• 제목/요약/키워드: General Surgery

검색결과 3,398건 처리시간 0.027초

선천성 양측 전방십자인대 결핍 (Bilateral Congenital Deficiency of The Anterior Cruciate Ligament)

  • 박승림;김형수;강준순;이우형;이주형;이동주
    • 대한관절경학회지
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    • 제1권1호
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    • pp.108-111
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    • 1997
  • Congenital deficiency of the anterior cruciate ligament (ACL) is a rare disorder that has been reported in association with other knee dysplasia like as congenital knee dislocation. congenital short femur, congenital absence of menisci, congenital ring meniscus, and thrombocytopenia-absent radius syndrome. There has been no published explanation about the etiology of bilaeral ACL deficiencies without other abnomality. The patient of congenital ACL deficiency must be carefully inspected about combined anomaly. Those efforts may be helful in treatment or ACL deficient patients and evaluation of pathophysiology or ACL deficiency. However there has not been a ruptured congenital deficiency of the ACL without other dysplasia or the knee and other congenital skeletal abnomalities. We reported a case of symptomatic bilateral congenital deficiencies of the ACL which have not been associated with other skeletal abnormalities.

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Treatment of primary cutaneous anaplastic large cell lymphoma

  • Baik, Bong Soo;Lee, Wu Seop;Ji, So Young;Park, Ki Sung;Yang, Wan Suk;Kim, Sun Young
    • 대한두개안면성형외과학회지
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    • 제20권3호
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    • pp.207-211
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    • 2019
  • Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is a rare subtype of primary cutaneous lymphoma with a favorable prognosis. Primary cutaneous CD30+ lymphoproliferative disorders, which include C-ALCL and lymphomatoid papulosis, are the second most common group of cutaneous T-cell lymphomas. C-ALCL is comprised of large cells with anaplastic, pleomorphic, or immunoblastic cytomorphology, and indeed, more than 75% of the tumor cells express the CD30 antigen. C-ALCL clinically presents with solitary or localized reddish-brown nodules or tumors, and sometimes indurated papules, and they may be with ulceration covering with dark eschar. Multifocal lesions are seen in 20% of the patients. Extracutaneous dissemination, which mainly involves the regional lymph nodes, occurs in 10% of patients. A 69-year-old man noticed a mild elevated cutaneous lesion containing central ulceration covering with brownish black necrotic tissue on the right lower lip, and the lesion was surgically removed. After the first operation, another skin lesion was developed and the histological examination confirmed the diagnosis, C-ALCL. Eight specimens were excised during the 7-month follow-up period. The patient started the treatment with low-dose oral methotrexate (15 mg/wk) and there was no recurrence for 11 months.

Cone Repair in Adult Patients with Ebstein Anomaly

  • Lee, Chang-Ha;Lim, Jae Hong;Kim, Eung Rae;Kim, Yong Jin
    • Journal of Chest Surgery
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    • 제53권5호
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    • pp.243-249
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    • 2020
  • Ebstein anomaly is a rare congenital heart malformation typically involving the tricuspid valve and the right ventricle that has a wide range of anatomical and pathophysiological presentations. Various surgical repair techniques for Ebstein anomaly have been reported because of its near-infinite anatomical variability. Cone repair for Ebstein anomaly can achieve nearly anatomical reconstruction of the tricuspid valve with promising outcomes. In this article, the surgical techniques for cone repair in adult patients with Ebstein anomaly are described in detail, and clinical experiences and technically challenging cases are presented.

Prognostic Factors in Patients Treated with DrugCoated Balloon Angioplasty for Symptomatic Peripheral Artery Disease

  • Sigala, Fragiska;Galyfos, George;Stavridis, Kyriakos;Tigkiropoulos, Konstantinos;Lazaridis, Ioannis;Karamanos, Dimitrios;Mpontinis, Vangelis;Melas, Nikolaos;Zournatzi, Ioulia;Filis, Konstantinos;Saratzis, Nikolaos
    • Vascular Specialist International
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    • 제34권4호
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    • pp.94-102
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    • 2018
  • Purpose: Aim of this study is to report real-life experience on the treatment of peripheral artery disease (PAD) with a specific drug-coated balloon (DCB), and to evaluate potential prognostic factors for outcomes. Materials and Methods: This is a retrospective study reporting outcomes in patients with PAD who were treated with the Lutonix DCB during a four-year period. Major outcomes included: all-cause mortality, amputation, clinical improvement, wound healing and target lesion revascularization (TLR). Mean follow-up was $24.2{\pm}2.3$ months. Results: Overall, 149 patients (mean age: $68.6{\pm}8.3$ years; 113 males) were treated, either for intermittent claudication (IC) (n=86) or critical limb ischemia (CLI) (n=63). More than half the target lesions (n=206 in total) were located in the superficial femoral artery and 18.0% were below-the-knee lesions. CLI patients presented more frequently with infrapopliteal (P=0.002) or multilevel disease (P=0.0004). Overall, all-cause mortality during follow-up was 10.7%, amputation-free survival was 81.2% and TLR-free survival was 96.6%. CLI patients showed higher all-cause mortality (P=0.007) and total amputation (P=0.0001) rates as well as lower clinical improvement (P=0.0002), compared to IC patients. Coronary artery disease (CAD), gangrene and infrapopliteal disease were found to be predictors for death whereas CLI and gangrene were found to be predictors for amputation, during follow-up. Conclusion: PAD treatment with Lutonix DCBs seems to be an efficient and safe endovascular strategy yielding promising results. However, CAD, gangrene, CLI and infrapopliteal lesions were found to be independent predictors for adverse outcomes. Larger series are needed to identify additional prognostic factors.

Transposition of Great Arteries and Ventricular Septal Defect in Jehovahs Withnesses

  • Yang-Bin Jeon, M.D;Seog-Ki Kee, M.D;Jun-Yong Cho, M.D;Man-Jong Baek, M.D;Soon-Ho Chun, M.D
    • Journal of Chest Surgery
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    • 제34권3호
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    • pp.243-245
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    • 2001
  • 여호와의 증인을 부모로 둔 환아는 생후 4개월, 5.6kg이었다. 심초음파상 완전 대혈관 전위와 심실 중격 결손, 심방 중격 결손, 동맥관 개존중 및 양측상대 정맥이 관찰되었다. 수술전 혈색소 값은 14.9 g/dl이었다. 수혈없이 심실 중격 결손 교정과 대혈관 치환술을 시행하였으며, 별문제 없이 수술 후 16일에 환아는 퇴원하였다. 퇴원 당시 혈색소 값은 12.8 kg/dl 였다. 복잡 심기형을 가진 영아에서 수술전 eryrhropoietin의 투여, 수술중 철저한 지혈 및 초여과법등의 방법으로 수혈 없이 완전 교정술이 가능하였기에 보고하는 바이다.

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관상동맥 개구부 직접 관류 후에 발생한 관상동맥 근위부 협착 -3예 보고- (Proximal Coronary Artery Stenosis after Direct Coronary Artery Ostial Perfusion -Report of 3 Cases -)

  • 김재현;오삼세;이길수;신성호;나찬영
    • Journal of Chest Surgery
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    • 제39권9호
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    • pp.706-709
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    • 2006
  • 관상동맥 개구부 직접 관류법과 관련된 근위부 관상동맥 협착은 매우 드물게 발생하지만 환자의 생명을 위협할 수 있는 심각한 합병증이다. 저자들은 관상동맥 개구부 직접 관류법과 관련된 근위부 관상동맥 협착을 2000년 9월에 처음 경험한 이후 최근까지 모두 3예를 경험하였기에 보고하는 바이다.

Vascularisation of Urethral Repairs with the Gracilis Muscle Flap

  • Kua, Ee Hsiang Jonah;Leo, Kah Woon;Ong, Yee Siang;Cheng, Christopher;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • 제40권5호
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    • pp.584-588
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    • 2013
  • Background The ability to achieve a long-term, stricture-free urethral repair is one of the ongoing challenges of reconstructive urologic surgery. A successful initial repair is critical, as repeat procedures are difficult, owing to distortion, scarring, and short urethral stumps. Methods We describe a technique in which the gracilis muscle flap is laid on or wrapped around the urethral repair site to provide a well-vascularised soft tissue reinforcement for urethral repair. This technique promotes vascular induction, whereby a new blood supply is introduced to the repair site to improve the outcome of urethral repair or anastomotic urethroplasty. The surface contact between the muscle flap and the repair site is enhanced by the use of fibrin glue to improve adherence and promote inosculation and healing. We employed this technique in 4 patients with different urethral defects. Results After a follow-up period of 32 to 108 months, all of the urethral repairs were successful without complications. Conclusions Our results suggest that the use of a gracilis muscle flap to vascularise urethral repairs can improve the outcome of challenging urethral repairs.

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.

Surgery for Pulmonary Fungal Infections Complicating Hematological Malignancies

  • Yamamichi, Takashi;Horio, Hirotoshi;Asakawa, Ayaka;Okui, Masayuki;Harada, Masahiko
    • Journal of Chest Surgery
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    • 제51권5호
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    • pp.350-355
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    • 2018
  • Background: The complication rate of fungal disease is higher among patients with hematological malignancies. We investigated the clinicobacteriological outcomes of resected pulmonary fungal infections complicating hematological malignancies. Methods: Between 2001 and 2017, 21 patients with pulmonary fungal infections complicating hematological malignancies underwent resection, and their clinical records and survival were retrospectively reviewed. Results: The median age of the patients was 47 years, and 13 were male. The histological diagnoses were pulmonary aspergillosis (19 cases), mucormycosis (1 case), and cryptococcosis (1 case). The indications for surgery were resistance to antifungal therapy and the necessity of surgery before hematopoietic stem cell transplantation in 13 and 8 cases, respectively. The diagnoses of the hematological malignancies were acute myelogenous leukemia (10 cases), acute lymphocytic leukemia (5 cases), myelodysplastic syndrome (3 cases), and chronic myelogenous leukemia, malignant lymphoma, and extramedullary plasmacytoma (1 case each). The surgical procedures were partial resection (11 cases), segmentectomy (5 cases), lobectomy (4 cases), and cavernostomy (1 case). The size of the lesions was 0.9-8.5 cm. Fourteen cases had cavitation. There were no surgical-related deaths or fungal progression. Conclusion: Pulmonary fungal infections are resistant to treatments for hematological malignancies. Since the treatment of the underlying disease is extended and these infections often recur and are exacerbated, surgery should be considered when possible.