No abstract available.
Depression* ; Humans ; Seoul*

Open carpal tunnel release has been the standard method of sumical treatment of carpal tunnel syndrome. Recently endoscopic carpal tunnel release has been introduced and is heing used by many authors. The advantages of this new technique are less postoperative pain, rapid restoration of power and rapid return-to-work. However many considerate authors, in spite of these advantages. insist that the inevitahle risk of neurovascular injury during the endoscopic procedure should not he underestimated. The purpose of our study is to compare the clinical results of endoscopic carpal tunnel release with those of open release. 20 open carpal tunnel releases in 16 patients and 15 endoscopic carpal tunnel reieases (single-portal technique) in 11 patients were performed hy the first author. Preoperative conditions of both groups are not different. Authors compared the clinical results between the two groups with some parameters. The overall clinical results were not different significantly hetween two groups. Rapid return-to-work(36 days in endoscopic group versus 60 days in open group) and less postoperative scar and pillar pain in endoscopic group were demonstrated. However, the major complication of one median nerve injury in endoscopic group seemed to overweigh these some benefits. We suggest that the standard operative technique for carpal tunnel syndrome should be open carpal tunnel release and more considerations should be takcn in choosing endoscopic method because of its inherent risk.
Carpal Tunnel Syndrome ; Cicatrix ; Humans ; Median Nerve ; Pain, Postoperative ; Return to Work

We investigate the serial change of the bone density of the lengthening sites in distraction osteogenesis in long bone lengthening of the lower extremity by measuring the pixel value of the PACS(Picture Archiving Communication System). The purpose of this study was to find the clinical implication of the pixel value in PACS in the distraction osteogenesis. The number of the distraction sites were 22 in tibia and 16 in femur. The average distraction length was 4.5cm ranged between 2.1cm and 7.0cm in femur, 4.1cm ranged hetween 1.9cm and 6.8cm in tibia. When the image were sent to the PACS workstations, they were directly interfaced to the workstation without any processing. The absolute and the relati ve pixel values of cortical bones of the original and the lengthening sites repr sented in workstation of PACS were obtained by average value measuring 3 times by 3 different persons. The average absoiute pixel value of the original cortical bone near distraction site was not significantly changed, maintaining 575+/-6 in femur, and 570+/-7 in tibia. The absolute pixel vaIues in AP and lateral view were not significantly changed until 6 week/cm, but rapidly increased after 7 week/cm hoth in the tibia and the femur. The relative pixel value of the lengthening sites were more than 95% in three of the four cortices at the time of the removal of the external fixators. in conclusion, the pixel value of the PACS can be a rapid, simple and easy method for detection of the change of the bone density in distraction osteogenesis.
Bone Density* ; Bone Lengthening* ; External Fixators ; Femur ; Humans ; Lower Extremity* ; Osteogenesis, Distraction* ; Tibia

No abstract available.
Rhinoplasty*

No abstract available.
Dementia* ; Humans ; Urinary Incontinence*

PURPOSE: Laparoscopic total gastrectomy (LTG) for gastric cancer is still uncommon because of technical difficulties, especially in esophagojejunostomy (EJ). There are many reports for various laparoscopic procedures of EJ using linear or circular staplers. On the other hands, there has been no report for hand-sewn anastomosis. We report successfully performed intracorporeally hand-sewn EJ after LTG. MATERIALS AND METHODS: The clinicopathologic data and short-term surgical outcomes of 6 patients who underwent totally laparoscopic total gastrectomy for upper gastric cancer from December 2010 and July 2011 were retrospectively reviewed. RESULTS: The mean age was 66.5 years and mean body mass index (kg/m2) was 24.6. All patients had medical comorbidities. The mean patient ASA score was 2.17. Among the 6 patients, previous abdominal operation was performed for 2 patients and combined operation was performed for 3 patients. The mean blood loss, operation time, and EJ anastomosis time was 130 ml, 379.7 minutes, and 81.5 minutes, respectively. The mean time to first flatus, first oral intake, and postoperative hospital stay was 3.0, 3.0, and 12.5 days, respectively. There was no 30-day mortality case. Postoperative aspiration pneumonia and multiple periventricular lacunar infarctions developed in 1 patient. There were no anastomosis-related complications and other major surgical complications. CONCLUSIONS: When the intracorporeal anastomotic technique becomes popular in LTG the intracorporeally hand-sewn EJ may be accepted as one method among the various laparoscopic procedures of EJ.
Body Mass Index ; Comorbidity ; Flatulence ; Gastrectomy ; Hand ; Humans ; Laparoscopy ; Length of Stay ; Pneumonia, Aspiration ; Reconstructive Surgical Procedures ; Retrospective Studies ; Stomach Neoplasms ; Stroke, Lacunar

To evaluate the results and clinical impact of defecography in patients with anorectal diseases, 304 defecographic examinations from 304 patients were reviewed. The defecographic results were screened for the anorectal angle and perineal descent at rest, squeezing and during straining. Changes of rectal configuration and canal width during straining were reviewed. 304 patients had defecation problems such as terminal constipation, defecation defficulty, blood or mucus discharge, tenesmus, obstruction sensation etc. They were performed anorectal physical examination and anal manometry etc., and were later treated by operation and conservative management. Normal anorectal angle were measured to be 101°, 91°, 131°at rest, during squeezing and straining respectively. In the spastic pelvic floor syndrome, increase of anorectal angle less than 10 ° from rest to straining was observed. Incontinent patients had a larger anorectal angle (mean: 128°) at rest. 7.8cm of perineal descent was found in descending perineal syndrome in comparison to 4.0cm in normal. Normal anal canal width was measured 1.4cm only during straining but identified in incontinent patients at rest (mean:1.2cm). Abnormal rectal configuration was found in 254 defecographic examinations: rectoceles were observed in 235 cases and were associated with rectal prolapse in 115 cases, and rectal prolapses were found in 134 cases. In conclusion, the anorectal angle was valuable in evaluation of spastic pelvic floor syndrome and fecal incontinence. Degree of perineal descent was abnormally increased in descending perineal syndrome. In the cases of the rectoceles and rectal prolapses, defecography is helpful in preoperative evaluation of rectal wall change and postoperative follow up.
Anal Canal ; Constipation ; Defecation ; Defecography* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Manometry ; Mucus ; Muscle Spasticity ; Pelvic Floor ; Physical Examination ; Rectal Prolapse ; Rectocele ; Sensation

No abstract available.
Uterus*

Purpose: To investigate whether retinal check-ups using fundus photography accurately predicted the visual outcomes of patients undergoing epiretinal membrane (ERM) removal. Methods: We reviewed the medical records of patients who underwent ERM removal by a single surgeon from January 2013 to June 2019. Patients were classified into two groups. The check-up group included patients who underwent fundus photography during their retinal check-ups, and were thus diagnosed with ERMs, even though they lacked any vision-related symptom. The work-up group included patients who underwent fundus photography to rule out retinal abnormalities, because they complained of vision-related symptoms such as decreased vision and metamorphopsia. The best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) findings were compared between the two groups before and 6 months after surgery. Results: The check-up group included 41 eyes and the work-up group 35 eyes. The preoperative BCVA did not differ significantly between the two groups (p = 0.710). However, the proportion of photoreceptor inner segment/outer segment (IS/OS) defects evident on OCT was significantly lower in the check-up than the work-up group (34.1% vs. 68.6%, p = 0.005). Six months after surgery, the BCVA was significantly better in the check-up group (0.07 ± 0.14 logMAR) than in the work-up group (0.19 ± 0.19 logMAR, p = 0.004) and the proportion of patients with poor visual acuity was also significantly lower in the check-up group (2.4%) than the work-up group (22.9%, p = 0.010). Conclusions We found that a retinal check-up facilitates early detection of an ERM and improves the postoperative visual prognosis. This supports the necessity of fundus photography during retinal check-ups.

Purpose: To investigate whether retinal check-ups using fundus photography accurately predicted the visual outcomes of patients undergoing epiretinal membrane (ERM) removal. Methods: We reviewed the medical records of patients who underwent ERM removal by a single surgeon from January 2013 to June 2019. Patients were classified into two groups. The check-up group included patients who underwent fundus photography during their retinal check-ups, and were thus diagnosed with ERMs, even though they lacked any vision-related symptom. The work-up group included patients who underwent fundus photography to rule out retinal abnormalities, because they complained of vision-related symptoms such as decreased vision and metamorphopsia. The best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) findings were compared between the two groups before and 6 months after surgery. Results: The check-up group included 41 eyes and the work-up group 35 eyes. The preoperative BCVA did not differ significantly between the two groups (p = 0.710). However, the proportion of photoreceptor inner segment/outer segment (IS/OS) defects evident on OCT was significantly lower in the check-up than the work-up group (34.1% vs. 68.6%, p = 0.005). Six months after surgery, the BCVA was significantly better in the check-up group (0.07 ± 0.14 logMAR) than in the work-up group (0.19 ± 0.19 logMAR, p = 0.004) and the proportion of patients with poor visual acuity was also significantly lower in the check-up group (2.4%) than the work-up group (22.9%, p = 0.010). Conclusions We found that a retinal check-up facilitates early detection of an ERM and improves the postoperative visual prognosis. This supports the necessity of fundus photography during retinal check-ups.