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The Treatment of Becker’s Nevus by Combination Therapy: Dr. Hoon Hur’s Golden Parameter Therapy and Dr. HOON Hur’s Optimal Melanocytic Suicide-1 Parameter Therapy 联合疗法治疗贝克尔痣:胡勋博士的黄金参数疗法和胡勋博士的最佳黑色素细胞自杀-1参数疗法
Pub Date : 2021-01-25 DOI: 10.11648/J.JS.20210901.13
H. Hur, Jiensup Kim, Duck Taik Shim, Suk‐Jin Choi, Pyoung-Su Kim, Yu Ri Kim
Becker’s nevus, a cutaneous hamartoma, usually occurs as a large, unilateral, hyperpigmented and hypertrichotic patch on the shoulder or upper trunk, which can be present in childhood or adolescence. Becker’s nevus can be treated with traditional laser therapy using various types of lasers including a 532nm potassium titanyl phosphate (KTP) laser, 694nm ruby laser and 755nm alexandrite laser. However, this may cause harmful side effects such as scarring, mottled hypopigmentation, post-inflammatory hyperpigmentation (PIH), purpurae, and crusts. As a result, no standard for the treatment of Becker’s nevus using lasers has been established. Therefore, this study was implemented to investigate the safety and efficacy of treating Becker’s nevus using Dr. Hoon Hur’s Golden Parameter Therapy (GPT) followed by Dr. Hoon Hur’s Optimal Melanocytic Suicide-1 Parameter Therapy (OMS-1 PT) which uses a high fluence 1064nm Q-switched Nd: YAG laser (QSNL). Forty-two Koreans suffering from Becker’s nevus participated in the study and received treatment on a weekly basis for 75-100 sessions using the QSNL according to Dr. Hoon Hur’s GPT then followed by Dr. Hoon Hur’s OMS-1 PT. The parameters for this study were a spot size of 7 mm, a fluence of 2.2 J/cm2 and a pulse rate of 10 Hz using a sliding-stacking technique for a single pass over the Becker’s nevus, followed by Dr. Hoon Hur’s OMS-1 PT using a sliding technique for 5 passes with the QSNL over the Becker’s nevus. Upon completion of the last treatment, all 42 patients with Becker’s nevus were cured, having no side effects, and entirely removing the pigmented lesions. None of the 42 patients reported any recurrences after their follow-ups 6-15 months after the final treatment. As a result of this study, we propose therapy to safely and effectively treat Becker’s nevus using a fusion of Dr. Hoon Hur’s GPT and Dr. Hoon Hur’s OMS-1 PT with a high fluence 1064nm QSNL to avoid any recurrences or harmful side effects.
贝克尔痣是一种皮肤错构瘤,通常表现为肩部或上躯干的一个大的、单侧的、色素沉着和多毛的斑块,可在儿童或青少年时期出现。贝克尔痣可以用传统的激光疗法治疗,使用各种类型的激光,包括532nm磷酸钛基钾(KTP)激光、694nm红宝石激光和755nm翠绿宝石激光。然而,这可能会导致有害的副作用,如疤痕,斑驳的低色素沉着,炎症后色素沉着(PIH),紫癜和结痂。因此,使用激光治疗贝克尔痣的标准尚未建立。因此,本研究旨在探讨使用Dr. Hoon Hur的黄金参数疗法(GPT)和Dr. Hoon Hur的最佳黑色素细胞自杀-1参数疗法(ms -1 PT)治疗贝克痣的安全性和有效性,该疗法使用高通量1064nm调q Nd: YAG激光(QSNL)。42名患有贝克尔痣的韩国人参加了这项研究,并根据Hoon Hur博士的GPT使用QSNL每周接受75-100次治疗,然后是Hoon Hur博士的ms -1 PT。这项研究的参数是斑点大小为7毫米,影响为2.2 J/cm2,脉冲率为10 Hz,使用滑动堆叠技术对贝克尔痣进行单次传递。然后是胡恩博士的OMS-1 PT,使用滑动技术在贝克尔痣上进行5次QSNL。最后一次治疗完成后,42例贝克尔痣患者全部治愈,无副作用,色素病灶完全去除。42例患者在最终治疗后6-15个月随访后均无复发。根据这项研究,我们建议使用Dr. Hoon Hur的GPT和Dr. Hoon Hur的OMS-1 PT结合1064nm高强度QSNL来安全有效地治疗Becker痣,以避免任何复发或有害的副作用。
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引用次数: 0
Pre-operative Imaging Avoids Unnecessary Surgery for Suspected Acute Appendicitis 术前影像学避免疑似急性阑尾炎的不必要手术
Pub Date : 2021-01-22 DOI: 10.11648/J.JS.20210901.12
G. Nair, J. Virgin, Tim Kenyon-Smith, Bev Thomas, Karolina Juszczyk, H. Kroon, P. Hollington
Background: The decision to perform an appendicectomy is traditionally based on clinical findings. This approach, however, results in high rates of negative (non-inflamed) appendicectomies with procedure morbidity associated. Therefore, some consider a negative appendicectomy to be a complication since surgical morbidity could have been avoided. The aim of this study was to evaluate the effect of preoperative imaging on the negative appendicectomy rate in case of suspected appendicitis. Methods: The prospectively collected database for all patients who had undergone acute surgery for a suspected appendicectomy, with or without preoperative imaging, was analysed over a 5-year period. Patient and treatment characteristics, histopathology and postoperative outcomes were recorded and analyzed. Results: A total of 2,070 patients were included, 848 (41%) with preoperative imaging (CT, ultrasound or MRI) and 1,222 (59%) without. Imaged patients were older and suffered from more comorbities. The negative appendicectomy rate was 19.2% (n=235) for the non-imaged patients, and 12.4% (n=105) for imaged patients (p<0.0001). When preoperative imaging was performed, a CT-scan was most accurate to diagnose appendicitis correctly compared to ultrasound (93.6 vs. 30.2%, p<0.0001). Median hospital stay was 3.2 days in the imaged group compared to 2.1 days in the non-imaged group (p=0.171). Conclusion: Preoperative imaging significantly reduces the negative appendicectomy rate. In this time of modern imaging modalities readily available, it is recommended to perform preoperative imaging in case of suspected acute appendicitis to avoid unnecessary surgery and associated morbidity.
背景:阑尾切除术的决定传统上是基于临床表现。然而,这种方法导致阴性(无炎症)阑尾切除术的高发生率,并伴有手术并发症。因此,有些人认为阴性阑尾切除术是一种并发症,因为手术并发症是可以避免的。本研究的目的是评估术前影像学检查对疑似阑尾炎患者阑尾切除阴性率的影响。方法:前瞻性收集所有疑似阑尾切除术的急性手术患者的数据库,术前有或没有影像学检查,分析5年期间的数据。记录和分析患者和治疗特点、组织病理学和术后结果。结果:共纳入2070例患者,848例(41%)术前有影像学检查(CT、超声或MRI), 1222例(59%)术前无影像学检查。成像的患者年龄较大,并有更多的合并症。未影像学检查患者阑尾切除阴性率为19.2% (n=235),影像学检查患者阑尾切除阴性率为12.4% (n=105) (p<0.0001)。术前影像学检查时,与超声相比,ct扫描对阑尾炎的诊断准确率最高(93.6% vs. 30.2%, p<0.0001)。显像组的中位住院时间为3.2天,而非显像组的中位住院时间为2.1天(p=0.171)。结论:术前影像学检查可显著降低阑尾切除术阴性率。在这个时代,现代影像学手段是现成的,建议进行术前成像的情况下,怀疑急性阑尾炎,以避免不必要的手术和相关的发病率。
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引用次数: 0
The Utility of Open-Book Enucleation of Keloids (OBEK), a Novel Procedure in Reducing Wound Burden in Tension Prone Keloid Surgery 开放式瘢痕疙瘩剜出术(OBEK)在张力性瘢痕疙瘩手术中减轻伤口负担的新方法
Pub Date : 2021-01-01 DOI: 10.37421/1584-9341.2021.17.006
R. Karamanoukian, R. Samaha, H. Karamanoukian, Z. Obagi, Yasmina Samaha
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引用次数: 0
Commentary on the Metastatic Colorectal Cancer: Review of Diagnosis and Treatment Options 转移性结直肠癌:诊断和治疗方案综述
Pub Date : 2021-01-01 DOI: 10.37421/1584-9341.2021.17.004
M. Palaghia
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引用次数: 0
General Surgery during Pandemic Era – Evolving Strategies: A Cohort Study from a Tertiary Care Centre in North India 大流行时期的普外科——演变策略:来自印度北部三级保健中心的队列研究
Pub Date : 2021-01-01 DOI: 10.13188/2332-4139.1000049
R. Wadhawan
Due to Corona Virus disease 2019 (CoViD-19) pandemic, healthcare systems worldwide have been suffering in terms of their capability to manage affected people and the ability to provide standard treatment. Multiple vaccines have been developed and it is being implemented globally on a large scale. However, mutant strains of the virus are being detected from all parts of the world and pandemic and it’s associated concerns are continuing. With the majority of patients being asymptomatic and high infectivity, safety related concerns have been there both for patients as well as healthcare workers. Various academic associations have issued guidelines to address these issues. The authors aim to provide a comprehensive overview of essential measures that healthcare providers and surgeons adopted to ensure safe performance of both elective and emergency surgical procedures at their institute. Total of 506 patients underwent 512 general surgical elective and emergency procedures between 1st April 2020 to 31st December 2020 for different indications. The surgeries included both laparoscopic and open approaches. The strategies for preoperative testing for the presence of SARS nCov2 have been varying with availability of more evidence and techniques. For the initial six months, it was primarily RT PCR for both elective and emergency cases. However, in the last three months, the majority of the patients were tested for SARS nCov2 via RT PCR and emergency cases who were tested by CBNAAT Gene-Xpert. The pandemic has affected the patient care globally. Various guidelines have been issued by different academic associations. However, every institution has to improvise depending upon the local resources and infrastructure available. With continuing pandemic every institution shall require infrastructural changes to continue to deal with continuous inflow of infected patients.
由于2019冠状病毒病(CoViD-19)大流行,世界各地的卫生保健系统在管理受影响人群和提供标准治疗的能力方面一直受到影响。已经开发出多种疫苗,并正在全球范围内大规模实施。然而,世界各地都发现了病毒的突变株,大流行及其相关的担忧仍在继续。由于大多数患者无症状且传染性高,因此患者和医护人员都存在与安全相关的担忧。各种学术协会已经发布了解决这些问题的指导方针。作者旨在全面概述医疗保健提供者和外科医生在其研究所采取的基本措施,以确保选择性和紧急外科手术的安全进行。在2020年4月1日至2020年12月31日期间,共有506名患者因不同适应症接受了512次普通外科选择性和急诊手术。手术包括腹腔镜手术和开放手术。术前检测SARS - nCov2是否存在的策略随着证据和技术的增加而有所不同。在最初的六个月里,主要是RT - PCR,用于选择性病例和紧急病例。然而,在过去的三个月里,大多数患者通过RT - PCR检测了SARS nCov2,紧急病例通过CBNAAT Gene-Xpert检测。大流行影响了全球的患者护理。不同的学术协会发布了各种指导方针。然而,每个机构都必须根据当地的资源和可用的基础设施即兴发挥。随着流行病的持续,每个机构都需要改变基础设施,以继续处理不断流入的受感染病人。
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引用次数: 0
Sacrocolpopexy's Progression and the Creation of Innovative Methods Using Natural Orifice Transluminal Endoscopic Surgery 骶colpop固定症的进展和使用自然孔道腔内内镜手术的创新方法的创造
Pub Date : 2021-01-01 DOI: 10.37421/1584-9341.2021.17.005
T. Koythong, Xiao Ming
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引用次数: 0
Editorial Note on Journal of Endocrine and Gynecologic 内分泌与妇科杂志编者按
Pub Date : 2021-01-01 DOI: 10.37421/1584-9341.2021.17.E036
R. Chinnadorai
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引用次数: 0
Editorial Note on Laparoscopic Surgery 关于腹腔镜手术的社论注释
Pub Date : 2021-01-01 DOI: 10.37421/1584-9341.2021.17.E035
N. Jayanthi
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引用次数: 0
Surgeon Preference May Be More Important Than Models of Care When It Comes to Early Laparoscopic Cholecystectomy Rates for Acute Cholecystitis 当涉及急性胆囊炎早期腹腔镜胆囊切除术率时,外科医生的偏好可能比护理模式更重要
Pub Date : 2020-12-22 DOI: 10.11648/J.JS.20200806.20
D. Feng, Luke Petschack, Georgia Marr, J. Gani
Aim: Early Laparoscopic Cholecystectomy (ELC) for acute cholecystitis is widely accepted as the standard of care. The capacity to deliver this has been strongly linked to the establishment of Acute Surgical Units (ASU). This study aimed to determine the relative effects of surgeon preference on ELC rates. Method: A retrospective audit of patients with acute cholecystitis was carried out over 6 months in 3 hospitals in 2018. One hospital had an ASU and 2 hospitals had no ASU. The timing of cholecystectomy, intraoperative cholangiogram rates and length of hospital stay were collected. Results: 175 patients were included; 92 admitted to the ASU hospital and 83 admitted to non-ASU hospitals. When adjusted for severity, the ELC rate was 62% and 31% (P<0.0001) in the ASU hospital and non-ASU hospitals respectively in patients with mild (Tokyo Grade I) disease. There was no difference between intraoperative cholangiogram rates between hospitals. The initial length of stay was on average 2.4 days shorter in the early ELC patients (MD=-2.4, 95% CI 1.3 to 3.4). The 2 Non-ASU hospitals varied significantly in ELC rates (19% and 48% P=0.0158), the hospital with the higher ELC rates shared senior surgical staff with the ASU hospital. Conclusion: Hospitals with an ASU are better able to provide timely surgery to patients presenting with acute cholecystitis and this is associated with a reduction of time in hospital for these patients, but surgeon preference may be more important in determining ELC rates than the ASU model of care.
目的:早期腹腔镜胆囊切除术(ELC)治疗急性胆囊炎被广泛接受为标准治疗。提供这种服务的能力与急性外科单位(ASU)的建立密切相关。本研究旨在确定外科医生偏好对ELC率的相对影响。方法:对2018年3家医院6个月以上急性胆囊炎患者进行回顾性审计。1家医院有ASU, 2家没有ASU。收集胆囊切除术时间、术中胆道造影率和住院时间。结果:纳入175例患者;92人住进亚利桑那州立大学医院,83人住进非亚利桑那州立大学医院。根据严重程度调整后,ASU医院和非ASU医院轻度(东京I级)疾病患者的ELC率分别为62%和31% (P<0.0001)。不同医院术中胆道造影发生率无差异。早期ELC患者的初始住院时间平均短2.4天(MD=-2.4, 95% CI 1.3 ~ 3.4)。两家非ASU医院ELC率差异显著(分别为19%和48% P=0.0158), ELC率较高的医院与ASU医院共用高级外科人员。结论:有ASU的医院能够更好地为急性胆囊炎患者提供及时的手术,这与这些患者住院时间的减少有关,但在决定ELC发生率方面,外科医生的偏好可能比ASU的护理模式更重要。
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引用次数: 0
Urinary Tract Lesions After Surgery for Gynecological Pelvic Cancers at the Conakry University Hospital 科纳克里大学医院妇科盆腔癌术后尿路病变
Pub Date : 2020-12-16 DOI: 10.11648/J.JS.20200806.19
Koundouno Aly Mampan, Traoré Bangaly, C. Naby, Keita Mamady, Diakité Saikou Yaya, Camara Fode Lansana, Balde Abdoulaye Korse, Balde Oumar Taibata, D. A. Bobo, T. Aboubacar
The aim of this study was to describe the urinary complications of surgery for gynecological pelvic cancers and their management at the university hospital in Conakry. Patients and methods: This was a descriptive multicenter study in the main surgical treatment services for gynecological pelvic cancer at the University Hospital of Conakry from 2007 to 2017. Results: Out of 22 cases collected, we found 10 (45.5%) cases during surgery and 12 cases of postoperative complications, including 8 (36.36%) early and 4 (18.18%) late. Direct suture on a ureteral probe in 3 cases and by reimplantation according to the Politano Leadbetter method in 2 cases. Laparotomy fistulorrhaphy was performed in 2 (9.1%) cases of VF. the Latzko technique for 6 (27.3%) other cases of FVV. The 2 cases of FUV were repaired by ureteral reimplantation according to the Lich-Gregoire method. In cases of stenosis, we proceeded to segmental resection followed by suturing on a ureteral probe. The morbidity consisted of: 2 cases of secondary VF, suppuration, 2 urinary incontinence, Operative mortality was 3 (13.6%) cases. Conclusion: The prevention of these lesions is the best way and requires a good knowledge of the anatomy and the surgical techniques. Early diagnosis of gynecologic pelvic cancer is necessary to minimize surgical risks.
本研究的目的是描述妇科盆腔癌手术的泌尿系统并发症及其在科纳克里大学医院的处理。患者和方法:这是一项描述性多中心研究,研究了2007年至2017年科纳克里大学医院妇科盆腔癌的主要手术治疗服务。结果:本组22例患者中,术中发现10例(45.5%),术后并发症12例,其中早期8例(36.36%),晚期4例(18.18%)。输尿管探头直接缝合3例,按Politano Leadbetter法再植2例。2例(9.1%)VF行剖腹造瘘术。其他FVV 6例(27.3%)采用Latzko技术。2例FUV均采用输尿管再植术,采用Lich-Gregoire法修复。对于狭窄的病例,我们进行节段性切除,然后在输尿管探针上缝合。其中继发VF、化脓2例,尿失禁2例,手术死亡3例(13.6%)。结论:预防这些病变是最好的方法,需要掌握良好的解剖学知识和手术技术。早期诊断妇科盆腔癌是必要的,以减少手术风险。
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引用次数: 0
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The Journal of Surgery
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