• Title/Summary/Keyword: Surgical therapy

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Fungal frontal sinusitis in a dog (개의 진균성 전두동염)

  • Jang, Kwang-ho;Kwon, Yong-sam;Kang, Won-mo;Jang, Hwan-soo;Song, Chang-hyun;Choi, Dong-hag;Kim, Dae-young;Lee, Keun-woo;Oh, Tae-ho;Jang, In-ho
    • Korean Journal of Veterinary Research
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    • v.40 no.3
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    • pp.627-633
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    • 2000
  • A 6-year-old male Basset hound weighing 9.3 kg was presented with a history of severe mucopurulent discharge from the bilateral fronto-nasal area which had been developed progressively over 1 year. At admission, the physical state and appetite of the patient was poor. There was bilateral thick and mucoprulent discharge on the fronto-orbital area with fistula opening in the skin over the frontal bone. A sample of exudate was cultured and fungi were isolated. Radiographically, there was an increased diffuse opacity of the frontal sinus with decreased definition and a thickening of the mucous membrane lining the sinus. This case was finally diagnosed as chronic fungal frontal sinusitis. After surgical obliteration of the sinus, local and systemic antifungal therapy with chlorhexidine and ketoconazole were applicated. The dog had gradually recovered the physical state and appetite.

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Amiodarone-Induced ARDS after MVR -A case report- (승모판치환술 후에 발생한 아미오다론에 의한 급성호흡곤란증훈군 -1례 보고-)

  • 이기복;김응중;지현근;신윤철
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.594-598
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    • 2002
  • Amiodarone is an iodinated benzofuran derivative that has been proved effective in the control of supraventricular and ventricular arrhythmias refractory to other antiarrhythmic drugs. In patients treated with amiodarone, subsequent surgical intervention is a common clinical scenario, but unfortunately we do not have definite data about complications due to amiodarone after cardiac surgery. Some reports have shown that amiodarone treatment can be associated with a state of $\alpha$-adrenergic and $\beta$-adrenergic receptor blockade, which requires more pacing and epinephrine infusion for perioperative hemodynamic support. And some reports have also identified a severe form of ARDS in patients on amiodarone therapy which was associated with siginificant morbidity and mortality. We exprienced a patient who expired after mitral valve replacement due to amiodarone-induced ARDS; therefore, we report this case with a brief literature.

Leiomyosarcoma of the Bronchus -A case report with long-term follow-up - (기관지에서 기원한 평활근육종 -1예 보고 -)

  • Kim, Hyung-Tae;Lee, Cheol-Joo;Yoon, You-Sang;Choi, Ho;Kang, Joon-Kyu;Kim, Jung-Tae
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.991-994
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    • 2003
  • Primary leiomyosarcomas are rare tumors of the lungs. No typical roentgenographic findings of unusual complex of symptoms distinguish this tumor. The most common therapy is surgical resection. Prognosis and significant survivorship are related to the size, grade, metastasis of the lesion. A 25-year-old female patient with chest pain and cough was admitted. In chest X-ray and CT scan, there was a pulmonary nodule in left upper lung field, She was taken a percutaneous needle aspiration biopsy. The result was a spindle cell tumor. Left upper lobe lobectomy was done, and pathologic diagnosis was a low grade leiomyosarcoma arising from left bronchus. During 5 years of follow-up period, she has not shown any metastasis or local recurrence.

Primary Hyperparathyroidism With Functioning Parathyroid Adenoma - A Case Report - (기능성 부갑상선 선종에 의한 원발성 부갑상선 기능항진증 - 1예 보고 -)

  • Chin Hyung-Min;Lee Seung-Ha;Lee Yoon-Bok;Kim Jun-Gi;Park Woo-Bae;Chun Chung-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.58-64
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    • 1996
  • The parathyroid adenoma is the most common cause of the primary hyperparathyroidism. The characteristic of primary hyperparathyroidism is hypercalcemia and high value of serum parathyroid hormone. The primary hyperparathyroidism with parathyroid adenoma is treated by excision of parathyroid gland involved. Especially, parathyroid storm in patients with primary hyperparathyroidism is more prevalent than commonly appreciated. The symptoms and signs of the syndrome are not only due to the hypercalcemia, but also to the toxic effects of the parathyroid hormone. Its wide, but nonspecific clinical presentations make it easily confused with other cardiovascular or renal diseases. The mortality rate in untreated cases of parathyroid storm is essentially 40%. A 33 year old woman with primary hyperparathyroidism was found to have a left lower parathyroid adenoma, presented with hypercalcemic crisis. Initially, good responsiveness to a saline infusion, furosemide administration was noted. Unfortunately, she became consciousness disturbance after fine-needle aspiration of the parathyroid tumor. The recurrent storm was refractory to medical therapy, but was treated succesfully by emergent surgical removal tumor revealed a parathyroid adenoma with parathyroid hormone. Hypercalcemia was alleviated postoperatively. These observations corroborated a functioning parathyroid adenoma.

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Surgical Treatment of Pathologic Fracture of the Long Bone due to Metastatic Tumor (골전이로 인한 장골의 병적 골절의 수술적 치료)

  • Shin, Kyoo-Ho;Kim, Dong-Soo;Hahn, Soo-Bong;Han, Dae-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.52-59
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    • 1995
  • Metastatic cancer is the most common tumor of the skeleton. The prevalence of pathologic fracture may increase as patient survival is prolonged by improved cancer therapy. With recent advances in orthopaedic procedure and medical management of terminal cancer patients, it is generally agreed that aggressive treatment should be undertaken for patient with pathologic fracture secondary to metastatic disease, and a team approach should be utilized. The authors have reviewed twenty cases of pathologic fracture of the long bone due to metastatic tumor treated in the Department of Orthopedic Surgery, Yonsei University College of Medicine, from April 1989 to April 1994 and the following results were obtained. 1. The mean age at surgery was 58.4 years (ranged from 24years to 86years) and among 20 cases, 10 cases were male and the others were female. 2. The most frequent site of pathologic fracture in long bone is femur(15 cases, 75%), and followed by humerus(4 cases, 20%), tibia(1 case). 3. The frequently encountered primary tumors that metastases to long bone are those of the lung(7 cases, 35%), breast(4 cases, 20%), and prostate(2 cases, 10%). 4. The operative procedure was performed by resection of the tumor mass extensively, and we used polymethylmetacrylate for filling the dead space after resection, in all cases. 5. The mean survival period after operation is 9.2 months(ranged from 1 month to 4 years and 9 month). 6. The results of postoperative pain relief status were graded as fair to excellent in 17 cases(85%).

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A Case of Retronychia on Toenail (발톱에 발생한 역행조갑 환자의 치험례)

  • Choi, Seok-Min;Kim, Chul-Han;Kang, Sang-Gue;Tark, Min-Seong
    • Archives of Plastic Surgery
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    • v.37 no.2
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    • pp.178-181
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    • 2010
  • Purpose: Retronychia is the embedding of the nail into proximal nail fold. Retronychia starts with disruption of the longitudinal growth of the nail. With the growth of a new nail, the old one is pushed upwards and backwards. This leads to embedding of the top nail into the ventral aspect of the proximal nail fold and results with chronic paronychia. We present a case of retronychia that was rarely reported in the literature. Methods: A 46-year old female presented with a 3-month history of painful right first, 2nd, 3rd toenail changes. Although she was initially treated with broad spectrum antibiotics, she did not response to therapy. Later, she presented to our department because of progressively worsening pain that impaired her walking. Physical examination revealed with proximal nail fold erythema, painful swelling, yellowish nail discoloration, and distal onycholysis. Bacterial and fungus culture showed no organism. Treatment was surgical nail avulsion under local anesthesia. Results: The postoperative course was uneventful. 10 months later, the patient had a normal growing nail and was free of symptoms. Conclusion: We report a case of retronychia on toenail. Retronychia is a proximal nail plate ingrowth into the proximal nail fold which is associated with multiple generations of nail plate misaligned beneath the proximal nail. Management consisted of simple avulsion of superimposed nail. Retronychia is suspected with a persistent paronychia, particularly in the setting of trauma. Avulsion of the top nail confirms the diagnosis and may be curative if the underlying nail appears healthy.

Treatment of Rhabdomyosarcoma (횡문근육종의 치료)

  • Lee, Jong-Seok;Jeon, Dae-Geun;Kim, Sug-Jun;Lee, Soo-Yong;Park, Hyun-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.200-204
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    • 1995
  • Twenty three rhabdomyosarcoma patients who were registered in Korea Cancer Center Hospital from Mar. 1985 to Apr. 1994 were analysed in the aspect of treatment and survival. Thirteen cases were male and 10 female. Average age was 29.5 years(range 1 to 66). Locations of the tumor were as follows: 13 in lower extremity, 6 in upper extremity and 4 in trunk. According to the UICC classification, stage II b was 1 case, stage III a 4, stage III b 10, stage IV a 3 and stage IV b 5. In histological categories, embryonal rhabdomyosarcoma was 7 cases, alveolar 7, pleomorphic 7 and undetermined 2. Average follow up period was 35.3 months(1 tk 7.5 years). Ten cases were continuous disease free, 3 no evidence of disease, 3 alive with disease and 7 died of disease at final follow up. Kaplan-Meier's actuarial 5-year survival rate was 60.3% and 5-year continuous disease free survival rate was 31.4%, Surgical margin was an important factor in local tumor control. Although there was no definite statistical significance, our results suggest chemotherapy and radiation therapy have meaningful roles in reducing local recurrence and improving survival.

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The Effect of the Combined Stretching and Strengthening Exercise on the Clinical Symptoms in Posterior Tibial Tendon Dysfunction Patient (후방 경골 건 기능부전 환자의 임상 증상에 운동 치료가 미치는 영향)

  • Jeong, Tae-Ho;Oh, Jae-Kun;Lee, Hong-Jae;Yang, Yoon-Joon;Nha, Kyung-Wook;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.47-54
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    • 2008
  • Purpose: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients' muscle function and range of motion, pain and gait in the management of the early stage PTTD. Materials and Methods: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. Results: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. Conclusion: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.

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Analysis of the Risk Factors of Hematoma Enlargement in Patients with Spontaneous Intracerebral Hemorrhage (자발성 뇌실질내 출혈 환자에서 혈종 증가의 위험 인자에 대한 분석)

  • Lee, Yong-Mook;Koh, Hyeon-Song;Youm, Jin-Young;Kim, Seong-Ho;Song, Shi-Hun;Kim, Youn
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.437-442
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    • 2001
  • Objective : The purpose of this study was to evaluate the risk factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage(ICH). Methods : A series of 214 ICH patients diagnosed by brain CT scan in our neurosurgery department from June 1995 to July 1998 were reviewed with clinical status, past medical histories, laboratory findings, CT findings and prognosis. Results : In 27 patients(12.6%), the second CT scan showed an enlarged hematoma. Age, sex, and site of hematoma were not related to hematoma enlargement. A long interval(>6 hours) between the onset and the 1st CT scan strongly reduced the incidence of hematoma enlargement. The incidence of hematoma enlargement significantly increased in patients with previous history of hypertension, cerebral infarction and ICH. This analysis also demonstrated the following independent factors predisposed to hematoma enlargement : initial high systolic blood pressure, high serum total protein, low serum albumin, low serum sodium, prolonged prothrombin time(>14 sec) and activated partial thromboplastin time(>29.5 sec), irregular hematoma shape, and combined intraventricular hemorrhage. Prognosis in the group of hematoma enlargement showed high mortality(48.1%) and poor outcome. Conclusion : Patients with previous history of hypertension, cerebral infarction and ICH, and with high systolic blood pressure, prolonged coagulation time, irregular hematoma shape and intraventricular hemorrhage in CT scan should be observed carefully. And, early surgical therapy of large hematoma and meticulous control of blood pressure may decrease the mortality and morbidity in patients with spontaneous ICH.

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Analysis of Prognostic Factors Relating to Postoperative Survival in Spinal Metastases

  • Yang, Soon-Bum;Cho, Won-Ik;Chang, Ung-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.51 no.3
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    • pp.127-134
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    • 2012
  • Objective: To analyze the prognostic factors thought to be related with survival time after a spinal metastasis operation. Methods: We retrospectively analyzed 217 patients who underwent spinal metastasis operations in our hospital from 2001 to 2009. Hematological malignancies, such as multiple myeloma and lymphoma, were excluded. The factors thought to be related with postoperative survival time were gender, age (below 55, above 56), primary tumor growth rate (slow, moderate, rapid group), spinal location (cervical, thoracic, and lumbo-sacral spine), the timing of radiation therapy (preoperative, postoperative, no radiation), operation type (decompressive laminectomy with or without posterior fixation, corpectomy with anterior fusion, corpectomy with posterior fixation), preoperative systemic condition (below 5 points, above 6 points classified by Tomita scoring), pre- and postoperative ambulatory function (ambulatory, non-ambulatory), number of spinal metastases (single, multiple), time to spinal metastasis from the primary cancer diagnosis (below 21 months, above 22 months), and postoperative complication. Results: The study cohort mean age at the time of surgery was 55.5 years. The median survival time after spinal operation and spinal metastasis diagnosis were 6.0 and 9.0 months. In univariate analysis, factors such as gender, primary tumor growth rate, preoperative systemic condition, and preoperative and postoperative ambulatory status were shown to be related to postoperative survival. In multivariate analysis, statistically significant factors were preoperative systemic condition (p=0.048) and postoperative ambulatory status (p<0.001). The other factors had no statistical significance. Conclusion: The factors predictive for postoperative survival time should be considered in the surgery of spinal metastasis patients.