• Title/Summary/Keyword: Surgical practice

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Surgical Management of Localized Scleroderma

  • Lee, Jae Hyun;Lim, Soo Yeon;Lee, Jang Hyun;Ahn, Hee Chang
    • Archives of Craniofacial Surgery
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    • v.18 no.3
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    • pp.166-171
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    • 2017
  • Background: Localized scleroderma is characterized by a thickening of the skin from excessive collagen deposits. It is not a fatal disease, but quality of life can be adversely affected due to changes in skin appearance, joint contractures, and, rarely, serious deformities of the face and extremities. We present six cases of localized scleroderma in face from our surgical practice. Methods: We reviewed six localized scleroderma cases that were initially treated with medication and then received follow-up surgery between April 2003 and February 2015. Six patients had facial lesions. These cases presented with linear dermal sclerosis on the forehead, oval subcutaneous and dermal depression in the cheek. Results: En coup de sabre (n=4), and oval-shaped lesion of the face (n=2) were successfully treated. Surgical methods included resection with or without Z-plasty (n=3), fat graft (n=1), dermofat graft (n=1), and adipofascial free flap (n=1). Deformities of the affected parts were surgically corrected without reoccurrence. Conclusion: We retrospectively reviewed six cases of localized scleroderma that were successfully treated with surgery. And we propose an algorithm for selecting the best surgical approach for individual localized scleroderma cases. Although our cases were limited in number and long-term follow-up will be necessary, we suggest that surgical management should be considered as an option for treating scleroderma patients.

Evaluation of Male Contraception in Korea (남성수태조절법의 신지견)

  • Lee, Hee-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.15 no.1
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    • pp.1-9
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    • 1988
  • The contraception practice rate in Korea has steadily increased from 9% in 1964 to 72% in 1987. Accordingly, natural increase rate of population declined from 28.4 per 1,000 in 1964 to 12.4 per 1,000 in 1987. Notably in recent years, the acceptance of surgical contraception services has sharply increased in this country. Now the author analyzes various factors influencing successful vasectomy and vasovasostomy based on his experience in performing more than 8,000 vasectomies and 1,000 vasovasostomies during the past 25 years. These various factors consist of preoperative screening interview, surgical vasectomy technique, vas irrigation technique, open-ended vasectomy, complications from vasectomy, sperm granuloma formation, spermatogenesis and steroidogenesis after vasectomy, immunological consequences after vasectomy, prostatic diseases and vasectomy, late post-vasectomy syndrome, psychological effects after vasectomy, and success rates of vasovasostomy. Besides, the author makes more comments on the results of the clinical trials on new approaches to reversible vas occlusion technique with a new device of Intravasal Thread and to reversible suppression of spermatogenesis with long-acting sex hormones.

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Treatment of acute high-grade acromioclavicular joint dislocation

  • Jeong, Jeung Yeol;Chun, Yong-Min
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.159-165
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    • 2020
  • Acromioclavicular (AC) joint dislocations account for about 9% of shoulder injuries. Among them, acute high-grade injury following high-energy trauma accounts for a large proportion of patients requiring surgical treatment. However, there is no gold standard procedure for operative treatment of acute high-grade AC joint injury, and several different procedures have been used for this purpose in clinical practice. This review article summarizes the most recent and relevant surgical options for acute high-grade AC joint dislocation patients and the outcomes of each treatment type.

Lymphaticovenular Anastomosis: Superficial Venous Anatomical Approach

  • Winaikosol, Kengkart;Surakunprapha, Palakorn
    • Archives of Plastic Surgery
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    • v.49 no.5
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    • pp.689-695
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    • 2022
  • Background Lymphaticovenular anastomosis (LVA) is an effective, functional treatment for limb lymphedema. This study reports an alternative surgical approach to lymphedema treatment without the use of indocyanine green mapping. Methods A retrospective analysis was performed on 29 consecutive lymphedema patients who underwent LVAs from January 2015 to December 2020, whereby incisions were made along the anatomy of the superficial venous systems in both upper and lower extremities around the joint areas. The evaluation included qualitative assessments and quantitative volumetric analyses. Result The mean number of anastomoses was 3.07, and the operative time was 159.55 minutes. Symptom improvement was recorded in 86.21% of the patients, with a mean volume reduction of 32.39%. The lymphangitis episodes decreased from 55.17% before surgery to 13.79% after surgery, and the median number of lymphangitis episodes per year decreased from 1 before surgery to 0 after surgery. Conclusions The superficial venous anatomical approach is an easy way to start a lymphedema practice using LVA without other advanced surgical equipment. With this reliable technique, microsurgeons can perform LVA procedures and achieve good results.

How to achieve the critical view of safety for safe laparoscopic cholecystectomy: Technical aspects

  • Vishal Gupta
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.201-210
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    • 2023
  • Laparoscopic cholecystectomy is associated with a higher incidence of biliary/vasculobiliary injuries than open cholecystectomy. Anatomical misperception is the most common underlying mechanism of such injuries. Although a number of strategies have been described to prevent these injuries, critical view of safety method of structural identification seems to be the most effective preventive measure. The critical view of safety can be achieved in the majority of cases during laparoscopic cholecystectomy. It is highly recommended by various guidelines. However, its poor understanding and low adoption rates among practicing surgeons have been global problems. Educational intervention and increasing awareness about the critical view of safety can increase its penetration in routine surgical practice. In this article, a technique of achieving critical view of safety during laparoscopic cholecystectomy is described with the aim to enhance its understanding among general surgery trainees and practicing general surgeons.

Plastic surgery and specialty creep: an analysis of publication trends

  • Mackenzie, Ethan L.;Larson, Jeffrey D.;Poore, Samuel O.
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.651-659
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    • 2021
  • Background Many surgical specialties have had pioneering influences from plastic surgeons. However, many of these areas of practice have evolved to include surgeons from diverse training backgrounds. This raises the question as to whether the prominence of other specialties in clinical practice translates to greater research productivity in these areas. The objective of this paper is to investigate the publication volumes of plastic surgeons in selected areas of practice compared to surgeons from other disciplines. Methods PubMed was used to examine publication trends in areas associated with plastic surgery. Searches for the following topics were performed: head and neck reconstruction, hand surgery, breast reconstruction, ventral hernia repair, abdominal component separation, brachial plexus injury, craniofacial surgery, and aesthetic surgery. Affiliation tags were used to examine contributions from nine specialties. Web of Science was used to identify the top cited articles for the last 10 years in each area. Results Articles by non-plastic surgeons comprise the majority of the literature for all areas of practice studied except for breast reconstruction and aesthetic surgery. Despite this, plastic surgeons contributed the greatest number of top cited articles over the last 10 years for five of the areas of practice. Conclusions While plastic surgeons do not contribute the greatest proportion of articles published each year in several of the selected areas of practice, they do publish a larger number of articles that are the most cited. Plastic surgeons remain the dominant academic force in terms of volume and citations for both breast and aesthetic surgery.

Job Analysis by Department in Clinical Practice for Realization of Legal Scope of Dental Hygienists: Focusing on Conservation, Pediatric Dentistry, Prosthodontics, Oral and Maxillofacial Surgery, and Implant Departments

  • Yoon, Mi-Sook
    • Journal of dental hygiene science
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    • v.20 no.4
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    • pp.230-244
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    • 2020
  • Background: The objective of the present study was to specifically divide the various work performed by dental hygienists in clinical practice for legal amendments regarding problems associated with conflict between job roles and illegal delegation to establish key basic data for legislation and policy utilization for realization of legal scope of dental hygienists. Methods: The study used work reports drafted based on research methods in the "Second Job Analysis Report on Dental Hygienists" researched by the Korean Health Personnel Licensing Examination Institute in 2012 and "Opinions of Dentists on Actual and Legal Work of Dental Hygienists," a report published by the Korean Dental Hygienists Association. Of these, the study focused on conservation dentistry, pediatric dentistry, prosthodontics, oral and maxillofacial surgery, and dental implant treatment, which make up some of the fields covered by dental hygiene practice, to investigate and analyzed work performed by clinical experience. Results: Analysis of work actually performed in dental practice showed that for work related to 33 items presented in the study methods, the participants responded that they are currently performing such work or are likely to perform such work in the future, although there were differences by year. Investigation by type of workplace showed that dental hygienists working in university hospitals could perform the work presented if they had ≥5 years of dental hygienist experience, whereas dental hygienists working in dental clinics or hospitals could perform simple duties in their first year and performed more diverse duties with greater degree of difficulty after their second to fourth year. Conclusion: The reality that medical assistance during surgical operations and various procedures that is still being performed is no longer legally protected directly contradicts the needs in dental practice, and thus, there is the need to amend laws that are realistic by clearly recognizing the work of dental hygienists.

Clinical Practice Guidelines for Hepatocellular Carcinoma: Current and Future Perspectives (간암 진료가이드라인의 현재와 전망)

  • Bo Hyun Kim;Joong-Won Park
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.21-28
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    • 2016
  • Hepatocellular carcinoma (HCC) is rather unique. Most of HCC patients have underlying chronic liver diseases with or without cirrhosis and the prognosis of HCC depends on the liver function, as well as the tumor extent. Non-invasive diagnosis of HCC can be made with certain risk factors and specific imaging findings (e.g. hypervascularity). Patients with HCC can receive surgical resection, radiotherapy, and systemic chemotherapy as other solid malignancies. HCC has more treatment options such as liver transplantation, transarterial chemoembolization (TACE) and radiofrequency ablation (RFA). A variety of practice guidelines for HCC has been published by many academic societies. Different healthcare systems and availability of resources also affect the practice guidelines; therefore, practice guidelines have similarities and dissimilarities. Herein, we review the current status of practice guidelines for HCC and future perspectives for the improvement of guidelines are also discussed.

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Thyroid Radiology Practice: Diagnosis and Interventional Treatment of Patients with Thyroid Nodules (갑상선 영상의학 진료: 갑상선 결절 환자의 진단과 중재적 치료)

  • Jung Hwan Baek;Dong Gyu Na
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.530-548
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    • 2020
  • Thyroid radiology practice is a medical practice in which thyroid diseases are diagnosed using imaging modality and treated by imaging-based interventional techniques, and the primary care target is thyroid nodular disease. Diagnosis of thyroid nodules is primarily done by ultrasound imaging and biopsy; thyroid nodules can be treated by non-surgical interventional treatment and thyroidectomy. Ethanol ablation is the first-line treatment for cystic benign nodules, and radiofrequency ablation is used for the treatment of benign solid nodules and recurrent thyroid cancers. Thyroid radiology practice has an essential clinical role in diagnosis and nonsurgical treatment of thyroid nodular diseases, and treatment should be performed based on standard care guidelines for proper patient care. In order to provide the best care to patients with thyroid nodular disease, it is desirable to treat patients in the radiology outpatient clinic. Thyroid radiology practice centered on outpatient clinic practice needs to be expanded.

Impact of Computerization on Direct and Indirect Nursing Time (병원전산화에 따른 직접 및 간접간호 양상의 변화)

  • Hwang, Jee-In
    • Journal of East-West Nursing Research
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    • v.11 no.1
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    • pp.58-64
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    • 2005
  • The purpose of this study was to examine impact of hospital computerization on the nursing practice. The study was conducted using the repeated measured design. The subjects were 166 nurses working at surgical nursing care units in a tertiary teaching hospital. A questionnaire was developed based on the Burke's study, and reviewed by a committee for content validity. Eighty-eight nurses responded the questionnaire throughout the study. Indirect nursing care time significantly decreased(p<0.05) after the computerization. These decrease related to time saving in checking physicians' order and writing nursing records. However, the change in direct nursing care time was not clear. In conclusion, the computerization led to the decrease in indirect nursing care time but it did not link to increase in direct nursing care time. Therefore, nurse managers should take into account redesign of the nursing works after computerization.

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