The objective of this paper is to introduce the schematic protocol of radiofrequency (RF) ablation for the treatment of varicose veins. Indication: anatomic or pathophysiologic indication includes venous diameter within 2-20 mm, reflux time > or =0.5 seconds and distance from the skin > or =5 mm or subfascial location. Access: it is recommended to access at or above the knee joint for great saphenous vein and above the mid-calf for small saphenous vein. Catheter placement: the catheter tip should be placed 2.0 cm inferior to the saphenofemoral or saphenopopliteal junction. Endovenous heat-induced thrombosis > or =class III should be treated with low-molecular weight heparin. Tumescent solution: the composition of solution can be variable (e.g., 2% lidocaine 20 mL+500 mL normal saline+bicarbonate 2.5 mL with/without epinephrine). Infiltration can be done from each direction. Ablation: two cycles' ablation for the first proximal segment of saphenous vein and the segment with the incompetent perforators is recommended. The other segments should be ablated one time. During RF energy delivery, it is recommended to apply external compression. Concomitant procedure: It is recommended to do simultaneously ambulatory phlebectomy. For sclerotherapy, it is recommended to defer at least 2 weeks. Post-procedural management: post-procedural ambulation is encouraged to reduce the thrombotic complications. Compression stocking should be applied for at least 7 days. Minor daily activity is not limited, but strenuous activities should be avoided for 2 weeks. It is suggested to take showers after 24 hours and tub baths, swimming, or soaking in water after 2 weeks.
Baths ; Catheter Ablation* ; Catheters ; Consensus* ; Heparin ; Knee Joint ; Lidocaine ; Saphenous Vein ; Sclerotherapy ; Skin ; Stockings, Compression ; Swimming ; Thrombosis ; Varicose Veins* ; Walking

PURPOSE: To compare two combined surgical techniques, endoscopic endonasal surgery with transconjunctival reconstruction and transcaruncular surgery with transconjunctival reconstruction, when used to treat both medial and inferior orbital wall fractures. METHODS: A retrospective review of 63 patients who were followed up from January 2011 to December 2014 at Inha University Hospital for surgical reconstruction of combined medial and inferior orbital wall fractures was undertaken. We compared between the patients the computed tomographic scans, diplopia, extraocular muscle (EOM) movements, and Hertel's exophthalmometer exams pre- and post-6 months surgery. A total of 29 patients received endoscopic transnasal surgery with trasconjunctival reconstruction, and 34 received transcaruncular surgery with trans-conjunctival reconstruction. RESULTS: There were no significant differences between the two combined methods in terms of the primary and peripheral gaze diplopia or the restriction of EOM movement 6 months after surgery. However, statistically significant differences were observed in exophthalmometer measurements 6 months after surgery. CONCLUSIONS: The two combined surgical methods showed similar results in terms of postoperative primary and peripheral gaze diplopia, EOM restriction, and enophthalmos. With respect to postoperative peripheral diplopia, endoscopic endosnasal surgery with transconjunctival reconstruction showed several advantages over the other method considered in this study. An appropriate surgical method should be selected by comparing the relative advantages and disadvantages.
Diplopia ; Enophthalmos ; Humans ; Methods ; Orbit* ; Retrospective Studies

BACKGROUND: Hemoptysis is a common clinical symptom, responsible for 11% of admission to the hospital chest service. Correct diagnosis, accurate localization of the bleeding source and proper management are imperative to reduce the risk of massive hemoptysis. We performed the study to define the optimal time of fiberoptic bronchoscopy in 63 patients with hemoptysis admitted to Kyung Hee University Hospital between Aug 1989 and Aug1992. METHODS: Retrospective analysis of medical records concerning the cause, amount, duration of hemoptysis and the timing of fiberoptic bronchoscopy in 63(M:F=36:27) patients. RESULTS: 1) The main causes of hemoptysis were pulmonary tuberculosis(52.4%) bronchiectasis(27.0%) and lung cancer(11.1%). 2) The bleeding sites were localized in 26 Patients(41.3%). 3) The rates of localization of bleeding site were not related to the amount and duration of hemoptysis. 4) The rates of localization of bleeding site were 61.8%(21/34) during hemoptysis,18.2%(122) within 24hr after resolution of hemoptysis, 14.3%(1/7) thereafter. CONCLUSION: Early bronchoscopy, especially during hemoptysis may show higher rates of successful localization than delayed bronchoscopy.
Bronchoscopy* ; Diagnosis ; Hemoptysis* ; Hemorrhage* ; Humans ; Lung ; Medical Records ; Retrospective Studies ; Thorax

Malignant transformation of fibrous dysplasia to osteosarcoma is rare. We report a case in which monostotic fibrous dysplasia of the proximal femur treated with curettage, Ender nailing and bone grafting was differentiated into the osteosarcoma in a 58-year-old female.
Bone Transplantation ; Curettage ; Female ; Femur ; Fibrous Dysplasia, Monostotic ; Humans ; Middle Aged ; Osteosarcoma

PURPOSE: To report the method of anatomical reduction and its maintenance by percutaneous wiring reduction in minimally invasive plate osteosynthesis for distal tibial fractures. MATERIALS AND METHODS: 17 cases that were diagnosed oblique, spiral or transverse fracture of distal tibia from August 2007 to February 2010 and were able to anatomically reduce by the method of percutanous wiring reduction in minimally invasive plate osteosynthesis were included in this study. Mean age was 50, and mean follow up period was 18 months. We investigated the period until bone union was achieved, degree of angulation angle, and complications. For postoperative evaluation, Olerud and Molander ankle score and VAS pain score in daily living were checked. RESULTS: The mean varus/valgus angulation after bone union on AP radiograph was 0.9 degrees and the mean anterior/posterior angulation on lateral radiograph was 2.0 degrees The mean Olerud and Molander ankle score was 89.4, and mean pain score due to walk adjacent to metal plate was 0 points. CONCLUSION: By the method of percutaneous wiring reduction in distal tibial fracture, anatomical reduction is easily acquired, and only by wire itself, reduction could be maintained, so that without additional manual reduction, plate could be easily fixed.
Animals ; Ankle ; Follow-Up Studies ; Tibia ; Tibial Fractures

Intravenous Patient Controlled Analgesia (IV PCA) after general or spinal anesthesia may be a method of postoperative pain control, but side effects such as nausea, vomiting, and sedation occurs in most patients. The following research is based on the ultrasound guided femorosciatic nerve block held on parts below the knee joint operation. Because this anesthesia is held locally on the sciatic nerve with continuous anesthesia performed through perineural catheterization, the complications of nausea, vomiting, and sedation may be reduced while postoperative pain caused by the sciatic nerve is controlled. The following report is held on this experience.
Analgesia, Patient-Controlled ; Anesthesia ; Anesthesia, Spinal ; Catheterization ; Catheters ; Humans ; Knee Joint ; Nausea ; Nerve Block ; Pain, Postoperative ; Sciatic Nerve ; Vomiting

The use of self-expanding metal stent has been widely reported that its utility can make a palliative decompression treatment and one stage operation without doing colostomy in the patient with unresectable and resectable obstructive colorectal cancer, respectively. It, however, can sometimes cause complications such as intestinal perforation. We report that the conservative treantment could be possible without removing stent or performing laparotomy in case of intestinal perforation during chemoradiotheraphy after insert of stent for relieving colonic obstruction in the 53 years old female patient with stage IV rectal cancer.
Colon ; Colorectal Neoplasms ; Colostomy ; Decompression ; Female ; Humans ; Intestinal Perforation ; Laparotomy ; Middle Aged ; Rectal Neoplasms* ; Stents*

This paper reviews the indications and surgical technique of supramalleolar osteotomy as one of the treatments for moderate degenerative ankle osteoarthritis. Although it is technically demanding and requires extensive preoperative planning, supramalleolar osteotomy will be a good treatment option for moderate degenerative ankle osteoarthritis. The osteotomy is designed to shift the weightbearing axis to the lateral side of the ankle joint and unload the medial side of the joint. In our experience, a supramalleolar osteotomy is effective to the treatment of moderate ankle osteoarthritis with a small amount of preoperative talar tilt and varus or normal heel alignment.
Ankle Joint ; Ankle* ; Heel ; Joints ; Osteoarthritis* ; Osteotomy* ; Weight-Bearing

A case of child fasciola liver abscess was reported. This case was a. A 5-years-old boy who had a history of fever and abdominal pain for 2 days. There was eosinophilia (15%) and an abdominal ultrasound demonstrated heterogenous hypoechoic mass in the liver. He was diagnosed with bacterial liver abscess and was treated with Unasyn, Amikin, Cefotaxime, and metronidazole. But, the fever did not subside completely and blood eosinophil count was increased to 50%. New hypoechoic lesion in the liver was revealed on the follow-up abdominal ultrasound. Liver biopsy was done and it revealed eosinophil infiltration. Also, there was eosinophil infiltration (20%) in his bone marrow. The serologic test for parasite-specific IgG antibody by micro-ELISA confirmed the diagnosis of Fasciola hepatica infection. He was successfully treated for two days with oral Triclabendazole, 15 mg/kg, daily. Blood eosinophil count was down to 10% and there was no abnormal lesion in the liver on abdominal ultrasound finding.
Abdominal Pain ; Amikacin ; Biopsy ; Bone Marrow ; Cefotaxime ; Child* ; Diagnosis ; Eosinophilia* ; Eosinophils ; Fasciola ; Fasciola hepatica ; Fascioliasis ; Fever ; Follow-Up Studies ; Humans ; Immunoglobulin G ; Liver Abscess* ; Liver* ; Male ; Metronidazole ; Serologic Tests ; Ultrasonography

The purpose of this study was to investigate the physical effect of tissue conditioner on polymerized acrylic resins. Surface hardness and transverse strength were measured for evaluating physical effect of tissue conditioner on polymerized acrylic resins. 1) To measured surface hardness, the resin specimens(65x10x10mm size) of each resin material were made, applied tissue conditioner, stored in 37degrees C water for 1week, and changed tissue conditioner every week for 3 weeks. Surface hardness was measured every week with Shore hardness tester for 4 weeks. 2) To measured transverse strength, the resin specimens(65x10x3mm size & 65x10x1.5mm) of each resin material were made. The specimens were divided into four groups, and measured by universial testing machine. Group I (control group) : The resin specimens were stored in 37degrees C water for 5 weeks. Group II : The resin specimens were stored in 37degrees C water for 5 weeks, and relined in 1.5mm thickness with same resin. Group III : The resin specimens were stored in 37degrees C water for 1 week, applied tissue conditioner in 1.5mm thickness, stored in 37degrees C water for 1 week, changed tissue conditioner and water every week for 3 weeks, removed tissue conditioner, reduced 1.5mm thickness from resin surface which was applied tissue conditioner, and relined in 1.5mm thickness with same resin. The following conclusions were obtained : 1. Surface hardness changes of Vertex RS and Vertex SC were not different significantly (p>0.01). 2. Surface hardness of K-33, Tokuso rebase, and Kooliner were decreased (p<0.01). 3. With the exception of Kooliner, transverse strength of all resin materials between control group and groups which applied with tissue conditioner were not different significantly (p>0.01).
Acrylic Resins* ; Hardness ; Hardness Tests ; Polymers* ; Water