• Title/Summary/Keyword: experience report

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Tumors of the Parotidomasseteric Area Associated with Inadequate Primary Treatment: Report of 2 Cases (부적절한 일차 처치와 연관된 이하선 종양 2례)

  • Song, Jin Woo;Choi, Hwan Jun;Kim, Mi Sun;Ahn, Hyung Sik;Kim, Jun Hyuk;Lee, Young Man
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.764-768
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    • 2006
  • Purpose: Parotid neoplasia are relatively frequent, representing approximately 3% of all tumors in the head and neck regions. But incomplete resection and misdiagnosis of parotid gland is followed by multiple tumor invasion, tumor recurrence, and other iatrogenic tumor formation. In patients undergoing parotidectomy for confirmed or suspected malignancy, the traditional or modified rhytidectomy incision may prove suboptimal because it does not easily lend itself to a continuous neck dissection. Similarly, patients with tumors of the anterior accessory lobe or patients with large anterior tumors may also require the modified Blair incision for adequate surgical exposure. This report serves to revisit the topic of accessory and parotid gland neoplasms to emphasize proper management, particularly the surgical aspects, so that consequences of recurrence are avoided. Methods: This is a retrospective review of our experience with two cases of parotid tumors; one accessory parotid gland neoplasm and one parotid gland neoplasm. We report the case of parotid tumor and epidermal cyst in a 54-year old male patient and the case of case of recurrent parotid tumor with local invasion in 30-year old male patient. Results: All were removed through a modified Blair incision. Pathologic report notified that One was found pleomorphic adenoma and epidermal cyst, and the other one pleomorphic adenoma with subcutenous invasion. The patients recovered well without any complication such as infection, hematoma, facial nerve palsy, and necrosis of skin flap. Patients were discharge POD#7. Patients were followed up to for 1 year and they have no sign of recurrence. Conclusions: A high index of suspicion, prudent diagnostic skills(including fine-needle aspiration biopsy, CT, US), and meticulous surgical approach are the keys to a successful management of these lesions. We experienced two cases of parotid neoplasia, in the treatment of tumor reccurence & iatrogenic tumor arising from the parotid gland and are presented with the review of literatures.

Application Study of Symptoms Weight For Standard of Korean Medicine Pattern Identification In Stroke (중풍 한의변증 표준화를 위한 증상의 중요도 적용 연구)

  • Go, Ho-Yeon;Kang, Byung-Gab;Kim, Bo-Young;Kang, Kyung-Won;Go, Mi-Mi;Park, Sae-Wook;Cha, Min-Ho;Kang, Bong-Ju;Bang, Ok-Sun;Yu, Byung-Chan;Choi, Sun-Mi
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.4
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    • pp.1051-1055
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    • 2007
  • The diagnosis of pattern identification in Korean Medicine depend on Korean Medicine doctor's experience and information. So, Pattern identification in Korean Medicine raise a question of objectification. This study is to standard stroke pattern identification in Korean Medicine. Weight of symptoms was given important(1points), very important(2points) by stroke specialist. So weight of symptoms is used two method. One is total sum and the other is total man. One had been compared Pattern identification between diagnosed patients by medical specialists and by applicated weight in case report form. The other had been compared Pattern identification between intersubjectivity by medical specialists and by applicated weight in case report form. It is 38%(total sum) or 40%(total man) concordance rate between diagnosed patients by medical specialists and by applicated weight in case report form. It is 82.4% concordance rate between intersubjectivity by medical specialists and by applicated weight in case report form. To acquire more concrete data on this theme, we need further and large scale of prospective researches.

Clinical Characteristics of Pediatric & Adolescent Thyroid Cancer: A Single Institution Experience of 20 Years (소아청소년 갑상선암의 임상적 특징들: 단일 기관에서의 20년간의 연구)

  • Moon, Ki Yoon;Kim, Kwangsoon;Bae, Ja Seong;Kim, Jeong Soo
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.2
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    • pp.1-7
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    • 2020
  • Background/Objectives: Pediatric & Adolescent thyroid cancer is a steadily increasing malignancy. We aimed to report our experience at a single tertiary institution and to evaluate the risk factors for recurrence in pediatric & adolescent patients with differentiated thyroid carcinoma (DTC). Materials & Methods: The data of 42 pediatric & adolescent patients (aged ≤19 years) with DTC who underwent thyroidectomy at Seoul St. Mary's Hospital (Seoul, Korea) between December 1997 and February 2019 were retrospectively reviewed. Clinicopathologic features and surgical outcomes were retrospectively analyzed through complete chart reviews. Results: The mean age was 16.6 years. A total of 6 (14.3%) patients experienced recurrence after initial treatment. The recurrence rate was significantly different between total thyroidectomy (TT) and lobectomy groups (23.1% vs. 0%, p=0.038). However, no statistically significant differences were found in the recurrence rate according to lymph node ratio (LNR) of 0.4 (10.7% vs 21.4%; P=0.383). Multivariate analysis confirmed age (hazard ratio [HR], 0.443; P=0.008) and bilaterality (HR, 11.477; P=0.022) as significant risk factors for DFS. Conclusion: Pediatric & Adolescent thyroid cancer is a rare malignancy and TT is recommended as the treatment of choice. However, lobectomy may be considered for Pediatric & Adolescent patients with age >16 years, tumor size <1 cm, and no bilateral disease.

Study of Growth and Development of Breast-fed Infants and Parenting Experience of their Mothers (모유수유아의 성장발달 상태와 어머니의 양육 경험)

  • Kwon, In-Soo;Baek, Kyoung-Seon;Yang, Young-Ok;Lee, Ji-Won;Jung, Hyang-Mi;Park, Jeong-Hee;Shin, Sang-Chun;Lee, Soo-Yeon
    • Child Health Nursing Research
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    • v.12 no.4
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    • pp.495-505
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    • 2006
  • Purpose: The purpose of the study was to describe growth and development of breast-fed infants and to depict experiences of breastfeeding mothers. Method: The data were collected from 145 infants and mothers participating in A Healthy Breastfeeding Infant Contest. The instrument used for this study was a self-report questionnaire completed by the participants and an evaluation record completed by the examiners. Results: The more specific results of the study are as follows: the weight of the infants was much higher than the Korean Standards. The height of infants was not significantly different from the Korean Standards except for 5 month old male infants. The results of Denver II showed all 145 infants were classified as normal. The breastfeeding experiences in mothers was as follows; 31.7% of the mothers breastfed for 5 months, 48.3% wanted to breastfed as long as the baby wanted. The mothers pointed out that the difficult problem in breastfeeding was insufficient breastfeeding room in public areas. What mothers want to know related to breastfeeding was, breastfeeding duration, time to begin solid food and recommended amounts, time to discontinue breastfeeding at sleep time and appropriate methods. Conclusion: Mothers' experience in breastfeeding was positive. We should provide mothers a comfortable place in public areas for breastfeeding. Based on the result of the study it's propose that health professionals must intervene in breast care during both antepartum and early postpartum periods.

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Risk Factors Influencing Probability and Severity of Elder Abuse in Community-dwelling Older Adults: Applying Zero-inflated Negative Binomial Modeling of Abuse Count Data (영과잉 가산자료(Zero-inflated Count Data) 분석 방법을 이용한 지역사회 거주 노인의 노인학대 발생과 심각성에 미치는 위험요인 분석)

  • Jang, Mi Heui;Park, Chang Gi
    • Journal of Korean Academy of Nursing
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    • v.42 no.6
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    • pp.819-832
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    • 2012
  • Purpose: This study was conducted to identify risk factors that influence the probability and severity of elder abuse in community-dwelling older adults. Methods: This study was a cross-sectional descriptive study. Self-report questionnaires were used to collect data from community-dwelling Koreans, 65 and older (N=416). Logistic regression, negative binomial regression and zero-inflated negative binomial regression model for abuse count data were utilized to determine risk factors for elder abuse. Results: The rate of older adults who experienced any one category of abuse was 32.5%. By zero-inflated negative binomial regression analysis, the experience of verbal-psychological abuse was associated with marital status and family support, while the experience of physical abuse was associated with self-esteem, perceived economic stress and family support. Family support was found to be a salient risk factor of probability of abuse in both verbal-psychological and physical abuse. Self-esteem was found to be a salient risk factor of probability and severity of abuse in physical abuse alone. Conclusion: The findings suggest that tailored prevention and intervention considering both types of elder abuse and target populations might be beneficial for preventative efficiency of elder abuse.

Clinical Implication of Surgically treated Abdominoperineal Soild Tumor in the Newborn : A Single-Center Experience

  • Cho, Yong-Hoon;Kim, Soo-Hong;Kim, Hae-Young;Han, Young-Mi;Lee, Na-Rae;Bae, Mi-Hye;Park, Kyung-Hee;Byun, Shin-Yun
    • Neonatal Medicine
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    • v.25 no.1
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    • pp.23-28
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    • 2018
  • Purpose: Abdominoperineal solid tumors presenting in neonates often require surgical intervention during the neonatal period. Although we report our single-center experience, this study would be meaningful to understand the clinical implications of these neoplasms. Methods: We retrospectively reviewed and analyzed the clinical data and characteristics of 22 patients (${\leq}28$ days old) diagnosed with histopathologically confirmed abdominoperineal solid neoplasms (benign or malignant) after surgical resection. Results: The mean gestational age and postnatal age at the time of operation were $38.3{\pm}1.8weeks$ and $13.5{\pm}8.3days$, respectively. Most patients (18/22, 81.8%) were diagnosed during antenatal care visits; however, 4 (18.2%) were identified after birth. The mean tumor size was $6.4{\times}5.3cm$ (3.5-17.0 cm), and tumors occurred most frequently within the sacrococcygeal region (8/22, 36.4%). Histopathologically, 14 patients (63.6%) demonstrated benign tumors and 8 (36.4%) demonstrated malignant tumors. Germ cell tumors and hepatoblastomas were the most commonly observed tumors. Fortunately, all patients showed a localized pattern of tumor involvement without distant metastasis. No recurrence or mortality was observed during the follow-up period (mean $66.4{\pm}44.2months$). Conclusion: Abdominoperineal solid tumors occurring in neonates show variable clinical patterns during the antenatal and postnatal monitoring/screening periods. We conclude that aggressive and multidisciplinary approaches could achieve good clinical results in these patients.

Ikkam(翼鑑) presumed to be written by Yeonam (연암 저작 추정서 『익감(翼鑑)』에 관하여)

  • Park, Sang-Young
    • The Journal of Korean Medical History
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    • v.27 no.2
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    • pp.121-126
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    • 2014
  • The purpose of this paper is to report a newly discovered book whose title is Ikkam (翼鑑) and prepare for a full-scale study. The book, Ikkam, has a variety of contexts in which it seems to be written by Park Ji-won. First, 'Sanin' in 'Yeonam-Sanin' is consistent with the behaviors of Yeonam Park Ji-won who lived in hiding in the Yeonam valley in 1777. In addition, many statements written in the introduction, such as "as we stick to the old things, we do not know a makeshift", "we are well versed in changes" and "many soldiers are not always good" remind us of other writings of Park Ji-won. Moreover, he writes the statements using antithesis. It is the force of writing style of a literary person who is not engaged in medical service. In addition, he puts six qi in the introduction, but it is not as sophisticated as Jejungsinpyeon (濟衆新編). It suggests that this book may be published earlier than Jejungsinpyeon. When comparing Ikkam with Euimunbogam (醫門寶鑑) and Jejungsinpyeon, it seems common to place six qi in the introduction at the time. In addition, through this book, we find that Park Ji-won known as a writer of Geumryosocho (金蓼小抄) has fairly much knowledge in the medicine. We can estimate his passion and depth about the medicine through a longing for a new medical book shown in the introduction of Geumryosocho. However, various approaches to similar disease symptoms shown in the introduction help us to recognize his true qualities in the medicine. In addition, like other experience prescriptions, this book excludes prescriptions using medicinal herbs with toxicity or rare medicinal herbs in the situation with a limited supply of them in remote areas but includes prescriptions which are widely used. It shows that experience prescriptions in the Joseon Dynasty are effective to specifically identify medicinal herbs and prescriptions which are widely used in Korea. These values cannot be compensated by Donguibogam (東醫寶鑑) which has an infinite value.

Developing Students' Self-Directed Camp Programs for Gifted Students (학생 주도적 영재 캠프 프로그램 개발)

  • Lee, Kyung-Sook
    • Journal of Gifted/Talented Education
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    • v.21 no.4
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    • pp.907-925
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    • 2011
  • This study is a report about the two summer camps of 2009 and 2010, which were held by some gifted classes of Liberal Arts areas in Chungnam Province. The students' self- directed methods, making an own project topic and an outline plan for that by students themselves before the camp, raised up the students' satisfaction of the camp effectively. Staying with their peer students and teachers for 3 days gave the gifted students a chance for relationship, self-confidence, and self-sufficiency. These joint summer camps provided the students with cognitive development, motivations and a chance to meet other gifted students. Teachers' preparation for the camp, their concrete feedback to each student's project, and students' time spending on one's own camp project were correlated with the students' satisfaction of the camp program. Experience of teacher training in gifted education made significant differences in understanding gifted students and expectations of students' social and emotional development throughout and after the camp.

Robot-Assisted Cardiac Surgery Using the Da Vinci Surgical System: A Single Center Experience

  • Kim, Eung Re;Lim, Cheong;Kim, Dong Jin;Kim, Jun Sung;Park, Kay Hyun
    • Journal of Chest Surgery
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    • v.48 no.2
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    • pp.99-104
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    • 2015
  • Background: We report our initial experiences of robot-assisted cardiac surgery using the da Vinci Surgical System. Methods: Between February 2010 and March 2014, 50 consecutive patients underwent minimally invasive robot-assisted cardiac surgery. Results: Robot-assisted cardiac surgery was employed in two cases of minimally invasive direct coronary artery bypass, 17 cases of mitral valve repair, 10 cases of cardiac myxoma removal, 20 cases of atrial septal defect repair, and one isolated CryoMaze procedure. Average cardiopulmonary bypass time and average aorta cross-clamping time were $194.8{\pm}48.6$ minutes and $126.1{\pm}22.6$ minutes in mitral valve repair operations and $132.0{\pm}32.0$ minutes and $76.1{\pm}23.1$ minutes in myxoma removal operations, respectively. During atrial septal defect closure operations, the average cardiopulmonary bypass time was $128.3{\pm}43.1$ minutes. The median length of stay was between five and seven days. The only complication was that one patient needed reoperation to address bleeding. There were no hospital mortalities. Conclusion: Robot-assisted cardiac surgery is safe and effective for mitral valve repair, atrial septal defect closure, and cardiac myxoma removal surgery. Reducing operative time depends heavily on the experience of the entire robotic surgical team.

Nonintubated Uniportal Video-Assisted Thoracoscopic Surgery: A Single-Center Experience

  • Ahn, Seha;Moon, Youngkyu;AlGhamdi, Zeead M.;Sung, Sook Whan
    • Journal of Chest Surgery
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    • v.51 no.5
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    • pp.344-349
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    • 2018
  • Background: We report our surgical technique for nonintubated uniportal video-assisted thoracoscopic surgery (VATS) pulmonary resection and early postoperative outcomes at a single center. Methods: Between January and July 2017, 40 consecutive patients underwent nonintubated uniportal VATS pulmonary resection. Multilevel intercostal nerve block was performed using local anesthesia in all patients, and an intrathoracic vagal blockade was performed in 35 patients (87.5%). Results: Twenty-nine procedures (72.5%) were performed in patients with lung cancer (21 lobectomies, 6 segmentectomies, and 2 wedge resections), and 11 (27.5%) in patients with pulmonary metastases, benign lung disease, or pleural disease. The mean anesthesia time was 166.8 minutes, and the mean operative duration was 125.9 minutes. The mean postoperative chest tube duration was 3.2 days, and the mean hospital stay was 5.8 days. There were 3 conversions (7.5%) to intubation due to intraoperative hypoxemia and 1 conversion (2.5%) to multiportal VATS due to injury of the segmental artery. There were 7 complications (17.5%), including 3 cases of prolonged air leak, 2 cases of chylothorax, 1 case of pleural effusion, and 1 case of pneumonia. There was no in-hospital mortality. Conclusion: Nonintubated uniportal VATS appears to be a feasible and valid surgical option, depending on the surgeon's experience, for appropriately selected patients.