• Title/Summary/Keyword: Surgical diagnosis

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Esophageal Perforation Due to Pneumatic Pressure of Carbonated Beverage - Report of two cases - (탄산 가스의 팽창 압력에 의한 식도의 천공 -2례 보고-)

  • 장인석;김종우;이정은;최준영;김성호;이상호
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.198-200
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    • 1999
  • Esophageal perforation due to the air pressure generated by forcefully evaporating gas is seldomly reported. If the diagnosis is confined to the injury of the oral cavity and the pharynx, missing the injury of the esophagus, the result may be fatal. Cases like this must be managed by early diagnosis and appropriate surgical intervention. The most important thing for early diagnosis is suspicion of esophageal injury from history and physical examination. We report two cases of esophageal pneumatic perforation caused by an explosive gas from the carbonated beverage bottle.

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Diagnosis and Treatment of Sleep Apnea (수면무호흡증의 진단과 치료)

  • Lee, Sang-Haak;Moon, Hwa-Sik
    • Sleep Medicine and Psychophysiology
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    • v.10 no.1
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    • pp.5-11
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    • 2003
  • Sleep apnea syndrome is a common clinical disorder characterized by intermittent cessation of airflow at nose and mouth during sleep. The clinical significance of this syndrome is that it is one of the most common causes of excessive daytime sleepiness. It can also cause neuropsychiatric, cardiovascular, and cerebrovascular complications. The standard for diagnosis of sleep apnea syndrome is nocturnal polysomnography. Because polysomnography is a time-consuming and expensive test, many efforts have been made to replace polysomnography with a simpler system of monitoring, but no method has yet been approved as a definitive investigation method. The goals of treatment for this syndrome are to eliminate excessive daytime sleepiness and to reduce the risk of possible cardiovascular complications. Continuous positive airway pressure is the most definite and widely accepted treatment for achieving these goals. Other treatments such as surgical treatment, oral appliances, and behavioral therapy may be useful for selected patients who are mildly affected.

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Supratentorial Intracerebral Schwannoma : Its Fate and Proper Management

  • Lee, Sungjoon;Park, Sung-Hye;Chung, Chun Kee
    • Journal of Korean Neurosurgical Society
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    • v.54 no.4
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    • pp.340-343
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    • 2013
  • Intracerebral schwannomas are rare and there have been none reported in Korea. We present the case of a 25-year-old man with newly developed right-side weakness and recent seizure aggravation. His seizures started approximately 9 years prior to admission. At that time, a 1 cm diameter intra-axial enhancing mass at the left precentral gyrus was found on magnetic resonance image (MRI). After 9 years of observation and treatment with antiepileptic medication, an MRI taken due to symptom aggravation revealed peri-tumoral cyst formation with tumor enlargement. The tumor was surgically removed. Subsequently, right-side weakness diminished and there was good seizure control. Pathologic diagnosis was schwannoma. Schwannoma is a very rare tumor and there are no pathognomonic findings on radiologic images; thus, it is challenging to make a correct diagnosis. However, considering the natural course and excellent prognosis after surgical treatment of this kind of intra-axial mass with benign features, early surgery for diagnosis and proper treatment is highly recommended.

Giant Lipoma of the Breast

  • Ramirez-Montano, Luis;Vargas-Tellez, Erik;Dajer-Fadel, Walid L.;Maceda, Silvia Espinosa
    • Archives of Plastic Surgery
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    • v.40 no.3
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    • pp.244-246
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    • 2013
  • Lipomas are benign mesenchymal tumors that develop in areas of abundant adipose tissue. Due to the fatty composition of the breast, difficulties in diagnosis, treatment, and reconstruction are often encountered. We report a case of a 55-year-old female with a giant tumor of the right breast that comprised most of its mass, causing breast asymmetry. A thorough preoperative evaluation, followed by an uneventful difficult surgical resection and reconstruction, resulted in diagnosis of a benign lipoma. The case prompted this report because of its challenging size, location, diagnosis, and reconstructive solution.

Surgical Treatment of Broncholithiasis (기관지 결석증의 외과적 치료)

  • 김주현
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.112-116
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    • 1992
  • I clinically analysed 13 cases of broncholithiasis which treated surgically and found only four cases of broncholithiasis caused by the erosion of the peribronchial lymph node named by extrinsic formation[Group II], and nine cases of broncholithiasis caused by intrinsic formation[group I] which indicates that no evidence of the erosion of the calcified per-ibronchial lymph node into the bronchial tree was found. This study is performed to see any differences between two groups regarding presenting symptoms, locations of broncholith, preoperative diagnosis, a history of pulmonary tuberculosis, a procedure of operation, and chemical compositions of broncholiths from both groups. There was no difference between two groups in the presenting symptoms, the procedure of operation, and chemical compositions of broncholiths. The broncholits from group two is located in the right middle lobe bronchus, and the broncholiths of group one were distributed at various bronchi, In group one, only five cases out of nine had preoperative diagnosis[55.5%], but in group two, all four had preoperative diagnosis. All cases had good postoperative courses without any complication and recurrences.

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Importance of Accurate Diagnosis in Pyoderma Gangrenosum

  • Kim, Yoon Soo;Kim, Han Kyeol;Han, Yea Sik
    • Archives of Craniofacial Surgery
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    • v.15 no.3
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    • pp.138-141
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    • 2014
  • Pyoderma gangrenosum is a rare inflammatory reactive dermatosis marked by painful cutaneous ulcers. Diagnosis of pyoderma gangrenosum is usually made based on past medical history and after the exclusion of other possible diseases based on the clinical manifestations of the lesion. Diseases that show rapid progression to necrosis and that should not be misdiagnosed as pyoderma gangrenosum include malignant neoplasms and necrotizing fasciitis. Immunosuppressive agents such as steroids and cyclosporine are considered first-line therapy. Surgical removal of the necrotic tissues is contraindicated, as it may further induce immune reaction and promote ulcer to enlarge. Here, we present a case to encourage plastic surgeons to consider pyodermagangrenosum in the differential diagnosis of idiopathic ulcers. Satisfactory outcomes for patients with pyodermagangrenosum may be expected when using steroids and immunosuppressive agents during the early stage of the disease.

MAXILLOFACIAL INFECTIONS MASQUERADING AS MALIGNANT TUMOR ; CASE REPORTS (악성종양과 감별이 어려웠던 악안면 영역의 감염질환에 대한 치험례)

  • Seo, Jae-Hoon;Yeo, Hwan-Ho;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.3
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    • pp.302-308
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    • 1995
  • It is very difficult to differentiate the malignant tumor from the maxillofacial infections that have unclear cause, severe indurated swelling, pain and nonresponsiveness to antibioitic treatment and incision and drainage. Incisional biopsy, CT, and MRI examination may not distinguish between infection and a malignant tumors. And then, the clinicians can make a mistake that they perform a unnecessary radical surgery because of inaccurate diagnosis. We present three case reports of maxillofacial infectious disease with diagnosis process, treatment and differential diagnosis. The infectious disease were not resolved with antibiotic and surgical drainage. The progression of clinical sign and radiographic, indings of these disease were masqueraded as malignant tumors.

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Diagnosis and Treatment of Extrapulmonary Tuberculosis

  • Lee, Ji Yeon
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.47-55
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    • 2015
  • Extrapulmonary tuberculosis (EPTB) constitutes about 20% of all cases of tuberculosis (TB) in Korea. Diagnosing EPTB remains challenging because clinical samples obtained from relatively inaccessible sites may be paucibacillary, thus decreasing the sensitivity of diagnostic tests. Whenever practical, every effort should be made to obtain appropriate specimens for both mycobacteriologic and histopathologic examinations. The measurement of biochemical markers in TB-affected serosal fluids (adenosine deaminase or gamma interferon) and molecular biology techniques such as polymerase chain reaction may be useful adjuncts in the diagnosis of EPTB. Although the disease usually responds to standard anti-TB drug therapy, the ideal regimen and duration of treatment have not yet been established. A paradoxical response frequently occurs during anti-TB therapy. It should be distinguished from other causes of clinical deterioration. Surgery is required mainly to obtain valid diagnostic specimens and to manage complications. Because smear microscopy or culture is not available to monitor patients with EPTB, clinical monitoring is the usual way to assess the response to treatment.

Left ventricular-right atrial shunt associated with PDA: a case report (동맥관개존증을 동반한 좌심실-우심방 단락 치험 1례)

  • Sin, Gi-U;Kim, Sang-Hyeong;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.316-321
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    • 1983
  • Left ventricular-right atrial [LV-RA] shunt is a relatively uncommon defect but is being encountered with increasing frequency. The diagnosis is often not suspected on the basis of clinical findings and so the specific anatomic diagnosis depends upon the use of selective left ventriculography. Recently we experienced LV-RA shunt associated with PDA, which was underwent successful surgical correction under the cardiopulmonary bypass. On the preoperative diagnosis coexistence of PDA was overlooked and identified at the time of operation. The type of LV-RA shunt was supravalvular, which was closed by direct suture with pledget.

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Intraoperative consultation for ovarian tumors

  • Kim, Insun
    • Journal of Yeungnam Medical Science
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    • v.36 no.3
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    • pp.163-182
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    • 2019
  • The primary function of intraoperative frozen consultation is to provide an as accurate and prompt diagnosis as possible during surgery and to guide the surgeon in further management. However, the evaluation of frozen section (FS) is sometimes difficult because of suboptimal tissue quality and frozen artifacts compared with routinely processed tissue section. The pathologist responsible for the FS diagnosis requires experience and good judgment. Ovarian tumors are a heterogeneous group of tumors including primary surface epithelial tumors, germ cell tumors and sex cord-stromal tumors, secondary tumors, and other groups of tumors of uncertain histogenesis or nonspecific stroma. Intraoperative FS is a very important and reliable tool that guides the surgical management of ovarian tumors. In this review, the diagnostic key points for the pathologist and the implication of the FS diagnosis on the operator's decisions are discussed.