• Title/Summary/Keyword: Types of surgery

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Surgical Management of Coexisting Glaucoma and Cataract (녹내장과 백내장이 동반된 환자의 수술적 치료)

  • Cha, Soon-Cheol
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.12-22
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    • 2004
  • The management of coincident glaucoma and cataract is not only a common clinical challenge but also an important research topic in the ophthalmic surgical field. The purpose of this article is to compare the different surgical options on the basis of their achievable postoperative intraocular pressure (IOP) control, success rates, and complication rates reported in the related literature, and to give advice on how to manage typical situations of patients with both glaucoma and cataract. Main topics were focused on indications and rationale of 3 surgical options (only cataract surgery first and later trabeculectomy, only trabeculectomy first and later cataract surgery, or simultaneous combined surgery). Modern clear corneal cataract extraction techniques resulted in a modest intermediate-term reduction of IOP and has considerably improved the success rates of combined glaucoma and cataract surgery. It also enabled future trabeculectomy to be successfully performed at a later date if necessary. Trabeculectomy alone achieved better IOP regulation than phacotrabeculectomy (combined surgery), but subsequent cataract surgery may compromise preexisting filtering bleb. Combined surgery augmented with mitomycin C achieved a lower IOP than combined surgery alone but had a higher complication rate. In conclusion, the choice of the preferred surgical method should be determined according to the target pressure, the amount of glaucomatous damage, and the grade of visual disturbance caused by the cataract. Phacotrabeculectomy with adjunctive mitomycin C offers visual improvement and achieves the best IOP lowering of all types of combined glaucoma and cataract surgery currently used but is associated with potentially sight-threatening complications.

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The Effects of Relaxation Therapy on Pain and Anxiety in Spinal Anesthesia Surgery Patients (척추마취 수술환자의 불안감소를 위한 이완요법 적용 효과)

  • Moon, Hyeun-Sook;Lee, Hyang-Yeon;Lee, Ji-A
    • Journal of East-West Nursing Research
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    • v.15 no.1
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    • pp.54-62
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    • 2009
  • Purpose: The purpose of this study was to examine the effects of relaxation therapy to reduce anxiety level among spinal anesthesia surgery patients. Methods: The study employed a quasi-experimental pre-and-posttest design with nonequivalent control group. The experimental group was provided with the 15-min muscle relaxation therapy on the day before the surgery and an hour before the spinal anesthesia. Data were collected from 44 patients (22 in experimental and 22 in control group) who were planned to have spinal anesthesia surgery from an orthopedic surgery department at a general hospital in Seoul from January 13 to March 21, 2006. Results: The experimental group reported lower level of state anxiety after the surgery (23.18 vs. 33.64) than did control group but was not statistically significant. There were no significant differences in blood pressure or pulse rate between experimental and control groups after surgery. Conclusions: The further research should be conducted to polish the muscle relaxation therapy for various types of patients and to create more comfortable environment setting for application of the therapy. The muscle relaxation therapy may be a convenient and useful nursing intervention to reduce anxiety among spinal anesthesia surgery patients if more studies prove its effectiveness.

Comparison of Spontaneous Recovery and Nerve Surgery in Brachial Plexus Injury (상완 신경총 손상에서 자연 회복과 신경 재건술간의 비교)

  • Baek, Goo-Hyun;Chung, Moon-Sang;Seo, Joong-Bae;Park, Jin-Soo;Park, Yong-Bum;Jun, Deuk-Soo
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.137-146
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    • 1996
  • There has been no general agreement about optimal time for nerve surgery in the closed brachial plexus injury(BPI). From our early experiences, we knew by chance that spontaneous recovery in BPI patients may begin even later than 8 months after injury. Authors' strategy, which was based on our early experiences, for the treatment of closed fresh injury was 'wait and see' unlit 8 months after injury. From 1985 to 1994, we observed 103 patients with BPI. All of them did not have any operation until 8 months after injury. There were 95 men and 8 women with a mean age of 29 years. Motorcycle injury(31%) and vehicle accident(28%) were main causes of injury. Whole plexus types were observed in 56 patients(54%), upper plexus types in 29(28%), lower plexus types in 3(3%), and infraclavicular types in 15(15%). Electromyography was performed in all patients. This was repeated every three months to detect the recovery. Results were evaluated by authors' criteria, in which AMA system of brachial plexus impairment was modified. Duration of follow up was average 25 months. 47 patients(46%) showed spontaneous improvement, which was initially detected at average 7.8 months(range,3 months-16 months) after trauma by electromyography. The average score of these 47 patients improved from 14.8 points to 39.8 points.31 patients(30%) had nerve surgery such as nerve graft, neurotization or neurolysis. Average duration from injury to nerve surgery, was 10 months. Among 31 patients who had nerve surgery, 16 patients improved from preoperative 21.5 points to postoperative 36.3 points in average. Because spontaneous recovery began in average 7.8 months after injury, we think that it would be better to 'wait and see' for at least one year in patients with closed BPI expecting spontaneous recovery.

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Second-look Arthroscopic Findings after ACL Reconstruction - The Changes around Graft - (전방 십자 인대 재건술후 2차 관절경 검사 소견 - 이식건 주위의 변화 -)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chung Shun-Wook;Hwang Hoon;Ko Dong-Oh;Kwon Gi-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.13-16
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    • 2001
  • Purpose : To evaluate the types of the fibrous scar formation around graft after ACL reconstruction. Materials and Methods : Between Nov 1997 and Jun. 1999, the second look arthroscopy was performed on 15 knees of 14 patients. We evaluated the changes around graft and measured the tunnel position that the tibial tunnel position as a percentage along the length of the tibial plateau from the anterior-to-posterior as seen on a lateral radiograph and the femoral tunnel position as a percentage along Blumensaat's line from anterior-to-posterior as seen on a lateral radiograph. Results : The tibial tunnel position was from $27\%\;to\;58\%(mean\;41\%)$ and the femoral tunnel position was from $58\%\;to\;83\%(mean\;76\%)$, so the tunnel position was ideal in almost cases. By arthroscopic findings, the grafts were not impinged in all cases and tile fibrous scar was formed between intercondylar notch and graft in almost cases except 3 cases. The types of fibrous scar formation were 6 cases of fibrillated fiber and 5 cases of fibrous nodule and 1 case of fibrous band. Conclusion : There was no impingement on graft in all cases and various types of fibrous scars were formed around grafts.

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A Case of Atypical Lipomatous Tumor of the Neck (경부에서 발견된 비정형 지방종성 종양 1예)

  • Loh, Young Jin;Lee, Dong Kun;Park, Heon Soo
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.286-289
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    • 2018
  • Liposarcoma is a malignant tumor that occurs in adipocytes, accounting for 5% of all sarcomas. Generally, it has no symptoms and it occurs in any parts of the body. There are various types of liposarcoma. Of these, 40-45% are known as highly differentiated liposarcoma, and highly differentiated liposarcoma is also referred to as atypical lipomatous tumor. We report a case of an atypical lipomatous tumor on the left neck.

Treatment of flat foot with Kalix implant - case report - (Kalix implant를 이용한 편평족의 치료 - 증례보고 -)

  • Lee, Kyung-Tai;Young, Ki-Won;Bae, Sang-Won;Tak, Sang-Bo;Lee, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.238-241
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    • 2002
  • There are two types of flat foot, the one is congenital type and the other is acquired type. The treatments of flat foot are various and conservative treatment is general, except such as congenital talus. But, operative method is needed for treatment of failure of conservative method, severe deformity in X-ray, with tenderness in a juvenile period. We reported using Kalix implant for flat foot with pain and severe deformity.

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Early Gastric Cancer with Signet Ring Cell Histology Remained Unresected for 53 Months

  • Lee, Seung-Soo;Ryu, Seung-Wan;Kim, In-Ho;Sohn, Soo-Sang
    • Journal of Gastric Cancer
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    • v.11 no.3
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    • pp.189-193
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    • 2011
  • The natural course of untreated patients with signet ring cell carcinoma of the stomach remains poorly understood while assumptions have been made to distinguish it from other types of gastric cancer. A 74-year-old Korean woman was diagnosed with early gastric cancer with signet ring cell histology and refused surgery. A satellite lesion was identified 46 months after the initial diagnosis. The patient finally agreed to undergo distal subtotal gastrectomy 53 months following the initial diagnosis. Postoperative histological examination of both lesions confirmed signet ring cell carcinoma associated with submucosal invasion. There was no evidence of lymph node metastasis.

Malignant pilomatricoma of the cheek in an infant

  • Kim, Yang Seok;Na, Young Cheon;Huh, Woo Hoe;Kim, Ji Min
    • Archives of Craniofacial Surgery
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    • v.19 no.4
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    • pp.283-286
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    • 2018
  • Malignant pilomatricoma (pilomatrical carcinoma) is a rare, locally occurring malignant tumor with a high rate of recurrence in the case of incomplete excision. This tumor has two characteristics. First, recurrences of pilomatrical carcinoma are common; second, distant metastasis is rare, but if it occurs, it is very fatal. It has characteristic features of high mitotic counts, cellular atypia, and local invasion. Although fine needle aspiration and excisional biopsy could help to confirm this tumor diagnosis, pathologic findings are critical. Pilomatricomas have some characteristic features in histological aspect, such as epithelial islands of basaloid cells and shadow cells or ghost cell. Also, various types of immunohistochemical staining are used to confirm the diagnosis. Despite the lack of clear surgical criteria, treatment is a wide local excision with histologically clear resection margins with or without adjuvant radiotherapy.

Treatment of Recurrent Respiratory Papillomatosis Using Laser and Available Adjuvant Therapies

  • Woo, Seung Hoon;Chung, Phil-Sang;Lee, Sang Joon
    • Medical Lasers
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    • v.9 no.2
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    • pp.126-133
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    • 2020
  • Recurrent respiratory papillomatosis (RRP) is a benign tumor that occurs in the respiratory tract, especially in the larynx. The etiology of RRP is human papillomavirus (HPV). According to the age of occurrence, RRP is divided into childhood-onset and adult-onset types. Generally, childhood-onset RRP shows a high recurrence rate and diffuse involvement in the respiratory tract. Adult-onset RRP is more localized and appears more frequently as a solitary lesion. It may be the result of sexual transmission or the proliferation of latent HPV infections. At present, the treatment of choice for RRP is CO2 laser ablation. In addition, pulse dye laser or KTP (KTiOPO: potassium-titanyl-phosphate) lasers are also used. Non-surgical adjuvant therapies can be applied in cases requiring repetitive surgery or with diffuse extensions. This review will introduce the clinical features of RRP and various treatment options including lasers.

Clinical use of cold blood potassium cardioplegia (냉혈 K 심정지액의 임상적 이용)

  • Oh, Bong-Suc;Kim, Sang-Hyung;Lee, Dong-Joon
    • Journal of Chest Surgery
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    • v.15 no.1
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    • pp.35-39
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    • 1982
  • Cold blood potassium cardioplegia, by two types of the infusion systems, was used in 45 patients who were undergone the open cardiac operation. Method A [in 25 patients] was the syringe infusion system and method B [in 20 patients] was the pump infusion system. Cold blood potassium cardioplegic solution was used less amount on method B than method A. Serum potassium was often increased significantly on method A as a result of excessive infusion of cold blood potassium cardioplegic solution. But method B, excessive infusion of cold blood potassium cardioplegic solution was prevented by reperfusion of the previous infused cold blood potassium cardioplegic solution through the recirculation system. Alteration of infused rate and concentration of potassium in cold blood potassium cardioplegic solution during infusion [which might be suggested on the method A] could be controlled on method B.

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