• Journal of Yeungnam Medical Science
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• v.31 no.1
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• pp.17-20
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• 2014

Iatrogenic femoral artery pseudoaneurysm is a complication in patients undergoing catheterization. The risk increased when large-bore sheaths, concomitant anticoagulation therapy, and antiplatelet therapy are used during the intervention. Ultrasound-guided thrombin injection has become the treatment of choice. Rapid expansion, rupture, infection, and mass effect resulting in distal or cutaneous ischaemia or peripheral neuropathy, as well as failure of other treatment options are all indications for surgery. We report a 48-year-old man who developed hemorrhagic shock due to femoral pseudoaneurysm rupture after coronary angiography, and successfully treated by ultrasound-guided thrombin injection.

• Archives of Plastic Surgery
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• v.50 no.2
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• pp.216-219
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• 2023

Neisseria gonorrhoeae is the most common sexually transmitted disease in the world and is known to cause disseminated disease, most commonly tenosynovitis. Classically, gonorrhea-associated tenosynovitis presents with concomitant dermatitis and arthralgias, though this is not always the case. N. gonorrhoeae-related tenosynovitis has become more commonly seen by hand surgeons. To aid in management, we present three cases of gonorrhea-induced tenosynovitis spanning a range of presentations with variable treatments to demonstrate the variety of patients with this disease. Only one of our patients had a positive gonococcal screening test and no patient had purulent urethritis, the most common gonorrhea-related symptom. A separate patient had the classic triad of tenosynovitis, dermatitis, and arthralgias. Two patients underwent operative irrigation and debridement, and one was managed with anti-gonococcal antibiotics alone. Though gonorrhea is a rare cause of flexor tenosynovitis, it must always be on the differential for hand surgeons when they encounter this diagnosis. Taking an appropriate sexual history and performing routine screening tests can assist in the diagnosis, the prescription of appropriate antibiotics, and potentially avoiding an unnecessary operation.

• Clinics in Shoulder and Elbow
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• v.27 no.2
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• pp.219-228
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• 2024

Background: Standard open acromioclavicular (AC) stabilization is associated with increased postoperative complications including deltoid injury, infection, tunnel complications, loss of reduction, and wound/cosmetic concerns. Arthroscopy may offer superior visualization and advantages that limit these risks. The aim of this prospective non-randomized study is to evaluate advantages and long-term reliability of arthroscopic AC stabilization. Methods: Thirty-two patients with acute grade III, IV and V AC dislocations underwent arthroscopic AC reconstruction with long-term assessment by clinical AC examination, Simple Shoulder Test, American Shoulder and Elbow Surgeons scores, visual analog scale, Specific AC Score and Quick Disabilities of the Arm, Shoulder and Hand scores. Radiographs verified conservation of initial reduction and presence of coracoclavicular (CC) ossifications. Complications, revision rate, and satisfaction were assessed and compared to the literature. Results: Mean follow-up time was 67.6 months. All clinical outcome scores improved and differences were statistically significant (P<0.001). Initial postoperative radiographs consistently showed complete reduction. Two patients experienced relapse to grade II AC dislocation without clinical implications. In total, 71.8% showed CC ossifications without functional impairment, and in 31.3% concomitant injuries were observed. Reintervention rate was 9.4%, and 96.9% of patients were satisfied with procedure outcomes. Conclusions: Arthroscopic stabilization for acute AC joint dislocations offers satisfactory clinical and radiographic outcomes, and our results show that the arthroscopic technique is reliable in the long run. We report better reduction in maintenance, fewer complications, and similar reoperation rates compared to other techniques.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.40-47
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• 2011

Purpose : Norovirus infection, a common cause of community-acquired gastroenteritis, can also lead to severe illness in immunocompromised patients. We investigated clinical manifestations of norovirus infection in pediatric cancer patients. Methods : Stool specimens were collected from pediatric patients with gastrointestinal symptoms between November 2008 and September 2009 at Samsung Medical Center, Seoul, Korea. Norovirus infection was identified by reverse-transcription polymerase chain reaction (RT-PCR). A retrospective chart review was performed in pediatric cancer patients who were diagnosed with norovirus infection. Results : Ten patients were diagnosed with norovirus infection by RT-PCR in stool samples. The median age was 0.83 years (range 0.25-5.5 years) and the male to female ratio was 1.5:1 (6 males and 4 females). Underlying diseases were hematologic malignancies (4/10, 40%), neuroblastoma (4/10, 40%), and brain tumors (2/10, 20%). Three patients were infected before hematopoietic cell transplantation (HCT) and four patients after HCT. All patients had diarrhea (10/10, 100%), with a median frequency of diarrhea of 8.5 times/day (range 4-22 times/day). Median virus shedding duration was 72.5 days (range 19-299 days). Four patients with pneumatosis intestinalis were conservatively treated with bowel rest and total parenteral nutrition. One patient with severe diarrhea and bloody stool had concomitant chronic gut graft-versus-host disease (GVHD). Norovirus infection-related mortality was not observed. Conclusion : Norovirus infection can cause significant clinical manifestations with prolonged viral shedding in immunocompromised patients. Norovirus should be considered in pediatric cancer patients with severe gastrointestinal symptoms.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.799-802
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• 2012

Background: Human papillomavirus (HPV) is a very common sexually transmitted disease affecting both men and women and is responsible for different ano-genital cancers in either sex. Co-existing sexually transmitted infections (STI) including HIV have been considered as important co-factors for carcinogenesis induced by HPV. The purpose of this study was to determine the prevalence of any HPV, HPV 16 and HPV 18 and also concomitant STIs among female sex workers (FSW), men having sex with men (MSM) and injectable drug users (IDU). Material and Method: This cross-sectional study was conducted among 45 FSWs, 26 MSMs and 58 IDUs who attended the STI or de-addiction clinics. Genital scrape samples collected from glans penis and coronal sulcus in males and cervical squamo-columnar junction in females were tested for HPV DNA by PCR using HPV L1 consensus primer. Type specific PCR to detect HPV 16 and 18 was done on the samples positive on consensus PCR. All participants were tested for associated STIs including HIV and hepatitis B and cervical cytology was done on all females. Results: Among the FSWs, HPV was detected in 73.3% and HPV 16 and 18 was detected in 25.7%. Though the HPV prevalence was similarly high among MSMs (69.2%) and IDUs (72.4%), the prevalence of HPV 16 and 18 was much lower in these groups compared to the FSWs. Prevalence of cervico-vaginal infection with Trichomonas vaginalis and syphilis was significantly higher in the HPV positive women compared to the HPV negative women. There was no statistically significant difference in the prevalence of other STIs among HPV positive and negative women and men. Conclusion: HPV infection is highly prevalent among FSW, MSM and IDUs. Trichomonas vaginalis infection is more frequent in HPV positive women.

• Neonatal Medicine
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• v.15 no.1
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• pp.61-66
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• 2008

Purpose : The purpose of this study was to describe the epidemiologic features of febrile illnesses in newborns and to predict the risk of serious infections in this population. Methods : A retrospective study was conducted on 123 full-term infants <30 days of age with an axillary temperature >38$^{\circ}C$ who were hospitalized between 2000 and 2006. Neonates with prenatal risk factors, congenital anomalies, antibiotic administration prior to admission to the hospital, or suspected hospital-acquired infections were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and clinical course between the high- and low-risk groups for serious infections. Results : The high-risk group included 30 infants with the following diagnoses in order of frequency: aseptic meningitis, urinary tract infection, bacterial meningitis, infectious enteritis, sepsis concomitant with disseminated intravascular coagulopathy, bacteremia, pneumonia, cellulitis, and omphalitis. Leukocytosis and thrombocytopenia were statistically different between the two groups. Factors, such as moaning signs, seizures, body temperature, and pulse rate were statistically significant. Conclusion : Unlike previous studies, we included newborns with clinical bacterial infections and aseptic meningitis as the high-risk group. Leukocytosis, thrombocytopenia, moaning signs, seizures, and changes in vital signs were considered useful predictors for identifying febrile neonates at high-risk for serious infections in spite of a difference in the definition of serious infection.

• Pediatric Infection and Vaccine
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• v.23 no.2
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• pp.128-136
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• 2016

Purpose: This study was done to define clinical characteristics of fever without localizing signs (FWLS) in infants younger than 100 days of age with a goal of providing baseline data to establish a new diagnostic paradigm in the future. Methods: We reviewed medical records of 183 patients who admitted to Daegu Catholic University Medical Center for FWLS younger than 100 days of age from January 2013 to September 2015 retrospectively. Demographic, clinical features and laboratory findings were analyzed. Patients were divided into serious bacterial infection (SBI) and non-SBI groups, and then were compared between two groups to find risk factors for SBI. Results: Among 183 patients, lumbar puncture was performed in 98.9% and CSF pleocytosis was present in 35.9%. Sterile CSF pleocytosis was found in 43% of urinary tract infection (UTI) patients. None had concomitant bacterial meningitis in patients with UTI. As final diagnosis, febrile syndrome without source (25.7%) was most common. Among SBI, UTI was most common (99%). Birth weight, ESR, and CRP were significantly higher in SBI group compared to non-SBI group. Male sex (OR 4.93, 95% CI 1.60-15.24) and pyuria (OR 18.88, 95% CI 6.76-52.76) were identified as risk factors for SBI. Presence of sibling (OR 0.30, 95% CI 0.11-0.83) was significantly lower in SBI group. Conclusions: Our results showed UTI was the most common SBI in young infants with FWLS. Though aseptic meningitis can be coexisting with UTI, lumbar puncture may not be necessary in all patients having UTI.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.20-24
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• 2016

Background: Midface concavity is a relatively common facial feature in East Asian populations. Paranasal augmentation is becoming an increasingly popular procedure for patients with mild concavity and normal occlusion. In this study, we evaluate clinical outcomes following a series of paranasal augmentation. Methods: A retrospective review was performed for patients with Class I occlusion who had undergone bilateral paranasal augmentation using custom-made silicone implants, between October 2005 and September 2013. Patient charts were reviewed for demographic information, concomitant operations, and postoperative complications. Preoperative and postoperative (1-month) photographs were used to evaluate operative outcome. Results: The review identified a total of 93 patients meeting study criteria. Overall, aesthetic outcomes were satisfactory. Five-millimeter thick silicone implant was used in 81 cases, and the mean augmentation was 4.26 mm for this thickness. Among the 93 patients, 2 patients required immediate implant removal due to discomfort. An additional 3 patients experienced implant migration without any extrusion. Nine patients complained of transient paresthesia, which had resolved by 2 weeks. There were no cases of hematoma or infection. All patients reported improvement in their lateral profile and were pleased at follow-up. Complications that arose postoperatively included 9 cases of numbness in the upper lip and 3 cases of implant migration. All cases yielded satisfactory results without persisting complications. Sensations were fully restored postoperatively after 1 to 2 weeks. Conclusion: Paranasal augmentation with custom-made silicone implants is a simple, safe, and inexpensive method that can readily improve the lateral profile of a patient with normal occlusion. When combined with other aesthetic procedures, paranasal augmentation can synergistically improve outcome and lead to greater patient satisfaction.

• Archives of Plastic Surgery
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• v.46 no.6
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• pp.550-557
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• 2019

Background In recent years, breast implants have been frequently placed in the subcutaneous pocket, in the so-called prepectoral approach. We report our technique of prepectoral implant-based breast reconstruction (IBR), as well as its surgical and aesthetic outcomes, in comparison with subpectoral IBR. We also discuss relevant considerations and pitfalls in prepectoral IBR and suggest an algorithm for the selection of patients for IBR based on our experiences. Methods We performed 79 immediate breast reconstructions with a breast implant and an acellular dermal matrix (ADM) sling, of which 47 were subpectoral IBRs and 32 were prepectoral IBRs. Two-stage IBR was performed in 36 cases (20 subpectoral, 16 prepectoral), and direct-to-implant IBR in 43 cases (27 prepectoral, 16 subpectoral). The ADM sling supplemented the inferolateral side of the breast prosthesis in the subpectoral group and covered the entire anterior surface of the breast prosthesis in the prepectoral group. Results The postoperative pain score was much lower in the prepectoral group than in the subpectoral group (1.78 vs. 7.17). The incidence of seroma was higher in the prepectoral group (31.3% vs. 6.4%). Other postoperative complications, such as surgical site infection, flap necrosis, implant failure, and wound dehiscence, occurred at similar rates in both groups. Animation deformities developed in 8.5% of patients in the subpectoral group and rippling deformities were more common in the prepectoral group (21.9% vs. 12.8%). Conclusions The indications for prepectoral IBR include moderately-sized breasts with a thick well-vascularized mastectomy flap and concomitant bilateral breast reconstruction with prophylactic mastectomy.

• Journal of Trauma and Injury
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• v.33 no.1
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• pp.18-22
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• 2020

Purpose: Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. The aim of the present study was to evaluate infection risk in the pelvic surgical site in patients who underwent emergent abdominal surgery. Methods: This single-center retrospective observational study was based on data collected from a prospectively maintained registry between January 2015 and June 2019. Patients who underwent laparotomy and pelvic internal fixation were included. Individuals <18 and ≥80 years of age, those with no microbiological investigations, and those who underwent one-stage abdominal surgery were excluded. Comprehensive statistical comparative analysis was not performed due to the small number of enrolled patients. Results: A total of six patients met the inclusion criteria, and the most common injury mechanism was anterior-posterior compression (67%). The average duration of open abdomen was 98 hours (range, 44-98), and the time interval between abdominal closure and pelvic surgery was 98 hours. One patient (16.7%) died due to multi-organ dysfunction syndrome. Micro-organisms were identified in the abdominal surgical site in five patients (83%), with no micro-organisms in pelvic surgical sites. There was no unplanned implant removal. Conclusions: Internal fixation of pelvic bone fracture(s) could be performed in the state of open abdomen, and the advantages of early fixation may countervail the risks for cross contamination.