• Title/Summary/Keyword: outpatient surgery

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Posterior Instability of the Shoulder (견관절 후방 불안정성)

  • Jeong, Jin-Young
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.4-7
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    • 2011
  • Rotator cuff disease is one of the most common shoulder problems. When dealing with patients suffering from rotator cuff disease, whether to perform surgery or not is the most common difficulty faced by the outpatient clinic. Choosing the adequate operation time as well as the method of operation is important when deciding to perform surgery. Selecting the type of non-surgical treatment is an important issue when opting not to perform surgery. This review article will focus on the decision-making process involved in the treatment of rotator cuff disease.

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Salvage of late flap compromise in deep inferior epigastric perforator flaps: To revise or not to revise

  • Hong, Seung Heon;Lee, Kyeong-Tae;Pyon, Jai-Kyong
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.97-101
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    • 2020
  • Although the success rate of deep inferior epigastric perforator (DIEP) flaps has increased, late flap failures still occur and have a low salvage rate. The present article describes a case of salvage of a case of late flap failure using the pedicle vein as a vein graft source. A 50-yearold woman underwent a bilateral DIEP free flap procedure. On postoperative day 6, she experienced flap compromise and underwent emergency flap revision. In the flap revision, flap venous drainage and the superficial inferior epigastric vein were completely obstructed. A Fogarty catheter was used to remove a thrombus from the completely obstructed pedicle vein, and this pedicle vein was used as a graft source and was ligated in retrograde fashion to the flap vein stump. After injection of urokinase into the arterial branch, venous flow to the flap was restored. At a 6-month follow-up visit in the outpatient clinic, only partial fat necrosis at the flap was noted. By dissecting various perforators in the initial operation, decisions regarding immediate revision can be made with more confidence. Additionally, the combined procedures performed in this case may be helpful even for practitioners treating cases of late flap compromise.

Acute Myeloid Leukemia Identified Incidentally in Patient with Infected Extraction Socket through Preoperative Screening Blood Test: A Case Report

  • Yuha, Jeong;Minwoo, Kang;Shin Young, Hyun;Jong-Ki, Huh;Jae-Young, Kim
    • Journal of Korean Dental Science
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    • v.15 no.2
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    • pp.141-146
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    • 2022
  • Leukemia is a neoplastic disease with an excessive proliferation of immature white blood cells and their precursors. Common oral manifestations of acute myeloid leukemia (AML) include ulceration, petechiae, spontaneous bleeding, and gingival hyperplasia. The estimated prevalence of AML is 19 per 100,000 populations, the median age of diagnosis is over 65 years, and of all the subtypes of leukemia, AML accounts for the highest percentage of leukemic deaths. The purpose of this study is to report the case of a 77-year-old female patient, who visited our outpatient clinic due to consistent inflammatory findings. Though she received surgical treatment, she was diagnosed with AML by chance after a preoperative blood test. We also discuss the necessity of performing a preoperative blood test prior to invasive dental procedures such as tooth extraction or biopsy.

Gigantomastia as a Cause of Pulmonary Hypertension

  • Castillo, Juan Pablo;Robledo, Ana Maria;Torres-Canchala, Laura;Roa-Saldarriaga, Lady
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.369-372
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    • 2022
  • Reduction mammaplasty is the gold standard treatment for gigantomastia. We report one female patient with juvenile gigantomastia associated with severe pulmonary hypertension where her pulmonary pressure decreased significantly after the surgery, improving her quality of life. A 22-year-old female patient with gigantomastia since 10 years old, tricuspid regurgitation, and pulmonary thromboembolism antecedent was admitted to the emergency department. Her oxygen saturation was 89%. Acute heart failure management was initiated. An echocardiogram reported left ventricle ejection fraction (LVEF) of 70% with severe right heart dilation, contractile dysfunction, and arterial pulmonary pressure (PASP) of 110 mm Hg. A multidisciplinary team considered gigantomastia could generate a restrictive pattern, so a Thorek reduction mammoplasty with Wise pattern was performed. Presurgical measurements were: sternal notch to nipple-areola complex, right 59 cm, left 56 cm. Three days after surgery, the patient could breathe without oxygen support. In the outpatient follow-up, patient referred reduction of her respiratory symptoms and marked improvement in her quality of life. Six months after surgery, a control echocardiogram showed a LVEF of 62% and PASP of 85 mm Hg. Pulmonary hypertension may be present in patients with gigantomastia. Reduction mammoplasty may be a feasible alternative to improve the cardiac signs and symptoms in patients with medical refractory management.

A Case of Mucosa-Associated Lymphoid Tissue Lymphoma (MALT Lymphoma) in Hypopharynx: A Case Report (하인두에 발생한 점막 연관성 림프조직 림프종 1예: 증례 보고)

  • Min-Ju Kang;Youn-Sun Park;Ju-Eun Lee;Hyun-Bum Kim
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.1
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    • pp.33-36
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    • 2023
  • Malignant lymphoma rarely occurs in the larynx and hypopharynx. Few cases of malignant lymphoma in the larynx were reported in Korea. However, malignant lymphoma in the hypopharynx had been not reported in Korea. A 68-year-old woman came to the outpatient clinic with a foreign body sensation in her throat. A round, smooth margin, bright pink-colored mass was confirmed by the laryngoscopy. The patient took neck computer tomography. A small bulging of mucosa was observed, but there was no peripheral infiltration or abnormally enlarged lymph nodes. We did excision using CO2 LASER. She was finally diagnosed with mucosa-associated lymphoid tissue lymphoma (MALT lymphoma). After diagnosis, several image studies confirmed that there was no metastatic lesion. She got only radiotherapy after that and kept a complete response state for over 2 years.

A Rare Case of Clear Cell Carcinoma of the Tongue Base: A Case Report (혀 기저부에 발생한 투명세포암종 1예)

  • Hong Jin Kim;Ye Hwan Lee;HwaEun Oh;Kyung Ho Oh;Soon Young Kwon
    • Korean Journal of Head & Neck Oncology
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    • v.40 no.1
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    • pp.15-17
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    • 2024
  • Clear cell carcinoma is a rare variant of salivary gland carcinoma, and its occurrence in the tongue base is even rarer. We present a case of a 55-year-old female patient with clear cell carcinoma of the tongue base. The patient initially presented with a 3-month history of palpable tongue mass, leading to her visit to the otolaryngology outpatient clinic. The patient underwent a complete resection of the tumor under general anesthesia. Postoperative follow-up imaging studies showed no evidence of recurrence. This case report highlights the diagnostic and management challenges associated with clear cell carcinoma of tongue base and demonstrates that a high index of suspicion is required to diagnose clear cell caricnoma, given its rarity and overlapping features with other clear cell neoplasms.

Fatigue and weakness hinder patient social reintegration after liver transplantation

  • Kang, So Hyun;Choi, YoungRok;Han, Ho-Seong;Yoon, Yoo-Seok;Cho, Jai Young;Kim, Sungho;Kim, Kil Hwan;Hyun, In Gun;Shehta, Ahmed
    • Clinical and Molecular Hepatology
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    • v.24 no.4
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    • pp.402-408
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    • 2018
  • Background/Aims: With improvements in the survival of liver transplantation (LT) recipients, the focus is shifting to patient quality of life (QOL), and employment is an important factor in aiding the social reintegration of LT patients. This study aims to evaluate the current employment status of liver graft recipients and various factors that may hinder reemployment. Methods: Fifty patients above age 18 who underwent either living or deceased donor LT at a single center from March 2009 to July 2016 were interviewed during their visit to the outpatient clinic. The internally developed questionnaire consisted of 10 items. The Karnofsky Performance Scale and EQ-5D were used to evaluate patient function and QOL. Results: A total of 25 (50%) patients returned to work after transplantation (the working group), and 21 (84%) patients in the working group returned to work within the first year after transplantation. In the non-working group (n=25), 17 (68%) answered that their health was the reason for unemployment. Fatigue and weakness were the most frequent symptoms. Conclusions: The data shows that as many as 50% of total patients returned to work after receiving LT. Fatigue and weakness were the most common complaints of the unemployed group, and resolving the causes of these symptoms may help to increase the employment rate.

Residual foreign body inflammation caused by a lumber beam penetrating the facial region: a case report

  • Jun Ho Choi;Sang Seong Oh;Jae Ha Hwang;Kwang Seog Kim;Sam Yong Lee
    • Archives of Craniofacial Surgery
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    • v.24 no.1
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    • pp.37-40
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    • 2023
  • Penetrating wounds to the face are cosmetically devastating and can be life-threatening. If the foreign body causing the penetrating wound is a piece of wood, small remnants might be left behind after the initial treatment. A 33-year-old male patient presented to the emergency center after a piece of lumber pierced his face as a passenger in a traffic accident. The patient's vital signs were stable, and emergency surgery was performed to remove the foreign body and repair the soft tissue. No noteworthy complications were seen after open reduction and internal fixation of the facial bone fractures. Seven months after the accident, the patient underwent scar revision along with full-thickness skin grafting for post-traumatic scars. After the surgery, pus-like discharge which was not previously present was observed, and the graft did not take well. A residual foreign body, which was the cause of graft failure, was found on computed tomography and the remaining foreign body was removed through revision surgery. The patient is receiving outpatient follow-up without any complications 6 months after surgery. This case demonstrates the importance of performing a careful evaluation to avoid missing a residual foreign body, especially if it is of wooden nature.

The Effect of the Impacted Position of Palatally Inverted Mesiodens on the Selection of Sedation Method

  • Soojin Choi;Jihyun Song
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.63-73
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    • 2023
  • Purpose: Hyperdontia is a developmental disorder of the oral cavity. Mesiodens refers to the hyperdontia located between the maxillary central incisors. During the surgical procedure, the anesthetic method for pain control should be considered along with factors related to the surgery itself. The purpose of this study was to evaluate the effect of the impacted position of the mesiodens on the selection of sedation method and to suggest incisive foramen as a brief reference. Materials and Methods: This study included 126 patients who were scheduled for extraction of mesiodens. The selection criteria included patients with one palatally impacted inverted mesiodens accessible from the palatal gingival margin, and those with good cooperation potential in order to control for clinical information. Using cone beam computed tomography, vertical, horizontal, and palatal positional factors were measured, and the anesthetic method was determined by two examiners. The patients were grouped into vertical and horizontal groups based on the position of the incisive foramen. Data were statistically analyzed using the Mann-Whitney test, the chi-square test, and logistic regression analysis. Result: All positional factors differed between the outpatient and inpatient anesthetic groups. The vertical minimum distance from the alveolar ridge to the mesiodens (Va) and the minimum distance from the palatal surface to the crown tip of the mesiodens (Tc) were factors affecting the choice of anesthetic method. The distribution of the vertical and horizontal positional groups differed between the outpatient and inpatient anesthetic groups. Conclusion: The incisive foramen can be used as a brief reference to determine the appropriate anesthetic method. Referral for inpatient anesthesia may be a priority if they are in the V2H2 group with Va ≥5 mm, and Tc ≥6 mm, and outpatient sedation may be considered if they are in the V1H1 group with Va ≤1.5 mm, and Tc ≤2.5 mm.

Stress Radiographs under Anesthesia for Painful Chronic Lateral Ankle Instability (동통을 동반한 족관절의 만성 외측 불안정성에 있어서 마취하 스트레스 방사선 검사)

  • Choi, Jun Young;Ahn, Hee Chan;Shin, Myung Jin;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.12-16
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    • 2017
  • Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.