• 제목/요약/키워드: surgical lesions

검색결과 782건 처리시간 0.032초

Surgical Management of Complex Spinal Cord Lipomas : A New Perspective

  • Pang, Dachling
    • Journal of Korean Neurosurgical Society
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    • 제63권3호
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    • pp.279-313
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    • 2020
  • This review summarises the classification, anatomy and embryogenesis of complex spinal cord lipomas, and describes in some detail the new technique of total lipoma resection and radical reconstruction of the affected neural placode. Its specific mission is to tackle two main issues surrounding the management of complex dysraphic lipomas : whether total resection confers better long term benefits than partial resection, and whether total resection does better than conservative treatment, i.e., no surgery, for asymptomatic lipomas. Accordingly, the 24 years progression-free survival data of the author and colleagues' series of over 350 cases of total resection are compared with historical data from multiple series (including our own) of partial resection, and total resection data specifically for asymptomatic lesions are compared with the two known series of non-surgical treatment of equivalent patients. These comparisons amply support the author's recommendation of total resection for most complex lipomas, with or without symptoms. The notable exception is the asymptomatic chaotic lipoma, whose peculiar anatomical relationship with the neural tissue defies even our aggressive surgical approach, and consequently projects worse results (admittedly of small number of cases) than for the other two lipoma subtypes of dorsal and transitional lesions. Prophylactic resection of asymptomatic chaotic lipomas is therefore not currently endorsed.

Incidence Data for Breast Cancer among Yemeni Female Patients with Palpable Breast Lumps

  • Alsanabani, Jamila Ali;Gilan, Waleed;Al Saadi, Azzan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권1호
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    • pp.191-194
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    • 2015
  • Purpose: To estimate the incidence of breast cancer in Yemeni female patients presenting with a breast mass. Materials and Methods: This retrospective study was carried out with 595 female patients with palpable breast lumps, attending to Alkuwait university hospital, Sana'a, Yemen. Triple assessment, including breast examination, mammography and biopsy (FNAC, core needle, or excision), for all patients were performed. Results: The incidences of benign and malignant lesions was calculated. Some 160 (26.9%) of 595 patients had malignancies; 213 (35.8%) were fibroadenomas; 12 (2.0%) were fibrocystic change; 143 (24.03%) were inflammatory lesions (including mastitis and ductectasia); 62 (10.4%) were simple cysts, while 5 (0.8%) were phyllodes tumors. The mean age of patients with malignant lumps was 44.3 years. Conclusions: Among Yemeni female patients with palpable breast lumps, the rate of breast cancer is high, with occurrence at an earlier age than in Western countries. Improving breast cancer awareness programs and increasing breast cancer screening centers inb different areas of Yemen are needed to establish early diagnosis and offer early and optimal treatment.

열상에 의하지 않은 표재 비골 신경과 비복 신경 병변의 치료 (Treatment of Superficial Peroneal and Sural Nerve Lesions Unrelated to Laceration)

  • 이우천;김유미;고한석
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.179-183
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    • 2006
  • Purpose: To review the results of surgical treatment for superficial peroneal and sural nerve lesion unrelated to laceration. Materials and Methods: Eleven superficial peroneal and sural nerve lesions in eleven patients were surgically treated at our hospital with follow up of average 20.7 months (range, 9-64 months). The anatomical locations of the lesion were on superficial peroneal nerve in seven patients including two patients having ganglion and sural nerve in four patients. Two patients were male and the average age at surgery was 41.5 years (range, 23-57 years). Six cases developed after repetitive sprain and five cases had no trauma history. Clinical results were assessed according to the criteria of Pfeiffer and Cracchiolo. Results: The methods of operation were proximal resection of the nerve lesion in nine cases and removal of ganglion only in two cases. The results were excellent in four cases, good in five cases, fair in one case and poor in one case. Ten cases (10 patients) were satisfied with the result of treatment. Conclusion: We can expect satisfactory results of surgical treatment for superficial peroneal and sural nerve lesion unrelated to laceration.

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성인에서 선천성 심장기형의 수술성적 -725 치험례 보고- (Operative result congenital cardiac disease in adult - A reort of 725 surgical cases-)

  • 이정렬;서경필
    • Journal of Chest Surgery
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    • 제19권1호
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    • pp.116-121
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    • 1986
  • Patients over 15 years of age who have undergone a surgical correction of a congenital cardiac malformation during period of January 1958 through January 1986 have been reviewed. During this period there were 3957 congenital cardiac lesions consisting of 2712 acyanotic and 1245 cyanotic cases. Among them, a total of 725 adults [18.3%] with a variety of congenital heart lesions, 548 acyanotic group and 177 cyanotic group were operated on. 372 patients were male and 252 patients were female. There were 280 patients under 20 years of age, 206 between 20-24 years, 102 between 25-29 years, 48 between 30-34 and 89 over 35 years. The most common defects were atrial septal defect which accounted for 207 cases [28.6%] and other common anomalies were VSD [140 cases, 19.3%], TOF [136 cases, 18.6%], PDA [120 cases, 16.6%] and PS [33 cases, 4.6%] in order of incidence. Overall operative mortality for this series was 3.6% [1.8% of a cyanotic group and 9.0% of cyanotic group] compared with 2.8% of total cases of congenital heart disease [acyanotic group 1.1% and cyanotic group 6.5%]. This reviewed series reveals the incidence of operable congenital heart defects appearing in any adult life and demonstrates that surgical repair can be accomplished with a satisfactory low mortality rate.

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Surgical Extraction in Patient with McCune-Albright Syndrome: A Case Report

  • Dohee Kim;Jeong Joon Han;Hoon Myoung
    • Journal of Korean Dental Science
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    • 제16권1호
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    • pp.99-103
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    • 2023
  • McCune-Albright syndrome (MAS) is a disease with clinical features such as fibrous dysplasia in which normal bone tissue is replaced with abnormal fibrous tissue, abnormalities in the endocrine system, and cafe-au-lait spots on the skin. Although MAS patients are generally known to have reduced bone healing ability, postoperative healing after invasive surgical extraction is still not clearly known due to its relatively rare occurrence. In this report, a 25-year-old female patient, who had been diagnosed with MAS and had a history of abnormal bone healing after fractures of her extremities, underwent surgical extraction of the mandibular third molar with surrounding bone removal. Postoperatively, the patient showed favorable soft tissue and bone healing at the surgical site without abnormal findings such as newly developed fibro-osseous lesions, postoperative infection, or osteomyelitis.

Treatment of Scalp Arteriovenous Malformation

  • Jung, Sung-Hoon;Yim, Man-Bin;Lee, Chang-Young;Song, Dal-Won;Kim, Il-Man;Son, Eun-Ik
    • Journal of Korean Neurosurgical Society
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    • 제38권4호
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    • pp.269-272
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    • 2005
  • Objective : The object of this study is to present the treatment experience of the 6cases of scalp arteriovenous malformations[AVMs] focus on treatment strategy. Methods : Six patients with scalp AVM were treated during past 12years. We analysis the clinical characteristics of the lesions, treatment methods and management outcomes. Results : The lesions were located on temporal in 2patients, parietal in 2patients, frontal and occipital area in each one. Four of six patients had a trauma history on scalp. The presenting symptoms were progressive enlarged pulsating mass with or without bruit. Four of the six lesions had the large fistula in the lesion. Two patients were treated with surgical resection alone, three patients with proximal feeding artery balloon[s] occlusion followed by surgical resection, and one patient with coil embolization through trans-venous route alone. We obtained good results in all patients. Conclusion : Most of scalp AVM can be completely cured by Judicious selection and a combination of treatment modalities, i.e., surgery only, or embolization only, or embolization plus surgical therapy. Although embolization became a primary therapy for this sort of scalp AVM recently, the selection of treatment modality should be chose based on the size, angioarchitecture, and clinical presentations of the lesion.

Surgical approach for venous malformation in the head and neck

  • Ryu, Jeong Yeop;Eo, Pil Seon;Lee, Joon Seok;Lee, Jeong Woo;Lee, Seok Jong;Lee, Jong Min;Lee, Sang Yub;Huh, Seung;Kim, Ji Yoon;Chung, Ho Yun
    • 대한두개안면성형외과학회지
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    • 제20권5호
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    • pp.304-309
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    • 2019
  • Background: Treatment for venous malformations of the head and neck includes sclerotherapy, surgical resection, or a combination of both. Surgical resection can remove or reduce the volume of vascular lesions; however, surgery can cause postoperative scarring and potential surgical complications. This study sought to determine the effectiveness of surgery for the treatment of venous malformations of the head and neck. Methods: A retrospective review of the medical records of patients who received surgeries for venous malformations of the head and neck from January 2011 to July 2019 was performed. Using clinical photographs, preoperative and postoperative Doppler ultrasonography, outpatient clinic records, and operation records, the postoperative result and complications were evaluated for each case. Results: Among patients who visited our vascular anomalies clinic, 43 patients (ratio of male to female= 24:19) received surgeries for venous malformations of the head and neck. Twenty-nine patients had undergone surgery only, five patients received sclerotherapy after surgery, and nine patients received surgery after preoperative sclerotherapy. In postoperative evaluations, the result was excellent in 24 patients, good in 18 patients, and poor in one patient. Four patients experienced a recurrence of lesions with lagophthalmos, drooping of the corner of the mouth, partial wound necrosis, and scar widening found in one patient each. Conclusion: Because the head and neck region is the most exposed area in the body, more active implementation of surgical treatments with or without sclerotherapy is essential to reduce the functional and cosmetic impairments associated with venous malformations.

융기성 피부섬유육종의 외과적 절제연 (Surgical Margins for Excision of Dermatofibrosarcoma Protuberans)

  • 배용찬;문재술;남수봉
    • Archives of Plastic Surgery
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    • 제32권4호
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    • pp.454-460
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    • 2005
  • Dematofibrosarcoma protuberans(DFSP) is a moderate-degree malignant tumor with high recurrence rate and low metastasis rate, from soft tissue. Principle of treatment is wide excision or Mohs micrographic surgery(MMS). Although wide excision has been performed with surgical margins of 2-5 cm until nowadays, there are problems of preservation of surrounding normal tissue. Therefore the authors tried to identify desirable surgical margins and operative method. From January 1999 to April 2003, 12 patients with DFSP were operated. We applied different surgical margins and operative methods according to the location of lesions. On the face, we performed MMS with surgical margin of 3-4 mm in 2 cases although there are problems of operation time and expense. But on the extremities and trunk, we performed authors' method to begin excising with surgical margins of 1 cm and excise extensively with MMS by 1 cm in 4 cases after April, 2001 although we had performed wide excision with surgical margin of 3 cm in 6 cases before. There was no recurrence or metastasis in the follow-up period. So we think that author's method is effective in surgical excision of DFSP

Comparison of Magnetic Resonance Imaging and Operation Waiting Times in Patients Having Traumatic Cervical Spinal Cord Injury; with or without Bony Lesions

  • Heo, Jeong;Min, Woo-Kie;Oh, Chang-Wug;Kim, Joon-Woo;Park, Kyeong-hyeon;Seo, Il;Park, Eung-Kyoo
    • Journal of Trauma and Injury
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    • 제32권2호
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    • pp.80-85
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    • 2019
  • Purpose: To compare the time intervals to magnetic resonance imaging (MRI) and surgical treatment in patients having traumatic cervical spinal cord injury (SCI) with and without bony lesions. Methods: Retrospectively analyzed adult patients visited Kyungpook National University Hospital and underwent surgical treatment for cervical SCI within 24 hours. The patients who were suspected of having cervical SCI underwent plain radiography and computed tomography (CT) upon arrival. After the initial evaluation, we evaluated the MRI findings to determine surgical treatment. Waiting times for MRI and surgery were evaluated. Results: Thirty-four patients were included. Patients' mean age was 57 (range, 23-80) years. Patients with definite bony lesions were classified into group A, and 10 cases were identified (fracture-dislocation, seven; fracture alone, three). Patients without bony lesions were classified into group B, and 24 cases were identified (ossification of the posterior longitudinal ligament, 16; cervical spondylotic myelopathy, eight). Mean intervals between emergency room arrival and start of MRI were 93.60 (${\pm}60.08$) minutes in group A and 313.75 (${\pm}264.89$) minutes in group B, and the interval was significantly shorter in group A than in group B (p=0.01). The mean times to surgery were 248.4 (${\pm}76.03$) minutes in group A and 560.5 (${\pm}372.56$) minutes in group B, and the difference was statistically significant (p=0.001). The American Spinal Injury Association scale at the time of arrival showed that group A had a relatively severe neurologic deficit compared with group B (p=0.046). There was no statistical significance, but it seems to be good neurological recovery, if we start treatment sooner among patients treated within 24 hours (p=0.198). Conclusions: If fracture or dislocation is detected by CT, cervical SCI can be easily predicted resulting in MRI and surgical treatment being performed more rapidly. Additionally, fracture or dislocation tends to cause more severe neurological damage, so it is assumed that rapid diagnosis and treatment are possible.