• Journal of Chest Surgery
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• 제39권7호
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• pp.569-571
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• 2006

자발성 벽내성 식도 박리는 드문 질환으로, 주로 $70{\sim}80$대 여성 노인층에 발생하며, 갑작스런 흉통과 연하장애를 증상으로 하는 것으로 알려져 있다. 추정되는 발생기전은 여러 가지가 있지만 현재까지 확립된 것은 없다. 진단은 식도 조영술과 식도 내시경으로 가능하며 다른 흉통을 일으키는 질환과의 감별 진단을 요한다. 치료는 대부분 보존적 치료로 합병증 없이 증세호전을 기대할 수 있다. 본원에서 체험한 중년 여성에 발생한 자발성 식도 벽내성 박리 1예를 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제48권4호
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• pp.281-284
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• 2015

We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1, aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and hypotension consistent with cardiogenic shock. We immediately performed coronary angiography and found a long dissection starting from the mid-left main coronary artery and progressing into the mid-left anterior descending (LAD) and circumflex arteries. She was then transferred to the operating room for surgery. A saphenous vein was grafted to the distal LAD. Since the patient was hypotensive under noradrenaline and dopamine infusions, she was transferred to the cardiovascular surgery intensive care unit on an extracorporeal membrane oxygenator and intra-aortic balloon pump. During follow-up, her blood pressure remained low, at approximately 60/40 mmHg, despite aggressive inotropic and mechanical support. On the second postoperative day, asystole and cardiovascular arrest quickly developed, and despite aggressive cardiopulmonary resuscitation, she died.

• 대한치과의사협회지
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• 제52권10호
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• pp.615-622
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• 2014

Oral cancer ablation surgery results in tissue defects with functional loss. Accompanying neck dissection results in facial nerve weakness and dysmorphic changes. To minimize the complications after oral cancer surgery, accurate dissection without damaging facial nerve and vital structures are mandatory. Marginal mandibular branch of facial nerve should be dissected or contained in the superficial layer of deep cervical fascia to minimized facial palsy after operation. Reconstruction after cancer ablations is routine procedures and free flap reconstruction is the most commonly used. Radial forearm free flap is the most versatile flap to reconstruct soft tissue defects and it is easy to design according to the defect size and shape. However, donor site scar and secondary skin graft from thigh result in unesthetic and cumbersome wounds. Double layered collagen graft in the donor site could reduce secondary donor site for skin graft. In conclusion, oral and maxillofacial surgeon should know the exact anatomy of the face and neck during neck dissection. Radial forearm free flap is most versatile flap for soft tissue reconstruction and double collagen graft can reduce postoperative scar and there is no need for secondary skin graft.

• 대한한의정보학회지
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• 제14권2호
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• pp.95-103
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• 2008

Objectives : The purpose of this case is to report the improvement of a patient with lymphedema due to axillary lymph node dissection after acupuncture therapy and herbal medicine. Methods : We treated the patient with Dong-Qi acupuncture, herbal medication(木通大安湯), lymph absorption massage, compresses, abdominal breathing. We measured the circumference of the patient's elbow and wrist every day at 6pm. Results : Since being hospitalized, the circumference of the patient' elbow and wrist has been decreased and VAS score has gotten lower gradually. Conclusions : We considered Dong-Qi acupuncture, herbal medication had a useful effect on lymphedema due to axillary lymph node dissection with lymph absorption massage, compresses, abdominal breathing.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.516-518
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• 2009

Purpose: To retrieve the retracted flexor tendon, additional incision and wide dissection are conventionally required. We introduce minimal - incision tenorrhaphy using 1 cm - length incision and minimal dissection. Methods: Transverse incision about 1 cm - length is made over the level of retracted tendon. Nelaton's catheter is advanced into tendon sheath from distal primary laceration wound to emerge proximally through the incisional wound. Catheter is sutured to proximal tendon in end - to - end fashion. By gently pulling the catheter, retracted tendon is delivered to distal wound. Tenorrhaphy with core suture and epitendinous suture is then carried out. Results: This retrieving technique provides minimal incision, minimal dissection, minimal bleeding, minimal injury to tendon end, and shorter operation time with preservation of vincula tendinum and pulley system. Conclusion: In case of flexor tendon rupture with retraction, this operative method is believed to allow reliable and effective tenorrhaphy and excellent postoperative outcomes.

• 대한두경부종양학회지
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• 제15권1호
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• pp.18-21
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• 1999

Background and Objectives: Occult neck metastasis rate of laryngeal and hypopharyngeal cancer varies widely depending upon authors. Materials and Methods: Sixty four cases, previously untreated, of N0 laryngeal and hypopharyngeal squamous cell carcinoma patients who underwent surgery as an initial treatment from 1992 to 1997 were evaluated. All had unilateral or bilateral elective neck dissection at the time of surgery for the primary. Occult neck metastasis rate was evaluated with pathologic examination of neck dissection specimen. Results: Occult neck metastasis rate by primary site was as follows. Supraglottis ipsilateral 32%(8/25) contralateral 15%(3/20), glottis ipsilateral 17%(5/30), contralateral 0%(0/22), hypopharynx ipsilateral 78%(7/9), contralateral 25%(2/8). Conclusion: Supraglottic and hypopharyngeal cancer may need elective neck treatment bilaterally. Occult neck metastasis of glottic cancer to opposite site was minimal.

• 대한두경부종양학회지
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• 제10권2호
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• pp.171-177
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• 1994

We reviewed retrospectively 152 patients' records with salivary gland tumors confirmed histologically at Hanyang University Hospital from Jan. 1984 to Dec. 1993. The results obtained were as follows: 1) Sites of tumors were parotid gland in 102 cases(67%), submandibular gland in 29 cases(19%) and minor salivary glands in 21 cases (14%). 2) 113 cases(74%) were benign. and 39 cases(26%) were malignant. 3) The incidence of benign and malignant tumors were 81% & 19%, 69% & 31% and 48% & 52% in the parotid gland, the submandibular gland and the minor salivary glands respectively. 4) The most frequent histologic types of benign and malignant tumors were pleomorphic adenoma (64%) and mucoepidermoid carcinoma (11%) respectively. 5) The surgical procedures include superficial parotidectomy. total parotidectomy. extended total parotidectomy & neck dissection in the parotid gland. wide excision & neck dissection in the submandibular gland and wide excision, partial maxillectomy & neck dissection in the minor salivary glands. 6) The postoperative recurrence rate were 4.4% in benign tumors and 27% in malignant tumors.

• Journal of International Society for Simulation Surgery
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• 제1권2호
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• pp.87-89
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• 2014

An aberrant left hepatic artery is one of the most common variants of hepatic arteries, and its prevalence has been reported 6.5-30%. During D2 lymph node dissection for gastric cancer, an aberrant left hepatic artery arising from left gastric artery is ligated which may lead to hepatic damage. In this case report, a 66-year-old male patient underwent total gastrectomy with D2 lymph node dissection during which the aberrant left hepatic artery was ligated. Post-operative liver function tests revealed elevated liver enzymes, and ischemic changes in the left lateral hepatic section was seen on the CT scan. On retrospective review of preoperative CT images, a replaced left hepatic artery from left gastric artery could have been identified. The information on the presence of aberrant LHA and its supplying area is clinically important when planning curative gastrectomy for gastric cancer, because extended lymph node dissection requires division of the left gastric artery and this may lead to severe liver damage. By using preoperative CT scan, detection of aberrant left hepatic artery could be done.

• Clinical Endoscopy
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• 제56권1호
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• pp.114-118
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• 2023

Gastric wall abscess, a localized form of phlegmonous gastritis, is a rare complication of endoscopic resection. We report the first case of gastric wall abscess developing after endoscopic submucosal dissection in Korea. A 72-year-old woman visited our clinic to receive treatment for gastric adenoma. The patient successfully underwent endoscopic submucosal dissection with no complications. The final diagnosis was well-differentiated tubular adenocarcinoma. We performed follow-up endoscopy 10 weeks later and found a large subepithelial lesion on the posterior wall of the gastric antrum. Abdominal computed tomography revealed hypodense wall thickening and a 5 cm heterogenous multilobular mass in the submucosal layer of the gastric antrum. Submucosal invasion with mucin-producing adenocarcinomas could therefore not be excluded. The patient agreed to undergo additional gastrectomy due to the possibility of a highly malignant lesion. The final diagnosis was acute suppurative inflammation with the formation of multiple abscesses in the mural layers and omentum. The patient was discharged with no complications.

• Clinical Endoscopy
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• 제56권4호
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• pp.423-432
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• 2023

Compared to endoscopic mucosal resection (EMR), colonoscopic endoscopic submucosal dissection (C-ESD) has the advantages of higher en bloc resection rates and lower recurrence rates of colorectal neoplasms. Therefore, C-ESD is considered an effective treatment method for laterally spread tumors and early colorectal cancer. However, C-ESD is technically more difficult and requires a longer procedure time than EMR. In addition to therapeutic efficacy and procedural difficulty, safety concerns should always be considered when performing C-ESD in clinical practice. Bleeding and perforation are the main adverse events associated with C-ESD and can occur during C-ESD or after the completion of the procedure. Most bleeding associated with C-ESD can be managed endoscopically, even if it occurs during or after the procedure. More recently, most perforations identified during C-ESD can also be managed endoscopically, unless the mural defect is too large to be sutured with endoscopic devices or the patient is hemodynamically unstable. Delayed perforations are quite rare, but they require surgical treatment more frequently than endoscopically identified intraprocedural perforations or radiologically identified immediate postprocedural perforations. Post-ESD coagulation syndrome is a relatively underestimated adverse event, which can mimic localized peritonitis from perforation. Here, we classify and characterize the complications associated with C-ESD and recommend management options for them.