• Title/Summary/Keyword: Surgical diagnosis

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Open Heart Surgery in Infants Weighing Below 10 kg. (영아 [10 kg] 개심술 환아의 임상적 고찰)

  • 조범구
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.605-614
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    • 1985
  • The principal aim of surgery for congenital heart anomalies is the establishment of normal hemodynamic function. Palliative and corrective operations are selected with time to attain this end with minimal risk. In recent years, as operative mortality after primary total correction is lower than the mortality after early palliation and delayed correction, corrective operations in infants have increasingly supplanted palliative ones. Two hundred and eighteen infants below 10 kg with congenital heart anomalies underwent primary surgical intervention at Yonsei Medical Center from March 1979 to June 1985. There were 155 infants with VSD, 35 Infants with TOF, 5 infants with ECD, 4 infants with TGV, 3 infants with DORV, 3 infants with Pulmonary atresia, 3 infants with ASD and PDA, 2 infants with DOLV, and the remainders were Sinus Valsalva rupture, residual mitral regurgitation after total correction of ECD, PAPVR, Cor triatriatum, Truncus arteriosus, and Tricuspid atresia. The overall surgical mortality was 15.1%. In the acyanotic group, 13 infants died among 168 infants, and mortality was 7.7%. But in the cyanotic group, the mortality rate was very high and 20 infants died among 50 infants raising the mortality to 40.0%. These poor surgical results in the cyanotic or complicated group was due to inaccurate diagnosis, improper surgical methods and inadequate post-operative care which should be improved.

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Correction of Mild-to-Moderate Constricted Ear Abnormality Using Mustardé Suture, Cartilage Onlay Graft, and Transposition Flap: A Case Report

  • Ha Jong Nam;Syeo Young Wee
    • Archives of Plastic Surgery
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    • v.50 no.4
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    • pp.393-397
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    • 2023
  • Constricted ear has a prevalence of 5.2 to 10% among ear abnormalities, and various surgical methods are suggested for treatment. We introduce a case of a constricted ear treated with a simple method using a novel concept cartilage graft and transposition flap, along with the well-known Mustardé suture, which is used for pediatric patients with mild to moderate constricted ears of Tanzer classification type IIA. A 10-year-old female patient visited the hospital complaining of an abnormality in the congenital right ear. Surgical approach was planned under the diagnosis of Tanzer classification type IIA constricted right ear. Posterior helix onlay graft and perichondrocutaneous transposition flap using excessive helical cartilage were performed along with the Mustardé suture. In the immediate postoperative period, ear contour was improved, and it was well-maintained without recurrence until 6 months' follow-up. In conclusion, the combination of Mustardé suture, and cartilage onlay graft and perichondrocutaneous transposition flap in the mild to moderate constricted ear would be a useful surgical option, producing aesthetically good results in a simple and effective method.

Prevention and treatment of microstomia

  • Sae Hwi Ki;Tae Jun Park
    • Archives of Craniofacial Surgery
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    • v.25 no.3
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    • pp.105-115
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    • 2024
  • The mouth, located in the lower third of the face, is a uniquely visible structure. It serves as a vital organ both aesthetically and functionally, playing a key role in speech, expression, and fundamental oral functions. Consequently, any alterations or defects in its shape, due to various causes, can lead to aesthetic and functional deficiencies. These issues may also result in challenges with social interactions and a decrease in confidence. In cases of microstomia, various surgical approaches are proposed based on the location, extent, shape, and cause of the defect, leading to numerous case reports. Plastic surgeons are proficient in oral reconstruction; however, cases of microstomia are relatively rare, which reduces their familiarity and interest in these cases. Additionally, preferences for oral size and shape vary according to factors such as geographical region and ethnicity, further complicating the functional definition of microstomia. Therefore, both subjective patient and physician judgments play crucial roles in the diagnosis and treatment of microstomia, as these may vary depending on individual and societal aspects. This review aims to classify the various causes and definitions of microstomia, as well as its non-surgical and surgical treatment options, with the goal of the treatment of this condition.

Effect on Wond Healing of Low Power Generating Laser Irradiation on Artificially Produced Wounds of Rabbits (저출력 레이저광선이 가토의 손상치유에 미치는 영향)

  • Young-Jin Park;Choung-Youl Kim
    • Journal of Oral Medicine and Pain
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    • v.19 no.1
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    • pp.73-91
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    • 1994
  • The author used rabbits in order to examine the effect of Ga-As low power generating semiconductor laser on artificially produced injuries of experimental animals. Artificially produced injuries include surgical wound of 3mm length, 2mm depth in size on ventral skin surface of rabbit and buccal mucosa, and electrical injury formed on opposite side of skin and buccal mucosa by electrical cauterization of same length and depth, and chemical injury formed by FC(Formocresol) solution applied on the anterior dorsal part of tongue. And then, on the experimental group, Ga-As laser was irradiated beginning on the day after the wound formation and continued to irradiate every each other day for five minutes. After1, 3, 6, 9, 13th day, certain number of animals of control and experimental group were sacrified, and wound site tissue was excised to make samples and was observed under light microscope. The following is the conclusions after comparing the healing procedure of experimental and control group. The following results were obtained : 1. Inflammation was decreased more rapidly in the experimental group than the control group. 2. In the surgical, the electrical and the chemical injuries in the oral mucosa, re-epithelialization was completed more rapidly in the experimental group than the control group. In the electrical injury on the skin, re-epithelialization was completed about 6 days after wound formation on both groups. 3. In the electrical and the surgical injuries on the oral mucosa, granulation tissue formation started at 3 days after injury on both groups, but in the chemical injury, it was completed about 3 days faster in the control group than the experimental group. In the surgical wound on the skin, it was completed about 9 days after injury, but faster in the experimental group. In the electrical injury on the skin, it was faster in the control group than the experimental group. 4. In the electrical and the surgical injuries on the oral mucosa, fibrosis was started at 6~9 days after injury on both groups, but regeneration of connective tissue in the experimental group was observed much more than the control group. 5. When comparing the effect of wound healing on skin and oral mucosa of control and experimental group, granulation tissue formation and re-epithelialization in the oral mucosa was more vigorous. In conclusion, the difference of timing and the sequence of wound healing process(inflammation, re-epithelialization, granulation tissue formation, fibrosis) following Laser irradiation between control and experimental group was not observed, but the healing tissue was observed much more in the Laser irradiated group.

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Diode laser surgery in the treatment of oral proliferative verrucous leukoplakia associated with HPV-16 infection

  • Bombeccari, Gian Paolo;Garagiola, Umberto;Candotto, Valentina;Pallotti, Francesco;Carinci, Francesco;Gianni, Aldo Bruno;Spadari, Francesco
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.16.1-16.5
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    • 2018
  • Background: Proliferative verrucous leukoplakia (PVL) is an oral potentially malignant disorder, characterized by multifocal expression, progressive clinical evolution, and a high rate of malignant transformation. Evidence-based information regarding optimal PVL management is lacking, due to the paucity of data. The present report describes a case of PVL associated with HPV-16 infection and epithelial dysplasia treated by diode laser surgery, and the outcome of disease clinical remission over a 2-year follow-up period. Case report: A 61-year-old Caucasian male with oral verrucous hyperkeratosis presented for diagnosis. The lesions were localized on the maxillary gingiva and palatal alveolar ridge. Multiple biopsy specimens have been taken by mapping the keratotic lesion area. Microscopic examination was compatible with a diagnosis of PVL with focal mild dysplasia, localized in the right maxillary gingiva. Polymerase chain reaction (PCR) was done for human papillomavirus (HPV) detection which revealed presence of HPV DNA, and the genotype revealed HPV 16 in the sample. The PVL in the right gingival area was treated on an outpatient basis by excision with a diode laser. This approach resulted in good clinical response and decreased morbidity over a 2-year follow-up period. Conclusions: This case illustrates the benefit of a conservative approach by diode laser treatment than wide surgical excision for management of the PVL lesions associated with mild dysplasia and HPV-16 infection.

CLINICAL STUDY OF SURGICAL TREATMENTS FOR SNORING AND OBSTRUCTIVE SLEEP APNEA (코골이 및 폐쇄성 수면 무호흡증의 외과적 처치에 대한 임상적 연구)

  • Lee, Yong-Kwon;Myung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin;Choi, Jin-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.4
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    • pp.435-444
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    • 2008
  • Purpose: Clinical study to evaluate the efficacy and the safety of various surgical treatments in snoring and obstructive sleep apnea. Methods and materials: We performed surgical treatments such as radiofrequency ablation, uvulopalatopharyngoplasty(UPPP) with tonsillectomy, uvulopalatopharyngoplasty with advancement genioplasty, orthognathic surgery(maxillomandibluar advancement), distraction osteogenesis device insertion. Diagnosis was performed with clinical examination, polysomnography, lateral cephalometric and computed tomography. 62(M : F = 45 : 17, mean age 41.5, mean follow-up 4 weeks) patients underwent radiofrequency ablation and 7 (M : F = 5 : 2, mean age 38.9, mean follow-up 19months)patients experienced uvulopalatopharyngoplasty with tonsillectomy. Uvulopalatophayngoplasty with advancement genioplasty was performed for 3 (M : F = 2: 1, mean age 30.2, mean follow-up 14 months)patients. The last 3(M : F = 2 : 1, mean age 21.5, mean follow-up 24 months)patients was treated with orthognathic surgery including distraction device insertion. The results was evaluated by questionnaires, polysomnography, investigation of complications. Results: Of the patients treated with radiofrequency ablation, 95% reported improvement of their symptom. 100% improvement was reported in patients treated with UPPP with tonsillectomy and UPPP with advancement genioplasty. The two of three patients who underwent orthognathic surgery showed the satisfactory of treatments. Dryness of mouth was the most common complication during short period in radiofrequency ablation and UPPP with tonsillectomy. Relapse complication was not found in any surgical treatments. Conclusion: Treatment for snoring and OSA is determined by severity degree of the physiologic derangements, predominant type of apnea and obstructive site. Accuracy diagnosis should be performed prior to treatment for satisfactory treatment result. This study demonstrates feasibility, safety and efficacy of surgical treatments in snoring and OSA.

Fine Needle Aspiration Cytology vs. Core Needle Biopsy for Thyroid Nodules: A Prospective, Experimental Study Using Surgical Specimen (갑상선 결절에 대한 세침 흡인 세포 검사와 중심부 바늘 생검의 비교: 수술 검체를 기반으로 한 전향적, 실험적 비교 연구)

  • Hyuk Kwon;Jandee Lee;Soon Won Hong;Hyeong Ju Kwon;Jin Young Kwak;Jung Hyun Yoon
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.645-657
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    • 2022
  • Purpose To evaluate and compare the diagnostic outcomes of ultrasonography (US)-guided fine needle aspiration (FNA) and core needle biopsy (CNB) performed on the same thyroid nodule using a surgical specimen for direct comparison. Materials and Methods We included 89 thyroid nodules from 88 patients from February 2015 to January 2016. The inclusion criterion was thyroid nodules measuring ≥ 20 mm (mean size: 40.0 ± 15.3 mm). Immediately after surgical resection, FNA and subsequent CNB were performed on the surgical specimen under US guidance. FNA and CNB cytopathologic results on the specimen were compared with the surgical diagnosis. Results Among the 89 nodules, 30 were malignant and 59 were benign. Significantly higher inconclusive rates were seen in FNA for malignant than benign nodules (80.0% vs. 39.0%, p < 0.001). For CNB, conclusive and inconclusive rates did not differ between benign and malignant nodules (p = 0.796). Higher inconclusive rates were seen for FNA among cancers regardless of US features, and in the subgroup of size ≥ 40 mm (62.5% vs. 22.9%, p = 0.028). Eleven cancers were diagnosed with CNB (36.7%, 11/30), while none was diagnosed using FNA. Conclusion In this experimental study using surgical specimens, CNB showed a potential to provide improved diagnostic sensitivity for thyroid cancer, especially when a conclusive diagnosis is limited with FNA.

Is This Symptom Even a Food Allergy?: Clinical Types of Food Protein-induced Enterocolitis Syndrome

  • Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.2
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    • pp.74-79
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    • 2014
  • Food protein-induced enterocolitis syndrome (FPIES) is an under-recognized non-IgE-mediated gastrointestinal food allergy. The diagnosis of FPIES is based on clinical history, sequential symptoms and the timing, after excluding other possible causes. It is definitively diagnosed by an oral food challenge test. Unfortunately, the diagnosis of FPIES is frequently delayed because of non-specific symptoms and insufficient definitive diagnostic biomarkers. FPIES is not well recognized by clinicians; the affected infants are often mismanaged as having viral gastroenteritis, food poisoning, sepsis, or a surgical disease. Familiarity with the clinical features of FPIES and awareness of the indexes of suspicion for FPIES are important to diagnose FPIES. Understanding the recently defined clinical terms and types of FPIES is mandatory to suspect and correctly diagnose FPIES. The aim of this review is to provide a case-driven presentation as a guide of how to recognize the clinical features of FPIES to improve diagnosis and management of patients with FPIES.

Diagnosis and Treatment of misdiagnosed odontogenic cutaneous sinus tract : a Case report (오진된 치성 피부 누공의 진단과 치료)

  • Kim, Sung-Joon;Kahm, Se-Hoon
    • The Journal of the Korean dental association
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    • v.52 no.6
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    • pp.363-369
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    • 2014
  • The cutaneous sinus tract is an uncommon disease. It is difficult to diagnose exactly of odontogenic cutaneous sinus tract for dentists or dermatologists except experienced clinicians or previously known clinicians. Many patients may be treated with repeated surgical excisions, biopsies, and antibiotic medications, but most of them could be frustrated with the recurrence of disease. There are several methods for diagnosis of odontogenic cutaneous sinus tract - such as GP cone tracing, conventional computed tomography(CT), periapical x-ray imaging, and cone beam computed tomography(CBCT). This case report describes the diagnosis and treatment of odontogenic cutaneous sinus tract that referred from medical doctors.

Isolated Supratentorial Intraventricular Recurrence of Medulloblastoma

  • Abode-Iyamah, Kingsley O.;Winslow, Nolan;Flouty, Oliver;Kirby, Patricia
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.557-559
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    • 2015
  • Medulloblastoma is a common pediatric tumor typically diagnosed before the age of fifteen. Initial therapy includes surgical resection and radiation of the entire neuro-axis. Recurrence is common and typically occurs within 2 years of initial diagnosis. Those fitting Collin's Law is considered tumor-free. We report a case of single supratentorial recurrence 13 years after initial diagnosis. Here we present a 22 year old male presenting 13 years after initial diagnosis with isolated septum pellucidum recurrence. He underwent complete resection of the tumor. Medulloblastoma is a common in the pediatric population. Late recurrence to the ventricular system is uncommon. Long term follow-up is recommended in these patients.