• Title/Summary/Keyword: Surgical approaches

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The Surgical Outcome of Thoracic Outlet Syndrome (흉곽출구증후군 환자의 수술성적)

  • Hwang Jung Joo;Joung Eun Kyu;Paik Hyo Chae;Lee Doo Yun
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.844-848
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    • 2005
  • Background: Thoracic outlet syndrome(TOS) is caused by the compression of neurovascular structures that supply to the upper extremities. Only a few reports have been published in Korea, and this study attempts to investigate the clinical aspects and results of the patients who underwent surgical treatment. Material and Method: This study consist of 16 patients who underwent operations for thoracic outlet syndrome from May, 2002 to October, 2004. The surgical indications were confined to patients with: 1) symptom too severe to perform ordinary daily life because of pain, paresthesia, edema of upper extremities, 2) no improvement after proper physical therapy, 3) definite finding of compression confined by radiologic examinations (MRI, angiography, etc), and 4) no other diseases such as cervical intervertebral herniation, myositis, neurologic diseases below the brachial plexus. The surgical approaches were by transaxillary approaches in 12 cases, supraclavicular approaches in 2 cases, and infraciavicular approaches in 2 cases. Result: There were 15 males and one female with an average age of 23.9 years (range:19$\∼$39). Rib anomalies were observed in four cases (25.0$\%$), but the others had no abnormal ribs. Right lesions were found in eight cases (50.0$\%$), left lesions in five cases (31.3$\%$), and bilateral lesions in three cases (18.7$\%$). The follow-up period was 9$\∼$26 months and recurrence rate was 12.5$\%$ (2/16). Complications were one case of ulnar nerve palsy, one case of persistent pain despite radiologic improvement and three cases of wound dehiscence due to fat necrosis and hematoma. Conclusion: Although the choice of treatment in patients with TOS has been disputed, patients who have no response with proper physical therapies can benefit from the surgical treatment which may help patients to return to normal daily activity in shorter period of time.

Management of the Sequelae of Severe Congenital Abdominal Wall Defects

  • Fuentes, Sara;Marti, Eunate;Delgado, Maria-Dolores;Gomez, Andres
    • Archives of Plastic Surgery
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    • v.43 no.3
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    • pp.258-264
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    • 2016
  • Background The survival rate of newborns with severe congenital abdominal wall defects has increased. After successfully addressing life-threatening complications, it is necessary to focus on the cosmetic and functional outcomes of the abdominal wall. Methods We performed a chart review of five cases treated in our institution. Results Five patients, ranging from seven to 18 years of age, underwent the following surgical approaches: simple approximation of the rectus abdominis fascia, the rectus abdominis sheath turnover flap, the placement of submuscular tissue expanders, mesh repair, or a combination of these techniques depending on the characteristics of each individual case. Conclusions Patients with severe congenital abdominal wall defects require individualized surgical treatment to address both the aesthetic and functional issues related to the sequelae of their defects.

Evaluation of Male Contraception in Korea (남성수태조절법의 신지견)

  • Lee, Hee-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.15 no.1
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    • pp.1-9
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    • 1988
  • The contraception practice rate in Korea has steadily increased from 9% in 1964 to 72% in 1987. Accordingly, natural increase rate of population declined from 28.4 per 1,000 in 1964 to 12.4 per 1,000 in 1987. Notably in recent years, the acceptance of surgical contraception services has sharply increased in this country. Now the author analyzes various factors influencing successful vasectomy and vasovasostomy based on his experience in performing more than 8,000 vasectomies and 1,000 vasovasostomies during the past 25 years. These various factors consist of preoperative screening interview, surgical vasectomy technique, vas irrigation technique, open-ended vasectomy, complications from vasectomy, sperm granuloma formation, spermatogenesis and steroidogenesis after vasectomy, immunological consequences after vasectomy, prostatic diseases and vasectomy, late post-vasectomy syndrome, psychological effects after vasectomy, and success rates of vasovasostomy. Besides, the author makes more comments on the results of the clinical trials on new approaches to reversible vas occlusion technique with a new device of Intravasal Thread and to reversible suppression of spermatogenesis with long-acting sex hormones.

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TREATMENT OF INVERTED MAXILLARY INCISORS : CASE REPORT (역위매복된 상악 중절치의 외과적 노출과 교정력을 이용한 증례보고)

  • Kim, Jae-Yun;Choi, Hyung-Jun;Lee, Jae-Ho;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.3
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    • pp.568-574
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    • 1997
  • Inverted maxillary incisor is a state in which the maxillary incisor rotates to the upward position. The present report provides two examples of correction of inverted maxillary incisors with surgical intervention & orthodontic appliance. Through surgical exposure & direct bonding of lingual button, the central incisor were brought into proper eruption path with elastic traction. The case 1 & 2 were both treated successfully. The results showed the good position of treated teeth and satisfactory esthetics and adequate width of keratinized gingiva were achieved. Careful differential diagnosis procedure is needed in order to avoid dissatisfactory results and the treatment approaches taken in this case report provided an esthetic and functional results.

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Diffuse Supravalvar Aortic Stenosis Associated with Congenital Anomaly of the Aortic Valve(Williams Syndrome) -1 case report- (선천성 대동맥 판막 이상과 무명동맥 협착이 동반된 미만성 대동맥 판막상부 협착증 치험 1례)

  • 김수철;전순호
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.748-751
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    • 2000
  • The diffuse form of supravalvar aortic stenosis represents a surgical challenge when the ascending aorta, aortic arch, proximal descending thoracic aorta and arch arteries are involved. It can be treated by a variety of surgical approaches. We report a case of severe diffuse supravalvar aortic stenosis combined with an aortic valve anomaly and occlusion of the right coronary artery ostium in a 14-year-old boy with Williams syndrome. We enlarged the aortic root(Nick's procedure), ascending aorta, aortic arch, proximal descending thoracic aorta, and innominate artery with patches and replaced aortic valve with 19 mm St. Jude valve. Deep hypothermic circulatory arrest and retrograde cerebral perfusion were used during repair of the arch and arch artery.

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Surgical Intervention for Benign Vocal Fold Lesions : When and How? (성대 양성점막 병변의 수술적 치료)

  • Kim, Han Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.2
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    • pp.94-96
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    • 2015
  • Several distinct pathologic entities are encompassed in benign vocal fold lesions, including intracordal cysts, vascular ectasia, as well as vocal fold nodules and vocal fold polyps. Treatment options for theses lesions include both medical/conservative and surgical techniques. First approaches should be focus on correcting the underlying causative factors, largely through voice therapy and education. There are several laryngomicrosurgery techniques for removal of benign lesions. Much debate continues regarding the relative merits of cold instruments versus carbon dioxide laser removal of benign vocal fold lesions. Both techniques have the merits and the demerits each other. Therefore the surgeon should well comprehend the merits of each techniques and choose the proper procedure for patient's lesions.

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Thoracoscopic Removal of Ectopic Mediastinal Parathyroid Adenoma

  • Kim, Young Su;Kim, Jhingook;Shin, Sumin
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.317-319
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    • 2014
  • Ectopic mediastinal parathyroid adenomas or hyperplasias account for up to 25% of primary hyperparathyroidism cases. Most abnormal parathyroid glands are found in the superior mediastinum within the thymus and can be removed through a cervical incision; however, a few of these glands are not accessible using standard cervical surgical approaches. Surgical resection has traditionally been performed via median sternotomy or thoracotomy. However, recent advancement in video-assisted thoracic surgery techniques has decreased the need for sternotomy or thoracotomy to remove these ectopic parathyroid glands. Here, we report a successful case of video-assisted thoracoscopic removal of a mediastinal parathyroid adenoma.

Totally Thoracoscopic Ablation for Treatment of Atrial Fibrillation after Atrial Septal Defect Device Closure

  • Kim, Young Su;Jeong, Dong Seop;Kang, I-Seok;On, Young Keun
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.280-282
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    • 2014
  • Atrial septal defect (ASD) is one of the most common congenital heart defects in adults. Surgical repair is the most common treatment approach, but device closure has recently become widely performed in accordance with the trend toward less invasive surgical approaches. Although surgery is recommended when ASD is accompanied by atrial fibrillation, this study reports a case in which a complete cure was achieved by closure of a device and totally thoracoscopic ablation.

Sacrococcygeal Teratoma : A Tumor at the Center of Embryogenesis

  • Phi, Ji Hoon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.3
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    • pp.406-413
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    • 2021
  • Sacrococcygeal teratoma (SCT) is an extragonadal germ cell tumor (GCT) that develops in the fetal and neonatal periods. SCT is a type I GCT in which only teratoma and yolk sac tumors arise from extragonadal sites. SCT is the most common type I GCT and is believed to originate through epigenetic reprogramming of early primordial germ cells migrating from the yolk sac to the gonadal ridges. Fetal SCT diagnosed in utero presents many obstetrical problems. For high-risk fetuses, fetal interventions (devascularization and debulking) are under development. Most patients with SCT are operated on after birth. Complete surgical resection is the key for tumor control, and the anatomical location of the tumor determines the surgical approaches. Incomplete resection and malignant histology are risk factors for recurrence. Approximately 10-15% of patients have a tumor recurrence, which is frequently of malignant histology. Long-term surveillance with monitoring of serum alpha fetoprotein and magnetic resonance imaging is required. Survivors of SCT may suffer anorectal, urological, and sexual sequelae later in their life, and comprehensive evaluation and care are required.

Approach for naso-orbito-ethmoidal fracture

  • Ha, Young In;Kim, Sang Hun;Park, Eun Soo;Kim, Yong Bae
    • Archives of Craniofacial Surgery
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    • v.20 no.4
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    • pp.219-222
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    • 2019
  • The purpose of this study is to discuss several approaches to addressing naso-orbito-ethmoidal (NOE) fracture. Orbital fracture, especially infraorbital fracture, can be treated through the transconjunctival approach easily. However, in more severe cases, for example, fracture extending to the medial orbital wall or zygomatico-frontal suture line, only transconjunctival incision is insufficient to secure good surgical field. And, it also has risk of tearing the conjunctiva, which could injure the lacrimal duct. Also, in most complex types of facial fracture such as NOE fracture or panfacial fracture, destruction of the structure often occurs, for example, trap-door deformity; a fracture of orbital floor where the inferiorly displaced blowout facture recoils to its original position, or vertical folding deformity; fractured fragments are displaced under the other fragments, causing multiple-packed layers of bone.