• Title/Summary/Keyword: Surgery: neurologic

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First Results of the Single Heartstring Aortotomy for Multiple Off-Pump Vein Grafts: A Case Series

  • Santos, Rafael Freire dos;Niclauss, Lars
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.403-407
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    • 2020
  • To validate the technique of the single Heartstring aortotomy for multiple off-pump venous bypass grafts (described in 2015), the results of a 38-month follow-up study of 18 patients, including high-risk patients, are presented. No early deaths or cardiac or cerebral complications occurred. During the follow-up period, 2 patients died of non-cardiac causes, and 3 developed coronary ischemia. Ischemia occurred due to late graft occlusion in 2 patients, both of whom had normal postoperative courses and correct graft flow. The presence of acute symptoms 24 months after surgery in these patients indicated that technical graft failure was unlikely. This safe technique combines the advantages of simple and reproducible revascularization, the off-pump approach, and minimal aortic manipulation.

A CLINICAL STUDY OF PALATAL LIFT FOR TREATMENT OF VELOPHARYNGEAL INCOMPETENCY (Palatal lift를 이용한 비인강폐쇄부전환자의 임상적 치험례)

  • Yoon, Bo-Keun;Ko, Seung-O;Shin, Hyo-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.1
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    • pp.92-96
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    • 2001
  • Velopharyngeal function refers to the combined activity of the soft palate and pharynx in closing and opening the velopharyngeal port to the required degree. In normal speech, various muscles of palate & pharynx function as sphincter and occlude the oropharynx from the nasopharynx during the production of oral consonant sounds. Inadequate velopharyngeal function caused by neurologic disorder - cerebral apoplexy, regressive diseases - disseminated sclerosis, Parkinson's disease, congenital deformity - cleft palate, cerebral palsy and etc. may result in abnormal speech characterized by hypernasality, nasal emission and decreased intelligibility of speech due to weak consonant production. In our study, we constructed speech aids prosthesis - Palatal lift in acquired idiophathic VPI patient and assessed velopharyngeal function with various diagnostic instruments which can evaluate the speech characteristics objectively.

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The Clinical Analysis of Flail Chest (동요흉 환자의 임상적 고찰)

  • 장재한
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1160-1166
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    • 1995
  • From 1980 through 1993, sixty one patients having traumatic flail chest were analysised retrospectively at the Department of Thoracic and Cardivascular Surgery, Chonbuk National University Hospital. There were 47 men and 14 women, mean age, 49.3 years, age range 4 to 82 years. The most common mode of trauma was automobile accident, common combined other organ injuries were skeletal injury [ 36 patients and neurologic injury [ 20 patients . In the mode of treatment, ventilator therapy was done in 34 cases and operative stabilization was done in 18 cases [ Kirschner or steel wire: 9 cases, Judet`s strut: 9 cases . Sixteen patients died [26 % . The main factors associated with fatal outcome were shock [ p < 0.002 , head injury [ p < 0.005 , and more than 50 years of age [ p < 0.05 . In fatal cases, 14 patients died during in ventilator therapy [ 14/34, 41 % and 2 patients died following operative stabilization of chest wall [ 2/18, 11 % .The overall cause of death was septicemia, ARDS, ARF, hypovolemic shock and hypoxic brain damage.

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Paradoxical Lower Lip Twitching after Removal of the Submandibular Gland (악하선 절제술 후 발생한 역설적 아랫 입술 경련)

  • Yoo, Ji Seob;Hong, Yong Tae
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.1
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    • pp.29-32
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    • 2021
  • Benign submandibular gland tumor is a common disease in the head and neck region and can be completely removed by transcervical approach. Typical submandibular gland resection can lead to neurological complications. The most common complications are damage to the marginal mandibular branch of the facial nerve and weakening of the lower lip. We report a case of ipsilateral lower lip twitching occurring 3 months after surgery. There was no difficulty during the operation, and there were no neurologic complications immediate after surgery. However, in the present case, the patient experienced lower lip twitching paradoxically after surgery which has not been reported in the literature yet. Therefore, we reported this case with a review of relevant literature.

Hybrid Technique to Correct Cerebral Malperfusion Following Repair of a Type A Aortic Dissection

  • Kim, Seon Hee;Song, Seunghwan;Kim, Sang-Pil;Lee, Jonggeun;Lee, Han Cheol;Kim, Eun Soo
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.163-166
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    • 2014
  • A 49-year-old man with drowsy mentality was diagnosed with acute type A aortic dissection; he underwent an emergency operation. When selective antegrade cerebral perfusion was initiated, the right regional cerebral oxygen saturation ($rSO_2$) decreased as compared to the left one. Adequate blood flow was perfused through the branch of the artificial graft, after distal anastomosis, but the right $rSO_2$ did not recover. Angiography revealed another intimal tear on the right common carotid artery. A stent was then inserted. The right $rSO_2$ promptly increased to the same level as that of the left one. The patient was discharged without any neurologic complications.

PSYCHOLOGIC CHANGES AFTER ORTHOGNATHIC SURGERY OF DENTOFACIAL DEFORMITY PATIENTS (턱기형의 악교정수술후 환자의 심리적변화)

  • Kim, Seon-Jong;Kim, Myeong-Rae;Kim, Yong-Han;Park, Young-Sook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.4
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    • pp.311-316
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    • 1995
  • This is to study the presurgical motivation, psychological changes and self satisfaction after the surgical treatment of dentofacial deformities. The subjects were 34 patients that the orthognathic surgeies were rendered and followed-up over 6 months. The results were as followings ; 1. The analysis of MMPI profiles in clinical scale reveals that 8.8%(3 patients) of neurologic type, 2.9% (1 patient) of personality problem type and none of psychotic type, while 88.3% of showed no abnormal findings in psychologic status. 2. The significant differences of personality characteristics were noticed in the Depression(D), Hypochondriasis(Hs), Musculinity-Feminity(Mf) were changed significantly following the orthognathic surgeries.(P<0.05) 3. The self assesment of the esthetic results were satisfactory in 78.6%, while no changes in 14.3%.

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Mediastinal Neurofibroma in a the Patient with Type 4 Neurofibromatosis -A case report- (피부 신경섬유종증을 동반한 환자에서의 종격동 신경섬유종 -1예 보고-)

  • Lee, Jong-Ho;Kwon, Jong-Bum;Moon, Mi-Hyoung;Park, Kuhn
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.317-320
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    • 2007
  • Neurogenic tumors are the most common posterior mediastinal tumors and accounting for $19{\sim}39%$ of all mediastinal tumors and 75% of all posterior mediastinal tumors. Neurofibromatosis is an autosomal dominant disorder with variable expression of tumors, including neurologic tumors of the peripheral nerves, nrve roots, and plexi. A posterior mediastinal neufibroma in neurofibromatosis patients is rare. We report here a case of posterior mediastinal neurofibroma in a patient with type 1 neurofibromatosis.

REPORT OF THE MANAGEMENT OF GUNSHOT WOUNDS TO THE LEFT FACE (산탄총에 의한 좌측 안면부 손상 환자의 치험례 (증례보고))

  • Kim, Il-Kyu;Lee, Sang-Sun;Oh, Sung-Sup;Choi, Jin-Ho;Kim, Hyung-Don;Oh, Nam-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.224-227
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    • 2000
  • Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.

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Cerebral Fat Embolism after Traumatic Multiple Fracture: A Case Report (외상성 다발성 골절 후 발생한 뇌 지방 색전증 1예)

  • Kim, Ho Hyun;Park, Yun Chul;Lee, Dong Kyu;Park, Chan Yong;Kim, Jae Hun;Kim, Yeong Dae;Kim, Jung Chul
    • Journal of Trauma and Injury
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    • v.26 no.2
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    • pp.58-62
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    • 2013
  • A cerebral fat embolism is an uncommon but serious complication of long bone fracture. It can be fatal, and early detection is not easy. Neurologic symptoms are variable, and the clinical diagnosis is difficult. The pathogenesis remains controversial, and several theories have been proposed. Magnetic resonance imaging can detect a cerebral fat embolism with a higher sensitivity than cerebral computed tomography. We report a case of a posttraumatic cerebral fat embolism without pulmonary involvement and review the existing literature.

Clinical Assessment of Pain and Sensory Function in Peripheral Nerve Injury and Recovery: A Systematic Review of Literature

  • John, Albin A.;Rossettie, Stephen;Rafael, John;Cox, Cameron T.;Ducic, Ivica;Mackay, Brendan J.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.427-439
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    • 2022
  • Peripheral nerve injuries (PNIs) often present with variable symptoms, making them difficult to diagnose, treat, and monitor. When neurologic compromise is inadequately assessed, suboptimal treatment decisions can result in lasting functional deficits. There are many available tools for evaluating pain and functional status of peripheral nerves. However, the literature lacks a detailed, comprehensive view of the data comparing the clinical utility of these modalities, and there is no consensus on the optimal algorithm for sensory and pain assessment in PNIs. We performed a systematic review of the literature focused on clinical data, evaluating pain and sensory assessment methods in peripheral nerves. We searched through multiple databases, including PubMed/Medline, Embase, and Google Scholar, to identify studies that assessed assessment tools and explored their advantages and disadvantages. A total of 66 studies were selected that assessed various tools used to assess patient's pain and sensory recovery after a PNI. This review may serve as a guide to select the most appropriate assessment tools for monitoring nerve pain and/or sensory function both pre- and postoperatively. As the surgeons work to improve treatments for PNI and dysfunction, identifying the most appropriate existing measures of success and future directions for improved algorithms could lead to improved patient outcomes.