• Title/Summary/Keyword: Preoperative Evaluation

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Open heart surgery in the first two years of life (2 세 이하 유아기의 개심술)

  • Park, Lee-Tae;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.16 no.4
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    • pp.431-443
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    • 1983
  • A hundred and fifty-one patients with congenital heart disease less than 24 months old underwent intracardiac repairs from January 1982 to July 1983, which consists 24.2% of all the patients with congenital heart diseases operated during the same period. There were 98 patients[64.9%] with acyanotic congenital heart disease and 53 patients[35.1%] with cyanotic congenital heart disease, and 55 patients[36.4%] were less than 1 year of age. Twenty-two patients died within 30 days after surgery and 3 patients died after postoperative 30th day: Ventricular septal defect, four of 90 patients; Tetralogy of Fallot, five of 23 patients; Transposition of great arteries, nine of 17 patients; Tricuspid atresia, four of 5 patients; Pulmonary atresia, all of 2 patients; Single ventricle, one of single patients. Over all mortality was 16.6% and mortality of acyanotic congenital heart disease, cyanotic congenital heart disease and patients less then 1 year of age was 4.1%, 39.6% and 20.0% respectively. Still the mortality of cyanotic congenital heart disease is high. Careful preoperative evaluation of the detailed intracardiac anatomy and hemodynamics of the patients and proper selection of surgical treatment yield better clinical results.

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Peroneal Perforator Flap (비골 동맥 천공지 피판)

  • Chung, Duke Whan;Hwang, Joon Sung
    • Archives of Reconstructive Microsurgery
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    • v.13 no.1
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    • pp.29-35
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    • 2004
  • Materials and Methods: Total number of peroneal perforator flap is 14 cases, which 10 cases were man, 4 cases were woman. The range of age was 12 years old minimally and until 63 years old. The trauma was most common etiology, which was like traffic accidents, 9 cases. We confirmed tibialis anterior artery patency by doppler flow meter, angiography as preoperative evaluation. Results: 1. The success rate was 91%, that in 14 cases, 13 cases were succeded. 2. To obtain successful result of peroneal flap, one must have the anatomic concept for vascular pattern, 8 cases were between peroneus muscle and soleus muscle branch type but, 3 cases were through soleus muscle branch type, so we treated these cases by using soleus muscle including peroneal perforating branch not to injury perforating artery directly. 3. The pedicle size was between minimally $2{\times}2.5cm$ and maximally $6.5{\times}8.5cm$ so we could treat large recipient site. 4. The pedicle length was between minimally 3.2 cm and maximally 11.5cm, average 7.5 cm. 5. The diameter of perforating artery was estimated by inspection, that was about 0.2-0.5 cm Conclusion: The peroneal perforating artery flap has merits that we can approach in avascular zone and has wide movable range from foot to distal femur and little donor site mobidity and can harvest osteocutaneous flap. The weak point was the irregular anatomy of nutrient artery and not to contain sensory nerve.

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Measuring and Predicting Success of Uvulopalatopharyngoplasty in Obstructive Sleep Apnea Patients (폐쇄성 수면무호흡증 환자에서 구개수구개인두 성형술의 결과평가 및 예측 변수에 관한 고찰)

  • Park, Young-Hak;Park, So-Young
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.31-37
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    • 1996
  • Uvulopalatopharyngoplasty(UPPP) is an operation that is frequently performed for the patient of obstructive sleep apnea(OSA). A major problem has been to select those patients who will have a good response to UPPP. We compared preoperative and postoperative polysomnography(PSG) in 20 patients to evaluate the success rate of the operation. Each subject underwent a cephalometric roentgenogram, and fiberoptic nasopharyngoscopy with Mueller maneuver was applied in roentgenogram and fiberoptic nasopharyngoscopy with Mueller maneuver was applied in preop evaluation of patients with OSA. No PSG parameter could accurately predict the changes in sleep after UPPP. There were no significant differences between the responders and the nonresponders concerning the cephalometric analysis, the type of obstruction by Mueller maneuver, and body mass index(BMI). The conclusions of this study are thus that UPPP is an effective treatment for the OSAS with a high success rate, but that there is no single useful parameter predicting the success of the operation.

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Giant Fibrovascular Polyp of the Esophagus -A Case Report- (식도에 발생한 거대 섬유혈관성 용종)

  • 오삼세;심영목
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.675-680
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    • 1996
  • A case of giant fibrovascular polyp of the esophagus with a review of the literature is presented. A 52 year old man with into rmittent dysphagia was found to have an intraluminal esophageal lesion of remarkable size by the radiological studies, but overlooked at esophagoscopy. A giant esophageal polyp w s successfully re- moved surgically by transthoracic approach, although preoperative evaluation of the location and characteristics of the lesion was problematic. These pedunculated intraluminal polyps are rare and characterized by slow growing. benign nature that almost always originate at the level of. the cricopharyngeus muscle, and often attain giant proportions. Symptoms are related to esophageal ob- struction and sudden death by asphyxia can occur. Surgical removal is the choice of treatment.

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Leiomyosarcoma of the Face

  • Ko, Young-Il;Lim, Jin-Soo;Han, Ki-Taik;Kim, Min-Cheol
    • Archives of Craniofacial Surgery
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    • v.15 no.1
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    • pp.36-39
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    • 2014
  • Leiomyosarcoma is a rare form of soft tissue neoplasm, with only 1% to 5% occurring in the head and neck region. Current recommended treatment suggests surgical excision with a wide lateral margin, but no definite guidelines regarding excisional margin have been established yet. Recently, complete excision with a narrow surgical margin has been recommended, and the authors present a case of cutaneous leiomyosarcoma on the face that was successfully managed by complete removal with a narrow excisional margin. A 74-year-old woman presented with a 3 cm sized, rapidly growing cutaneous mass on her right preauricular area. Preoperative biopsy of the skin lesion suggested a cutaneous leiomyosarcoma. The authors performed complete surgical excision with a 1 cm lateral margin, and the resulting skin defect was repaired with bilateral V-Y advancement local flaps. Histopathology and immunohistochemistry evaluation confirmed a moderately differentiated cutaneous leiomyosarcoma, with negative margin involvement. The patient refused of any additional treatment, but showed no locoregional recurrence during the 1.5 years of postoperative follow-up period. With a regular postoperative follow-up, cutaneous leiomyosarcomas may be successfully treated with a narrow surgical margin.

Subcutaneous Sarcoidosis Occurring in Both Chin and Toe

  • Kim, Kwang Seog;Lim, Dong Seob;Choi, Jun Ho;Hwang, Jae Ha;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.18 no.3
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    • pp.207-210
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    • 2017
  • Sarcoidosis is a systemic inflammatory disease characterized by non-caseating granulomas of unknown origin. Of the fewer than 6% of sarcoidosis cases that occur in subcutaneous tissue, most occur on the face or forearm, but rarely in the toe. A 33-year-old man was admitted to our institute with a 2-cm mass on his chin and a 0.5-cm mass on his right fourth toe. Based on preoperative ultrasonography, epidermal cysts were suspected, and histopathological tests were performed after removing the masses. Histopathologically, the chin and toe tissue samples showed chronic granulomatous inflammation, without necrosis, indicative of sarcoidosis. Chest computed tomography revealed a large number of small nodules in both the interlobar fissures and the peribronchial area, and a large number of small lymph nodes in both the hilar and interlobar node areas. On the basis of the histopathologic and imaging findings, the patient was diagnosed with sarcoidosis. This very rare case of sarcoidosis, occurring in both chin and toe, suggests that thorough evaluation is needed to find other mass when we find sarcoidosis in facial area.

Development of Cone-Shaped Electrode for Promontory Stimulation Electrically Auditory Brainstem Response (와우 갑각 전기자극 뇌간유발반응용 원추형 전극의 개발)

  • Heo, Seung-Deok;Jung, Dong-Keun;Kang, Myung-Koo;Kim, Lee-Suk;Ko, Do-Heung
    • Speech Sciences
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    • v.10 no.4
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    • pp.181-187
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    • 2003
  • This paper introduces a new zinc coated copper wire electrode with coiled cone shape which has low surface resistance and tolerance to the motion artifact for promontory stimulation electrically auditory brainstem responses (PSEABR). Auditory brainstem responses (ABR) can be used to predict hearing threshold level with a great deal of accuracy particularly for a young child who cannot cooperate mechanically and some hearing impaired who are exaggerating a hearing loss for economic compensation. While severe profound sensorineural hearing losses may not be implemented by auditory potentials, PSEABR is proven as a useful tool even for some sensorineural related hearing impaired. It was shown that PSEABR gives the electrical stimuli to promontory of the cochlear instead of giving acoustic stimuli. For this reason, PSEABR can be used as an alternative for cochlear implantation, and can also be used as an optimal device selection and neural information for MAP. It was found that the role of electrode is very important in PSEABR. Even though this cone-shaped electrode was applied in animal experiments, waveforms are well produced by PSEABR. Thus, it was concluded that cone-shaped electrode turned out to be a useful preoperative audiological evaluation tool in deciding time for cochlear implantation surgery.

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Clinical Applications of Breast MRI (유방자기공명영상의 임상 적용)

  • Cho, Nariya;Moon, Woo-Kyung
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.1
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    • pp.1-8
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    • 2009
  • Breast MRI is a cutting-edge technology in the diagnosis and intervention of breast abnormalities. Over the last decade, breast MRI has evolved from a research field to a clinical field. Radiologists should understand the indications, how to obtain adequate images, and how to interpret and report their findings. Breast MRI is now used in the differentiation of benign from malignant mass, preoperative staging of breast cancer patients, assessment of tumor response to neoadjuvant chemotherapy, and evaluation of women with breast implants. It can also be used as a supplemental screening modality for high-risk women. Qualified radiologists and adequate MRI technique are crucial for the success of these purposes. This review is focused on the indication, standardized use of lexicon and categorization of breast MRI.

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Use of cone-beam computed tomography and three-dimensional modeling for assessment of anomalous pulp canal configuration: a case report

  • Sinanoglu, Alper;Helvacioglu-Yigit, Dilek;Mutlu, Ibrahim
    • Restorative Dentistry and Endodontics
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    • v.40 no.2
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    • pp.161-165
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    • 2015
  • Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment.

Measurement Method of the Masseter Muscle Volume Using 3D Computed Tomography (3D CT를 이용한 교근의 부피측정)

  • Baek, Jung Hwan;Choi, Jong Woo;Yoo, Sun Kuk;Kim, Yong Oock;Park, Beyoung Yun
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.589-592
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    • 2005
  • Since G.N. Hounsfield's clinical use of computed tomography in 1971, digital imaging technique using computers has shown an eye opening progress. Progress has made 3-dimensional understanding of not only facial bones but muscles and other connective tissues possible through 3-dimensional reconstruction of preexisting tomographical images. Also, quantitative analysis of density, distance, volume has become possible, allowing objective analysis of preoperative and postoperative states through imaging. The authors measured the masseter muscle volume of 20 normal individuals and 8 female patients through 3-D reconstructive CT imaging and made a statistical analysis of the measurements. The method used in our study may be applied to the diagnosis of disease causing the change of the facial volume and presurgical design as a useful tool to provide objective information on the evaluation of surgery outcome.