• Archives of Hand and Microsurgery
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• 제22권3호
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• pp.137-146
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• 2017

상완 신경총 손상은 상지의 가장 심각한 손상으로 정확한 진단을 내리는 것이 성공적인 결과를 얻는 데에 있어 중요하다. 기본적인 수술 전 평가에는 단순방사선 촬영, 경부 척수조영, 자기공명영상, 혈관조영술, 전기생리학적 검사 및 수술시의 평가가 있다. 또한, 적절한 수술 시기와 적응증, 수술계획과 환자의 예후에 대한 충분한 예후가 만족스러운 결과를 얻기 위한 필수적 조건이다. 저자들은 상완 신경총 손상의 진단, 수술 시의 관찰과 외상 후 상완신경총 손상 치료의 적절한 수술 계획에 대해 기술하고자 한다.

• 대한영상의학회지
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• 제84권1호
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• pp.280-285
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• 2023

자궁 근종은 여성에서 가장 흔한 양성 골반 강 내 종양이며 증상이 있을 경우 수술적 제거를 하게 된다. 내시경 수술이 발달하게 되면서 포트 삽입 부위의 기생 평활 근종들이 보고되기 시작하였다. 40세의 여자 환자가 왼쪽 아랫배에서 만져지는 종괴를 주소로 외래로 내원하였고 2년 전 내시경 근종 제거를 받은 과거력이 있었다. 조영증강 CT와 MRI를 시행하여 해당 종괴에 대한 평가를 시행하였으며 수술적 제거를 시행하였다. 병리 검사에서 해당 종괴는 기생 평활 근종으로 최종 진단되었는데 이는 이전 내시경 근종 제거술을 시행한 환자에서 수술부위에 만져지는 종괴를 주소로 내원하였을 때 반드시 기생 평활 근종을 감별 진단으로 고려하여야 함을 시사한다.

• Journal of Korean Neurosurgical Society
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• 제58권2호
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• pp.125-130
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• 2015

Objective : Repeated computed tomography (CT) follow up for traumatic brain injury (TBI) patients is often performed. But there is debate the indication for repeated CT scans, especially in pediatric patients. Purpose of our study is to find risk factors of progression on repeated CT and delayed surgical intervention based on the repeated head CT. Methods : Between March, 2007 and December, 2013, 269 pediatric patients (age 0-18 years) had admitted to our hospital for head trauma. Patients were classified into 8 subgroups according to mechanisms of injury. Types, amount of hemorrhage and amount changes on repeated CT were analyzed as well as initial Glasgow Coma Scale (GCS) scores. Results : Within our cohort of 269 patients, 174 patients received repeat CT. There were progression in the amount of hemorrhage in 48 (27.6%) patients. Among various hemorrhage types, epidural hemorrhage (EDH) more than 10 cc measured in initial CT was found to be at risk of delayed surgical intervention significantly after routine repeated CT with or without neurological deterioration than other types of hemorrhage. Based on initial GCS, severe head trauma group (GCS 3-8) was at risk of delayed surgical intervention after routine repeated CT without change of clinical neurologic status. Conclusion : We suggest that the patients with EDH more than 10 cc or GCS below 9 should receive repeated head CT even though absence of significant clinical deterioration.

• Journal of Korean Neurosurgical Society
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• 제37권4호
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• pp.282-286
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• 2005

Objective: Symptomatic chronic subdural hematoma(CSDH) is a well-known neurosurgical entity and most of the lesion is managed by surgical treatment. The authors analyze the surgical indication and the treatment results of twist drill craniostomy with closed-system drainage(TDD) for the symptomatic CSDH. Methods: From March 2001 through December 2003, 31 patients who were treated with TDD for the symptomatic CSDH and followed more than 6months were included. The radiologic criteria of TDD in this study were 1) homogeneous density of hematoma on computed tomography(CT), 2) no septation of hematoma on magnetic resonance imaging(MRI), and 3) thicker hematoma more than twice thickness of skull. Surgical procedures were performed on the maximum thickness of hematoma on CT/MRI. Short and long Steinman pins were used to penetrate the skull and hematoma membrane. As the 5L catheter was inserted through the drill hole, it was kept for 1 - 7days for the drainage of CSDH. The patients of CSDH were followed with clinical symptoms and CT studies. Results: Most of all the 31 patients were improved. However, one patient was suffered from postoperative epidural hematoma and the other patients have received the secondary operation because of the recurrence of CSDH on 3 months after initial surgery. Conclusion: TDD is safe procedure for the symptomatic CSDH if the patients are selected appropriately.

• Archives of Plastic Surgery
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• 제40권6호
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• pp.748-753
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• 2013

Background Nasal reconstruction is one of the most difficult challenges for the head and neck surgeon, especially in the case of complex full thickness defects following malignant skin tumor resection. Full-thickness defects require demanding multi-step reconstruction. Methods Seven patients underwent surgical reconstruction of full-thickness nasal defects with a bi-pedicled forehead flap shaped appropriately to the defect. Patients were aged between 58 and 86 years, with a mean age of 63.4 years. All of the tumors were excised using traditional surgery, and in 4 of the patients, reconstruction was performed simultaneously following negativity of fresh frozen sections of the margins under general anesthesia. Results Nasal reconstruction was well accepted by all of the patients suffering non-melanoma skin tumors with acceptable cosmetic outcomes. The heart-shaped forehead flap was harvested in cases of subtotal involvement of the nasal pyramid, while smaller defects were reconstructed with a wing-shaped flap. No cartilaginous or osseous support was necessary. Conclusions This bi-pedicled forehead flap was a valid, versatile, and easy-to-implement alternative to microsurgery or multi-step reconstruction. The flap is the best indication for full-thickness nasal defects but can also be indicated for other complex facial defects in the orbital (exenteratio orbitae), zygomatic, and cheek area, for which the availability of a flap equipped with two thick and hairless lobes can be a valuable resource.

• Journal of Gastric Cancer
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• 제10권4호
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• pp.182-187
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• 2010

Purpose: Additional surgery is commonly recommended in gastric cancer patients who have a high risk of lymph node metastasis or a positive resection margin after endoscopic resection. We conducted this study to determine factors related to residual cancer and to determine the appropriate treatment strategy. Materials and Methods: A total of 28 patients who underwent curative gastrectomy due to non-curative endoscopic resection for early gastric cancer between January 2006 and June 2009 were enrolled in this study. Their clinicopathological findings were reviewed retrospectively and analyzed for residual cancer. Results: Of the 28 patients, surgical specimens showed residual cancers in eight cases (28.6%) and lymph node metastasis in one case (3.8%). Based on results of the endoscopic resection method, the rate of residual cancer was significantly different between the en-bloc resection group (17.4%) and the piecemeal resection group (80.0%). The rate of residual cancer was significantly different between the diffuse type group (100%) and the intestinal type group (20%). The rate of residual cancer in the positive lateral margin group (25.0%) was significantly lower than that in the positive vertical margin group (33.3%) or in the positive lateral and vertical margin group (66.7%). Conclusions: We recommended that patients who were lateral and vertical margin positive, had a diffuse type, or underwent piecemeal endoscopic resection, should be treated by surgery. Minimal invasive procedures can be considered for patients who were lateral margin positive and intestinal type through histopathological examination after en-bloc endoscopic resection.

• 대한후두음성언어의학회지
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• 제23권2호
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• pp.104-110
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• 2012

The usages of botulinum toxin were most commonly for the treatment of spasmodic dysphonia in the otolaryngology field. It has been not only widely used in otolaryngology-Head Neck surgery but also plastic surgery, ophthalmology, rehabilitation medicine, and orthopedics. Now botulinum toxin is used such as blepharospasm (excessive blinking), strabismus, cosmetic, muscle spasms, upper motor neuron syndrome, severe primary axillary hyperhidrosis (excessive sweating), cervical dystonia (spasmodic torticollis), chronic migraine, bruxism, and achalasia. The indication of this drug still gradually expanding with the times. In this articles, the author will demontrate how to use the botulinum toxin for treating cricopharyngeal spasm, arytenoid dislocation, sialocele, Frey syndrome, contact granuloma, bilateral vocal fold paralysis, and mutaional falsetto instead of conventional surgical treatment.

• Journal of Chest Surgery
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• 제24권11호
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• pp.1144-1148
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• 1991

Ventricular false aneurysm is a rare complication of myocardial infarction We successfully operated on a case of left ventricular false aneurysm complicating a silent, undiagnosed myocardial infarction The patients, 64 year-old female, showed marked improvement in her congestive symptom after the operation and was discharged without any complication With its peculiar feature, i.e., propensity to rupture, in addition to the functionally harmful aspects shared with the true aneurysms, a false aneurysm must always be considered to be a surgical indication. Good results can be achieved by proper diagnosis and management with low operative risk.

• 대한한방부인과학회지
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• 제23권4호
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• pp.176-186
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• 2010

Purpose: To review the effectiveness affecting to the shoulder functionalities and upper numbness by Traditional Korean Medical treatment who are given a surgical operation for breast resection by breast tumor Method: To report the patients with dysfunction of shoulder joint and numbness in upper limb after breast surgery who improved by Traditional Korean Medical treatment and to study Traditional Korean Medicine(TKM) management of complications of breast surgery. Results: After about 2weeks treatment, patient's symptoms and signs were improved. TKM management was effective in recovery of shoulder function and upper limb numbness after breast surgery. Conclusion: We need to actively participate in management of complications of breast surgery as adjuvant therapy. And more study is needed for developing Traditional Korean Medical indication of complications of breast surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권1호
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• pp.3-8
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• 2013

Reconstruction of oral soft-tissue defects following resection of oral carcinomas can be achieved using various techniques including microsurgical tissue transfer. However, there seems to be a role for regional or local flaps. Small to medium-size defects can be functionally reconstructed with the platysma myocutaneous flap as an excellent choice particularly in medically compromised patients not being eligible for free tissue transfer. The present paper reviews the indication, surgical technique, and complications following reconstruction of defects of the oral cavity with the platysma myocutaneous flap.