• Journal of Korean Neurosurgical Society
• /
• 제30권3호
• /
• pp.319-324
• /
• 2001

Objectives : The percutaneous vertebroplasty provides a good result in the treatment of osteoporotic vertebral compression fractures. But, the epidural leakage of polymethylmetacrylate(PMMA) after vertebroplasty may decrease the therapeutic effects because of the compression of thecal sac and/or nerve roots. The authors carried out a prospective study to evaluate the causative factors of epidural leakage of PMMA and to assess the influence on the outcome. Methods : This study involved 347 vertebral levels of compression fractures in 159 patients. Among these, the epidural leakages were identified in 92 vertebral levels(26.5%) in 64 patients(40.3%) on post-operative CT scan. Results : The incidence of epidural leakage of PMMA was significantly higher in the level above T7(p=0.001). The large amount of the injected PMMA and the use of an injector also increased the incidence(p=0.03 and p=0.045, respectively). The position of the needle tip in the vertebral body and the pattern of venous drainage did not influence. The immediate post-operative visual analogue scale(VAS) scores and facial scales(FS) were higher in the patients with epidural leakage(p=0.009). But there were no significant differences between the two groups after three months of operation(p=0.541). Conclusions : The incidence of epidural leakage of PMMA after percutaneous vertebroplasty appears to have relationship with the amount of PMMA and the levels injected. The epidural leakage of PMMA reduced the immediate therapeutic effects of vertebroplasty, but did not influence the late outcome. However, the epidural leakage should be avoided because of its potential neurological complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제27권6호
• /
• pp.565-569
• /
• 2001

A new surgical approach to the area of the infratemporal fossa and parapharyngeal space is described. This approach results in a wide-field exposure of the infratemporal fossa, pterygomaxillary space and parapharyngeal space. We used two osteotomies on the patient's mandible and temporary resection of zygomatic arch for superior margin of tumor. Lower lip splitting was not needed because the incision was started in the frontal scalp, curved in front of and below the external auditary canal, and extended anteriorly to the greater horn of hyoid bone on the neck along a skin crease. We had good results without sacrifice of the facial nerve, mandibular function and sensory supply of the face and oral cavity.

• 대한두개안면성형외과학회지
• /
• 제10권1호
• /
• pp.44-48
• /
• 2009

Purpose: The treatment of arteriovenous malformation (AVM) of the face remains a difficult challenge in plastic surgery. Incomplete resection resulting in uncontrolled bleeding, postoperative enlargement of the remaining malformation, and a poor functional and cosmetic result could be the problems confronted by the surgeons. Methods: A 37 year-old male with large arteriovenous malformation in face treated with preoperative superselective transarterial embolization and free flap transfer. The size of the defect was $13{\times}9cm$. Sclerotheraphy without resection were performed several times but the results were unsatisfactory. Resection was performed the next day of embolization. We were able to repair with the thoracodorsal artery perforator free flap. And facial muscle reconstruction performed by simultaneous muscle and nerve transfer. Results: During the follow-up period 8 months the patient regained an acceptable cosmetic appearance. And he has shown no reexpansion of the malformation. Conclusion: The thoracodorsal artery perforator free flap could be a good choice for the reconstruction for massive defects of the face. A huge arteriovenous malformation could be safely removed and successfully reconstructed by the complete embolization, wide excision and coverage with a well vascularized tissue.

• Journal of Acupuncture Research
• /
• 제28권5호
• /
• pp.65-76
• /
• 2011

Objectives : Study about needle retaining time. Methods : We reviewed the ancient and the present text of China with using the China academic journal(CAJ) of China national knowledge infrastructure(CNKI) Results & Conclusions : 1. Needle retaining time is important in acupuncture, because the therapy effect is influenced by it. 2. The time of needle retaining is up to those conditions like different disease, viscera and bowels(臟腑), meridian and collateral(經絡), obtaining Qi(得氣), seasons, constitution of the patients and acupuncture tools. In ${\ll}$Hwangdineijing(黃帝內經) ${\gg}$, needle retaining time is called by 'Zhiruzhichu(直入直出)', 'Jichu(疾出)', 'Liu(留)', 'Buliu(不留)', 'Jiuliu(久留)' and 'Liu ${\bigcirc}$ hu(留${\bigcirc}$呼)', and the time was shorter than nowadays. 3. The respiration number was counted to check needle retaining time but we can't find out any evidence. Recently in China, 'obtaining Qi(得氣)' and 'Qi arrival(氣至)' is used to check it. 4. Looking into clinical researches, different diseases need different needle retaining time. For example, 20~30min is appropriate time for musculoskeletal system. 60min is for circulatory system, 10~20min is for peripheral facial nerve paralysis. Insomnia and some stubborn diseases need longer time. Cold and heat(寒熱), deficiency and excess(虛實) are always influences the needle retaining as well. 5. It is important to figure out the most effective needle retaining time for different disease with the base of connection between needle retaining time and effect.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제28권1호
• /
• pp.68-72
• /
• 2006

Mucoepidermoid carcinoma is one of the most common malignant salivary gland neoplasm. It occurs over a wide age range, and is most common in the parotid gland and usually appears as an asymptomatic swelling. Pain or facial nerve palsy may develop. Minor salivary gland tumors also typically appear as asymptomatic swellings, which are sometimes fluctuant and have blue or red color that can be mistaken clinically for a mucocele. Histopathologically the mucoepidermoid carcinoma is composed of a mixture of mucous-producing cells and squamous (epidermoid) cells. Low-grade tumors show prominent cyst formation, minimal cellular atypia, and relatively high proportion of mucous cells. Mucoepidermoid carcinoma of the minor salivary glands are treated usually by assured surgical excision. For low-grade neoplasm, only a modest margin of surrounding normal tissue may need to be removed, but high-grade or large tumors warrant wider resection. Postoperative radiation therapy also may be used for more aggressive tumors. Mucoepidermoid carcinoma of the oral minor salivary glands generally have a good prognosis, because they are mostly low-to intermediate grade tumors. We present a case of mucoepidermoid carcinoma managed with surgical enucleation and postoperative irradiation and a good clinical result with review of literatures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제33권6호
• /
• pp.631-635
• /
• 2007

Purpose: The classic technique for open reduction of subcondylar fractures is the submandibular approach. The aim of this study was to evaluate clinical result of retromandibular approach to displaced subcondylar fractures. Material and methods: During a period of 24months we perfomed a prospective study with a retromandibular approach in 23 patients with displaced subcondylar fractures. In this article we describe clinical result in 23 patients with follow ups for 3 months after surgery. Preoperatively all patients had malocclusion and radiology demonstrated displacement. Result: The retromandibularl approach for ORIF was good in all case. Mouth opening(M/O) was 49mm. Occlusion was good too. Permanent facial nerve palsy was not detected. Conclusion: Our findings indicate that the retromandibular approach is a safe technique for subcondylar fractures.

• Pediatric Infection and Vaccine
• /
• 제22권1호
• /
• pp.40-44
• /
• 2015

비정형 가와사키병은 가와사키병의 진단기준을 충족하지 않는 경우를 말하며, 주로 6개월 미만의 영아에게서 발현하는 경우가 많다. 비정형 가와사키병의 임상소견은 뇌수막염과 같은 감염질환과 비슷할 때가 있어서, 이러한 경우 임상적으로 비정형 가와사키병을 감염질환과 감별하기 어려울 때가 많다. 또한 가와사키병과 연관되어 보고된 신경계 이상은 무균수막염, 경막하삼출, 안면신경마비, 뇌경색증, 뇌병증, 뇌자기공명영상의 가역적 뇌량팽대 변화 등이 있다. 본 저자들은 뇌척수액세포증가증과 경막외삼출액이 동반된 비정형 가와사키병으로 진단된 5개월 여아에 대해 보고하는 바이다. 환자의 심장초음파검사에서 관상동맥이 늘어나 있었고, 추적관찰에서 경막외 삼출액과 관상동맥 합병증이 모두 회복되었으며 생후 12개월에 발달이정표는 정상이었다.

• 대한두경부종양학회지
• /
• 제12권2호
• /
• pp.161-168
• /
• 1996

The neuorogenic tumor is known to be originated from neural crest, and the involved cells are Schwann cell, ganglion cell, and paraganglion cell. The Schwannoma, neurofibroma, and malignant schwannoma arise from the schwann cell, ganglioneuroma is from ganglion cell, and carotid body tumor and glomus tumor are originated from paraganglion cell. Authors reviewed thirty-eight patients of the neurogenic tumors in the head and neck, excluding intracranial tumor and Von-Recklinghausen disease, surgically treated at the Department of Surgery, Pusan Paik Hospital from January 1981 to May 1996. Of the 38 cases, 28 cases were schwannoma, 6 cases neurofibroma, 2 cases malignant schwannoma, and 2 cases paraganglioma. These tumors occurred at any age, but the majority of patients occurred in the fourth decade of life. There was female preponderance (M : F=1 : 1. 53) in sex ratio. The lateral cervical region was the most common distribution. 12 cases arose from the anterior triangle of neck, and 12 cases from the posterior triangle of neck. The major nerve origin of tumor could be identified in 30 cases (80%). 11 cases were treated by simple excision, and partial excision was 3 cases. Excision with parotidectomy 1 case, enucleation 11 cases, enucleation with parotidectomy 7 cases, radical neck dissection 1 cases, upper neck dissection 2 cases, suprahyoid dissection 1 case, Caldwell­Luc operation 1 case. The postoperative complications were hoarseness (2 cases), facial palsy (1 case), Homer syndrome (1 case), and hypoesthesia of tongue (1 case).

• Archives of Plastic Surgery
• /
• 제33권4호
• /
• pp.499-502
• /
• 2006

Purpose: Grave's disease is an autoimmune disease with chronic and systemic features. It affects the orbital fat and muscle bringing about defect in extrinsic eye motility, diplopia, optic nerve defect and lid retraction. In patients with lagopthalmos and resulting facial deformity, treatment can be done by rectus muscle recession or filling with various material. Autogenous auricular cartilage graft is often used and synthetic material such as synthetic acellular dermis, polyethylene meshs are also used for filling of the depressed area. Nevertheless, autogenous auricular cartilage grafts are difficult to utilize and synthetic materials sometimes result in protrusion or infection. Therefore, hard palate mucosa was considered as an alternative. We report two cases of patients with lower eyelid retraction corrected with autogenous hard palate mucosa. Methods: We performed this operation in two patients of Graves' ophthalmopathy. The capsulopalpebral fascia was incised and elevated through an incision on the conjunctiva. Then, the harvested hard palate mucosa was sutured to the inferior border of the tarsus and covered with the conjunctiva. Results: The lower eyelid retraction was corrected successfully. No hypertrophy or deformation of the transplanted hard palate mucosa was noted 6 months after the surgery. Conclusions: From the results above, we may conclude that the hard palate mucosa serves as an ideal spacer for the curvature and the inner lining in lower lid retraction. Hard palate mucosa is as sturdy as the autogenous cartilage but is much easier to utilize. It can be also used for lid retraction after lower lid aesthetic surgeries or traumas.

• 대한두개안면성형외과학회지
• /
• 제13권2호
• /
• pp.151-155
• /
• 2012

Purpose: Basal cell adenoma of the salivary gland is an uncommon type of monomorphic adenoma. The most frequent location is parotid gland. It usually appears as a firm, mobile and slow-growing mass. Originally the term "basal cell adenoma" is described as a benign salivary gland tumor comprised of uniform appearing basaloid cells which are arranged in solid, trabecular, tubular, and membranous patterns. But the myxoid and chondroid mesenchymal like component as seen in pleomorphic adenoma is lacking in basal cell adenoma. We report a case of basal cell adenoma of parotid gland with review of the literatures. Methods: The 59-year-old female patient was referred to our department with a painless palpable mass in the left preauricular region for about 1 year. Movable and nontender subcutaneous mass was palpable. There was no evidence of cervical metastasis in computed tomography and ultrasonography. On fine needle aspiration cytology, pleomorphic adenoma was suspected. Under general anesthesia, superficial parotidectomy including tumor was performed. The biopsy result was basal cell adenoma. Results: Long-term follow-up for 54 months showed favorable result without evidence of recurrence except for temporary facial nerve weakness right after the surgery. Conclusion: Basal cell adenoma is the third most frequent benign tumor of the salivary gland, following pleomorphic adenoma and Warthin's tumor, although the incidence is low. The typical clinical feature of the basal cell adenoma is slowly growing, asymptomatic, and freely movable parotid mass. Basal cell adenoma should be also considered as a differential diagnosis of the parotid gland benign tumor.