• 제목/요약/키워드: surgical diseases

검색결과 918건 처리시간 0.025초

Treatment of the wide open wound in the Ehlers-Danlos syndrome

  • Baik, Bong Soo;Lee, Wu Seop;Park, Ki Sung;Yang, Wan Suk;Ji, So Young
    • 대한두개안면성형외과학회지
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    • 제20권2호
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    • pp.130-133
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    • 2019
  • Ehlers-Danlos syndrome (EDS) is an inherited disorder of collagen biosynthesis and structure, characterized by skin hyperextensibility, joint hypermobility, aberrant scars, and tissue friability. Besides the skin, skeleton (joint) and vessels, other organs such as the eyes and the intestine can be affected in this syndrome. Accordingly, interdisciplinary cooperation is necessary for a successful treatment. Three basic surgical problems are arising due to an EDS: decreased the strength of the tissue causes making the wound dehiscence, increased bleeding tendency due to the blood vessel fragility, and delayed wound healing period. Surgery patients with an EDS require an experienced surgeon in treating EDS patients; the treatment process requires careful tissue handling and a long postoperative care. A surgeon should also recognize whether the patient shows a resistance to local anesthetics and a high risk of hematoma formation. This report describes a patient with a wide open wound on the foot dorsum and delayed wound healing after the primary approximation of the wound margins.

요추부 최소침습적 시술 후 길랑-바레 증후군: 증례보고 (Guillain-Barre Syndrome after Minimally Invasive Lumbar Procedure: A Case Report)

  • 이봉연;윤서라;류수라;최유리
    • 대한근전도전기진단의학회지
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    • 제20권2호
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    • pp.159-163
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    • 2018
  • Guillain-Barre syndrome (GBS) after trauma and general orthopedic surgery is rare. A 74-year-old woman showed ascending paralysis symmetrically, dysarthria, dysphagia and areflexia on 14 days after minimally invasive endoscopic thermoannuloplasty on L4-5 level. Brain and lumbar magnetic resonance imaging demonstrate no abnormal findings. The electrodiagnostic study showed prolonged distal motor, sensory latencies and F-wave latencies and reduced amplitude of compound muscle action potential in nerves of upper and lower extremities. In the cerebrospinal fluid (CSF) examination, total protein and IgG were increased. We diagnosed Guillain-Barre Syndrome based on clinical features, electrodiagnostic study and CSF examination and the patient improved symptoms after immunoglobulin injection and rehabilitation. Because the occurrence of GBS after minimally invasive procedure has not been reported, we report a case of GBS after minimally invasive procedure with literature review.

Distribution of Coagulase-Negative Staphylococci and Antibiotic Resistance

  • Park, Heechul;Park, Sung-Bae;Kim, Junseong;Kim, Sunghyun
    • 대한의생명과학회지
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    • 제27권2호
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    • pp.45-50
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    • 2021
  • Coagulase-negative staphylococci (CoNS) are a typical group of microorganisms, and the recent advances in laboratory technology and medicine has dramatically modified their significance in medical practice. CoNS, which were previously classified as normal bacterial flora, have recently been reported to be associated with serious infectious diseases, such as surgical wound infection or periprosthetic joint infection. Representative CoNS include Staphylococcus epidermidis, S. haemolyticus, and S. saprophyticus, which are known to cause serious problems in biomaterial-based and prosthetic device infections, as well as to cause simple urinary tract infections in sexually active women. Over the last decade, the clinical isolation rate of CoNS has been increasing, and antibiotic resistance has also been occurring. This review aimed to investigate the incidence of CoNS infection and to use the results as basic data for the management of CoNS, with a focus on the isolation rate and antibiotic resistance in clinical surgery.

A Case of Ocular Sparganosis in China: Episode of Migration from Muscle Cone to Subconjunctiva

  • Xinyuan Chen;Yanyuan Fang;Liming Tao;Miao Liu;Kun Liang
    • Parasites, Hosts and Diseases
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    • 제60권6호
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    • pp.419-421
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    • 2022
  • To improve our understanding of the migration of sparganum in humans, we report a case of ocular sparganosis having the migratory episode from the muscle cone to the subconjunctiva. A 34-year-old woman was admitted to the Hospital of Anhui Medical University (Hefei, China), in December 2019. She presented with conjunctival hemorrhage and recurrent pain in the left eye. A foreign body was found in the muscle cone of the eye. Two months later, a ribbon-like white material was found under the conjunctiva on slit-lamp examination. A long and slender, actively moving parasite was extracted by surgery. The extracted worm was approximately 8 cm long and 2 mm wide. The worm was whitish, wrinkled, ribbon shaped, and had a slightly enlarged scolex. The worm sample was morphologically identified as a plerocercoid larva (sparganum) of the Spirometra tapeworm. Her conjunctival blood suffusion and eye pain ceased within 1 week after operation. She has been in good health without any symptoms during the 2-year follow-up. A case of ocular sparganosis, in which larval worm migrated from the muscle cone to the subconjunctiva is reported from China.

Serous tubal intraepithelial carcinoma detected during benign gynecologic surgery: a case report

  • Eun Seo Shin;Sung Yob Kim
    • Journal of Medicine and Life Science
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    • 제20권1호
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    • pp.48-52
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    • 2023
  • High-grade serous carcinoma (HGSC) is the most common type of pelvic cancer among women. Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion of HGSC. Herein, we report a rare occurrence of STIC in patients undergoing surgery for benign indications without a family history of ovarian cancer. A 77-year-old woman underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for uterine prolapse. Pathological examination revealed bilateral STIC without ovarian abnormalities, and no other abnormal findings were noted. Another patient, a 49-year-old woman, underwent laparoscopic total hysterectomy and bilateral salpingectomy for uterine fibroids. STIC lesions were observed in both fallopian tubes. Subsequently, a staging was performed. No additional lesions were found, and the patient was followedup through imaging and blood tests. As reports of STIC lesions are rare, data on their clinical outcomes and management strategies are limited. In this report, we present cases of incidental STIC in benign surgery and discuss its proper interpretation and management. Through the early detection of STIC lesions, patients with risk factors can be identified in advance, which will allow prevention and early detection of ovarian cancer. Opportunistic salpingectomy was also actively discussed in this regard.

가성통풍으로 인한 수근관 증후군 (Carpal Tunnel Syndrome Caused by Pseudogout)

  • 김유진;채승완;이호석;이석원
    • 대한정형외과학회지
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    • 제54권4호
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    • pp.372-376
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    • 2019
  • 가성통풍으로 인한 수근관 증후군은 드물게 발생한다. 저자들은 수근관 내 종괴로 인한 급성 정중신경 압박 증세로 내원한 65세 여자환자에게 종괴 절제술과 횡수근 인대 절개술을 시행하고 조직검사를 통해 가성통풍으로 진단된 증례를 경험하여 문헌 고찰과 함께 보고하고자 한다.

항암치료를 받는 소화기 암환자에서 코로나바이러스 감염증-19 백신접종 (COVID-19 Vaccination in Patients with Gastrointestinal Cancer Receiving Chemotherapy)

  • 이종현;김동욱
    • Journal of Digestive Cancer Research
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    • 제10권2호
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    • pp.107-111
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    • 2022
  • In 2019, coronavirus disease (COVID-19), which originated in Wuhan, has spread worldwide. In most people, COVID-19 symptoms are not severe. However, the mortality rate and severity were high in risk groups such as in older people and patients with underlying diseases. As patients with cancer are one of the risk groups, the vaccination for COVID-19 is emphasized in these patients. However, COVID-19 vaccines are not tested enough in special groups such as in patients with cancer because these vaccines are developed at an unprecedented speed. This causes confusion about whether patients undergoing chemotherapy should be vaccinated or not. In this study, international guidelines and studies were reviewed. Most of the studies recommended vaccination. No evidences of any negative effects for the efficacy or safety were recorded in patients undergoing cytotoxic, targeted, and immune agents. However, in critical conditions such as cytopenia, vaccination must be decided according to the patient's condition. COVID-19 vaccines were also recommended for patients on surgery or radiation therapy. If possible, vaccine is given before surgery to avoid confusion between surgical complications and side effects of the vaccine. The radiation recall phenomenon after vaccination has been reported in some cases of radiation therapy. Clinicians should consider these situations before vaccinating each patient. We hope that clearer guidelines will be established by accumulating verified data.

영상의학과 의사들을 위한 여성형 유방과 남성 유방암에 관한 리뷰 (A Review on Gynecomastia and Male Breast Cancer for Radiologists)

  • 황은진;차주희
    • 대한영상의학회지
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    • 제81권5호
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    • pp.1096-1108
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    • 2020
  • 남성에서 만져지는 종괴나 비대칭적인 유방 등의 증상을 일으키는 가장 흔한 원인은 여성형 유방이며, 남성 유방암은 매우 드물긴 하지만 간과해서는 안 되는 질환이다. 남성 유방의 해부학과 호발하는 질환을 알고 여성과의 차이를 숙지하여 정확히 진단하고 불필요한 검사나 외과적 절제술을 줄이는 것이 중요하다. 이 종설에서는 증상이 있는 남성에서의 유방 검사 알고리즘과 여성형 유방 및 남성 유방암에 대하여 정리하고자 한다.

타액선 질환에 대한 세침흡인세포검사의 유용성 (Efficacy of Fine Needle Aspiration Cytology of Salivary Gland Diseases)

  • 박민현;이승신;최병윤;김인상;최승호;고태용;김광현;성명훈
    • 대한두경부종양학회지
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    • 제16권1호
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    • pp.42-45
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    • 2000
  • Background and Objectives: To review efficacy of the fine-needle aspiration cytology(FNAC) in patients with salivary glands lesions. Materials and Methods: From January 1994 through June 1999, FNACs and surgical biopsies were carried out on 109 patients with salivary gland diseases. The medical records were reviewed retrospectively. Benign tumor was found in 81 patients, and malignant tumor was in 19 patients. Nine patients had inflammatory lesion. Results: In 6 of 109 cases the aspiration was inadequate. Of the remaining 103 patients, FNAC correctly diagnosed 87 lesions(84.5%). For benign tumor lesions, the accuracy was 91%(71/78), and for malignant lesions 55.6%(10/18). The accuracy for inflammatory lesions was 85.7%(6/7). Regarding the capacity to discriminate between neoplastic and nonneoplastic lesions, sensitivity, specificity and total diagnostic accuracy were 99%, 85.7% and 84.5% respectively. Regarding the capacity to discriminate between malignant and benign tumors, sensitivity and specificity were 55.6% and 97.4% respectively. FNACs misdiagnosed malignant tumors as benign lesions in eight patients, in which three were with adenoid cystic carcinomas. Carcinoma ex pleomorphic adenoma, malignant lymphoma and mucoepidermoid carcinoma 'were others. Conclusion: FNAC showed high accuracy to diagnose benign lesions in salivary gland diseases. But the accuracy was rather low for malignant lesions. If a salivary gland lesion was suspected for malignant tumor, other diagnostic methods such as tissue biopsy should be seriously considered.

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양성식도질환(良性食道疾患)에 대(對)한 임상적(臨床的) 고찰(考察) (Surgical Management of the Benign Esophageal Diseases)

  • 박주철;노준량;김환종;서경필;이영균
    • Journal of Chest Surgery
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    • 제9권2호
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    • pp.298-310
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    • 1976
  • A clinical analysis was performed on 118 cases of the benign esophageal diseases experienced at Department of Thoracic Surgery, Seoul National University Hospital during 20 year period from 1957 to 1976. Of 118 cases of the benign esophageal diseases, there were 84 patients of esophagenal stenosis, 14 of esophageal perforation, 8 of esophageal atresia, 7 of achalasia, 2 of hiatal hernia, 2 of esophageal foreign body and one of esophageal diverticulum. Fifty-one patients were male and sixty-seven were female, and ages ranged from one day to sixty-four years with peak incidence in the age group of 20 to 29 years. All but one of the esophageal stenosis were caused by corrosive esophagitis and ages ranged from three to sixty-four years with peak incidence in third decade. Main symptoms of the esophageal stenosis were dysphagia, weight loss and chest pain in order and mostly began between one month and one year after ingestion of corrosive agents. Corrosive esophageal stenosis developed most frequently in middle one-third of the esophagus and about one-forth of them were diffuse. Operations were performed on 72 patients of esophageal stenosis of whom 26 patients had esophagocologastrostomy, 21 gastrostomy, 20 esophagogastrostomy, 4 esophagojejunogastrostomy and 2 pharyngogastrostomy. There were 5 deaths in the postoperative period, an operative mortality of 6.9 percent, and 20 patients had one or two complications; eight were anastomotic leaks, 6 gangrenes of replaced loop, 4 wound abscesses and others. The causes of the esophageal perforation were traumatic in 7 cases, caustics in 4 and spontaneous in 3, and the most frequent site of the perforation was lower one-third of the esophagus. Frequent symptoms of the esophageal perforation were pain, fever, dysphagia and dyspnea, and preoperatively there were mediastinitis in 8 cases, empyema in 7, lung abscess in 3 and others. All 14 patients of the esophageal perforation underwent operation: primary closure in 7 cases, drainage in 4, esophagogastrostomy in 2 and 'esophageal diversion in one. There were 4 postoperative deaths and 11 postoperative complications occurred in 7 patients. The duration of symptoms in achalasia was between 3 months and 25 years, with an average duration of 6. 2 years. Frequent symptoms of the achlasia esophagi were dysphagia, regurgitation, pain and weight loss in order. All 7 patients of achlasia underwent modified Heller's operation where 2 patients had complications, restenosis in one and esophageal perforation in another. All 8 patients of congenital esophageal atresia had distal tracheoesophageal fistula and were admitted within 5 days of life, but there were pneumonic consolidation on chest X-ray in patients. Five patients underwent one staged operation with the result of 2 deaths and one anastomotic leak.

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