• 대한두경부종양학회지
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• 제38권2호
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• pp.29-32
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• 2022

Lipoma is one of the most common benign soft tissue tumors. However, giant lipomas compressing and deforming the neurovascular structure rarely occur in the lateral neck. A 70-year-old man visited our outpatient clinic for treatment of a visible painless neck mass that had been identified 2 years prior. Neck magnetic resonance imaging revealed that a 10 × 9 × 4 cm fatty mass located between the sternocleidomastoid and sternohyoid muscles invaded the carotid sheath. Under general anesthesia, the mass was excised without damage to the adjacent neurovascular structures. Upon histopathological examination, the mass was identified as a lipoma. During the surgery, enlargement of the internal jugular vein was observed under the resected mass. However, on ultrasound examination, the function of the internal jugular vein was evaluated as good. No recurrence or neurological and vascular complications were reported during a 6-month follow-up after the surgery. As a giant lipoma located in the deep layer of the lateral neck can deform important cervical structures, its impact on the surrounding structures should be carefully assessed preoperatively to minimize the rate of possible complications.

• 대한두경부종양학회지
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• 제39권1호
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• pp.53-57
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• 2023

In general, the anatomical location and number of parathyroid glands are well known, but they are often found in a variety of locations, making it difficult to find parathyroid glands during surgery. Besides Intra-thyroidal parathyroid adenoma is extremely rare case, and it is harder to identify in surgery. We encountered a 51-year-old patient with a thyroid nodule. The results of the additional blood test and the Tc-99m MIBI were combined to determine that the left lower lobe parathyroid adenoma was highly likely. This patient was treated with left thyroid lobectomy with parathyroid identification using Near-infrared (NIR) imaging. Afterwards, the biopsy confirmed that it was a parathyroid adenoma, and has since been monitored through outpatient observation without any problem. We present this rare case with a review of related literatures.

• Journal of Chest Surgery
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• 제38권10호
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• pp.685-692
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• 2005

배경: 좌심실 벽 운동장애는 관상동맥 우회술 후 장기생존율에 영향을 줄 수 있다. 이 연구는 심근경색증 후 발생한 좌심실 벽 운동장애가 관상동맥 우회술 후 장기생존율에 어떠한 영향을 주는가를 알아보았다. 대상 및 방법: 관상동맥 우회술 후 9년이 넘은 환자들 133예(남/여, 92/41)를 대상으로, 심근경색 후 좌심실 벽 운동장애가 있는 환자 56예(남/여 42/14, 평균연령 $59.2\pm9.2$세)와 좌심실 벽 운동장애가 없는 환자 77예(남/여 50/27,평균연령 $58.0\pm7.6$세)로 나누어 비교 분석하였다. 대부분의 환자들(l12/133, $84.2\%$)에서 체외순환 하에 좌측 속 가슴동맥과 하지 큰 두렁정맥을 이용하여 수술하였고 대동맥 차단 상태에서 근위연결 및 원위연결을 시행하는 방법으로 수술하였다. 걸과: 좌심실 벽 운동장애가 있는 환자들의 좌심실 구혈률은 평균 $48.7\pm13.2\%$로 좌심실 벽 운동장애가 없는 환자들(평균$57.1\pm10.1\%$)보다 감소되어 있었다(p=0.0001). 운동장애가 없는 환자군에서 평균 $135.1\pm18.0$개월의 추적으로 5년, 10년, 13년의 생존율은 각각 $85.7\pm4.0\%,\;76.2\;4.9\%,\;57.2\pm10.3\%$였고, 좌심실 운동장애가 있는 환자군에서 평균 $122.8\pm22.7$개월의 추적으로 5년, 10년, 13년의 생존율은 각각 $80.4\pm5.3\%,\;58.7\pm7.3\%,\;11.9\pm7.9\%$이었다(p=0.1). 심근경색에 의한 좌점실 벽 국소 운동장애가 있는 환자의 장기생존율에 영향을 미치는 인자는 좌심실 구혈률과 외래 치료였다. 다변량 분석에서 좌심실 벽 운동장애가 있는 환자군의 장기생존율은 외래 치료를 한 환자에서 우수하였고 좌심실 벽 운동장애가 없는 군의 장기생존율은 여성에서 우수하였다. 결론: 심근경색 후 좌심실 벽의 운동장애가 있는 경우 장기 생존율은 운동장애가 없는 경우보다 떨어지는 경향을 보이며, 그런 환자들에서 수술 후 외래 치료가 장기 생존에 매우 중요하다고 생각한다.

• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.97-102
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• 2009

Purpose: To close anterior cranial base, various types of pedicle flaps have been developed previously. However, the results of those pedicle flaps were not constant. To solve such problem, the author designed bipedicle temporalis-pericranial (BTP) flap based on various types of existing flaps and this study intends to introduce this flap and present clinical application case. Methods: The pedicle of the proposed temporalis-pericranial flap is temporalis muscle. The point of this BTP flap is that because of both sides of the unilateral temporalis-pericranial flap are connected by midline pericranial tissue connected with dense vascular network communicate one another locally, that BTP flap can be safely elevated. The case is a 14 months old male patient of frontoethmoidal encephalomeningocele. Surgery was done in a way that after elevating BTP flap and removing encephalomeningocele, BTP flap was moved intracranially, and to prevent cerebrospinal fluid leakage, anterior cranial base was closed. Results: During 1 year and 6 month outpatient tracking observation, no particular finding like CSF leakage, meningitis or hydrocephalus was observed. Conclusion: The benchmarked BTP flap, effective in the treatment of frontoethmoidal encephalomeningocele, is one of the methods to close intracranium and extracranium.

• 기본간호학회지
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• 제24권3호
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• pp.209-218
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• 2017

Purpose: The purpose of this research was to identify factors that influence health-related quality of life of patients who have had knee or hip arthroplasty. Factors included sleep disorders, pain, activities of daily living, and depression. Methods: The participants in this research were 97 patients within one year after receiving knee or hip arthroplasty surgery and who regularly visited a hospital outpatient department. Data were analyzed using descriptive statistics, t-test, ANOVA, and stepwise regression analysis with the SPSS program. Results: Sleep disorders, pain, activities of daily living, and depression had significant correlations with health related quality of life. Factors influencing health-related quality of life among arthroplasty patients were the length of time since surgery, sleep disorders, activities of daily living, and depression. These factors explained 58% of the participants' health-related quality of life. Conclusion: The results show that various factors can affect patients' health-related quality of life following joint replacement surgery. The findings indicate that sleep disorders and depression should receive continued attention after the arthroplasty. It is also necessary to develop appropriate nursing intervention programs to lower depression and increase patient participation in daily living activities.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권2호
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• pp.161-163
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• 2005

In the reconstruction of the hard tissue defect of the oral cavity, the usefulness of the chin bone graft, one of the intraoral donor site, is gradually increased. The advantages include reduced resorption rate after graft due to its membranous bone nature, relatively ease to harvest under local anesthesia, reduced operative time because of the same operative field, decreased morbidity, and relatively large amount of bone can be harvested compared to other intraoral donor site. It has also postoperative complications including paresthesia of the lip or chin area, discomfort of lower anterior teeth, and facial swelling around chin area. Of these complications, facial swelling occurs more frequently, is more severe as a early postoperative discomfort, and prevents fast recover of patient's social activity since this procedure is generally accomplished in the outpatient base under local anesthesia. So we applied a modified " gull-wing" type incision to minimize this complication, and now we report this simple but effective surgical technique with clinically favorable result.

• 대한후두음성언어의학회지
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• 제20권1호
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• pp.11-16
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• 2009

OPD based laryngeal procedures offers a new avenue to the modern laryngologist, incorporating new technology in the office setting. With the development of flexible fiberoptic endoscopes, compact video system, and short acting anesthetics and sedatives allow these procedures. The success or failure of procedures are depend on excellent topical anesthesia. An inadequately anesthetized patient is apt to be uncomfortable, anxious and hyperresponsive and therefore unlikely to tolerate the procedure. On the other hand, a patient who is well informed, reassured, and thoroughly anesthetized can complete procedures. Therefore, optimal anesthesia is obligatory for excellent surgical results. The phonosurgeon should choose the anesthetic and sedative agents based on duration of action, time of onset of action, and any medical contraindications that the patient may have. And should be familiar with the properties and interaction of the agents used, as well as the signs of toxicity.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.674-678
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• 2011

Purpose: Straight closure line of classic Weir excision leaves visible scars and makes it difficult to precisely approximate resection margins. Hence this study introduces Park-Weir excision that effectively reduces alar width with minimal alar rim scar by 3-dimensional zigzag incision and properly controls the approximation of edges. Methods: From 2008 to 2010, 14 patients underwent Park-Weir excision, crossed wedge excision on alar rim not exceeding 5 mm in width. Each patient was photographed in the same position. Alar width and columellar height against intercanthal distance was compared preoperatively and postoperatively, using image analysis software. Results: Five patients were female and nine were male. Average follow up period was 8 month. Alar width was reduced by 50.50% to 45.96%, original alar width reduced by 8.98% without significant changes in columellar height which was reduced by 0.39%. No visible scar was reported during outpatient follow-up. Conclusion: Park-Weir excision effectively reduces alar width and corrects the flaring of alar without affecting the columellar height. Zigzag incision of Park-Weir excision leaves aesthetically more pleasant scar than straight single incision of classical Weir excision.

• 대한영상의학회지
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• 제84권1호
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• pp.280-285
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• 2023

자궁 근종은 여성에서 가장 흔한 양성 골반 강 내 종양이며 증상이 있을 경우 수술적 제거를 하게 된다. 내시경 수술이 발달하게 되면서 포트 삽입 부위의 기생 평활 근종들이 보고되기 시작하였다. 40세의 여자 환자가 왼쪽 아랫배에서 만져지는 종괴를 주소로 외래로 내원하였고 2년 전 내시경 근종 제거를 받은 과거력이 있었다. 조영증강 CT와 MRI를 시행하여 해당 종괴에 대한 평가를 시행하였으며 수술적 제거를 시행하였다. 병리 검사에서 해당 종괴는 기생 평활 근종으로 최종 진단되었는데 이는 이전 내시경 근종 제거술을 시행한 환자에서 수술부위에 만져지는 종괴를 주소로 내원하였을 때 반드시 기생 평활 근종을 감별 진단으로 고려하여야 함을 시사한다.

• Journal of Chest Surgery
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• 제20권2호
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• pp.241-250
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• 1987

We scrutinized the preoperative electrocardiographic and hemodynamic findings in adult atrial septal defects older than 15 years, and then followed up the postoperative electrocardiographic changes sequentially. In preoperative electrocardiographs, the mean PR interval [0.17 sec] was prolonged than normal adults [M;0.13,F;0.15], and the mean QRS axis [93.1*] was deviated to rightward than normal [M;63.7*,F;64.4*], and 122 cases of all 159 patients [77.8%] were in RAD quadrant. The QRS morphology was classified into three groups; a] crista supraventricularis hypertrophy, 25 cases, b] right ventricular outflow tract hypertrophy, 89 cases, c] right ventricular hypertrophy, 44 cases, and normal rs pattern, 1 case. Comparing the QP/QS, Pp/Ps, Rp/Rs in these three groups, Qp/Qs increased a] 2.65 to b] 2.97 and decreased b] 2.97 to c] 2.55, Pp/Ps increased a] 0.27 to b] 0.35 to c] 0.44, and Rp/Rs increased a] 0.1 to b] 0.14 to c] 0.2. In comparing the atrial fibrillation with sinus rhythm, the patient`s mean age was increased [26.4 to 45.7], the mean Qp/Qs was decreased [2.97 to 2.7], the mean Pp/Ps was increased [0.35 to 0.46], the mean Rp/Rs increased [0.14 to 0.2], and the QRS morphology was RVOT hypertrophy;7 cases, RVH;2 cases in all 11 cases. Therefore, the atrial fibrillation was appeared in progressed status. Increasing the mean pulmonary arterial pressure, size of the R` wave in Vl lead increased, and the QRS morphology tended to become severe patterns. Postoperatively, the PR interval shortened and QRS axis tended to normal axis quadrant, and size of R` wave decreased sequentially, atrial fibrillation disappeared in 4 cases. Conclusively, by use of the conventional surface electrocardiography, we could anticipate the hemodynamic changes and the prognosis at outpatient department.