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Review article
Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review
Jinseok Yeo
J Yeungnam Med Sci. 2024;41(3):166-178.   Published online June 10, 2024
DOI: https://doi.org/10.12701/jyms.2024.00339
  • 4,089 View
  • 203 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Amid the worldwide increase in spinal surgery rates, a significant proportion of patients continue to experience refractory chronic pain, resulting in reduced quality of life and escalated healthcare demands. Failed back surgery syndrome (FBSS) is a clinical condition characterized by persistent or recurrent pain after one or more spinal surgeries. The diverse characteristics and stigmatizing descriptions of FBSS necessitate a reevaluation of its nomenclature to reflect its complexity more accurately. Accurate identification of the cause of FBSS is hampered by the complex nature of the syndrome and limitations of current diagnostic labels. Management requires a multidisciplinary approach that may include pharmacological treatment, physical therapy, psychological support, and interventional procedures, emphasizing realistic goal-setting and patient education. Further research is needed to increase our understanding, improve diagnostic accuracy, and develop more effective management strategies.

Citations

Citations to this article as recorded by  
  • Short-term Effects of Combined Korean Medicine Treatment Including Acupotomy in a Patient with Failed Back Surgery Syndrome: A Case Report
    Heejeon Hong, Soo Kwang An, Taewook Lee, Jihun Kim, Eunseok Kim
    Journal of Acupuncture Research.2025;[Epub]     CrossRef
  • Using Key Predictors in an SVM Model for Differentiating Spinal Fractures and Herniated Intervertebral Discs in Preoperative Anesthesia Evaluation
    Shih-Ying Yang, Shih-Yen Hsu, Yi-Kai Su, Nan-Han Lu, Kuo-Ying Liu, Tai-Been Chen, Kon-Ning Chiu, Yung-Hui Huang, Li-Ren Yeh
    Diagnostics.2024; 14(21): 2456.     CrossRef
Case report
Intraabdominal abscess mimicking gastric cancer recurrence: a case report
Yong-Eun Park
J Yeungnam Med Sci. 2023;40(4):426-429.   Published online February 1, 2023
DOI: https://doi.org/10.12701/jyms.2022.00864
  • 2,434 View
  • 40 Download
AbstractAbstract PDF
Surgical site infection is a common healthcare-associated infection that rarely occurs several months after surgery. Herein, a case is described in which an abdominal mass lesion was found at a 6-month follow-up visit after gastrectomy was performed for early gastric cancer. Positron emission tomography-computed tomography revealed a 2.5 cm-sized mass with a high maximal standard uptake value (8.32), located above a previous anastomosis site. Locoregional recurrence of gastric cancer was diagnosed by multidisciplinary team discussion, and explorative laparotomy was performed. However, surgical and pathologic findings revealed that the mass was an intraabdominal abscess. In conclusion, differential diagnosis of delayed abscess formation should be considered if the possibility of tumor recurrence is low, especially after early gastric cancer surgery.
Original article
Outcomes after repair of complete atrioventricular canal with a modified single-patch technique: a retrospective study
George Samanidis, Konstantinos Kostopanagiotou, Meletios Kanakis, Georgios Kourelis, Kyriaki Kolovou, Georgios Vagenakis, Dimitrios Bobos, Nicholas Giannopoulos
J Yeungnam Med Sci. 2023;40(2):187-192.   Published online February 1, 2023
DOI: https://doi.org/10.12701/jyms.2022.00759
  • 2,256 View
  • 67 Download
AbstractAbstract PDF
Background
This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique.
Methods
This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique.
Results
The median age of the patients was 5.7 months (interquartile range [IQR], 5.0–7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5–5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006–0.50; p=0.01).
Conclusion
A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.
Case report
Transient osteoporosis of the hip with a femoral neck fracture during follow-up: a case report
Yusuke Tabata, Shuhei Matsui, Masabumi Miyamoto, Koichiro Omori, Yoichiro Tabata, Tokifumi Majima
J Yeungnam Med Sci. 2023;40(2):212-217.   Published online September 26, 2022
DOI: https://doi.org/10.12701/jyms.2022.00479
  • 5,428 View
  • 72 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
We report a case of transient osteoporosis of the hip with a femoral neck fracture found during follow-up. A 53-year-old man presented with left hip pain without trauma. The pain did not improve after 2 weeks and he was brought to our hospital by ambulance. Magnetic resonance imaging (MRI) of the left hip joint showed diffuse edema in the bone marrow, which was identified by low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and increased signal intensity on short tau inversion recovery. This edema extended from the femoral head and neck to the intertrochanteric area. He was diagnosed with transient osteoporosis of the left hip. Rest gradually improved his pain; however, 3 weeks later, his left hip pain worsened without trauma. X-ray, computed tomography, and MRI results of the hip joint demonstrated a left femoral neck fracture, and osteosynthesis was performed. Differential diagnoses included avascular necrosis of the femoral head, infection, complex regional pain syndrome, rheumatoid arthritis, leukemia, and other cancers. Transient osteoporosis of the hip generally has a good prognosis with spontaneous remission within a few months to 1 year. However, a sufficient length of follow-up from condition onset to full recovery is necessary to avoid all probable complications such as fractures.

Citations

Citations to this article as recorded by  
  • Hip effusion/synovitis influences results after multiple drilling core decompression for bone marrow edema syndrome of hip
    Hua-zhang Xiong, Yan-li Peng, Yu-hong Deng, Ying Jin, Ming-hong Tu, Shu-hong Wu
    BMC Surgery.2023;[Epub]     CrossRef
Original articles
Infection prevention measures and outcomes for surgical patients during a COVID-19 outbreak in a tertiary hospital in Daegu, South Korea: a retrospective observational study
Kyung-Hwa Kwak, Jay Kyoung Kim, Ki Tae Kwon, Jinseok Yeo
J Yeungnam Med Sci. 2022;39(3):223-229.   Published online November 5, 2021
DOI: https://doi.org/10.12701/yujm.2021.01431
  • 6,031 View
  • 99 Download
AbstractAbstract PDF
Background
The first large coronavirus disease 2019 (COVID-19) outbreak outside China occurred in Daegu. In response, we developed infection prevention measures for surgical patients during the outbreak at our hospital and retrospectively reviewed the outcomes of COVID-19–related surgical patients.
Methods
We reviewed the medical records of 118 COVID-19–related surgical patients and monitored their clinical outcomes until March 31, 2021. We also interviewed healthcare workers who participated in their perioperative care at Kyungpook National University Chilgok Hospital. The perioperative management guidelines for COVID-19–related patients were prepared through multidisciplinary discussions, including the infection control department, surgical departments, and anesthesiology department before and during the COVID-19 outbreak.
Results
One standard operating room was temporarily converted to a negative-pressure room by increasing the exhaust air volume, creating a relative pressure of −11.3 Pa. The healthcare workers were equipped with personal protective equipment according to the patient's classification of the risk of COVID-19 transmission. The 118 COVID-19–related patients underwent emergent surgery in the negative-pressure room, including three COVID-19–confirmed patients and five COVID-19–exposed patients.
Conclusion
All surgeries of the COVID-19–related patients were performed without specific adverse events or perioperative COVID-19 transmission. Our experience setting up a negative-pressure operating room and conservative perioperative protocol to prevent COVID-19 transmission will help plan and execute infection control measures in the future.
Personal experience with microvascular decompression and partial sensory rhizotomy for trigeminal neuralgia
Jung Hwan Lee, Jae Meen Lee, Chang Hwa Choi
Yeungnam Univ J Med. 2021;38(3):202-207.   Published online November 23, 2020
DOI: https://doi.org/10.12701/yujm.2020.00745
  • 8,642 View
  • 129 Download
  • 6 Crossref
AbstractAbstract PDF
Background
Trigeminal neuralgia (TN) is a severe, paroxysmal pain in the distribution of the fifth cranial nerve. Microvascular decompression (MVD) is the most widely used surgical treatment for TN. We undertook this study to analyze the effects of and complications of MVD and to refine the surgical procedure for treating TN.
Methods
A total of 88 patients underwent for TN underwent surgery at our hospital. Among them, 77 patients underwent MVD alone, and 11 underwent partial sensory rhizotomy (PSR) with or without MVD. The medical records of these patients were retrospectively analyzed for patient characteristics, clinical results, offending vessels, and complications if any.
Results
The mean follow-up duration was 43.2 months (range, 3–216 months). The most common site of pain was V2+V3 territory (n=27), followed by V2 (n=25) and V3 (n=23). The most common offending vessels were the superior cerebellar artery and anterior inferior cerebellar artery in that order. The overall rate of postoperative complications was 46.1%; however, most complications were transient. There were two cases of permanent partial hearing disturbance. In the MVD alone group, the cure rate was 67.5%, and the improvement rate was 26.0%. Among 11 patients who underwent PSR with or without MVD, the cure rate was 50.0%, and the improvement rate was 30.0%.
Conclusion
The clinical results of MVD were satisfactory. Although the outcomes of PSR were not as favorable as those of pure MVD in this study, PSR can be considered in cases where there is no significant vascular compressive lesion or uncertainty of the causative vessel at the surgery.

Citations

Citations to this article as recorded by  
  • Revisiting the Efficacy of Redo Microvascular Decompression for Trigeminal Neuralgia
    Zhongding Zhang, Hua Zhao, Yinda Tang, Baimiao Wang, Qing Yuan, Ying Zhang, Yihua Li, Jun Zhong, Shiting Li
    World Neurosurgery.2024; 186: e335.     CrossRef
  • A systematic review on the efficacy of adjunctive surgical strategies during microvascular decompression for trigeminal neuralgia without intraoperative evidence of neurovascular conflict
    Nicola Montano, Grazia Menna, Alessandra Musarra, Renata Martinelli, Alessandro Izzo, Quintino Giorgio D’Alessandris, Manuela D’Ercole, Alessandro Olivi
    Neurosurgical Review.2024;[Epub]     CrossRef
  • Progress in Surgical Treatment of Trigeminal Neuralgia
    滨 何
    Advances in Clinical Medicine.2023; 13(02): 2313.     CrossRef
  • How Far Has Radiofrequency Thermocoagulation Come Along as a Treatment Procedure in Treating Trigeminal Neuralgia Patients?
    Stephen D Howard, Varun Soti
    Cureus.2023;[Epub]     CrossRef
  • Historical aspects of the problem of treatment of trigeminal neuralgia and the role of neurosurgical methods in its solution (literature review)
    A. N. Zhurkin, A. V. Semenov, V. A. Sorokovikov, N. V. Bartul
    Acta Biomedica Scientifica.2021; 6(4): 123.     CrossRef
  • Trigeminal Neuralgia: Current Approaches and Emerging Interventions
    Risheng Xu, Michael E Xie, Christopher M Jackson
    Journal of Pain Research.2021; Volume 14: 3437.     CrossRef
Case report
Diplopia developed by cervical traction after cervical spine surgery
Ji-Yoon Kim, Hyuna Kim, So Jeong Kang, Hyunjee Kim, Young-Seok Lee
Yeungnam Univ J Med. 2021;38(2):152-156.   Published online July 29, 2020
DOI: https://doi.org/10.12701/yujm.2020.00241
  • 8,009 View
  • 194 Download
  • 1 Crossref
AbstractAbstract PDF
Diplopia is a rare complication of spine surgery. The abducens nerve is one of the cranial nerves most commonly related to diplopia caused by traction injury. We report a case of a 71-year-old woman who presented with diplopia developing from abducens nerve palsy after C1–C2 fixation and fusion due to atlantoaxial subluxation with cord compression. As soon as we discovered the symptoms, we suspected excessive traction by the instrument and subsequently performed reoperation. Subsequently, the patient’s symptoms improved. In other reported cases we reviewed, most were transient. However, we thought that our rapid response also helped the patient’s fast recovery in this case. The mechanisms by which postoperative diplopia develops vary and, thus, remain unclear. We should pay attention to the fact that the condition is sometimes an indicator of an underlying, life-threatening condition. Therefore, all patients with postoperative diplopia should undergo thorough ophthalmological and neurological evaluations as well as careful observation by a multidisciplinary team.

Citations

Citations to this article as recorded by  
  • Transient internuclear ophthalmoplegia following anterior cervical discectomy and fusion
    Kevin N. Cordeiro, Garret P. Greeneway, Paul S. Page, Nathaniel P. Brooks
    Surgical Neurology International.2022; 13: 527.     CrossRef
Original article
Perioperative outcomes of interrupted anticoagulation in patients with non-valvular atrial fibrillation undergoing non-cardiac surgery
Bo Eun Park, Myung Hwan Bae, Hyeon Jeong Kim, Yoon Jung Park, Hong Nyun Kim, Se Yong Jang, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Shung Chull Chae
Yeungnam Univ J Med. 2020;37(4):321-328.   Published online July 16, 2020
DOI: https://doi.org/10.12701/yujm.2020.00353
  • 6,380 View
  • 103 Download
  • 1 Crossref
AbstractAbstract PDF
Background
This study aimed to investigate the incidences of and risk factors for perioperative events following anticoagulant discontinuation in patients with non-valvular atrial fibrillation (NVAF) undergoing non-cardiac surgery.
Methods
A total of 216 consecutive patients who underwent cardiac consultation for suspending perioperative anticoagulants were enrolled. A perioperative event was defined as a composite of thromboembolism and major bleeding.
Results
The mean anticoagulant discontinuation duration was 5.7 (±4.2) days and was significantly longer in the warfarin group (p<0.001). Four perioperative thromboembolic (1.85%; three strokes and one systemic embolization) and three major bleeding events (1.39%) were observed. The high CHA2DS2-VASc and HAS-BLED scores and a prolonged preoperative anticoagulant discontinuation duration (4.4±2.1 vs. 2.9±1.8 days; p=0.028) were associated with perioperative events, whereas the anticoagulant type (non-vitamin K antagonist oral anticoagulants or warfarin) was not. The best cut-off levels of the HAS-BLED and CHA2DS2-VASc scores were 3.5 and 2.5, respectively, and the preoperative anticoagulant discontinuation duration for predicting perioperative events was 2.5 days. Significant differences in the perioperative event rates were observed among the four risk groups categorized according to the sum of these values: risk 0, 0%; risk 1, 0%; risk 2, 5.9%; and risk 3, 50.0% (p<0.001). Multivariate logistic regression analysis showed that the HAS-BLED score was an independent predictor for perioperative events.
Conclusion
Thromboembolic events and major bleeding are not uncommon during perioperative anticoagulant discontinuation in patients with NVAF, and interrupted anticoagulation strategies are needed to minimize these.

Citations

Citations to this article as recorded by  
  • Bleeding risk in female patients undergoing intravesical injection of onabotulinumtoxinA for overactive bladder: a Danish retrospective cohort study
    Meryam El Issaoui, Sophia Elissaoui, Marlene Elmelund, Niels Klarskov
    International Urogynecology Journal.2023; 34(10): 2581.     CrossRef
Case report
Effective strategy in the treatment of aortobronchial fistula with recurrent hemoptysis
Shin-Ah Son, Deok Heon Lee, Gun-Jik Kim
Yeungnam Univ J Med. 2020;37(2):141-146.   Published online February 25, 2020
DOI: https://doi.org/10.12701/yujm.2019.00444
  • 6,484 View
  • 100 Download
  • 3 Crossref
AbstractAbstract PDF
Aortobronchial fistula (ABF) involves the formation of an abnormal connection between the thoracic aorta and the central airways or the pulmonary parenchyma and is associated with an increased risk of mortality. An ABF typically manifests clinically with symptoms of hemoptysis, and currently, there is a lack of defined guidelines for its treatment. Here, we report the cases of two patients who suffered from recurrent hemoptysis due to ABF with pseudoaneurysm. We propose that removal of the aorta with concomitant lung resection and coverage of the aorta using the pericardial membrane is a definite treatment to lower recurrence of ABF and persistent infection.

Citations

Citations to this article as recorded by  
  • Descending Thoracic Aorta Replacement in the Setting of Coexisting Aortobronchial and Aortoesophageal Fistula Formation After Open Thoracic Aortic Graft Placement and Subsequent Endovascular Aortic Repair
    Rachel S. Dada, Jahnavi Kakuturu, Chris Cook, Alper Toker, Matthew Ellison
    Journal of Cardiothoracic and Vascular Anesthesia.2024; 38(2): 499.     CrossRef
  • Aortobronchopulmonary Fistula—An Unusual Cause of Hemoptysis
    Laura Castellanos López, Elisa Martínez Besteiro, Adrián Martínez Vergara
    Archivos de Bronconeumología.2023; 59(8): 510.     CrossRef
  • Hybrid Management of an Aortobronchial Fistula after Patch Aortoplasty for Aortic Coarctation in a Patient with SARS-CoV-2 Pneumonia: Case Report and Review of the Literature
    Grigore Tinica, Andrei Tarus, Alberto Bacusca, Raluca Ozana Chistol, Alexandra Cristina Rusu, Mihaela Tomaziu Todosia, Cristina Furnica
    Medicina.2022; 58(10): 1385.     CrossRef
Original article
Nasal tip plasty using three-dimensional printed polycaprolactone (Smart Ball®)
Joo Hyoung Kim, Geon Woo Kim, Won Kyung Kang
Yeungnam Univ J Med. 2020;37(1):32-39.   Published online September 5, 2019
DOI: https://doi.org/10.12701/yujm.2019.00290
  • 8,784 View
  • 168 Download
  • 11 Crossref
AbstractAbstract PDF
Background
Rhinoplasty is one of the most commonly performed cosmetic surgery procedures. Most Asians desire elevation of their relatively flat nasal dorsum and tip to make them appear more prominent. This study introduces a simple method of nasal tip plasty using three-dimensional (3D)-printed polycaprolactone (PCL) (Smart Ball®), which provides the required length and volume for this purpose and enables the creation of a nasal tip of the desired shape in a safe and simple manner.
Methods
Between September 2014 and May 2017, 22 patients participated in a survey to assess postoperative satisfaction levels. Additionally, three plastic surgeons compared patients’ pre- and 1-year postoperative photographs to evaluate the results. All patients underwent 2- to 4-year postoperative follow-up.
Results
Levels of subjective satisfaction among patients were 3.59, 3.50, 3.82, 3.73, 3.55, and 3.82 for each of the 6 categories evaluated, with a mean of 3.67/4 points, indicating high satisfaction levels. The mean plastic surgeon-reported score for the 22 patients was 4.47/5 points, which also indicates highly successful outcomes. Postoperative nasal tip rotation and tip projection were ideal in most patients.
Conclusion
Our novel method using 3D-printed PCL (Smart Ball®) provides the optimal length and volume required for nasal tip plasty and enables the creation of a nasal tip of the desired shape, in a safe and simple manner. An advantage of our method is that it retains the original nasal structure in contrast to structural changes observed with the use of conventional methods.

Citations

Citations to this article as recorded by  
  • From Novel Facial Measurements to Facial Implantology: A Systematic Review
    Helena Baecher, Alexandra Scheiflinger, Katya Remy, Niklas Straub, Bhagvat Maheta, Khalil Sherwani, Can Deniz, Samuel Knoedler, Ali-Farid Safi, Martin Kauke-Navarro, Max Heiland, Leonard Knoedler
    JPRAS Open.2025; 43: 1.     CrossRef
  • Evaluating the Mechanical Strength of 3-Dimensionally Printed Implants in Septorhinoplasty through Finite Element Analysis
    Sujata Syamal, Iulianna C. Taritsa, Angelica Hernandez Alvarez, Kirsten Schuster, Jose Foppiani, David Kaplan, Samuel J. Lin
    Plastic & Reconstructive Surgery.2025; 155(2): 319e.     CrossRef
  • Unveiling the Impact of Three-Dimensional Technology on Rhinoplasty: A Systematic Review and Meta-analysis
    Methini Werathammo, Kachorn Seresirikachorn, Prapitphan Charoenlux
    Facial Plastic Surgery.2024;[Epub]     CrossRef
  • Implanted cartilaginous grafts following rhinoplasty: A retrospective histopathological study
    Susumu Matsukuma, Ayano Matsunaga, Sho Ogata
    Experimental and Therapeutic Medicine.2024;[Epub]     CrossRef
  • Nasal Tip and Alar Groove Plasty Through External Nasal Cutting in Asians: A Clinical Study
    Meng-Qiong Xu, Yu-Xi Tang, Bao-Fu Yu, Qi Zeng, Jiao Wei, Chuan-Chang Dai
    Journal of Craniofacial Surgery.2023; 34(3): 870.     CrossRef
  • Cosmetic Open Rhinoplasty in Acute Nasal Bone Fracture With Pre-Existing Deformity
    Yong-Ha Kim, Won Seob Lee, Jae-Won Kim, Kyu-Jin Chung
    Journal of Craniofacial Surgery.2023; 34(4): e358.     CrossRef
  • The latest trends in Asian rhinoplasty
    Haibo Xiang, Wanwen Dang, Yang An, Yonghuan Zhen, Dong Li
    Chinese Journal of Plastic and Reconstructive Surgery.2022; 4(2): 82.     CrossRef
  • Ex Vivo Maturation of 3D-Printed, Chondrocyte-Laden, Polycaprolactone-Based Scaffolds Prior to Transplantation Improves Engineered Cartilage Substitute Properties and Integration
    Carlos M. Chiesa-Estomba, Raquel Hernáez-Moya, Claudia Rodiño, Alba Delgado, Gonzalo Fernández-Blanco, Javier Aldazabal, Jacobo Paredes, Ander Izeta, Ana Aiastui
    CARTILAGE.2022; 13(4): 105.     CrossRef
  • The Nasal Tip Rotation After Primary Rhinoplasty Using Columellar Strut Graft
    Yazeed Alghonaim , Fahad Alobaid, Jury Alnwaiser
    Cureus.2021;[Epub]     CrossRef
  • Aesthetic Nasal Lobule Correction Using a Three-Dimensional Printed Polycaprolactone Implant
    Syeo Young Wee, Tae Hyung Kim, Hee Yong Kang, Eun Soo Park
    Journal of Craniofacial Surgery.2021; 32(8): e808.     CrossRef
  • A Review of Current Developments in Three-Dimensional Scaffolds for Medical Applications
    Ufkay Karabay, Resit Bugra Husemoglu, Mehtap Yuksel Egrilmez, Hasan Havitcioglu
    Turkish Journal of Plastic Surgery.2021; 29(Suppl 1): S38.     CrossRef
Original Article
Retrograde balloon dilation as a therapeutic option for post-gynecologic surgery ureteral stricture followed by ureteroureterostomy: a comparative study regarding stricture length
Geon Woo Lim, Young Dong Yu, Kyung Hwa Choi, Seung Ryeol Rhee, Dong Soo Park, Young Kwon Hong
Yeungnam Univ J Med. 2018;35(2):179-186.   Published online December 31, 2018
DOI: https://doi.org/10.12701/yujm.2018.35.2.179
  • 6,295 View
  • 75 Download
  • 3 Crossref
AbstractAbstract PDF
Background
To evaluate the success rate of balloon dilation and the factors possibly influencing the outcomes of balloon dilation for the ureteric strictured portion of ureteroureterostomy (UUS) site in patients with post-gynecologic surgeries.
Methods
A single institution data base was screened for the patients who received balloon dilation for a treatment of ureteral stricture diagnosed after gynecologic surgery. Overall 114 patients underwent primary intra-operative UUS due to ureteral injury during gynecologic surgery. Among them, 102 patients received balloon dilation, and their medical records were retrospectively reviewed. Success of balloon dilation was defined as the condition that requires no further clinical interventions after 6 months from balloon dilation.
Results
The ureter injury rate of women treated with open radical abdominal hysterectomy was highest (32 cases, 31.4%). 60 patients (60.8%) showed successful outcomes regarding dilation. All patients underwent technically successful dilation with a full expansion of balloon during the procedure, but 40 patients (39.2%) were clinically unsuccessful as they showed a recurrence of ureteral stricture on the previous balloon dilation site after the first dilation procedure. Univariate logistic regression analyses showed that stricture length >2 cm was a significant predictor of successful dilation (odds ratio, 0.751; 95% confidence interval, 0.634-0.901; p-value, 0.030), but it failed to achieve independent predictor status in multivariate analysis.
Conclusion
Balloon dilation can an effective alternative treatment option for strictured portion of the primary UUS in post-gynecologic surgery patients when its length is <2 cm.

Citations

Citations to this article as recorded by  
  • Mechanical characteristics of the ureter and clinical implications
    Sorcha O’Meara, Eoghan M. Cunnane, Stefanie M. Croghan, Connor V. Cunnane, Michael T. Walsh, Fergal J. O’Brien, Niall F. Davis
    Nature Reviews Urology.2024; 21(4): 197.     CrossRef
  • Analysis of the Efficacy and Risk Factors for Failure of Balloon Dilation for Benign Ureteral Stricture
    Bing Wang, Wenzhi Gao, Kunlin Yang, Honglei Liu, Yangjun Han, Mingxin Diao, Chao Zuo, Minghua Zhang, Yingzhi Diao, Zhihua Li, Xinfei Li, Gang Wang, Peng Zhang, Chunji Wang, Chunjuan Xiao, Chen Huang, Yaming Gu, Xuesong Li
    Journal of Clinical Medicine.2023; 12(4): 1655.     CrossRef
  • Left-sided flap transposition of the appendix for urethroplasty in oncourology
    A. K. Nosov, D. I. Rumyantseva, E. M. Mamizhev, P. A. Lushina, N. A. Shchekuteev, M. V. Berkut
    Cancer Urology.2022; 18(1): 127.     CrossRef
Review Articles
Recent advances in minimally invasive surgery for gynecologic indications
Yu-Jin Koo
Yeungnam Univ J Med. 2018;35(2):150-155.   Published online December 31, 2018
DOI: https://doi.org/10.12701/yujm.2018.35.2.150
  • 6,091 View
  • 110 Download
  • 15 Crossref
AbstractAbstract PDF
Recently, an increasing interest in less invasive surgery has led to the advent of laparoendoscopic singlesite surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES). LESS and NOTES could be technically challenging, but available literature has demonstrated the feasibility and safety of LESS for benign gynecologic diseases. However, the evidence is not strong enough to recommend the use of LESS over that of conventional multiport laparoscopic surgery (MLS). As per the results of the most recently published meta-analysis, the majority of surgical outcomes are equivalent between LESS and MLS, except for the longer operative time in LESS for both adnexal surgery and hysterectomy. Although an increasing number of studies have reported on robotic LESS, NOTES, and LESS for gynecologic malignancy, definite conclusions have not been drawn owing to the lack of sufficient information.

Citations

Citations to this article as recorded by  
  • Optimizing Hysterectomy: A Prospective Comparative Analysis of Surgical Techniques and Their Impact on Women’s Lives
    Aslihan Yurtkal, Mujde Canday
    Journal of Personalized Medicine.2024; 14(3): 265.     CrossRef
  • Comparative study to determine the proper sequence of simulation training, pelvic trainer versus virtual reality simulator: a pilot study
    Ngima Yangji Sherpa, Ahmed El Minawi, Ahmed N Askalany, Marwa Abdalla
    Middle East Fertility Society Journal.2024;[Epub]     CrossRef
  • Innovative ICG Application in Benign Gynaecological Surgery: Enhancing Safety and Precision
    Summer Deah Menezes, Tanushree Rao, Kyousuke Takeuchi
    Case Reports in Obstetrics and Gynecology.2024;[Epub]     CrossRef
  • On the Control and Validation of the PARA-SILSROB Surgical Parallel Robot
    Doina Pisla, Calin Popa, Alexandru Pusca, Andra Ciocan, Bogdan Gherman, Emil Mois, Andrei-Daniel Cailean, Calin Vaida, Corina Radu, Damien Chablat, Nadim Al Hajjar
    Applied Sciences.2024; 14(17): 7925.     CrossRef
  • Transumbilical laparoendoscopic single-site surgery vs. multiport laparoscopic surgery for benign ovarian cysts: a retrospective cohort study
    Shuzhi Shan, Sufen Zhao, Xiao Wang
    BMC Surgery.2024;[Epub]     CrossRef
  • Magnetic Catheter Placement in Neonates: A Handheld Solution to Radiation Exposure and Operational Delays
    Liam Swanepoel, Alexander Przybysz, Pieter Fourie, Jurgen Kosel
    Advanced Sensor Research.2023;[Epub]     CrossRef
  • Surgical Microgrippers: A Survey and Analysis
    Liseth V. Pasaguayo, Zeina Al Masry, Sergio Lescano, Noureddine Zerhouni
    Journal of Medical Devices.2023;[Epub]     CrossRef
  • Teres lift-up technique: a retrospective comparative study for an alternative route for laparoscopic entry in gynecologic and oncologic surgery
    Selim Afsar, Ceyda Sancaklı Usta, Akın Usta, Duygu Lafcı, Izel Gunay, Can Berk Karabudak
    Archives of Gynecology and Obstetrics.2023; 308(5): 1549.     CrossRef
  • Serosal Injury to a Distended Stomach during Open Entry for Laparoendoscopic Single-Site Surgery
    Pei-Chen Chen, Pei-Chen Li, Hsuan Chen, Dah-Ching Ding
    Gynecology and Minimally Invasive Therapy.2022; 11(2): 121.     CrossRef
  • Laparoscopic single site versus conventional laparoscopic surgery for benign ovarian masses
    Xiaoping Jia, Jing Zhou, Yanyan Fu, Hui Wang, Cailing Ma
    Journal of Radiation Research and Applied Sciences.2022; 15(3): 255.     CrossRef
  • A Facile Magnetic System for Tracking of Medical Devices
    Liam Swanepoel, Nouf Alsharif, Alexander Przybysz, Pieter Fourie, Pierre Goussard, Mohammad Asadullah Khan, Abdullah Almansouri, Jurgen Kosel
    Advanced Materials Technologies.2021;[Epub]     CrossRef
  • Laparoendoscopic Single Site Hysterectomy: Literature Review and Procedure Description
    Liliana Mereu, Francesca Dalprà, Saverio Tateo
    Journal of Clinical Medicine.2021; 10(10): 2073.     CrossRef
  • Cervicovaginal reconstruction with small intestinal submucosa graft in congenital cervicovaginal atresia: A report of 38 cases
    Yan Ding, Xuyin Zhang, Ying Zhang, Fang Shen, Jingxin Ding, Keqin Hua
    European Journal of Obstetrics & Gynecology and Reproductive Biology.2021; 267: 49.     CrossRef
  • Factors related to blood loss in laparoscopic hysterectomy
    Cengiz Andan, Serif Aksin, Mehmet Rifat Goklu, Seyhmus Tunc
    Clinical and Experimental Obstetrics & Gynecology.2021;[Epub]     CrossRef
  • Benefícios relacionados à cirurgia minimamente invasiva na ginecologia
    Isys Holanda Albuquerque de Vasconcelos, Renata Nogueira Andrade, Beatriz Amâncio Rodrigues, Beatriz Leite Assis, Lorenna da Silva Santos, Luana Lemos Alves, Marlon José dos Santos Rosa, Monica Aparecida Miranda Carvalho, Renata Correia Freire, Scanagatt
    Revista Científica Multidisciplinar Núcleo do Conhecimento.2020; : 28.     CrossRef
Functional recovery after radical prostatectomy for prostate cancer
Young Hwii Ko
Yeungnam Univ J Med. 2018;35(2):141-149.   Published online December 31, 2018
DOI: https://doi.org/10.12701/yujm.2018.35.2.141
  • 7,387 View
  • 159 Download
  • 2 Crossref
AbstractAbstract PDF
With the enthusiasm regarding robotic application in radical prostatectomy in accordance with the widespread use of serum prostate-specific antigen as a screening test, the number of surgeries performed for complete removal of the gland is increasing continuously. However, owing to the adjacent anatomical location of the prostate to the nerve and urethral sphincter complex, functional recovery, namely improvement from post-prostatectomy incontinence (PPI) and post-prostatectomy erectile dysfunction, still remains a main problem for patients who are reluctant to undergo surgery and tend to choose alternative ways instead. Since the late 1980s, the introduction of radical prostatectomy by open surgical modalities, the depth of the anatomical understanding of the structure surrounding the prostate is getting tremendous, which leads to the development of new surgical modalities and techniques that are consequently aimed at reducing the incidences of PPI and erectile dysfunction. Briefly, recent data from robotic radical prostatectomy, particularly on PPI, are quite acceptable, but by contrast, the reported potency regain rate still remains <20%, which indicates the need for advanced surgical modification to overcome it. In this review, the authors summarized the recent findings on the anatomy and surgical techniques reported up to now.

Citations

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  • The assessment of erectile dysfunction after radical prostatectomy using pudendal somatosensory evoked potential
    Se Yun Kwon, Jin-Mo Park, Appuwawadu Mestri Nipun Lakshitha de Silva
    PLOS ONE.2023; 18(11): e0292847.     CrossRef
  • Fidgetin-like 2 negatively regulates axonal growth and can be targeted to promote functional nerve regeneration
    Lisa Baker, Moses Tar, Adam H. Kramer, Guillermo A. Villegas, Rabab A. Charafeddine, Olga Vafaeva, Parimala Nacharaju, Joel Friedman, Kelvin P. Davies, David J. Sharp
    JCI Insight.2021;[Epub]     CrossRef
Case report
Surgical treatment of esotropia and unilateral ptosis in a patient with Cornelia de Lange syndrome
Won Jae Kim
Yeungnam Univ J Med. 2019;36(2):152-154.   Published online December 17, 2018
DOI: https://doi.org/10.12701/yujm.2019.00066
  • 5,849 View
  • 87 Download
AbstractAbstract PDF
Cornelia de Lange syndrome (CdLS) is a rare multisystemic disorder that is characterized by mental retardation, prenatal and postnatal growth retardation, limb anomalies, and distinctive facial features, which include arched eyebrows that often meet in the middle (synophrys), long eyelashes, low-set ears, small and widely spaced teeth, and a small and upturned nose. Ophthalmic manifestations include long eyelashes, nasolacrimal duct obstruction, myopia, ptosis, and strabismus. There has been no report of surgical treatment for esotropia and unilateral ptosis in patients with CdLS in Korea. We report a patient with CdLS who underwent surgical treatment for esotropia and unilateral ptosis with a good surgical outcome.
Original Article
Comparison of sevoflurane and propofol anesthesia on the incidence of hyperglycemia in patients with type 2 diabetes undergoing lung surgery
Hyuckgoo Kim, Jisoo Han, Sung Mee Jung, Sang-Jin Park, Nyeong Keon Kwon
Yeungnam Univ J Med. 2018;35(1):54-62.   Published online June 30, 2018
DOI: https://doi.org/10.12701/yujm.2018.35.1.54
  • 7,815 View
  • 110 Download
  • 6 Crossref
AbstractAbstract PDF
Background
The type and regimen of anesthesia may affect perioperative hyperglycemia following major surgical stress. This study compared the effects of sevoflurane and propofol on the incidence of hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.
Methods
This retrospective study included 176 patients with type 2 diabetes mellitus who had undergone lung surgery. Blood glucose levels and clinical outcomes from the preoperative period to the first 2 postoperative days (PODs) were retrospectively examined in patients who received sevoflurane (group S, n= 87) and propofol (group P, n=89) for maintenance of general anesthesia. The primary endpoint was the incidence of persistent hyperglycemia (2 consecutive blood glucose levels >180 mg/dL [10.0 mmol/L]) during the perioperative period. The secondary composite endpoint was the incidence of major postoperative complications and 30-day mortality rate after surgery.
Results
Blood glucose levels similarly increased from the preoperative period to the second POD in both groups (p=0.857). Although blood glucose levels at 2 hours after surgery were significantly lower in group P than in group S (p=0.022; 95% confidence interval for mean difference, -27.154 to -2.090), there was no difference in the incidence of persistent hyperglycemia during the perioperative period (group S, 70%; group P, 69%; p=0.816). The composite of major postoperative complications and all-cause in-hospital and 30-day mortality rates were also comparable between the two groups.
Conclusion
Sevoflurane and propofol were associated with a comparable incidence of perioperative hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.

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  • Propofol-Induced Hyperglycemia in the Critically Ill: An Unfamiliar Side Effect of a Common Anesthetic
    Muhammad A Qureshi, Greeshma A Thomas, Tijin Mathew, FNU Anshul
    Cureus.2024;[Epub]     CrossRef
  • The Maternal and Neonatal Glycemic Stress Response in Normal Vaginal Delivery: A Comparative Study Between Epidural and Parenteral Opioids Analgesia
    Ala”a Alhowary, Omar Altal, Diab Bani Hani, Anas Alrusan, Yaser Ba Jusair, Rania Al-Bataineh, Ahmed Al Sharie, Abdelwahab Aleshawi
    Local and Regional Anesthesia.2024; Volume 17: 117.     CrossRef
  • Strategies for intraoperative glucose management: a scoping review
    Nathaniel Morin, Sarah Taylor, Danae Krahn, Leyla Baghirzada, Michael Chong, Tyrone G. Harrison, Anne Cameron, Shannon M. Ruzycki
    Canadian Journal of Anesthesia/Journal canadien d'anesthésie.2023; 70(2): 253.     CrossRef
  • Impact of total intravenous anesthesia and total inhalation anesthesia as the anesthesia maintenance approaches on blood glucose level and postoperative complications in patients with type 2 diabetes mellitus: a double-blind, randomized controlled trial
    Xinghui Xiong, Yong He, Cheng Zhou, Qin Zheng, Chan Chen, Peng Liang
    BMC Anesthesiology.2023;[Epub]     CrossRef
  • Current trends in management of hyperglycaemia in surgical patients with diabetes mellitus: a review
    Vladimir N. Kuklin, J. Matri, N. P. Barlow, S. H. Tveit, J. E. Kvernberg, E. -M. Ringvold, V. Dahl
    Annals of Critical Care.2022; (4): 33.     CrossRef
  • Effects of sevoflurane anesthesia and abdominal surgery on the systemic metabolome: a prospective observational study
    Yiyong Wei, Donghang Zhang, Jin Liu, Mengchan Ou, Peng Liang, Yunxia Zuo, Cheng Zhou
    BMC Anesthesiology.2021;[Epub]     CrossRef
Review Article
Recent updates in transcatheter aortic valve implantation
Jeonghwan Cho, Ung Kim
Yeungnam Univ J Med. 2018;35(1):17-26.   Published online June 30, 2018
DOI: https://doi.org/10.12701/yujm.2018.35.1.17
  • 6,440 View
  • 65 Download
  • 2 Crossref
AbstractAbstract PDF
Transcatheter aortic valve implantation (TAVI) has evolved from a challenging intervention to a standardized, simple, and streamlined procedure with over 350,000 procedures performed in over 70 countries. It is now a novel alternative to surgical aortic valve replacement in patients with intermediate surgical risk and its indications have been expanded to cohorts with bicuspid aortic valves, low surgical risk, and younger age and fewer comorbidities. Attention should be paid to further reducing remaining complications, such as paravalvular aortic regurgitation, conduction abnormalities, cardiac tamponade, and stroke. The aim of this review is to provide an overview on the rapidly changing field of TAVI treatment and to explore past achievements, current issues, and future perspectives of this treatment modality.

Citations

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  • Surgical Repair of Ventricular Septal Defect Following Transcatheter Aortic Valve Implantation: A Case Report
    Satoru Fujii, Mohammed Tarabzoni, Pantelis Diamantouros, Rodrigo Bagur, Michael W. A. Chu
    A&A Practice.2024; 18(6): e01790.     CrossRef
  • Might simplification of transcatheter aortic valve implantation reduce the burden on hospital resources?
    Lenka Kratochvílová, Petr Mašek, Marek Neuberg, Markéta Nováčková, Petr Toušek, Jakub Sulženko, Tomáš Buděšínský, , and Viktor Kočka
    European Heart Journal Supplements.2022; 24(Supplement): B28.     CrossRef
Review
Surgical treatment of perianal fistula in Crohn's disease
Sohyun Kim
Yeungnam Univ J Med. 2017;34(2):169-173.   Published online December 31, 2017
DOI: https://doi.org/10.12701/yujm.2017.34.2.169
  • 2,344 View
  • 16 Download
AbstractAbstract PDF
Perianal Crohn's disease is a major problem that impair quality of life. This article reviews the current surgical treatment of Crohn's perianal fistula. Fistulotomy and loose seton are commonly used surgical methods for treatment of perianal Crohn's disease. Mucosal advancement flap and fibrin glue are used in this treatment, despite a lake of controlled trials. Fecal diversion is disturbingly high in complicated complex perianal fistula in Crohn's disease. Ligation of intersphincteric fistula and autologous or allogenic stem cells are new surgical procedures for treatment of Crohn's disease that need further studies. Treatment success might be improved by multimodal treatment and new surgical and medical treatment options.
Case Report
A late onset solitary mediastinal cystic lymphangioma in a 66-year-old woman who underwent kidney transplantation.
Jung Mo Lee, Sang Hoon Lee, Youngmok Park, Chi Young Kim, Eun Kyoung Goag, Eun Hye Lee, Ji Eun Park, Chang Young Lee, Se Kyu Kim
Yeungnam Univ J Med. 2015;32(2):155-158.   Published online December 31, 2015
DOI: https://doi.org/10.12701/yujm.2015.32.2.155
  • 1,958 View
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AbstractAbstract PDF
Lymphangioma is a congenital abnormality of the lymphatic system detected primarily in early childhood. There are rare reports of mediastinal lymphangioma in older adults. We hereby report on a 66-year-old female patient who underwent kidney transplantation 20 years previously and who developed pathologically confirmed solitary mediastinal lymphangioma 1 year ago. Chest radiography showed a mediastinal nodule, which was not observed 2 year previously, therefore she was referred to the pulmonary division. She had no symptoms, and chest computed tomography demonstrated a 25-mm, well-defined, low-density nodule located at the anterior mediastinum. The size of the nodule had increased from 25 mm to 34 mm 1 year later, and it was completely resected via video-assisted thoracic surgery. The histological diagnosis was cystic lymphangioma. Therefore, we recommend that clinicians consider cystic lymphangioma as a possible diagnosis even in older patients with a mediastinal cystic mass that shows progressive enlargement.
Original Articles
Comparision of Mandible Changes on Three-Dimensional Computed Tomography image After Mandibular Surgery in Facial Asymmetry Patients.
Mi Ryoung Kim, Byung Rho Chin
Yeungnam Univ J Med. 2008;25(2):108-116.   Published online December 31, 2008
DOI: https://doi.org/10.12701/yujm.2008.25.2.108
  • 1,789 View
  • 2 Download
AbstractAbstract PDF
BACKGROUND
When surgeons plan mandible ortho surgery for patients with skeletal class III facial asymmetry, they must be consider the exact method of surgery for correction of the facial asymmetry. Three-dimensional (3D) CT imaging is efficient in depicting specific structures in the craniofacial area. It reproduces actual measurements by minimizing errors from patient movement and allows for image magnification. Due to the rapid development of digital image technology and the expansion of treatment range, rapid progress has been made in the study of three-dimensional facial skeleton analysis. The purpose of this study was to conduct 3D CT image comparisons of mandible changes after mandibular surgery in facial asymmetry patients. MATERIALS & METHODS: This study included 7 patients who underwent 3D CT before and after correction of facial asymmetry in the oral and maxillofacial surgery department of Yeungnam University Hospital between August 2002 and November 2005. Patients included 2 males and 5 females, with ages ranging from 16 years to 30 years (average 21.4 years). Frontal CT images were obtained before and after surgery, and changes in mandible angle and length were measured. RESULTS: When we compared the measurements obtained before and after mandibular surgery in facial asymmetry patients, correction of facial asymmetry was identified on the "after" images. The mean difference between the right and left mandibular angles before mandibular surgery was 7degrees, whereas after mandibular surgery it was 1.5degrees. The right and left mandibular length ratios subtracted from 1 was 0.114 before mandibular surgery, while it was 0.036 after mandibular surgery. The differences were analyzed using the nonparametric test and the Wilcoxon signed ranks test (p<0.05). CONCLUSION: The system that has been developed produces an accurate three-dimensional representation of the skull, upon which individualized surgery of the skull and jaws is easily performed. The system also permits accurate measurement and monitoring of postsurgical changes to the face and jaws through reproducible and noninvasive means.
Risk Factors of Acute Renal Failure after Colorectal Surgery.
Hae Mi Lee, Chang Jae Hwang, Jaehwang Kim, Heung Dae Kim, Dae Pal Park, Il Suk Seo, Sun Ok Song, Sae Yeon Kim, Deuk Hee Lee, Daelim Jee
Yeungnam Univ J Med. 2007;24(2):275-286.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.275
  • 1,892 View
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AbstractAbstract PDF
BACKGROUND
Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. MATERIALS AND METHODS: Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. RESULTS: The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). CONCLUSION: Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.
Cone-Beam CT Image-Guided Radiosurgery of Brain Metastasis : Technical Note and Clinical Application
Sei-One Shin, Sang Mo Yun
Yeungnam Univ J Med. 2007;24(2 Suppl):S591-597.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S591
  • 1,367 View
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AbstractAbstract PDF
Background
:This study was performed to test feasibility of CBCT(cone-beam computerized tomography) guided radiosurgery. Materials and Methods:We used CBCT which was mounted on a retractable arm at 90° to the treatment source. CBCT images were overlapped on the digitally reconstructed images from simulation CT scan. Then, 3 dimensional volumetric CT image matching was performed. If there were any positioning errors, automated patient re-positioning was done.
Results
:A radiosurgery treatment plan was carried out with a set of specially designed multiple non-coplanar arcs. The goal of plan was to deliver single session 18 Gy at periphery of the target. We treated a patient with a solitary brain metastasis from left upper lung cancer. Serial imaging study for treatment response revealed a satisfactory result with no remarkable treatment related side effects.
Conclusion
:CBCT image guided radiosurgery system is very simple and could be a convenient image guiding modality for stereotactic radiosurgery or fractionated radiotherapy with an acceptable geometric accuracy and radiation exposure.
Review Article
Neurosurgical Treatment for Cerebral Palsy Spasticity
Seong-Ho Kim, Byung-Yon Choi
Yeungnam Univ J Med. 2007;24(2 Suppl):S186-191.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S186
  • 1,406 View
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AbstractAbstract PDF
The spasticity of cerebral palsy is usually a useful substitute for deficiency of motor strength. However not infrequently, it may become harmful leading to an aggravation of motor disability. When excessive spasticity is not sufficiently controlled by physical therapy and pharmacological treatment, patients can have recourse to neurosurgery: neurostimulation, intrathecal baclofen or selective ablative procedures. Because excessive hypertonia has to be reduced without suppression of the useful muscular tone or impairment in the residual motor and sensory functions, neuroablative procedures must be as selective as possible. These selective lesions can be performed at the level of peripheral nerves, spinal roots, or the dorsal root entry zone(DREZotomy). The new neurological status brought about by the neurosurgical operation will reach its optimal level only if intensive, prolonged, comprehensive treatment is provided by an expert multidisciplinary team including rehabilitation medicine. The neurosurgical treatment must take place before the onset of irreversible articular disturbances and musculotendinous retractions, which require complementary orthopedic corrections.
Original Articles
The Effects of Preoperative Sprayed 10% Lidocaine on the Hemodynamic Response during Suspension Microlaryngeal Surgery.
Deok Hee Lee, Hyun Seok Do
Yeungnam Univ J Med. 2007;24(2):162-169.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.162
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AbstractAbstract PDF
PURPOSE: It is well known that suspension microlaryngeal surgery produces marked increases in arterial blood pressure and heart rate. In this study, we evaluated the effects of 10% lidocaine preoperatively sprayed for attenuation of the perioperative hemodynamic response during suspension microlaryngeal surgery. MATERIALS AND METHODS: Fifty American Society of Anesthesiologists (ASA) class 1 patients scheduled for excision of a vocal polyp by suspension laryngoscopy were randomly divided into two groups (n=25 for each group). They were intubated without 10% lidocaine spray (control group) or given 1.5 mg/kg of 10% lidocaine sprayed onto the pharyngolaryngeal and intratracheal sites 90 sec prior to intubation (10% lidocaine group). Anesthesia was maintained using desflurane in O2/N2O 50%. The arterial blood pressure and heart rate were measured at preinduction (T0), 1 min (T1), 3 min (T2), 5 min (T3) after tracheal intubation, and 1 min (T4), 3 min (T5), 5 min (T6) and 10 min (T7) after the suspension laryngoscopy. RESULTS: In the 10% lidocaine group, the arterial blood pressure and heart rate at 1 (T1), 3 (T2) min after tracheal intubation and 1 (T4), and 3 (T5) min after suspension laryngoscopy were lower than the same measurements in the control group. CONCLUSION: 10% lidocaine sprayed onto the pharyngolaryngeal and intratracheal sites before intubation was an effective method for attenuation of the perioperative hemodynamic response during suspension microlaryngeal surgery.
Myocardial Protective Effect of Histidine-Tryptophan-Ketoglutarate Solution and Cold Blood Cardioplegic Solution in Pediatric Cardiac Surgery.
Tae Eun Jung, Dong Hyup Lee, Sung Sae Han
Yeungnam Univ J Med. 2006;23(1):19-25.   Published online June 30, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.1.19
  • 1,615 View
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AbstractAbstract PDF
BACKGROUND
There is limited data on comparisons between the effect of histidine-tryptophan-ketoglutarate (HTK) solution and cold blood cardioplegic (CBC) solution in pediatric cardiac surgery. The purpose of this study was to compare the myocardial protective effect of HTK solution and CBC solution in patients undergoing pediatric cardiac surgery. MATERILAS AND METHODS: We selected 49 patients with ventricular septal defect and atrial septal defect. HTK solution was used in 21 patients and CBC solution was used in 28 patents. HTK solution was given as a single dose, whereas CBC solution was used in the usual multi-dose method. The incidence of EKG change and concentration of Troponin T and CK-MB were compared for the evaluation of myocardial damage. RESULTS: There were no significant differences in the incidence of ST, T segment change by EKG and serial cardiac enzyme levels between two groups. CONCLUSION: These results suggested that the myocardial protective effect of HTK solution was similar to CBC solution in simple pediatric cardiac surgery.
Review
Recent Advances in Surgery for Atrial Fibrillation.
Dong Hyup Lee, Tae Eun Jung
Yeungnam Univ J Med. 2005;22(1):13-26.   Published online June 30, 2005
DOI: https://doi.org/10.12701/yujm.2005.22.1.13
  • 1,801 View
  • 1 Download
AbstractAbstract PDF
Atrial fibrillation (AF) is the most common cardiac rhythm disturbance, which carries significant cardiovascular morbidity and mortality. The medical treatment for AF is cumbersome and unsatisfactory, which has highlighted the need to develop alternative treatments for AF. The recent discovery that AF is often initiated by atrial ectopic beats has resulted in treatments designed to target the ectopic sources, particularly those within the pulmonary veins. Building on the pioneering work of Cox et al., a recent reported series demonstrated the feasibility of treating patients undergoing cardiac surgery for other structural heart diseases with limited, left-atrial ablation lesion sets using alternative energy sources. As less complex modifications of the Maze procedure have been developed, a number of energy sources have been introduced to create of electrically isolating lesions within the atria. These sources have been used both endocardially in arrest heart procedures as well as epicardially in a beating heart setting. This review summarizes the recent advances in surgery for AF that will aid in the development of an effective, minimally invasive surgical procedure to cure patients with AF.
Case Report
Treatment in Bimaxillary Prognathism with Anterior Open Bite: A Case Report.
Sang Deuk Chun, Byung Rho Chin
Yeungnam Univ J Med. 2004;21(2):242-250.   Published online December 31, 2004
DOI: https://doi.org/10.12701/yujm.2004.21.2.242
  • 1,998 View
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AbstractAbstract PDF
In general, the skeletal class III has the characteristics of mandibular overgrowth with a normal maxillary growth or maxillary undergrowth with a normal mandibular growth And clinical and radiographic evaluations of the patient are needed. However, the treatment plan is not dependent on these evaluations alone, because patient's general condition and hope for aesthetics varies. The aim of this report is to consider the treatment of a medically compromised patient with an anterior open bite and skeletal class III, which showed a severe mandibular overgrowth. In 2003, a 17-year-old boy with epilepsy, mental retardation presented at our clinic complaining of concave profile. A clinical examination showed severe mandibular prognathism with an anterior open bite. The radiographic examination revealed a short cranial base, a moderate maxillary overgrowth, severe mandibular overgrowth and skeletal open bite tendency. In 2004, he was verified to have no potential of growth by hand-and-wrist radiographs and an endocrine examination. He completed the preoperative orthodontic treatment and orthognathic surgery (sagittal split ramus osteotomy, genioplasty). He was evaluated on the first visit, the preoperative period and the postoperative period with a clinical and radiographic examination. At the first visit, the patient showed moderate overgrowth of the maxilla, severe overgrowth of the mandible, and a subsequential skeletal open bite. After the preoperative orthodontic treatment (preoperative period), the patient showed the same skeletal problem as before and a decompensated dentition for orthognathic surgery. After orthognathic surgery, his profile had improved, but he had still a skeletal openbite tendency because the maxillary orthognathic surgery was not performed. Severe mandibular prognathism with a maxillary overgrowth and anterior open bite should be treated by bimaxillary orthognathic surgery. However, one-jaw orthognathic surgery on the remaining the skeletal open bite tendency was performed for his medical problem and facial esthetics. This subsequential open bite should be resolved with a postoperative orthodontic treatment.
Review
Total Knee Arthroplasty.
Dong Chul Lee, Wook Jin Sohn
Yeungnam Univ J Med. 2004;21(1):1-11.   Published online June 30, 2004
DOI: https://doi.org/10.12701/yujm.2004.21.1.1
  • 1,698 View
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AbstractAbstract PDF
Total knee arthroplasty has become a common procedure for treatment of severe osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. In the past, failure of total knee arthroplasty was commonly attributable to aseptic loosening, often associated with component malalignment, soft tissue imbalance. With improved surgical instrumentation and soft tissue balancing techiniques, failure secondary to mechanical loosening has been minimal. But surgeons are still dissatisfied with implant malalignment. Correct tibiofemoral alignment seems to be particularly important since it is generally agreed that axial deviation and imprecise implantation may lead to loosening of the implant component. Navigation systems and robotic techniques could potentially solve problems of imprecision in traditional total knee arthroplasty. It is expected that the success rate and longevity of total knee arthroplasty will be improved during the twenty first century.
Original Article
Treatment Outcomes and Acoustic Rhinometric Results in Endoscopic Sinus Surgery of Adult Chronic Paranasal Sinusitis.
Yong Dae Kim, Jae Yeul Kim, Keun Young Chang, Hyung Joong Lee, Si Youn Song, Seok Keun Yoon
Yeungnam Univ J Med. 2002;19(1):28-38.   Published online June 30, 2002
DOI: https://doi.org/10.12701/yujm.2002.19.1.28
  • 1,597 View
  • 1 Download
AbstractAbstract PDF
BACKGROUND
Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paranasal sinusitis with or without polyp. MATERIALS AND METHODS: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. RESULTS: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. CONCLUSIONS: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.
Review
Pediatric Outpatient Anesthesia.
Il Sook Seo
Yeungnam Univ J Med. 2001;18(2):145-169.   Published online December 31, 2001
DOI: https://doi.org/10.12701/yujm.2001.18.2.145
  • 1,721 View
  • 1 Download
AbstractAbstract PDF
In recent years, health care cost containment concerns have resulted in an increase in outpatient (or same-day) surgery. Many procedures previously performed on an inpatient surgery basis have been shifted to outpatient settings. Anesthesia for outpatient surgery is exactly the same as inpatient anesthesia, except that the primary concern is the selection of patients who can be discharged safely on the day of surgery. The anesthesiologist should have a sound rational basis for choice of pharmacologic agents that are geared to expeditious patient discharge from the hospital. Cost concerns aside, outpatient surgery has many additional advantages in the pediatric setting. It minimizes the length of time the child is hospitalized, decreases separation anxiety, promotes parental involvement in the child's postoperative care in the more congenial environment of home, and decreases risk of nosocomial infection and iatrogenic illness.
Case Report
Suprameatal Transvaginal Urethrolysis in Urethral Obstruction Associated with Anti-incontinence Surgery: A Case Report.
Jin Wook Yoo, Hee Chang Jung, Tong Choon Park
Yeungnam Univ J Med. 1999;16(2):376-379.   Published online December 31, 1999
DOI: https://doi.org/10.12701/yujm.1999.16.2.376
  • 1,687 View
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AbstractAbstract PDF
We report our experience with a case of urethrolysis using a transvaginal suprameatal approach without lateral perforation of the urethropelvic ligament. A 43-year-old woman suffered from voiding difficulties such as hesitancy, frequency, urgency, decreased urinary flow, residual urine sensation after Marshall-Marchetti-Krantz operation concurrent with hysterectomy. The results of multidisciplinary work-ups of urethral obstruction such as history, vaginal examination, voiding cystourethrography, urodynamic study, showed that she had urethral obstruction due to a previous operation. Since clean intermittent catheterization and alpha-blocker therapy did not improve her symptoms, suprameatal transvaginal urethrolysis was performed to resolve the symptoms. Postoperative follow-up for 5 months showed that the patient remained free from voiding difficulty in their life. We believe that suprameatal transvaginal urethrolysis is worth attempting for urethral obstruction associated with anti-incontinence surgery.
Original Article
Clinical Experience of Nephron Sparing Surgery for Renal Tumor with a Normal Opposite Kidney.
Jun Young Lee, Jung Hyun Kim, Kang Min Lee, Ki Hak Moon, Hee Chang Jung, Tong Choon Park
Yeungnam Univ J Med. 1999;16(1):94-100.   Published online June 30, 1999
DOI: https://doi.org/10.12701/yujm.1999.16.1.94
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The aims of this retrospective study were to determine whether a nephron sparing surgery might be feasible in patients with a small solid renal tumor. Materials and methods: Between 1988 and 1999, 21 patients with radiologically detectable small solid renal tumor underwent enucleoresection, wedge resection and polar segmental nephrectomy. The mean age of the 11 men and 10 women in this study was 43 years (range 14 to 68). According to the preoperative radiological diagnosis, 15 among the 21 patients were considered to have renal cell carcinoma, 4 were considered to have angiomyolipoma, and the remaining 2 patients were difficult to differentiate as renal tumors radiologically. Among 15 patients considered to have renal cell carcinoma, 14 were found to have renal cell carcinoma and the remaining one patient was diagnosed as having oncocytoma on pathologic examination. Radiological determination of angiomyolipoma in four patients was confirmed to be correct on pathological examination. The 2 patients whose radiological diagnose wasdificult were founf to have cavernous hemangioma and angiomyolipoma. One patient with renal cell carcinoma developed arteriocaliceal fistula, the only immediate complication in this series, and underwent nephrectomy on postoperative 10th day. The mean follow-up duration for the 14 patients with renal cell carcinoma was 18.6 months(range:1-103). There were no other tumor involvement in the resection margins following the nephron sparing surgery. These results suggest that nephron sparing surgery provides an effective treatment for patients with a single, small, unilateral, localized renal tumor. Longer follow-up is suggested for more definite verification of the role of nephron sparing surgery.
Case Reports
A Case reports of a Surgical Correctiona of the Mandibular Retrusion.
Nan Hee Im, Jin Ho Park, Byung Rho Chin, Hee Kyung Lee
Yeungnam Univ J Med. 1995;12(2):393-399.   Published online December 31, 1995
DOI: https://doi.org/10.12701/yujm.1995.12.2.393
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Mandibular retrusion showing the facial problem with a marked maxillarry incisors protrusion and chin deficiency, resulting in a highly convex profile is uncommon in Korea.. The large incisor overjet and deep-bite create functional limitations and unpleasing esthetic result. The majority of theses cases are susceptible to correction by orthodontic therapeutic methods. But severe Class II retrognathic cases in which orthodontic treatment alone has not been capable of achieving good results. Orthognathic surgery offers several approaches. In this case, mandibular advancement by bilateral sagittal split ramus osteotomy and augmentation genioplasty has a special surgical problems. The suprahyoid muscle gorup are lengthened if the body of the mandible is surgically repositioned anteriorly. Instability of results and relapse return to original position shoud predicted during post-surgical muscular readjustment.. To maintain maximum correction with this technique, it is suggested that the mandibular body be well rotated forward at time of surgical intervention and overcorrected anteriory as much as possible. So, the authors report the case with review of concerned literature.
A case of free-floating left atrial ball thrombus in mitral stenosis.
Young Jin Kim, Tea Il Lee, Kyo Won Choi, Seung Ho Kang, Dong Gu Sin, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee, Eun Pyo Hong
Yeungnam Univ J Med. 1993;10(1):237-244.   Published online June 30, 1993
DOI: https://doi.org/10.12701/yujm.1993.10.1.237
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A free-floating ball thrombus in the left atrium is a rare complication of the mitral valvular disease. A 53-year-old man was admitted for pain and paresthesia on both legs. On admission he had auscultatory sign of mitral stenosis and mitral regurgitation, and the roentgenogram of his chest revealed a slight pulmonary ve..ous congestion, enlargement of the pulmonary conus and cardiomegaly. Laboratory findings including complete blood counts, coagulation studies and blood chemistry were normal. An echocardiographic examination revealed a mitral stenosis and a free-floating ball thrombus in the left atrium. We performed the emergent open heart surgery for removal of the ball thrombus and mitral replacement successfuly with Duromedics 29 mm valve. The size of thrombus was 39 X 32 X 30 mm.
Original Article
The Dosimetry of Radiosurgery using of Rando Phantom.
Sung Kyu Kim, Sei One Shin, Myung Se Kim
Yeungnam Univ J Med. 1990;7(1):113-119.   Published online June 30, 1990
DOI: https://doi.org/10.12701/yujm.1990.7.1.113
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The stereotactic radiosurgery using ionizing radiation of high energy is a technique for exadicating intracranial small tumors, which are inaccessible or unsuitable for open surgical technique. For such a small field radiosurgery, TLD or film dosimetry is essential. The three dimensional dose planning of radiosurgery was performed with dose planning computer system (Therac 2300). The target dose distribution and its error according to patient position were discussed. And were measured of circular cone which specially designed in our Hospital. The position error of Rando Phantom compared with CT were 0.4 mm in the AP-LAT section and in the AP-VERT section, 1.0 mm in the AP-VERT 45°section. The ratio of accuracy of the gantry and couch rotation were 1.5 mm diameter for central axis of 18MeV linear accelerator. Our study suggested that radiosurgery of small field in out department will be appropriate for clinical application.

JYMS : Journal of Yeungnam Medical Science
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