• Journal of Chest Surgery
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• 제36권11호
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• pp.883-885
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• 2003

보존적 치료로 해결되지 않는 유미흉의 전통적인 수술적 치료방법은 우측 개흉술을 통한 흉관 결찰술이다. 저자들은 늑막외층 접근법을 이용한 새로운 흉관 결찰법을 소개하고자 한다. 이 수술의 장점은 통상적인 개흉술에 비해 환자에게 덜 침습적이며, 술후 새로운 흉관을 넣을 필요가 없고, 흉관을 찾기가 더 쉽다는 점이다. 저자들은 새로운 수술 방법으로 유미흉을 치험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Clinics in Shoulder and Elbow
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• 제21권4호
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• pp.220-226
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• 2018

Background: This study introduces a surgical technique with good clinical outcome useful in the treatment of osteoporotic displaced 3- or 4-part proximal humeral fractures. Methods: From May 2014 to February 2016, 16 patients with displaced 3- or 4-part proximal humeral fractures were treated by application of a locking plate with an endosteal strut allograft via a deltoid splitting approach with a minimum follow-up of 12 months. The allograft was inserted through a fractured gap of the greater tuberosity to support the humeral head and then fixed by a locking plate with meticulous soft tissue dissection to protect the axillary nerve. Surgical outcomes were evaluated by the American Shoulder and Elbow Surgeons (ASES) and visual analogue scale (VAS) scores, radiological imaging, and clinical examination. Fixation failure on radiographs was defined as a >$5^{\circ}$ loss of neck shaft angle (NSA) compared to that on an immediate postoperative radiograph. Avascular necrosis (AVN) of the humeral head was also evaluated. Results: In all cases, complete union was achieved. The ASES and VAS scores were improved to $85.4{\pm}2.1$ and $3.2{\pm}1.3$, respectively. Twelve patients (75.0%) had greater than a $5^{\circ}$ change in NSA; the average NSA change was $3.8^{\circ}$. Five patients (31.3%) had unsatisfactory ranges of motion exhibiting a <$100^{\circ}$ active forward flexion. No axillary nerve injuries or AVN were observed at the last follow-up. One patient was converted to reverse total arthroplasty due to severe pain and functional deficit. Conclusions: Minimally invasive fixation via a locking compression plate and an endosteal fibula strut allograft in Neer classification 3-or 4-part fractures with severe osteoporosis in elderly patients can achieve good clinical results.

• Pediatric Infection and Vaccine
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• 제16권1호
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• pp.1-5
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• 2009

Methicillin-resistant Staphylococcus aureus (MRSA), a leading cause of nosocomial infections, has been increasingly recognized in communities of the United States. This article will review the clinical spectrum and treatment of MRSA infections in children in the context of recent epidemiological changes of MRSA infections. In general, community-associated (CA) MRSA most frequently causes skin and soft tissue infections and has an increased association with invasive infections, particularly pneumonia and musculoskeletal infections. Hospital-associated (HA) MRSA strains tend to be associated with bloodstream infections, pneumonia, and surgical site infections. Different from the United States, CA-MRSA infections are not common in Korea (only 5.9%); however, there are some CA-MRSA clones that are different from HA-MRSA clones in Korea and from CA-MRSA clones in other countries. The treatment of MRSA infections should be guided by antimicrobial susceptibility testing, the site of infection, and the infection severity. Vancomycin is the treatment of choice for invasive MRSA infections. Other agents such as trimethoprim-sulfamethoxazole, clindamycin, linezolid, quinupristin-dalfopristin, and daptomycin have been used for some conditions.

• Childhood Kidney Diseases
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• 제27권2호
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• pp.89-96
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• 2023

Renal nutcracker syndrome (NCS) is the entrapment of the left renal vein between the abdominal aorta and superior mesenteric artery. Although uncommon in pediatric patients, early diagnosis is crucial to avoid potential severe complications, such as anemia or renal vein thrombosis. NCS presents a variety of symptoms, most commonly including "Triade's symptoms"-hematuria, proteinuria, and flank pain. Diagnosis and treatment include invasive and noninvasive management, although due to a lack of pediatric clinical studies, management is widely variable. Conservative diagnosis and treatment are recommended as a first-line option for pediatric patients; however, invasive surgical treatment may be recommended based on symptom severity. This review aims to provide a comprehensive overview of NCS in children to better understand the widely variable incidence, occurrence, and management from early on to allow for early-onset management.

• Journal of Korean Neurosurgical Society
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• 제42권1호
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• pp.11-15
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• 2007

Objective : Lumbar foraminal stenosis is an important etiology of lumbar radicular symptomatology and frequent causes of remained symptoms after decompressive surgery. This study was conducted to determine the precise clinical and radiologic diagnosis of lumbar foraminal stenosis, and to demonstrate thorough treatment by decompressive surgery using a minimally invasive technique. Methods : Seven patients with established unilateral lumbar foraminal stenosis according to clinical and radiologic diagnosis were retrospectively studied. All patients underwent combined interlaminar and paraisthmic procedure with partial facetectomy. The outcome of surgery was evaluated and classified into excellent, good, fair and poor. Results : The results were excellent in four patients, good in two, and fair in one during the follow-up. There were no surgery-related complications. Conclusion : Minimally invasive combined interlaminar and paraisthmic approach provides good outcome in carefully selected patients with symptomatic lumbar foraminal stenosis.

• 대한족부족관절학회지
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• 제14권1호
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• pp.66-72
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• 2010

Purpose: To evaluate the clinical efficacy of the minimally invasive posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2006 to October 2008, we studied retrospectively 45 patients, 56 cases who were treated with minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and AOFAS score, circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared Bohler angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 1 was 81, type 2 was 75, type 3 was 69, type 4 was 61. By AOFAS score, Sanders type 1 was 88, type 2 was 82, type 3 was 78, type 4 was 63. And by circle draw test, type 1 was 8.8 cm, type 2 was 8.5 cm, type 3 was 8 cm, type 4 was 6.6 cm. Preoperative Bohler angle and Gissane angle were $7.2^{\circ}$, $98^{\circ}$, and it increased to $21.2^{\circ}$, $116^{\circ}$ after postoperative 1 year. Conclusion: Minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture was considered to be an effective treatment modality.

• 대한두경부종양학회지
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• 제31권2호
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• pp.1-5
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• 2015

The role of transoral robotic surgery in the treatment of upper aerodigestive tract tumor has expanded in recent. Since the approval of the da Vinci system, the number of transoral robotic surgery has increased significantly. The main indications of transoral robotic surgery are tumors of oropharynx, hypopharynx, and larynxs. Transoral robotic surgery is a minimally invasive surgical approach that offers surgical access to the laryngopharynx without the morbidity of open surgeries while achieving excellent oncologic and functional outcomes. The appropriate application of transoral robotic surgery is still being investigated and previous studies supports transoral robotic surgery as a viable option in the management of upper aerodigestive tract tumor.

• Childhood Kidney Diseases
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• 제28권2호
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• pp.59-65
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• 2024

Hydronephrosis, characterized by dilation of the renal pelvis and calyces due to urine flow obstruction, poses a significant clinical challenge. Although often asymptomatic and capable of spontaneous resolution, surgical intervention is necessary for specific scenarios such as febrile urinary tract infections, deteriorating hydronephrosis, or declining renal function. The efficacy of continuous antibiotic prophylaxis in preventing urinary tract infections remains controversial. Yet, it may benefit high-risk patients, emphasizing the importance of individualized patient selection, as surgical treatment methods for patients with hydronephrosis have become less invasive than in previous decades. However, long-term follow-up outcomes are lacking, necessitating further clarification. This review presents an overview of the etiology, natural progression, and modern management of hydronephrosis, encompassing advancements in minimally invasive procedures.

• Journal of Korean Neurosurgical Society
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• 제40권5호
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• pp.323-329
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• 2006

Objective : This study was designed to analyze surgical strategies for patients with intractable supplementary sensorimotor area[SSMA] seizures. Methods : Seventeen patients who had surgical treatment were reviewed retrospectively. Preoperatively, phase I [non-invasive] and phase II [invasive] evaluation methods for epilepsy surgery were done. Seizure outcome was assessed with Engel's classification. The mean follow-up period was 27.2 months [from 12 months to 54 months]. Results : An MRI identified structural abnormality in eight patients and 3D-surface rendering revealed abnormal gyration in three. PET, SPECT, and surface EEG could not delineate the epileptogenic zone. Video-EEG monitoring with a subdural grid or depth electrodes verified the epileptogenic zone in all patients. Surgical procedures consisted of a resection of the SSMA and simultaneous callosotomy in two patients, a resection of the SSMA extending to the adjacent area in seven, a resection of a different area without a SSMA resection in seven, and a callosotomy in one. Seizure outcomes were class I in 11 [65%]. class II in five [29%], class III in one [6%]. Conclusion : In patients with intractable SSMA seizure, surgery was an excellent treatment modality. Precise delineation of the epileptogenic zone based on multimodal diagnostic methods can provide good surgical outcomes without neurological complications.

• 대한족부족관절학회지
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• 제24권2호
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• pp.87-93
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• 2020

Purpose: This study evaluated the clinical results of surgical treatment with minimally invasive plate osteosynthesis for treating displaced intra-articular fractures of the calcaneus in comparison with conventional lateral extensile approach plate osteosynthesis. Materials and Methods: Of 79 cases of Sanders type II or III calcaneus fractures, 15 cases treated with the minimally invasive calcaneal plate (group M) and 64 cases treated with lateral extensile approach calcaneal plate (group E) were identified. After successful propensity score matching considering age, sex, diabetes mellitus history, and Sanders type (1:3 ratio), 15 cases (group M) and 45 cases (group E) were matched and the demographic, radiologic, and clinical outcomes were compared between the two groups. Results: The median time of surgery from injury was 2.0 days in group M and 6.0 days in group E (p=0.014). At the six months follow-up, group M showed results comparable with those of group E in radiographic outcomes. In the clinical outcomes, group M showed better postoperative American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) scores than did group E (p=0.001, p=0.008). A greater range of subtalar motion was achieved at the six months follow-up in group M (inversion 20.0° vs. 10.0°, p=0.002; eversion 10.0° vs. 5.0°, p=0.025). Although there were no significant differences in complications between the two groups (1 [6.7%] vs. 7 [15.6%], group M vs. group E; p=0.661), there was only one sural nerve injury and no wound dehiscence and deep infection in group M. Conclusion: Minimally invasive plate osteosynthesis showed superior clinical outcomes compared with that of the conventional lateral extensile approach plate osteosynthesis in Sanders type II or III calcaneus fractures. We suggest applying minimally invasive plate osteosynthesis in Sanders type II or III calcaneus fractures.