• Title/Summary/Keyword: Symptomatic approach

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Serous cystic neoplasm: Do we have to wait till it causes trouble? Season 2

  • Min Chul Shin;Hye Yeon Yang;Ji Su Kim;Chang Moo Kang
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.217-219
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    • 2023
  • A 50-year-old male presented gradually growing pancreatic body mass. An abdominal computed tomography showed a 9.9-cm mass, larger than the 8.9-cm mass one year ago. As the patient did not have complaints for any symptomatic problems, the gastroenterologist decided to check it with regular follow-up. However, as the tumor grew faster than expected, the patient was recommended for surgical resection. Laparoscopic pylorus preserving pancreaticoduodenectomy was done. Since the tumor abutted to the superior mesenteric vein and the portal vein, wedge resection of vessel was inevitable. Pathology was serous cystadenoma. The patient was discharged without postoperative complications. Herein, we report this case with asymptomatic large serous cystic neoplasm treated by laparoscopic approach. The appropriateness of current guidelines for surgery in serous cystic neoplasm is also discussed.

Surgical Result of the Os Trigonum Syndrome (족관절 후방 삼각골 증후군의 수술적 치료 결과)

  • Lee, Kyung-Tai;Young, Ki-Won;Lee, Young-Koo;Park, Shin-Yi;Park, Jung-Min
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.55-58
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    • 2008
  • Purpose: The purpose of this study is to find out the clinical results of excision of the Os trigonum through a posterolateral approach and to compare the surgical results of athletes with non-athletes. Materials and Methods: Within a five year and four month period, from July 2001 to October 2006, twenty patients underwent excision of symptomatic os trigonum, with a mean age of 22 years and 9 months at the time of the operation. There were fifteen female patients and five male patients. Eight were athletes and twelve were non-athletes. Results: The average duration of postoperative follow-up was thirty months. The postoperative AOFAS scored an average of 89 points compared to the preoperative AOFAS scored an average of 67 points. Sixteen patients (80%) who were operated, had good or excellent satisfactory results. The average preoperative AOFAS score of the athletes were 61 points, compared to the average postoperative AOFAS score of 90 points. For non-athletes, the average preoperative score was 71 points, compared to the average postoperative AOFAS score of 88 points. Seven athletes (87%) and nine non-athletes (75%) had good or excellent satisfaction results after surgery. The time until full recovery averaged 88 days for all the patients. 133 days for the athletes and 56 days for the non-athletes. There is no analytic difference between result in athletes and result in non-athletes. Conclusion: Open surgical treatment through posterolateral approach of os trigonum syndrome of the ankle may be effective modality regardless of the patient being an athlete or non-athlete.

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Treatment of Brainstem Cavernous Malformation: Treatment Indication, Technical Consideration, and Results

  • Lee, Sang-Bok;Lee, Jung-Il;Kim, Jong-Soo;Hong, Seung-Chyul;Park, Kwan
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.173-178
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    • 2005
  • Objective: The goal of this study is to provide the clinical data of patients with brainstem cavernous hemangiomas after treatment with microsurgery or radiosurgery after conducting a retrospective analysis of 21 patients at one institution. Methods: Twenty one patients with brainstem cavernous hemangiomas were treated at the authors' institution between 1995 and 2004 and clinical analysis was performed by retrospective review of medical records and neuroimaging examinations. Thirteen patients underwent microsurgical resection and radiosurgery was performed as an initial treatment in 9 patients. Results: Radical excision was achieved in 12 among 13 patients and transitory neurological deterioration or new neurological deficit developed during the immediate postoperative period in 7 (54%). The final outcomes at 5 - 70 months after surgery were improved in 11 patients (85%) and worsened in 2 patients (15%) compared with the preoperative state. Radiosurgery was performed in 9 patients. During the follow up period from 5 to 70 months there was neurological improvement in 3 patients, no significant change in 3 and deterioration in 3 patients. Two patients developed rebleeding at 5 months, 60 months respectively after radiosurgery. Conclusion: Microsurgery for symptomatic cavernous hemangioma of brainstem can be performed with acceptable morbidity. Fatal complication is rare with careful selection of the optimal operative approach in well selected patients. Radiosurgery is an effective alternative for the lesions which are not accessible by surgical approach, however, there is still a possibility of rebleeding over a long period after radiosurgical treatment and microsurgery should be considered as a treatment with priority for the majority of cases.

Mobile Telecommunication Policy Analysis of Moon Government In Korea (문재인 정부의 이동통신정책 분석)

  • Shin, Jin
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.12
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    • pp.2387-2393
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    • 2017
  • The Moon government, launched in May 2017, regards telecommunication service as part of people's welfare and is trying to save telecommunication costs. However, the direction of policy presented is assessed as symptomatic approach. This is largely attributable to the a partial improvement approach from the framework of the present mobile telecommunication industry. However if we restart from an essential point of view, the result is likely to be much better. The nation's mobile communication costs are not adequate because the government's role was not sufficient. There is a problem with the mobile phone supply chain, the subsidy payment mechanism, and the billing system. Addressing these complex issues requires the establishment of an independent system of handset distribution from telecommunication companies, ban on discriminative subsidies payment, and adoption of volume rate system. Telecommunications Business Act that defines the service charges to normalize the market might be somewhat useful, but the normal application of the Fair Trade Act is more important.

Comparative Study of Posterior Lumbar Interbody Fusion via Unilateral and Bilateral Approaches in Patients with Unilateral Leg Symptoms

  • Seong, Ji-Hoon;Lee, Jong-Won;Kwon, Ki-Young;Rhee, Jong-Joo;Hur, Jin-Woo;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.363-369
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    • 2011
  • Objective : We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. Methods : We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. Results : In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. Conclusion : Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.

Clinical Analysis of Benign Osteomas on Head and Neck region (두경부 양성 골종의 임상적 분석)

  • Song, Jin Woo;Choi, Hwan Jun;Choi, Chang Yong;Kim, Mi Sun
    • Archives of Craniofacial Surgery
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    • v.9 no.1
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    • pp.1-7
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    • 2008
  • Osteomas are most often located in the femur, tibia, humerus, spine, and talus. They are rare in the skull. Osteomas in the head and neck regions are benign bone neoplasms usually found in the frontoethmoid area. The developmental theory postulates that osteomas develop at the sites of fusion of tissues different embryological origin such as occur at the junction of the embryonic cartilaginous frontal and ethmoid bones. Trauma and infection have also been implicated as causative factors, but many patients with osteoma deny any preceding history of these. Osteomas are usually produce symptoms primary to cosmetic problems and secondary to pressure on adjacent structures. The objects of this study are from a 5-year period of April of 2002 to April of 2007, consisting of 48 male patients and 52 female. There were 33 cases of frontal bone osteomas, 5 cases of madibular bone osteomas, 5 cases of occipital bone osteomas, 6 cases of symptomatic paranasal sinus osteomas, 48 cases of asymptomatic paranasal sinus osteomas, and 3 cases of mastoid osteomas. We reviewed medical records of patients to find out their presentations, diagnostic considerations, therapeutic options, and outcomes. Patients were followed up six months postoperatively on the average. The authors experienced 48 cases of osteoma in the head and neck lesion, which were removed via direct approach or endoscopic approach. The 100 cases who came to the hospital with or without symptoms after diagnosis healed completely without sequelae. During the follow-up periods, excellent functional and cosmetic results were observed with an inconspicuous scar. There was no specific complications related to this procedure. Results of surgery in most cases were satisfied. We discussed the surgical procedure and the characteristics of the osteomas, and we report several cases with the review of literatures.

A REVIEW OF STUDIES ON OPERATOR'S INFORMATION SEARCHING BEHAVIOR FOR HUMAN FACTORS STUDIES IN NPP MCRS

  • Ha, Jun-Su;Seong, Poong-Hyun
    • Nuclear Engineering and Technology
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    • v.41 no.3
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    • pp.247-270
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    • 2009
  • This paper reviews studies on information searching behavior in process control systems and discusses some implications learned from previous studies for use in human factors studies on nuclear power plants (NPPs) main control rooms (MCRs). Information searching behavior in NPPs depends on expectancy, value, salience, and effort. The first quantitative scanning model developed by Senders for instrument panel monitoring considered bandwidth (change rate) of instruments as a determining factor in scanning behavior. Senders' model was subsequently elaborated by other researchers to account for value in addition to bandwidth. There is also another type of model based on the operator's situation awareness (SA) which has been developed for NPP application. In these SA-based models, situation-event relations or rules on system dynamics are considered the most significant factor forming expectancy. From the review of previous studies it is recommended that, for NPP application, (1) a set of symptomatic information sources including both changed and unchanged symptoms should be considered along with bandwidth as determining factors governing information searching (or visual sampling) behavior; (2) both data-driven monitoring and knowledge-driven monitoring should be considered and balanced in a systematic way; (3) sound models describing mechanisms of cognitive activities during information searching tasks should be developed so as to bridge studies on information searching behavior and design improvement in HMI; (4) the attention-situation awareness (A-SA) modeling approach should be recognized as a promising approach to be examined further; and (5) information displays should be expected to have totally different characteristics in advanced control rooms. Hence much attention should be devoted to information searching behavior including human-machine interface (HMI) design and human cognitive processes.

Single Life Time Cytological Screening in High Risk Women as an Economical and Feasible Approach to Control Cervical Cancer in Developing Countries Like India

  • Misra, Jata Shankar;Srivastava, Anand Narain;Das, Vinita
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.859-862
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    • 2015
  • In view of funding crunches and inadequate manpower in cytology in developing countries like India, single lifetime screening for cervical cancer has been suggested. In this study, an attempt was made to cscreening to make it more effective for early detection. Cytological data were derived from the ongoing routine cervical cytology screening program for women attending Gynaecology Out Patient Department of Queen Mary's Hospital of K.G.Medical University, Lucknow, India during a span of 35 years (April 1971 - December 2005). Cervical smears in a total of 38,256 women were cytologically evaluated. The frequencies of squamous intraepithelial lesions of cervix (SIL) and carcinoma cervix were found to be 7.0% and 0.6%, respectively, in the series. Predisposing factors related to cervical carcinogenesis were analyzed in detail to establish the most vulnerable groups of women for single life time screening. The incidence of SIL and carcinoma cervix was found to be maximal in women above the age of 40 years irrespective of parity and in multiparous women (with three or more children) irrespective of age. The incidence of cervical cytopathologies was significantly higher in symptomatic women, the frequency of SIL being alarmingly higher in women complaining of contact bleeding and that of carcinoma cervix in older women with postmenopausal bleeding. It is consequently felt that single life time screening must include the three groups of women delineated above. Such selective screening appears to be the most economical, cost effective and feasible approach to affordably control the menace of cervical cancer in developing countries like India.

Eagle's syndrome: a case report

  • Moon, Chang-Sig;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Jun;Lee, Jung-Woo;Lee, Hyun-Woo;Yun, Sun-Ung;Ohe, Joo-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.1
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    • pp.43-47
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    • 2014
  • Eagle's syndrome is a disease caused by an elongated styloid process or calcified stylohyoid ligament. Eagle defined the disorder in 1937 by describing clinical findings related to an elongated styloid process, which is one of the numerous causes of pain in the craniofacial and cervical region. The prevalence of individuals with this anatomic abnormality in the adult population is estimated to be 4% with 0.16% of these individuals reported to be symptomatic. Eagle's syndrome is usually characterized by neck, throat, or ear pain; pharyngeal foreign body sensation; dysphagia; pain upon head movement; and headache. The diagnosis of Eagle's syndrome must be made in association with data from the clinical history, physical examination, and imaging studies. Patients with increased symptom severity require surgical excision of the styloid process, which can be performed through an intraoral or an extraoral approach. Here, we report a rare case of stylohyoid ligament bilaterally elongated to more than 60 mm in a 51-year-old female. We did a surgery by extraoral approach and patient's symptom was improved.

TRANSORAL TREATMENT OF EAGLE'S SYNDROME: 2 CASE REPORT (구내 접근을 통한 이글씨 증후군의 치험 2례)

  • Kim, Jae-Young;Choi, Ji-Wook;Kim, Nam-Kyun;Tae, Il-Ho;Kim, Seong-Taek;Kim, Hyung-Jun;Cha, In-Ho;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.2
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    • pp.180-183
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    • 2009
  • Eagle's syndrome refers to a symptomatic elongation of the styloid process or calcification of the stylohyoid and stylomandibular ligaments that usually accompanies facial and pharyngeal pain, dysphagia, and foreign-body sensation in the throat. Making an accurate diagnosis is difficult as Eagle's syndrome can be accompanied with referred pain to various areas of head and neck. Treatment options for Eagle's syndrome include non-surgical and surgical methods. The surest and the most effective method for relieving the symptom is surgical removal or reduction of the elongated styloid process. The present study reports two cases of female whom were diagnosed as "Eagle's syndrome" and whose chief complain was foreign-body sensation and pain in the throat on movement. Surgical removal via transoral approach of the elongated styloid process is a safe surgical option with favorable results compared to extraoral approach.