• 제목/요약/키워드: open resection

검색결과 147건 처리시간 0.02초

Arthroscopic Treatment of Synovial Chondromatosis of the Shoulder Joint with Mini-open Procedure for the Lesions of Biceps Tendon Sheath

  • 오주한;조기현;최정아;정진행;윤종필;공현식
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2008년도 제16차 학술대회
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    • pp.170-170
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    • 2008
  • Synovial chondromatosis is an uncommon condition, and the involvement of the shoulder joint is rare. A 15 year old female patient presented to author's institution for right shoulder pain. We checked the plain radiographs and MRI. And they showed that a diagnosis of synovial chondromatosis in the shoulder, and they also demonstrated that the disease involved the bicipital tendon sheath as well as glenohumeral joint. We removed all loose bodies with total synovectomy by arthroscopic procedure, and a mini-open procedure for the lesions of biceps tendon sheath. Arthroscopic treatment affords excellent visualization of the shoulder joint with less morbidity. However, with current arthroscopic techniques, it is difficult to manage the synovial chondromatosis of biceps tendon in bicipital groove. The authors suggest that the complete elimination of synovial chondromatosis involving shoulder requires a mini-open procedure for the lesions of biceps tendon sheath in addition to the arthroscopic resection of the affected synovium and loose body removal in the glenohumeral joint.

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Outcomes of Critical Pathway in Laparoscopic and Open Surgical Treatments for Gastric Cancer Patients: Patients Selection for Fast-Track Program through Retrospective Analysis

  • Choi, Ji Woo;Xuan, Yi;Hur, Hoon;Byun, Cheul Su;Han, Sang-Uk;Cho, Yong Kwan
    • Journal of Gastric Cancer
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    • 제13권2호
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    • pp.98-105
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    • 2013
  • Purpose: The aim of this study is to investigate the clinical factors affecting on the cure rate by invasive and open surgery for gastric cancer and to establish a subgroup of patients who can be applied by the early recovery after surgery program through this retrospective analysis. Materials and Methods: In this retrospective study, we analyzed 425 patients who underwent gastric cancer surgery between January 2011 and December 2011 and were managed with conventional clinical therapies. This clinical algorithm was made when the patient was in minimally invasive surgery group and discharged from hospital one day faster than them in open surgery group. Results: The completion rate of the clinical pathway was 62.4%. Despite the different applications of clinical pathway, completion rate in minimally invasive surgery group was significantly higher than that of open group (P<0.001). In multivariate analysis, the surgical procedure of minimally invasive surgery (odds ratio=4.281) was the most predictable factor to complete clinical pathway. Additionally, younger patients (odds ratio=1.933) who underwent distal gastrectomy (odds ratio=1.999) without combined resection (odds ratio=3.069) were predicted to accomplish the clinical pathway without any modifications. Conclusions: We concluded that high efficacy of the clinical pathway for gastric cancer surgery was expected to selected patients through retrospective analysis (expected completion rate=85.4%). In addition, these patients would become enrolled criteria for early recovery program in gastric cancer surgery.

Helicobacter pylori Eradication Reduces the Metachronous Recurrence of Gastric Neoplasms by Attenuating the Precancerous Process

  • Jung, Da Hyun;Kim, Jie-Hyun;Lee, Yong Chan;Lee, Sang Kil;Shin, Sung Kwan;Park, Jun Chul;Chung, Hyun Soo;Kim, Hyunki;Kim, Hoguen;Kim, Yong Hoon;Park, Jae Jun;Youn, Young Hoon;Park, Hyojin
    • Journal of Gastric Cancer
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    • 제15권4호
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    • pp.246-255
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    • 2015
  • Purpose: The importance of Helicobacter pylori eradication after endoscopic resection (ER) of gastric neoplasms remains controversial. In this study, we clarified the importance of H. pylori eradication for metachronous lesions after ER. Materials and Methods: This study included 3,882 patients with gastric neoplasms who underwent ER. We included patients infected with H. pylori who received eradication therapy. Among them, 34 patients with metachronous lesions after ER and 102 age- and sex-matched patients (nonmetachronous group) were enrolled. Background mucosal pathologies such as atrophy and intestinal metaplasia (IM) were evaluated endoscopically. The expression levels of CDX1, CDX2, Sonic hedgehog (SHH), and SOX2 were evaluated based on H. pylori eradication and the development of metachronous lesions. Results: The eradication failure rate was higher in the metachronous group than in the nonmetachronous group (P=0.036). Open-type atrophy (P=0.003) and moderate-to-severe IM (P=0.001) occurred more frequently in the metachronous group. In patients with an initial diagnosis of dysplasia, the eradication failure rate was higher in the metachronous group than in the nonmetachronous group (P=0.002). In addition, open-type atrophy was more frequent in the metachronous group (P=0.047). In patients with an initial diagnosis of carcinoma, moderate-to-severe IM occurred more frequently in the metachronous group (P=0.003); however, the eradication failure rate was not significantly different between the two groups. SHH and SOX2 expression was increased, and CDX2 expression was decreased in the nonmetachronous group after eradication (P<0.05). Conclusions: Open-type atrophy, moderate-to-severe IM, and H. pylori eradication failure were significantly associated with metachronous lesions. However, eradication failure was significantly associated with dysplasia, but not carcinoma, in the metachronous group. Thus, H. pylori eradication may play an important role in preventing metachronous lesions after ER for precancerous lesions before carcinomatous transformation.

표준 GIS 웹 서비스를 위한 항공사진측량 WPS의 프로파일 설계 및 구현 (부등각사상변환, 후방교회법 중심으로) (Profile Design and Implementation of Aerial Photogrammetry WPS for Standard GIS Web Service (With Emphasis on Affine Transformation and Resection))

  • 김병조;염재홍;경민주
    • 한국측량학회지
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    • 제28권3호
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    • pp.337-345
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    • 2010
  • 일반적으로 비용이 많이 들고 복잡한 처리과정을 거치는 디지털 항공사진측량은 독립형 워크스테이션 시스템을 기반으로 사용되어 왔다. 본 연구에서는 Open Geospatial Consortium에서 제안한 국제 GIS 표준인 Web Processing Service을 통해 항공사진측량 처리 과정에 대한 새로운 접근 방안을 제시하고자 한다. 실험을 위해 항공사진측량 업무를 기본단위로 정의하는 WPS 프로파일링 과정을 거쳐 여러 개의 제네릭 프로세스로 정의하였고, 정의된 프로세스는 WPS 표준에 따라 각각 서버 S/W와 클라이언트 S/W 모듈을 구현하였다. 본 연구를 통해 WPS의 기본 단위 항공사진측량 프로세스를 다수의 사용자가 웹을 사용하여 공유, 재활용 측면의 접근을 기대할 수 있었다.

An unstable patient with a large sucking chest wound managed with gauze packing for preventing tension and bleeding control before surgery in Korea: a case report

  • Chang-Sin Lee;Min-Jeong Cho;Tae-Wook Noh;Nak-Jun Choi;Jun-Min Cho
    • Journal of Trauma and Injury
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    • 제37권2호
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    • pp.147-150
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    • 2024
  • This case report describes the management of a 51-year-old female patient who arrived at the emergency room with a stab wound to the upper right chest. Immediate medical interventions were undertaken, including blood transfusions and endotracheal intubation. To prevent tension and control bleeding, gauze packing was applied directly through the large open wound. Further surgical exploration identified a laceration in the lung, necessitating a right upper lobe resection. Postoperatively, the patient's vital signs stabilized, and she was subsequently discharged without complications. This case highlights the decision-making process in selecting between an emergency department thoracotomy and an operating room thoracotomy for patients with penetrating chest trauma. It also illustrates the role of gauze packing in managing tension and hemorrhage. In summary, gauze packing can be an effective interim measure for stabilizing patients with traumatic injuries, unstable vital signs, and large open chest wounds, particularly when a chest tube is already in place, to prevent tension and facilitate bleeding control prior to surgical intervention.

Pituitary Apoplexy Following Mitral Valvuloplasty

  • Kim, Young Ha;Lee, Sang Weon;Son, Dong Wuk;Cha, Seung Heon
    • Journal of Korean Neurosurgical Society
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    • 제57권4호
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    • pp.289-291
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    • 2015
  • Pituitary apoplexy is a rare but potentially life-threatening clinical syndrome caused by the sudden enlargement of a pituitary adenoma secondary to hemorrhage or infarction. Pituitary apoplexy after cardiac surgery is a very rare perioperative complication. Factors associated with open heart surgery that may lead to pituitary apoplexy include hemodynamic instability during cardiopulmonary bypass and systemic heparinization. We report a case of pituitary apoplexy after mitral valvuloplasty with cardiopulmonary bypass. After early pituitary tumor resection and hormonal replacement therapy, the patient made a full recovery.

유방하 피부절개를 통한 개심술 (Bilateral Submammary Skin Incision for Open Heart Surgery)

  • 김기봉
    • Journal of Chest Surgery
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    • 제21권6호
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    • pp.1095-1098
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    • 1988
  • Congenital cystic adenomatoid malformation[CCAM] is a rare disease that cause respiratory distress in the newborn and infants, but is one of the two causes along with lobar emphysema. This malformation has the pathologic characteristics which can be differentiated from other forms of diffuse cystic disease, i.e. CCAM is marked proliferation of the terminal bronchioles and that can enlarge rapidly by air trapping in cystic areas. The CCAM has a clinical importance because of rapid worsening respiratory distress, with tachypnea, subcostal retraction and cyanosis. This is a strict surgical condition and after operation[lobar, segmental resection or pneumonectomy] the symptoms relieved obviously. We experienced 6 cases of CCAM from July, 1980 to September, 1987 at the Department of Cardiovascular and Thoracic Surgery, Severance Hospital, College of Medicine, Yonsei University. The male patients were two and female patients were four. The age distribution was from premature to 10 year old. One of them was 27 weeks gestational premature female who was borne dead. The other 5 patients were performed on thoractomy[1 case pneumonectomy and 5 cases lobectomy]. The postoperative courses were good and no complications were seen.

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Subpulmonary VSD 를 동반한 활로 4증: 수술 치험 1례 보고 (Tetralogy of Fallot with Subpulmonary Ventricular Septal Defect: A Case Report)

  • 우종수
    • Journal of Chest Surgery
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    • 제11권2호
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    • pp.175-180
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    • 1978
  • A rare form of tetralogy of Fallot, in which large ventricular septal defect was located at subpulmonary position rather than beneath a well developed crista supraventricularis was operated in this Department. This case satisfied the criteria for the diagnosis of tetralogy of Fallot, having large ventricular septal defect beneath the aortic valve with overriding of aorta, pulmonary stenosis and right ventricular hypeFtrophy. The operation was done through a median sternotomy using cardiopulmonary bypass. A vertical right ventriculotomy was extended to the pulmonary valve ring. Pulmonary and aortic valve were adjacent to each other, in contrast to the situation of classic tetralogy of Fallot. Pulmonary valvulotomy was done and ventricular septal defect was closed. with Teflon, and right ventricular outflow tract was reconstructed with woven Dacron covered by pericardial patch after minimal resection of septal band. The post-operatiove courses was uneventful except wound infection. The patient was discharged 15 days after open heart surgery.

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성대암에서 $CO_2$ 레이저를 이용한 경구강절제술 (Transoral $CO_2$ Laser Microsurgery for Glottic Carcinoma)

  • 정필상;문태현
    • 대한기관식도과학회지
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    • 제16권1호
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    • pp.20-26
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    • 2010
  • Transoral $CO_2$ Laser Microsurgery of glottic Carcinoma is replacing external approaches. The qualify of life after surgery for laryngeal cancer may be as important as complete resection of the tumor for patient. Transoral $CO_2$ laser cordectomy for the management of early laryngeal cancer has advantages with regard to oncological results, preservation of laryngeal functions, morbidity and cost in comparison to those of open surgery or radiation therapy. Moreover, transoral laser surgery can be a useful choice as a salvage surgery in radiation therapy failed early glottic cancer. A classification of laryngeal endoscopic cordectomies which included eight different types was described by the European laryngological Society in 2000. We will also introduce type VI which was newly proposed recently.

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국소마취하의 흉강경의 임상적 응용 (Thoracoscopy for Diagnosis and Treatment of Pneumothorax Under Local Anesthesia; Analysis of 68 patients)

  • 홍순필
    • Journal of Chest Surgery
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    • 제26권3호
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    • pp.204-208
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    • 1993
  • The review of 68 patients, who were diagnosed as spontaneous pneumothorax during the period from Dec, 1991. to Jul, 1992. were performed thoracoscopy of 70 cases under local anesthesia with 1% lidocaine at the department of thoracic & cardiovascular surgery, HanYang University Hospital. Clinical data on distribution of Age & Sex, Location, Frequency of Reccurrence and other aspects of pneumothorax were summerized.37 cases were treated by thoracoscopic management and closed thoracostomy. As thoracoscopic management, Electrocauterization of bullae or blebs[37 cases], Endo-clip application [2 cases], Removal of foreign body[1 case] were performed. 31 cases were cured by open thoracotomy. The thoracotomy indications under thoracoscopic finding were followed as: 1. Severe pulmonary adhesion and destroyed lung parenchyme 2. multiple bullae or blebs on several areas 3. finding of pulmonary tuberculous caseous lesion 4. persistant air leakage after 7 days from thoracoscopic management Excision, wedge resection of bullae or blebs was performed in most cases [22 cases], 2 cases by median sternotomy and Segmentectomy of 7 cases were carried out depending on the pathologic change of lung.There was no operative mortality and Follow-up for all patients were showed good results.

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