• Title/Summary/Keyword: Non-surgical treatment

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Blunt Cardiac Injuries That Require Operative Management: A Single-Center 7-Year Experience

  • Lee, Seung Hwan;Jang, Myung Jin;Jeon, Yang Bin
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.242-247
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    • 2021
  • Purpose: Blunt cardiac injuries (BCI) have a wide clinical spectrum, ranging from asymptomatic myocardial contusion to cardiac rupture and death. BCIs rarely require surgical intervention, but can be rapidly fatal, requiring prompt evaluation and surgical treatment in some cases. The aim of this study was to identify potential factors associated with in-hospital mortality after surgery in patients with BCI. Methods: The medical records of 15 patients who had undergone emergency cardiac surgery for BCI between January 2014 and August 2020 were retrospectively reviewed. We included trauma patients older than 18 years admitted to Regional Trauma Center, Gachon University Gil Medical Center during the study period. Clinical and laboratory variables were compared between survivors and non-survivors. Results: Non-survivors showed a significantly higher Injury Severity Score (p=0.001) and Abbreviated Injury Scale in the chest region (p=0.001) than survivors. American Association for the Surgery of Trauma-Organ Injury Scale Grade V injuries were significantly more common in non-survivors than in survivors (p=0.031). Non-survivors had significantly more preoperative packed red blood cell (PRBC) transfusions (p=0.019) and were significantly more likely to experience preoperative cardiac arrest (p=0.001) than survivors. Initial pH (p=0.010), lactate (p=0.026), and base excess (BE; p=0.026) levels showed significant differences between the two groups. Conclusions: Initial pH, lactate, BE, ventricular injury, the amount of preoperative PRBC transfusions, and preoperative cardiac arrest were potential predictors of in-hospital mortality.

Silicone radial head prostheses revisited: do they have a role in today's practice? A systematic review of literature on clinical outcomes

  • Erik M van Bussel;Anneluuk L. Lindenhovius;Bertram The;Denise Eygendaal
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.312-322
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    • 2023
  • Background: Silicone radial head prostheses (SRHP) are considered obsolete due to reports of frequent failure and destructive silicone-induced synovitis. Considering the good outcomes of modern non-radial silicone joint implants, the extent of scientific evidence for this negative view is unclear. The aim of this research was to systematically analyze the clinical evidence on complications and outcomes of SRHP and how SRHP compare to both non-SRHP and silicone prostheses of other joints. Methods: A systematic literature review was conducted through the Cochrane, PubMed, and Embase databases. Results: Eight cohort studies were included, consisting of 142 patients and follow-up periods ranging from 23 months to 8 years. Average patient satisfaction was 86%, range of 71%-100%, and 58 complications were seen, but no cases of synovitis. These outcomes were in line with non-SRHP. Four case series with 11 cases of synovitis were found, all due to implant fractures years to decades after implantation. Six systematic reviews of currently used non-radial silicone joint implants showed excellent outcomes with low complication rates. Conclusions: Since SRHP have satisfactory clinical results and an acceptable complication rate when selecting a patient group in suitable condition for surgical indications, it is considered that SRHP can still be chosen as a potential surgical treatment method in current clinical practice.

Aorto-bicarotid-subclavian Bypass in Takayasu`s Arteritis - One case report - (Takayasu 동맥염에서 aorto-bicarotid-subclavian bypass수술 1예)

  • 이진명
    • Journal of Chest Surgery
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    • v.25 no.3
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    • pp.330-334
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    • 1992
  • Takayasu`s arteritis is a non-specific arteritis involving the aorta and its major branches. Because of the complexity in the feature of vessel involvement, it represents various clinical presentations according to the sites of involvement. In general, the medical and the surgical treatment of this progressive disease are known to be unsatisfactory but the surgical treatment can provide symptomatic relief and prolong life in selected cases. Recently we experienced one case of Takayasu`s arteritis involving the aortic arch and its major branches. A 45 year-old male patient admitted with the complaints of dizziness, headache, visual disturbance and coldness of upper extremities. Ascending aortogram revealed total occlusion of innominate artery and near total occlusion of left common carotid artery at the site of origin of both vessels. Under the clinical diagnosis of Takayasu`s arteritis, aorto-bicarotid-right subclavian bypass was performed. Postoperative course was uneventful and most of symptoms were relieved except mild residual visual disturbance.

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Two Cases of Glomus Tumor Arising in Large Airway: Well Organized Radiologic, Macroscopic and Microscopic Findings

  • Choi, In Ho;Song, Dae Hyun;Kim, Jhingook;Han, Joungho
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.1
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    • pp.34-37
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    • 2014
  • Glomus tumors of the lung are rare benign neoplasm, originating from modified smooth muscle cells. The patients are usually presented with no or non-specific symptoms such as cough, dyspnea or hemoptysis. Although surgical treatment is considered as the treatment of choice, the endobronchial therapy can be applied to the patients who are unfit for surgical excision. Herein, we describe two rare cases of glomus tumor originated at large airway (trachea and main bronchus) without respiratory symptoms and review their characteristic radiologic, macroscopic and pathological features.

Perforated Afferent Loop Syndrome in a Patient with Recurrent Gastric Cancer: Non-Surgical Treatment with Percutaneous Transhepatic Duodenal Drainage and Endoscopic Stent (재발된 위암 환자에서 발생한 천공성 수입각 증후군의 비수술적 치료)

  • Song Kyo Young;Son Chang Hee;Park Cho Hyun;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.4 no.3
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    • pp.176-179
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    • 2004
  • Surgical treatment for afferent loop syndrome (ALS) in patients with recurrent gastric cancer is usually not feasible because of the recurrent tumor mass at the anastomosis site and/or extensive carcinomatosis resulting in bowel loop fixation. Furthermore, ALS usually makes oral intake impossible, resulting in a rapid deterioration in general condition. In this situation, gastroscopic stenting at the anastomotic site and/or percutaneous external drainage may be a more feasible alternative for palliation. We herein report a recurrent gastric cancer whose ALS was successfully treated with internal and external drainage procedures.

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Two Cases of Paraphimosis in Dogs (개 감돈포경의 2례)

  • 조종기;이소현;현상환;김대영;이병천;황우석
    • Journal of Veterinary Clinics
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    • v.17 no.2
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    • pp.499-501
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    • 2000
  • Paraphilmosis, is a condition in which the extruded penis cannot be withdrawn back into the preputial cavity. In this study, the 2 dogs that showed prolonged erection. exposed penis from the sheath and hair surrounding the prepural orifice for several days, were ana1ysis of blood and urine ard carried out surgical treatment. In urinalysis, there were struvites, spermuria and bactera (streptococci) in urine. Firstly, these dogs were treated with non-surgical method, however severe necrosis of the Penis was developed form prolonged exposure and vascular compromise. Finally, partial penile amputation and preputial lengthening were performed and resulted in successful treatment.

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Non Surgical Treatment of Eagle's Syndrome - A Case Report -

  • Han, Min Kyu;Kim, Do Wan;Yang, Jong Yeun
    • The Korean Journal of Pain
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    • v.26 no.2
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    • pp.169-172
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    • 2013
  • Eagle's syndrome is a disease without a clear lesion that is associated with repeated episodes of pharyngalgia, odynophagia, the sensation of a foreign body in the pharynx, tinnitus, and otalgia in which patients displaying these types of symptoms must be given a differential diagnosis. It is known to be characterized by styloid process elongation or increasing compression to adjacent anatomical structures through stylohyoid ligament calcification. In serious cases, continuous pressure to the carotid artery can lead to a stroke. Diagnosis is confirmed through clinical symptoms, radiological findings, and physical examinations. The most common type of treatment consists of a surgical excision of elongated styloid process. Nonetheless, this study presents a case of treating Eagle's syndrome with conservative management.

A Clinical Report about Primary Trigeminal neuralgia patient (원발성 삼차신경통 환자 치험 1례)

  • Kim, Kyoung-Ok;Kim, Su-Youn
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.1
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    • pp.221-226
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    • 2005
  • The trigeminal neuralgia whose pain is led repeatedly and fitfully is limited inside the trigeminal nervous territory. The cause reveals so far clearly from the western medicine. According to this cause, the treatment is divided into surgical and non-surgical method. But the reduction of pain is not certificate and the case which concurs a sequela is many. So we made up to control typical primary trigeminal neuralgia by oriental medicine treatment like Herb Medication and A-Tx. In this case, patient is diagnosed 'Fire from stagnation of liver and stomach'(肝胃實熱)based on several symptoms. According to this, we used herbal medicine-chungpyesagantang-, and these efforts helped the case of disease.

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Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome

  • Hosseinian, Mohammad Ali;Loron, Ali Gharibi;Soleimanifard, Yalda
    • Journal of Chest Surgery
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    • v.50 no.1
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    • pp.36-40
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    • 2017
  • Background: Surgical treatment of thoracic outlet syndrome (TOS) is necessary when non-surgical treatments fail. Complications of surgical procedures vary from short-term post-surgical pain to permanent disability. The outcome of TOS surgery is affected by the visibility during the operation. In this study, we have compared the complications arising during the supraclavicular and the transaxillary approaches to determine the appropriate approach for TOS surgery. Methods: In this study, 448 patients with symptoms of TOS were assessed. The male-to-female ratio was approximately 1:4, and the mean age was 34.5 years. Overall, 102 operations were performed, including unilateral, bilateral, and reoperations, and the patients were retrospectively evaluated. Of the 102 patients, 63 underwent the supraclavicular approach, 32 underwent the transaxillary approach, and 7 underwent the transaxillary approach followed by the supraclavicular approach. Complications were evaluated over 24 months. Results: The prevalence of pneumothorax, hemothorax, and vessel injuries in the transaxillary and the supraclavicular approaches was equal. We found more permanent and transient brachial plexus injuries in the case of the transaxillary approach than in the case of the supraclavicular approach, but the difference was not statistically significant. Persistent pain and symptoms were significantly more common in patients who underwent the transaxillary approach (p<0.05). Conclusion: The supraclavicular approach seems to be the more effective technique of the two because it offers the surgeon better access to the brachial plexus and a direct view. This approach for a TOS operation offers a better surgical outcome and lower reoperation rates than the transaxillary method. Our results showed the supraclavicular approach to be the preferred method for TOS operations.

Surgical management of male genital lymphedema: A systematic review

  • Aulia, Indri;Yessica, Eva Chintia
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.3-8
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    • 2020
  • Genital lymphedema (GL) is an uncommon and disabling disease that manifests as enlargement of the genital region resulting from the disturbance of lymphatic drainage. Although conservative treatment such as decompression is typically the first-line approach, surgical intervention has been shown to be effective in certain cases. This study aimed to systematically review studies evaluating available surgical alternatives for the treatment of male GL. A systematic search strategy using keyword and subject headings was applied to PubMed, Scopus, EMBASE, and Cochrane Library in May 2019. Studies investigating various surgical techniques to treat penile and scrotal lymphedema were included. The potential risk of bias of included trials was evaluated using the methodological index for non-randomized studies (MINORS). In total, 13 studies met the inclusion criteria, nine of which were determined to be high-quality. The average MINORS score was 12.45 for studies involving excision and 14 for studies involving lymphovenous anastomosis (LVA). The most common reason for a low score was a failure to describe the inclusion criteria. Recurrence of lymphedema during follow-up was reported in four studies involving excision and in no studies involving LVA. In general, the quality of the included literature was considered to be fair. Although surgical intervention might not always prevent the recurrence of lymphedema, all of the studies reported improved quality of life after the procedure. This study could be used as the basis for evidence-based guidelines to be applied in clinical practice for managing male GL.