Jang, Pal Young;Shin, Sang Ho;Lee, Kyung Suk;Kim, Nam Gyun;Kim, Jun Sik
Archives of Plastic Surgery
/
v.35
no.3
/
pp.325-328
/
2008
Purpose: Steatocystoma multiplex is a rare benign disease that occurred multiply on whole body surface. Many physicians have tried managing steatocystoma in variable methods. However it is hard to define the optimal way to cure steatocystoma. We performed both aspiration and excisional method to study the usefulness of both methods. Methods: A 28-year-old woman has asymptomatic multiple subcutaneous nodules on whole body. Most lesions were aspirated with 26-guage needled 3 cc syringe but large and purulent three nodules were excised. Results: We diagnosed the lesion histologically as steatocystoma multiplex. Aspirated wound healed without scar, excised wound remained scar but esthetically acceptable. Axillary lesion contained so clustered type cysts that was difficult to aspirate whole cyst. Thus additional excisional method was needed. Conclusion: There are many practical methods to cure steatocystoma. However, there is no appropriate method to cure it. Therefore we should select different therapeutic method according to anatomical location and cyst size. Especially at subcutaneous fat-rich lesion like axilla and abdomen, it is better to excise the clustered cyst than to aspirate.
Objectives : The purpose of this study was to investigate two subjects: the diagnostic value of bilateral lowering of electrical activity at point H4,5,6 of Ryodoraku and the mechanism for Ryodoraku phenomena. Methods : Electrical activities of Ryodoraku test and electrogastrography recorded simultaneously and monitored continuously from 16 cases of functional dyspeptic patients were collected and their variations were grouped by the topics of discussion which were peculiarity, stability, lagging, alterability, and anomaly. Ryodoraku recordings obtained from 6 patients with different gastrointestinal diseases and 1 normal healthy person were used as control. The results are discussed with Nakatani's suggestion, theory of sympathetic nerve and Meridian Principle, respectively. Finely, coincidence of stomach arrangement between anatomy and meridian system in Ryodoraku was also evaluated. Results : Time-course variation showed a regular relationship between the typical pattern of Ryodoraku at point H4,5,6 and gastric myoelectrical activity. However, an irregular relationship and atypical pattern of Ryodoraku occasionally appeared. A literature search suggested that electrical response at the Ryodoraku point H4,5,6 may be dependent on an afferent sympathetic spinal reflex transmitted from the stomach. However, there was no evidence for making clear whether bilateral lowering of electrical activity at this point was induced by hypofunction of local sympathetic nerve in the skin itself or of signals transmitted from the gastric sympathetic nerve or not. The coincidence of 19% could not provide a visceral arrangement of the stomach between anatomy and meridian systems. Conclusions : Bilateral lowering of electrical activity at Ryodoraku point H4,5,6 has value as a diagnostic index for gastric dysmotility of functional dyspepsia. This phenomenon is associated with spinal reflex transmitted from the afferent sympathetic nerve in the stomach but not that of meridian function.
Background: To know the clinical aspects of varicose vein and the effectiveness of operative treatment, the patients who had been operated during the five and a half years were reviewed. Material and Method: From September 1993 to February 1999, 227 patients with varicose vein were operated upon. These patients were reviewed with history taking, physical examination, laboratory tests, operation and follow up visits at an out patient department. Result: The ages of the patients were from 20 to 69 years, mean 40.2 years. varicose veins. Occupations of the patients include housewives, store or factory owners, cooks, waiter or waitresses in a restaurant, salary men(women), teachers, hair stylists, professional athletes, in sequence, most of them require standing all day long. The 126 women had experienced child birth, among them 116 patients delivered more than 2 babies. All patients had protruding leg veins as the symptom. Most of them(61%) had pain. Other additional symptoms were heaviness, heatness, tingling, cramp, fatigue, etc. 68.3% of the patients had the symptoms for more than 10 years. Anatomical location of varicose vein was in long saphenous vein in 157 patients, in small saphenous vein in 27, and in other regions(combined or perforating vein) in 43 patients. There was no operative mortality. There were 2 patients who underwent reoperation due to recurrence during this study period. In one patient, it recurred in the distal perforating vein in small saphenous vein. The other patient had recurrence at the saphenofemoral junction in groin. The patients are doing well after the reoperation, but a long term observation is needed. Conclusion: Clinical aspects of varicose vein were reviewed. For the patients with varicose vein who had saphenofemoral regurgitation, operative treatment seemed to bea safe and effective modality of treatment.
Objective: To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. Methods: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 patients. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis. Results: Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. Conclusion: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.
Yoon, Kyung Bong;Kim, Shin Hyung;Park, Sang Jun;Moon, Ji Ae;Yoon, Duck Mi
The Korean Journal of Pain
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v.29
no.3
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pp.197-201
/
2016
Because of its anatomical location and function, the costotransverse (CTRV) joint can be a source of thoracic back pain. In this retrospective observational study, we evaluated the clinical effectiveness of the CTRV joint injection in thoracic back pain patients with suspected CTRV joint problems. We enrolled 20 thoracic back pain patients with localized tenderness that was provoked by the application of pressure on the affected CTRV joints. We injected it with 0.5 ml of a ropivacaine and triamcinolone mixture at each level. The mean pre-injection pain score decreased by 37.9% ($7.2{\pm}1.5$ to $4.5{\pm}1.7$, P < 0.001) two weeks after CTRV joint injection. In addition, 70% of patients reported an excellent or good level of satisfaction. We demonstrated that an ultrasound-guided injection of the CTRV joint reduced patients' pain scores and led to a high level of satisfaction at short-term follow-ups in patients with suspected CTRV joint problems.
De Andres, Jose;Perotti, Luciano;Villanueva, Vicente;Asensio Samper, Juan Marcos;Fabregat-Cid, Gustavo
The Korean Journal of Pain
/
v.26
no.4
/
pp.336-346
/
2013
Intrathecal drug delivery is an effective and safe option for the treatment of chronic pathology refractory to conventional pain therapies. Typical intrathecal administered drugs are opioids, baclofen, local anesthetics and adjuvant medications. Although knowledge about mechanisms of action of intrathecal drugs are every day more clear many doubt remain respect the correct location of intrathecal catheter in order to achieve the best therapeutic result. We analyze the factors that can affect drug distribution within the cerebrospinal fluid. Three categories of variables were identified: drug features, cerebrospinal fluid (CSF) dynamics and patients features. First category includes physicochemical properties and pharmacological features of intrathecal administered drugs with special attention to drug lipophilicity. In the second category, the variables in CSF flow, are considered that can modify the drug distribution within the CSF with special attention to the new theories of liquoral circulation. Last category try to explain inter-individual difference in baclofen response with difference that are specific for each patients such as the anatomical area to treat, patient posture or reaction to inflammatory stimulus. We conclude that a comprehensive evaluation of the patients, including imaging techniques to study the anatomy and physiology of intrathecal environment and CSF dynamics, could become essential in the future to the purpose of optimize the clinical outcome of intrathecal therapy.
A clinical and statistical study was done for 123 patients with histologically proven colorectal malignant tumor from 1983 to 1986 at the department of anatomical pathology. Yeung Nam University Hospital. The results were as follows: 1. Ratio between male and female was 1.6:1 and incidence was most prevalent in 7th decades comprising 29.3%. 2. Location of tumor was the most frequent in rectum(65%). 3. Frequent symptoms and signs in case of right colon were pain, abdominal mass and bowel habit change. In left colon, they were pain, bowel habit change and bloody stool or melena. In rectum, they were bloody stool or melena, bowel habit change and pain. 4. Duration of symptom was 1 to 3 months(33.3%). 5. The most frequent histological type was adenocarcinoma(82.9%). 6. According to Dukes's classification, 32.9% of the tumor were stage $C_2$. 7. Operative procedures were Mile's operation(47.0%), right hemicolectomy(19.8%) and lower anterior resection(11.7%). 8. Polyps were the most frequent associated disease. 9. The most common complication was wound infection(11.1%).
Kim, Tae Young;Park, Jong Tae;Han, Weon Cheol;Moon, Seong Keun
Journal of Korean Neurosurgical Society
/
v.29
no.9
/
pp.1222-1227
/
2000
Objective : Vascular endothelial growth factor(VEGF), an endothelial cell specific cytokine, is a potent angiogenic growth factor implicated in the tumor angiogenesis and increases vascular permeability dramatically. Peritumoral brain edema(PTBE) occurs in 40-60% of meningiomas. Many causative factors have been investigated, but the mechanism of PTBE associate with meningioma is unclear. VEGF has been implicated as one of the causative factors of PTBE. This study was designed to determine whether the extent of VEGF expression is correlated with degree of PTBE in meningiomas. Methods : Meningioma tissue samples from 40 patients(7 men and 33 women, mean age $53{\pm}13years$) who underwent surgery were examined retrospectively for the expression of VEGF immunohistochemically. The extent of PTBE was estimated by using preoperative CT or MRI as an edema index(EI). In addition to VEGF, several causative factors including tumor size, location, histologic type, microvasculature(CD31) were compared with EI. Results : Twenty-six meningiomas demonstrated PTBE, and the other 14 did not. Of the 40 patients of meningiomas, 28 were positive(17 were 1+ and 11 were 2+) for VEGF. The EI increased significantly just as VEGF was strongly expressed(p=0.006). Microvascular proliferation was also closely correlated with the extent of peritumoral brain edema(p<0.05). Conclusion : These data suggest that VEGF expression and microvascular proliferation are closely correlated with PTBE in meningioma.
Jin, Hyeongmin;Kim, Dong-Yun;Park, Jong Min;Kang, Hyun-Cheol;Chie, Eui Kyu;An, Hyun Joon
Progress in Medical Physics
/
v.30
no.4
/
pp.104-111
/
2019
Purpose: Online magnetic resonance-guided adaptive radiotherapy (MRgART), an emerging technique, is used to address the change in anatomical structures, such as treatment target region, during the treatment period. However, the electron density map used for dose calculation differs from that for daily treatment, owing to the variation in organ location and, notably, air pockets. In this study, we evaluate the dosimetric effect of electron density override on air pockets during online ART for pancreatic cancer cases. Methods: Five pancreatic cancer patients, who were treated with MRgART at the Seoul National University Hospital, were enrolled in the study. Intensity modulated radiation therapy plans were generated for each patient with 60Co beams on a ViewrayTM system, with a 45 Gy prescription dose for stereotactic body radiation therapy. During the treatment, the electron density map was modified based on the daily MR image. We recalculated the dose distribution on the plan, and the dosimetric parameters were obtained from the dose volume histograms of the planning target volume (PTV) and organs at risk. Results: The average dose difference in the PTV was 0.86Gy, and the observed difference at the maximum dose was up to 2.07 Gy. The variation in air pockets during treatment resulted in an under- or overdose in the PTV. Conclusions: We recommend the re-contouring of the air pockets to deliver an accurate radiation dose to the target in MRgART, even though it is a time-consuming method.
Journal of The Korean Dental Society of Anesthesiology
/
v.9
no.1
/
pp.24-29
/
2009
When performing the inferior alveolar nerve block anesthesia, surgeon often faced a difficulty of the surgical operation due to the incomplete anesthesia. One of the reason is the variety of mandibular canal anatomy. Up to now, there are some reports of index cases about bifid mandibular canal among mandibular canal anatomic variation, and some classification is applied according to anatomical location and configuration. When surgical operation is performed involving mandible such as dantal implant treatment, extraction of an impacted third molar, sagittal split ramus osteotomy, etc, the position of mandibular canal should be considered. Bifid mandibular canal clinically causes troublesome cases of anesthesia when inferior alvelor nerve block, especially is performed extraction of an impacted third molar. Therefore, It is important for clinicians to recognize the presence of bifid canals on radiographys. Nowadays, the position of mandibular canal can be measured precisely by using Dental CT. It is not found by panorama image but is found by Dental CT sometimes. Among the patients, which take panorama and Dental CT simultaneously, for tooth extraction of lower impacted third molar in our department, we report the case that did not identifying in panorama but identifying it in Dental CT.
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