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Open Reduction and Internal Fixation (ORIF) of Trapdoor Orbital Floor Blowout Fracture with Absorbable Mesh Plate (뚜껑문 안와저 골절에 있어서 망상 흡수성 판을 이용한 관혈적 정복술 및 내고정술)

  • Kwon, Yu-Jin;Kim, Ji-Hoon;Hwang, Jae-Ha;Kim, Kwang-Seog;Lee, Sam-Yong
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.619-625
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    • 2010
  • Purpose: Trapdoor orbital blowout fracture is most common in orbital blowout fracture. Various materials have been used to reconstruct orbital floor blowout fracture. Absorbable alloplastic implants are needed because of disadvantages of nonabsorbable alloplastic materials and donor morbidity of autogenous tissue. The aim of the study is to evaluate usefulness of absorbable mesh plate as a reconstructive material for orbital blowout fractures. Methods: From December 2008 to October 2009, 18 trapdoor orbital floor blowout fracture patients were treated using elevator fixation, depressor fixation, or elevatordepressor fixation techniques with absorbable mesh plates and screw, depending on degree of orbital floor reduction, because absorbable mesh plates are less rigid than titanium plates and other artificial substitutes. Results: Among 18 patients, 5 elevator fixation, 4 depressor fixation, and 9 elevator and depressor fixation technique were performed. In all patients, postoperative computed tomographic (CT) scan showed complete reduction of orbital contents and orbital floor, and no displacement of bony fragment and mesh plate. Mean follow-up was 10 months. There were no significant intraoperative or postoperative complications. Conclusion: Three different techniques depending on the degree of orbital floor reduction are useful for open reduction and internal fixation of trapdoor orbital floor blowout fracture with absorbable mesh plates.

A Case of Lemierre Syndrome Manifests with Persistent Fever and Neck Stiffness Following Acute Oropharyngeal Infection (급성 입인두 감염 후에 발열과 경부 강직을 주소로 내원한 Lemierre 증후군 1례)

  • Lee, Yena;Hong, Ye-Seul;Kim, Sung Soo
    • Pediatric Infection and Vaccine
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    • v.23 no.2
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    • pp.143-148
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    • 2016
  • Lemierre syndrome is a rare disease involving multiple organs affected by septic emboli following oropharyngeal infection. After the introduction of penicillin in the 1940s, it became a "forgotten" disease. However, due to the development of diagnostic image modalities including neck computed tomography (CT) scan, the number of published reports of Lemierre syndrome and diagnosis has been increasing since the 1990s. In this report, we describe a case of Lemierre syndrome, following oropharyngeal infection in a 16-year-old patient, who manifested with persistent fever and neck stiffness. Neck ultrasonography confirmed thrombus formation in the right internal jugular vein without definite evidence of septic emboli to other organs. After the three-week-long antibiotics therapy was completed, the thrombus in the right internal jugular vein finally disappeared.

Diagnostic Imaging of Nasal Lymphoma in a Cat (고양이에서 비강 림프종의 영상 진단 증례)

  • Jung, Joo-Hyun;Seo, Kyoung-Won;Chang, Jin-Hwa;Bae, Il-Hong;Kim, Dae-Yong;Yoon, Hwa-Young;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.361-365
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    • 2006
  • A spayed female, 5-year-old, weighing 2.7 kg, domestic short hair cat was referred to Veterinary Medical Teaching Hospital, Seoul National University. The clinical signs of this patient were weight loss, sneezing, respiratory distress, nasal discharge, epistaxis, ocular discharge, left exophthalmos, and left facial edema and deformity. The laboratory tests represented mild leukocytosis. On the skull radiographs, soft tissue density filled nasal cavity with loss of turbinate detail was found. Destructive and lytic changes of the left nasal bone with soft tissue swelling were identified. On the thorax radiographs, there were a tracheobronchial lymph node swelling and a soft tissue round mass in the left caudal lung field. On computed tomographic scan images, asymmetrical destruction of turbinate and nasal septum and increased soft tissue opacity in the nasal cavity were identified. Destruction of the lateral maxillary bone, invasion to the left retrobulbar region, and craniodorsal deviation of the left eye were seen. Also, there was lysis of hard palate and cribriform plate. Invasion to the brain was found. The patient was diagnosed as nasal lymphoma by cytology and histopathology.

Diagnostic Imaging of Nasal Adenocarcinoma in Four Dogs (개에서 비강 샘암종의 영상 진단 증례)

  • Jung, Joo-Hyun;Chang, Jin-Hwa;Oh, Sung-Kyoung;Kim, Kyoung-Min;Lee, Sung-Ok;Lee, Jung-Min;Kim, Hak-Sang;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.355-360
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    • 2006
  • Four dogs with similar respiratory signs were referred to Veterinary Medical Teaching Hospital, Seoul National University. The clinical signs observed in these cases were anorexia, nasal discharge, sneezing, epistaxis, ocular discharge, and exophthalmoses. The routine laboratory tests revealed leukocytosis in two cases. On the skull radiographs, soft tissue density filled nasal cavity with loss of turbinate detail and increased density in frontal sinuses were found in all cases. Lysis of nasal bone was seen in two cases. Lysis of zygomatic arch was seen in one case. On computed tomography scan images, asymmetrical destruction of turbinate and nasal septum, and the superimposition of a soft tissue mass over the turbinate with peripheral contrast enhanced effect were identified in all cases. Destruction of ipsilateral orbital bone and invasion to retrobulbar region were visualized in all cases. In addition, all cases had lysis of cribriform plate. Lysis of nasal bone and destruction of hard palate were seen in two cases. Swelling of submandibular lymph node and salivary gland was seen in a case. Invasion to brain was identified in a case. All cases were diagnosed as nasal adenocarcinoma by cytology with fine needle aspiration and curettage.

Leiomyosarcoma of the Bronchus -A case report with long-term follow-up - (기관지에서 기원한 평활근육종 -1예 보고 -)

  • Kim, Hyung-Tae;Lee, Cheol-Joo;Yoon, You-Sang;Choi, Ho;Kang, Joon-Kyu;Kim, Jung-Tae
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.991-994
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    • 2003
  • Primary leiomyosarcomas are rare tumors of the lungs. No typical roentgenographic findings of unusual complex of symptoms distinguish this tumor. The most common therapy is surgical resection. Prognosis and significant survivorship are related to the size, grade, metastasis of the lesion. A 25-year-old female patient with chest pain and cough was admitted. In chest X-ray and CT scan, there was a pulmonary nodule in left upper lung field, She was taken a percutaneous needle aspiration biopsy. The result was a spindle cell tumor. Left upper lobe lobectomy was done, and pathologic diagnosis was a low grade leiomyosarcoma arising from left bronchus. During 5 years of follow-up period, she has not shown any metastasis or local recurrence.

da Vinci Robot-Assisted Esophagectomy for Esophageal Cancer: A Case of Esophago-gastrostomy through the Retrosternal Route - A case report - (식도암 환자에서 da Vinci 로봇을 이용한 식도암 수술 (흉골하 통로를 통한 식도-위 문합술) - 1예 보고 -)

  • Jeong, Sang-Seok;Choi, Pill-Jo;Woo, Jong-Soo;Kim, Si-Ho;Bang, Jung-Hee;Park, Kwon-Jae
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.396-400
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    • 2009
  • Operations using the da Vinci robot have performed in for many surgeries, but the adoption of robotics to general thoracic surgery has been slow. The patient (age 74, male) visited our hospital complaining of hiccups and dysphagia. The CT scan and endoscopic biopsy revealed esophageal cancer (squamous cell carcinoma). We performed transthoracic esophagectomy using a da Vinci robot and this was followed by gastric tube mobilization via laparoscopy. Cervical esophago-gastric anastomosis was done using the hand-sewn method. The gastric tube was brought into the neck through the retrosternal route. The patient was discharged without any complications. We report here on a case of successful da Vinci robotic esophgagectomy.

Inferior Vena Cava Thrombectomy in a Patient with Antiphospholipid Syndrome - A case report - (하대정맥의 혈전증을 동반한 인지질항체 증후군의 수술적 치료 - 1예 보고 -)

  • Jang, Jae-Seok;Kwon, Oh-Choon;Lee, Sub;Kim, Seok
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.371-374
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    • 2009
  • A 36-year-old woman with a history of spontaneous abortion and photosensitivity was admitted to our hospital with periumbilical pain and lower extremity edema. The preoperative CT scan revealed massive inferior vena cava thrombus, which extended from the suprarenal portion of the vena cava to the hepatic vein. The laboratory data showed an elevated level of anticardiolipin antibody, which suggested the diagnosis of antiphospholipid syndrome. After medical management, she underwent an operation for removal of an vena cava thrombus by performing cavectomy and thrombectomy. After the operation, she has been taking oral anticoagulation and she is doing quite well at 9 months after her operation.

Open Lung Biopsy for Diffuse Infiltrative Lung Disease (미만성 폐질환에 대한 개흉적 폐생검)

  • 김남혁
    • Journal of Chest Surgery
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    • v.28 no.11
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    • pp.1014-1018
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    • 1995
  • To confirm diagnosis and to set proper therapeutic strategy, open lung biopsies were done in 57 patients who were suspected for diffuse interstitial lung disease from January 1985 to December 1994. Among them, 35 were male and 22 were female[M:F=l.6: 1 and mean age of the patients is 53.5$\pm$ 2.3[24-81 years. Tissue for histologic studies were obtained from left lung in 33, from right lung in 24according to the distributions of the pathology. Preoperative diagnostic work-up`s were chest X-ray, CT[HRCT scan, sputum study, bronchoscopy[BAL, TBLB and PTNA and all of them were unsuccessful to confirm diagnosis. In comparison of pulmonary function tests between preoperative and postoperative values, there were no significant differences in FVC, FEV1, FEV1/FVC[p 0.05 but in AaDO2[p[0.05 . Postoperative complications including atelectasis, wound infection, pulmonary edema and respiratory insnfficiency, were shown in 5 cases[8.8% , and two of them were died of respiratory failure and sepsis[mortality rate 3.5% . Pathologic diagnosis was confirmed in 53 cases postoperatively but it was undetermined in 4[diagnostic yield rate 93.0% . In comparison between preoperative clinical diagnosis and postoperative pathologic diagnosis, new diagnosis were made in 17 cases[29.8% and preoperative tentative diagnosis were confirmed histologically in 36 cases[63.2% . In 4 cases[7.0% , however, diagnoses were not confirmed after biopsies. Therapeutic plans were reset in 46 cases[80.7% in accordance with the final diagnosis.In conclusion, open lung biopsy is recommended for a specific diagnosis and proper therapeutic plan in diffuse interstitial lung diseases because of its high diagnostic yield Irate and it`s relatively low morbidity and mortality rate in these tompromised patents.

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Large aspergilloma cavity treated by Cavernostomy md ometal, muscle flaps A case report (공동절개술과 유경성 대망이식술 및 근육 충진술을 이용한 거대 폐공동(폐국균증)의 치험 1례)

  • 방정희;편승환
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.936-940
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    • 1997
  • Pulmonary aspergilloma is potentially a life threatening disease resulting from the colonization of lung cavities by Aspergillus fumigatus. A case is reported: a 43-year-old man with symtomatic cavitary aspergilloma presenting with severe productive coughing, hemopt sis, occasional fever, and chilling. On preoperative plain chest radiograph and CT scan, we could find a rounded irregular opacity in a large pulmonary cavity. He received 2 separate operations for therapeutic need. At the first opertion, we performed cavernostomy and thoracoplasty because of severe pleural adhesions, tearing of cavity wall, and high risk of respiratory insufficiency. At the second operation, we performed myoplasty and omentoplasty for closure of remaining air space and complete wrapping of the BPF site. All symptoms of dyspnea and hemoptysis have since resolved. We believed that in the high risk patients who have severe respiratory symptoms, such as in aspergilloma and open cavity with a risk of respiratory insufficiency, cavernostomy followed by myoplasty or omentoplasty should be recommended.

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Clinical evaluation of Acupuncture on Herniated of Cervical Intervertebral Disc by DITI (컴퓨터 적외선(赤外線) 전신체열촬영(全身體熱撮影)으로 본 경추추간판(頸椎椎間板) 탈출증(脫出症)의 침구치료효과(鍼灸治療效果))

  • Lee, Geon-Mok
    • The Journal of Korean Medicine
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    • v.16 no.1 s.29
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    • pp.132-140
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    • 1995
  • Object : This study is designed to evaluate the correlation between the data of DITI(Digital Infrared Thermographic Imaging)examination and the changes of clinical symptom after the therapy of acupuncture in the patients with herniated cervical intervertebral disc. Content : The conservative therapy with acupuncture was performed during $4{\sim}5$ weeks, The acupuncture points of SI3, B62, TE3, G34, LI4, S36, GV26, G21, SII5 were used. In the pre- and post therapy, DITI examinations were performed in patients who had HIVD and were treated by acupuncture simultaneously, and then tried to correlate the results of clinical symptoms with the difference of thermographic findings at pre-acupuncture and post-acupuncture. Setting : The standard routine thermoghaphic examinations were performed with thermography(DITI) in the 15 patients with lumbar disc herniations at pre- and post acupuncture. Patient : Thermographic imaging of 15 cases were analyzed. They has disc herniations in X-ray, CT scan and MRI and they were treated by acupuncture theraphy in our hospital from March, 1994 to January, 1995. Result : 1) The causes were trauma(60%), retention of phlegm and fluid(8.7%) and cold & moisture(33.3%) 2) Levels of herniated cervical disc are C2/3(1 case). C3/4(2 cases), C5/6 & C6/7 (2 cases), C6/7(4 cases), Normal(6 cases). 3) Classifications of thermographic pattern are radiculopathy(80%), spot(13.3%), and nonspecific(6.7%) in order. 4) In evaluation Results of clinical symptom are Excellent(80%), Good(6.7%), and Poor(6.7%). Data of DITI are Excellent(80%), Good(6.7%), Fair(6.7%), and Poor(6.7%). Conclusion ; Acupuncture showed good results over 86.7% in clinical evaluation and 86.7% in DITI. Thermographic examination was valuable in the evaluation of therapeutic effect of acupuncture treatment.

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