• Title/Summary/Keyword: Preoperative Evaluation

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An Intradural Extramedullary Hemangioblastoma of Distal Spinal Cord - A Case Report - (척수 원위부에 발생한 경막내수막외 혈관아세포종 - 증례보고 -)

  • Park, Sung-Ho;Cho, Joon;Youn, Seung-Whan;Chang, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1523-1526
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    • 2000
  • It has been known that hemangioblastoma of spinal cord occurs about 4% of all the spinal tumors. The authors present a rare case of intradural extramedullary(IDEM) hemangioblastoma of distal spinal cord in 41-year-old male patient. This IDEM mass at the level of conus medullaris showed iso-signal intensities on T1-weighted image(T1-WI) and high-signal intensities on T2-WI, and was enhanced homogeneously on MRI. At surgery, T12- L1 total laminectomy and enbloc mass removal were performed. This IDEM hemangioblastoma was confirmed by histopathologic findings. For less postoperative complication in IDEM tumors, we suggest that precise preoperative evaluation and complete excision via proper surgical approach to distal conus should be reemphasized.

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Heart Transplantation in a Patient with Persistent Left Superior Vena Cava

  • Lee, Jae-Hong;Park, Eun-Ah;Lee, Whal;Cho, Hyun-Jai;Kim, Ki-Bong;Hwang, Ho Young
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.533-535
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    • 2014
  • A 56-year-old male presented with severe exertional dyspnea and pitting edema in the lower extremities. The preoperative evaluation demonstrated biventricular dysfunction associated with severe tricuspid valve regurgitation and a persistent left superior vena cava. He was registered as a transplantation candidate, and orthotopic heart transplantation was performed using the standard bicaval technique. The left superior vena cava was connected to the right atrial appendage after the construction of a conduit using the recipient's autologous coronary sinus tissue. One-month postoperatively, computed tomography imagery demonstrated a patent conduit between the left superior vena cava and right atrial appendage.

Radiculopathy Caused by Internal Iliac Artery Pseudoaneurysm Managed with Endovascular Embolization

  • Choi, Il;Im, Soo-Bin;Kim, Bum-Tae;Shin, Won-Han
    • Journal of Korean Neurosurgical Society
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    • v.42 no.6
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    • pp.484-486
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    • 2007
  • The authors describe a case of pseudoaneurysm arising from internal iliac artery presented with radiculopathy mimicking the symptoms of lumbar disc disease or spinal cord tumor. Among the several preoperative evaluation including CT, MRI, electrophysiologic study and ultrasonography, important diagnostic clue was obtained by ultrasonographic findings of turbulence flow at the core of partially enhanced mass in the pelvic cavity. The patient was managed with endovascular coil embolization successfully. The current case makes us remind that assessment of neurological symptoms on lower extremity should include consideration of extraspinal cause in pelvis.

Clinical Application of Image Guided Surgery : Zeiss SMN System (영상유도 뇌수술 장비의 임상적 적용 : Zeiss SMN System)

  • Lee, Chea Heuck;Lee, Ho Yeon;Whang, Choong Jin
    • Journal of Korean Neurosurgical Society
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    • v.29 no.1
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    • pp.72-77
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    • 2000
  • The authors describe the experience with the interactive image-guided Zeiss SMN system, which has been applied to 20 patients with various intracranial lesions during one year. Preoperative radiologic evaluation was CT scan in 6 cases, MRI in 14 cases. In all except one case, average fiducial registration errors were less than 2mm. There was no statistical difference in registration error between CT and MR image. This system considered to be relatively stable with respect to soft and hardware. Also it was useful for the designing of the scalp incision and bone flap and assessing the extent of resection in tumors, especially in gliomas. Moreover, it was helpful to evaluate complex surgical anatomy in skull base surgery.

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The Value of Mediastinoscopy for Evaluation of Mediastinal Lymph Nodes in Bronchogenic Carcinoma : Accuracy of Mediastinoscopy (원발성 폐암에서 종격동 림프절 평가에 대한 종격동경 검사의 가치)

  • O, Sang-Jun;Kim, Chang-Ho
    • Journal of Chest Surgery
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    • v.24 no.8
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    • pp.751-756
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    • 1991
  • For the period from June 1988 to July 1991 we studied 29 patients who were judged to have operable disease before mediastinoscopy on clinical criteria[absence of distant metastases, phrenic or laryngeal nerve paralysis, positive scalene node biopsy, and malignant pleural effusion]. All patients had computed tomography and mediastinoscopy prior to operation. In the present study, the sensitivity, specificity, and accuracy of CT were 92%, 56%, and 72%, respectively. And the sensitivity, specificity, and accuracy of mediastinoscopy were 92%, 100%, and 97%, respectively. We concluded that because of the low accuracy of CT, CT cannot replace mediastinoscopy, and routine mediastinoscopy should be performed in preoperative staging of bronchogenic carcinoma.

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Evaluation of Male Contraception in Korea (남성수태조절법의 신지견)

  • Lee, Hee-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.15 no.1
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    • pp.1-9
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    • 1988
  • The contraception practice rate in Korea has steadily increased from 9% in 1964 to 72% in 1987. Accordingly, natural increase rate of population declined from 28.4 per 1,000 in 1964 to 12.4 per 1,000 in 1987. Notably in recent years, the acceptance of surgical contraception services has sharply increased in this country. Now the author analyzes various factors influencing successful vasectomy and vasovasostomy based on his experience in performing more than 8,000 vasectomies and 1,000 vasovasostomies during the past 25 years. These various factors consist of preoperative screening interview, surgical vasectomy technique, vas irrigation technique, open-ended vasectomy, complications from vasectomy, sperm granuloma formation, spermatogenesis and steroidogenesis after vasectomy, immunological consequences after vasectomy, prostatic diseases and vasectomy, late post-vasectomy syndrome, psychological effects after vasectomy, and success rates of vasovasostomy. Besides, the author makes more comments on the results of the clinical trials on new approaches to reversible vas occlusion technique with a new device of Intravasal Thread and to reversible suppression of spermatogenesis with long-acting sex hormones.

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Preoperative Evaluation and Anesthesia (수술 전 평가와 마취)

  • 오용석
    • 대한위암학회:학술대회논문집
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    • 2002.04a
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    • pp.37-46
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    • 2002
  • 전통적으로 수술 전 평가는 수술 전날 밤에 시행되는 것이 일반적이었다. 그러나 외래수술을 받는 환자의 증가로 인하여 많은 환자들이 수술 당일 아침에 마취과 의사를 처음 만나게 되는 경우가 많고 심지어는 심각한 내과적 문제를 가진 환자들도 충분한 수술 전 평가가 이루어지지 않은 상태에서 수술실로 들어오게 되는 경우가 있다. 그러나 이러한 상황에서도 마취과의사는 주술기(perioperative period)의 환자 상태를 관리하는 주된 역할자로서 수술 전 환자에 대한 평가를 충실히 해야 한다. 수술 전 평가는 환자의 현재 상태를 평가하는 것이고, 수술 중 발생할 수도 있는 상황에 대비하며, 수술실을 넘어서 중환자실, 통증치료실에서의 마취의사의 역할로 이어지도록 하는 것이다. 최근 발전하고 있는 수술 전 평가 클리닉은 환자의 수술준비의 기초적인 정보를 제공한다. 이는 마취의사에게는 상당한 장점과 편리성을 제공하는 것이고, 환자 관리의 질적 향상과 급변하는 병원관리정책의 요구에 부합하는 것이다.

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Subperiosteal Osteoid Osteoma of the Knee: Case Report

  • Suh, Hie Bum;Lee, In Sook;Rhee, Seung Joon;Song, You Seon;Song, Jong Woon
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.1
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    • pp.61-65
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    • 2016
  • Osteoid osteoma, a frequent lesions of bone, is usually intraosseous but occasionally subperiosteal. We describe the case of a 19-year-old male with knee pain caused by subperiosteal osteoid osteoma. Radiologic evaluation was performed with radiographic, computed tomography (CT), ultrasonographic (US) and magnetic resonance imaging (MRI). But the preoperative diagnosis of osteoid osteoma was delayed because of unusual imaging findings and atypical symptom. After excisional biopsy, histological examination confirmed the diagnosis of osteoid osteoma. The lesion was treated successfully with CT-guided radiofrequency ablation.

A Case of Nasopharyngeal Angiofibroma (비인강 혈관섬유종 1례)

  • Song, Kei-Won;Yoon, Seok-Keun;Park, Young-Sik
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.191-197
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    • 1984
  • Nasopharyngeal angiofibroma is a relatively rare, but is a well known tumor that occurs almost in male, most frequently during the adolescent stage. Its character is histologically benign but clinically malignant because of locally invasive character to the adjascent structures, massive bleeding tendency during surgical procedure and high recurrence rate after treatment. Recently many advancements in diagnostic method and surgical technique has reached satisfactory result in treating this difficult tumor. The authors present a case of nasopharyngeal angiofibroma in 16 years old male patient, who was received surgical removal of the tumor through the transpalatal approach after full diagnostic evaluation and preoperative hormonal therapy.

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Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Biopsy in Malignant Thyroid Nodules: Utility for Micronodules

  • Unal, Betul;Sezer, Cem
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8613-8616
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    • 2014
  • Background: The diagnostic approach to thyroid nodules involves ultrasound-guided fine needle aspiration biopsy (US-FNAB). We especially aimed to evaluate the contribution and the place of US-FNAB in preoperative evaluation of the malignant cases and draw attention to discordant cases diagnosed with papillary thyroid microcarcinoma (PTMC). Materials and Methods: A total of 276 cases were retrospectively reviewed who were subsequently diagnosed with a malignancy and who underwent US-FNAB. Results: Some 45 were found to have previously undergone the US-FNAB procedure. Of the patients in whom the surgical specimen was diagnosed with a malignancy, 21 (46.7%) were diagnosed as malignant or suspicious for malignancy, and 24 (53.3%) were concluded as benign or insufficient for diagnosis. Patients with the diagnosis of PTMC outnumbering the others was a striking finding (11 cases, 24%). Conclusions: We suggest performing repeat aspiration biopsy considering sampling errors in cases where inconsistency exists between clinical findings and cytological results in thyroid nodules smaller than 10 mm in diameter and with suspicious findings on ultrasonography.