한 거대한 유피낭종)

  • Kim, Chul-Hwan;Park, Sung-Min;Lee, Chul-Won
    • The Journal of the Korean dental association
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    • v.49 no.8
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    • pp.472-477
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    • 2011
  • Dermoid cyst is a benign neoplasm, so called by teratoma that is derived from both ectoderm and mesoderm during embryonic period. The majority of dermoid cysts are found in the ovaries and approximately only 7% of dermoid cysts are found in the head and neck. The growth of dermoid cysts in the floor of the mouth is considered a rare condition. We report one case of huge dermoid cyst in the floor of mouth suffered with double chin appearance and difficulty in pronunciation and respiration. The cyst was excised successfully only intra-oral incision. Clinical progress was uneventful and postoperative recovery excellent without recurrence.

Technique Tip: Percutaneous Gastrocnemius Aponeurosis Recession - A Modified Minimal Invasive Technique (수술 술기: 변경된 비침습적 경피적인 비복근 근막 절제술)

  • Kim, Tae-Hun;Han, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.1
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    • pp.47-50
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    • 2011
  • Equinus contracture of the gastrocnemius-soleus complex is associated with many foot and ankle diseases. We introduce a new simple technique that can be performed using a minimal incision with simple devices. Briefly, 0.5 cm sized medial and lateral longitudinal skin incisions are made at the level of the distal one third of the calf. The musculotendinous junction of the gastrocnemius is gently transected using an Arachnoid blade. The skin is, then, closed with non-absorbable sutures.

In Situ Saphenous Vein Arterial Bypass - A case report - (자연위치의 복재정맥을 이용한 하지동맥 우회술 1례 보)

  • Lee, Hong-Seop;Park, Guk-Yang;Kim, Chang-Ho
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.187-190
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    • 1987
  • The Saphenous vein is still the graft of choice for bypass of small calibered peripheral arteries, and many recent studies revealed that the "In Situ" technique had higher rate of long term patency than the conventional "reversed" one. A 71-year-old male who had atherosclerotic obstruction in the superficial femoral and popliteal trifurcation underwent In Situ saphenous vein arterial bypass. The saphenous vein is exposed by a long medial skin incision over the course of the vein. All branches of vein are ligated. A olive-tipped metal needle is introduced into the vein from above and everts the valves. The patient has been followed for 2 months after operation. The graft remained pulsatile and the gangrenous areas on the toe proceeded to heal. We think In situ vein bypass offers an excellent and safe method of revascularization of the arterial occlusion below the knee although it is technically demanding and the time consuming. time consuming.

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